Item No. 6

Report of the Corporate Director (Social Services)

Health, Social Care and Well Being Overview and Scrutiny Board- 22nd June 2010

BRIEFING ON SOCIAL SERVICES ACTIVITIES AND KEY ISSUES

Purpose The purpose of this report is to provide an overview of the arrangements that exist within the Social Services Directorate along with key responsibilities.

Content The report describes the activities and context in which Social Services is required to operate.

Councillors are being asked to

Consider the report and to make comments and observations as necessary.

Lead Councillor(s)

Councillor Nick Tregoning, Cabinet Member for Social Services.

Lead Officer(s) Chris Maggs, Corporate Director (Social Services)Deborah Driffield, Head of Adult Services

Report Author Chris Maggs, Corporate Director (Social Services)Telephone: (01792) 636245Email: Chris.Maggs@swansea.gov.uk

1. INTRODUCTION

1.1 Social Services is one of the largest Directorates within the Local Authority, measured by the size of the budget and the number of staff employed. The net budget for Social Services in 2010 - 2011 is £93,633,000. Social Services currently directly employ more than 2,000 staff in about 70 offices/locations.

1.2 Range of Activities

The range of responsibilities covered by Social Services is wide and complex. These include:

Children who are at risk of being harmed or whose development may be impaired;

Families who are having difficulty in coping with bringing up their children;

Children who do not have a family or are unable to live with their own family;

Children with disabilities or mental health problems; Adults who need support because of:

o advancing ageo physical disabilityo learning disabilityo serious mental health problems

Vulnerable adults who are at risk of being abused or exploited; People who are affected by HIV/AIDS; People who are terminally ill; People who are affected by the misuse of drugs or alcohol; Social Inclusion/ Welfare Rights Supporting People

A summary of relevant legislation and guidance for Child and Family Services can be found in Appendix A. A summary of relevant legislation and guidance for Adult Services can be found in Appendix B.

1.3 Partnership working

Partnership working is key to the delivery of Social Care services for both policy and practical reasons. Social Services work closely with a range of other agencies and organisations, including:

The Health Service Education Housing Probation Police Independent Sector Care and Social Services Inspectorate Wales

1.4 Social Services and the wider Social Care economy in Swansea

Social Services purchase a range of services from the independent sector, both private and not-for-profit organisations. Currently, over 40% of the Social Services budget is spent in the independent sector. Social Services has duties for the Social Care sector as a whole, and in addition to the staff it employs, there are estimated to be about another 4,000 people engaged in providing social care in Swansea.

2. THE STRATEGIC CONTEXT FOR SOCIAL CARE

2.1 National Strategy for Social Care

A national ten-year Strategy for Social Services in Wales was launched in February 2007, Fulfilled Lives, Supportive Communities. It outlines the role of Social Services to:

Promote social inclusion and independence Support people at times of difficulty distress, vulnerability or illness Protect people from harm, abuse or neglect Act as corporate champion in local government for the most vulnerable

and at-risk groups in their area

The vision outlined in the Strategy is of:

“Social services which are strong, accessible, and accountable, in tune with citizens’ and communities’ needs and promote social inclusion, citizens’ rights and good outcomes“.

2.2 Health Social Care and Wellbeing Strategy

The Local Authority has a duty to produce a Health Social Care and Wellbeing (HSCWB) Strategy in conjunction with the Local Health Board. This is one of the four strategies that the Local Authority is required to produce.

2.3 Single Strategic Plan for Young People

The Local Authority has a duty to produce a single strategic Plan for Children and Young People, aged 0-19. This is one of the four strategies that the Local Authority is required to produce.

3. REGULATION, PERFORMANCE AND INSPECTION OF SOCIAL CARE

3.1 Care and Social Services Inspectorate Wales (CSSIW)

Social Care services are inspected and regulated by the CSSIW. The CSSIW came about in April 2007 through the amalgamation of two different functions, the Care Standards Inspectorate in Wales (CSIW), which regulated and inspected a range of services including residential homes, domiciliary care services, playgroups, childminders etc., and the Social Services Inspectorate which inspected the way that Local Authorities carried out their responsibilities to deliver Social Care.

3.2 Regulation of individual care providers

The CSSIW currently regulates and inspects individual services and agencies which are provided both by the independent sector and directly by the Local Authority e.g. residential homes, domiciliary care agencies, playgroups, childminders etc.

3.3 Inspection of the delivery of social care services by the Local Authority

The CSSIW also inspects the way that Local Authorities carry out their responsibilities to deliver Social Care. The CSSIW carries out individual service reviews as well as reviews of the way that Local Authorities deliver their social care functions.

4. STRUCTURE OF SOCIAL SERVICES

4.1 Social Services are delivered through two Services, Adult Services and Child and Family Services. The overall service is the responsibility of the Corporate Director (Social Services) who is a member of the Corporate Management Team. Some activities within the Directorate are managed directly by the Corporate Director. The staffing structure for the Directorate is provided at Appendix C.

4.2 In Adult Services the key areas of activity are Assessment and Care management and directly provided services for each service area (Older People, Disabled People, Mental Health Services, Learning Disability Services). A structure chart for Adult Services is provided at Appendix D.

4.3 In the Child and Family Services the key areas of activity are Assessment and Case