Agenda item

Invitees:

-          Phil Diamond - Service Manager – Gwent Regional Partnership Board

-          Mary Ryan - Head of Adult Services

-          Natalie Poyner – Head of Children’s Services

-          Mark Saunders – Service Manager – Regional Commissioning and Partnerships

 

The Service Manager for the Gwent Regional Partnership Board presented an overview of the Regional Market Stability Report (MSR) and explained that it is a statutory duty for the local authority and local Health Board to produce one market stability report every 3 years to be formally signed off by full Council. The MSR must be signed off by the 5 local authorities’ full Councils and the Aneurin Bevan University Health Board before March 31st 2023. The Service Manager then advised of the assessment of impact and highlighted how the pandemic has brought significant challenges across health and social care settings.

 

The Committee asked the following:

·         The Chair asked the partners to explain the representation of the five authorities and queried if there is political perspective on the board.

 

The Service Manager confirmed that it is Cabinet Member led. Councillor Jason Hughes sits on the partnership board with the Strategic Director, Sally Ann Jenkins and advised that there is similar representation from the other four authorities, the Chief Executive of the Health Board also sits on the board.

 

·         The Chair complimented the partners and officers on the content of the report, such as the inclusion of the seven boxes where partners discuss the challenges. It was very useful for the committee as the Chair suggested that they also share those challenges after austerity. 

 

·         The Chair went on to ask with regard to Domiciliary Care, whether the challenge is getting people to go deal with those issues; and asked for the partners to confirm they would look to come back to Committee with reports on how things have developed from their point of view.

 

The Service Manager advised that the partners will come back and update the committee on the Area Plan and to discuss mitigation of the challenges. Members were assured that it would not be a report and action plan sitting on a shelf, as there are constant conversations between Health and Social Care as they approach the Winter season. The Regional Integration Fund was mentioned, from the Welsh Government which is seasonal and equips boards to mitigate the mentioned challenges in the winter plan. The Manager will look to discuss the Winter Plan with the Strategic Director on her return as it was added that the Committee would benefit from the discussion.

 

·         The Chair asked both the Head of Children Services and Head of Adult Services if there was anything in the report they would want the Committee to be alerted of.

 

The Head of Adult Services explained that the report is very thorough, it would be more of the next plans, as we know we have regional plans but also for the Committee to look at the local plans for Newport and highlighted how all representatives across the region who sit on the board have different stresses on priorities. The Head of Children Services echoed the prior point by highlighting that the Children Services area also has regional and local plans in talks to mitigate the risks. It was explained they were in quite a good position compared to other Welsh Local Authorities as they have a lot of in house provisions for local children and they are taking a lead in supporting colleagues both regionally and nationally.

 

·         A Member asked if the partnership board is a priority with the practical strategies in the current situation and if the board has a role in advocacy in flagging up key issues to the Welsh Government and Westminster Government to get real solutions during the crisis. The Member mentioned that the important solutions to this crisis may lie outside of the partnership board for example due to resourcing.

 

The Service Manager confirmed that the partners definitely have a role in highlighting these issues through various mechanisms, such as the Regional Partnership Board (RPB) Chair and Health Board Chair who meet with the ministers on a quarterly basis. The Head of Adult Services will be taking forward a strong message developed with the Directors to highlight issues. Issues are also raised via forums consultations, and noted there is consultation going on with Welsh Government at the moment where they use it for flagging up issues. The manager also noted Britain Independent with the Eliminate agenda, and advised Members that the Strategic Director, Sally Jenkins led on a joint letter from the five Directors in the region alongside the elected Members to highlight the risks.

 

The Service Manager also asked the Councillors if they could keep this on their agenda to support the partners and noted that Councillor Hughes and the Leader are well aware that there are a lot of issues but it was noted as a national issue therefore a national solution is needed. The Chair guaranteed the support on behalf of the Members as they appreciate that it is a top priority for the authority.

 

·         A Member referred to the section in the report alluding to the Domiciliary care recent evidence, which shows that some domiciliary care providers have joined care homes to avoid using their cars for works due to fuel prices, and that the recruitment crisis is having an impact on the service of care. What effect that has had on the release of elderly from the hospital?

 

The Service Manager asserted that those issues have had a direct impact on the release of elderly patients from the hospital, and that section is not just anecdotal information, as they are taken from real life examples provided by care providers. An example was used where one Local Authority’s Domiciliary Care provider contacted the Social Care managers that they could not come into work as they could not afford petrol to travel.

As a mitigation over the last two years and last Winter, emergency fuel payments to domiciliary care providers to enable them to access funds at short notice. The Committee were advised that this would be part of the winter plan going forward. The partner recognised there are lots of actions taking place in the Domiciliary Care sector but the advocacy and representation to Welsh Government is only paving over the cracks with this funding, and that everyone is looking at large scale solutions.

 

The Head of Adult Services noted how from a Newport perspective there are funds available in terms of the current climate, such as monies from Welsh Government for the help with electric vehicles. The funding such as the winter plan is enough time to offset the shortages, and will be a temporary measure funding for around 6 months. The Committee were advised that the Strategic Director is a great advocate to put that on the agenda of where they are in terms of a crisis. They wish to keep the elderly in the community for as long as possible; to avoid people going into hospital when acutely unwell and stay in there for longer than necessary. Members were assured that the partners are working on a daily basis on the Home First Regional Service which is at the front of their service which helps them assess how else medical needs can be addressed in the community.

 

·         A Member expressed his concern with the retention of staff and resource issues and queried whether the social care national insurance removal will have an alternative for funding that sector.

 

The Service Manager advised that at the moment, they are unsure of how that would pan out at a regional level and local authority level but is something they will raise through the RPB chair when in discussions with the ministers. The officer was unable to confirm how as the Welsh Government and national government may not know just yet on how to ensure the funds available for plans going forward but it is something they will have to advocate for information and will look to update the committee as soon as possible.

 

·         A Member used an example of being aware of someone in hospital and asked the partners and officers for advice on what a neighbour could do to support this individual in case that person may not have immediate family.

 

The Head of Adult Services responded that by not assuming that they got much care in the community and assured the Member that there are discussions on what the community needs in terms of personal care to ensure keeping them as safe as possible by knowing who is vulnerable. The Chair pointed out that query is in relation to the relationship of the board with the National Health Service and that perhaps the Head of Adult Services or Service Manager could answer as the key factor because sometimes they may not work together. The Head of Adult Services reminded Members that it cannot be assumed whether some people want others involved in their lives in some situations and that these patients would look to provide that information unless the services are asked for it. The team work regularly with community connectors and the staff in hospital to see what they can do to support.

 

The Chair appreciated that if those individuals would not want certain services but noted how the Council and partners should be informed of that. The Head of Adult Services assured the Members that the officers and partners know a lot around such situations but that does not mean that the Councillors would due to the sensitivity. On the wards, some patients may feel ready to go home but however the Health staff may feel different about that.

 

·         A Member referred to the recent news coverage over support being given from the Government to businesses and asked the partners to confirm whether any of the cost of the living crisis support grants would be applicable to the care homes and care providers.

 

The Service Manager confirmed that an RPB has been able to advocate funding for that. For instance, supporting the care homes in the pandemic; the support dropped off as many residents were in hospital with lots of spare beds in care homes. In terms of the latest issues such as fuel costs. Announcements have been made clear from the discussions last week. The partners would look to follow it up with fuel payments for care providers but as a partnership board, they have been looking to support with enhance payments which would also help to retain staff in a competitive market and some also to be used for utility bills.

 

·         A Member asked for clarification if the care is Welsh Government funded and if the board and authority needs to know what funds could be dispersed from the UK government which then goes to the Welsh Government.

 

The Service Manager confirmed this and that the authority would not know how much funds the care providers receive until a settlement is sorted.

 

·         A Member asked the partners if they could state whether Brexit has affected the ability to find care workers, appreciated that it was not mentioned in the report but wished to confirm if that has been a factor in the loss of care staff in Gwent.

The Service Manager acknowledged that was a political question and recognised that there has been feedback from providers which suggests that there has been an issue but stressed to the Committee that there has not been a wholesale analysis throughout Gwent. They received pockets of information through the progress made throughout the pandemic where they met with providers on 4-6 weekly basis. Through the pandemic, they also met on a day to day basis to glean information, referring to the bullet points on page 38 of the report. They advised some industries struggled as stated on the news and some providers have had an impact but the partner reiterated that they could not speak with a degree of certainty that Brexit was a significant factor.

 

·         A Member of the Committee complimented the officers on providing a comprehensive report. The Member referred to page 67 where the report covers the analysis of implications of the report. Some aspects of council work and public work and the shortest one was number 10 on equity, on human rights and had a summary of the equality act. The Member requested assurance there is regard for this area and mentioned that Covid has had massive implications in terms of equality, for example on ethnic minorities for incomes. The impact on society is a big issue and asked if the board monitors this to help address the issue.

 

The Service Manager highlighted they have undertaken this report alongside existing reports. For instance, they used the RPB assessment which broke down needs against different characteristics. It was mentioned there is a lot of information in another document to be read alongside the report but partners were mindful that it is a large report therefore a link was made for cross referencing. For instance, the population needs assessment for analysis, so the partners signposted the information within the report. The Service Manager agreed with the Member that in terms of equality, whether that be children, carers, ethnic minorities, gypsies, travellers will be where they would look to mitigate services in the action to help tackle the inequality via the area plan that has to be produced. Members were advised that the partners will send across the documents for the committee to further consider.

 

The Chair assured the Committee that social equality is embedded in everything that the authority does.

 

·         A Member commented on how the pandemic has had a huge impact on mental health and learning difficulties and referred to the table on page 41. It was pointed out that it states that Newport City Council has not got data available on that. The Member queried for the reason behind that as there is a need to promote mental well-being and asked if the council has got the commission to properly address the issue.

 

The Head of Adult Services addressed that she was unsure why the data was not available and assured the scrutiny committee that they have a variety of placement to help support individual learning needs and mental health. There is targeted provision for people with specific needs and noted that the officers have only just picked up on that and apologised for that. The Head of Adult Services advised that the missing information can be forwarded to the Committee.

 

·         The Member went on to ask if the council has got the commissioning to appropriately address mental health and learning support through provisions.

 

The Head of Adult Services confirmed that they have commissioning for over 16’,s and also to those who are transitioning into adult life and noted how the data would have been helpful in the report to show that and apologised for not including that.

 

 

Conclusions

 

1.     The Committee noted the Market Stability Report for the local authority area.

 

2.     The Committee agreed that the authority continues to engage with Regional Partnership Board (RPB) and support the development of the regional Area Plan.

 

-       The Committee thanked officers for attending, and praised the report for being comprehensive and well explained, leaving issues in no doubt.

 

-       Members to be sent a copy of the regional Area Plan following publication on 1st April 2023 to ensure priorities highlighted in the Market Stability Reported are reflected in the action plan.

 

-       Members to receive a copy of the Regional Winter Plan and Population Needs Assessment for reference. (Scrutiny Adviser to send out to Committee following meeting).

 

-       Members to receive missing information regarding Adult Mental Health placements.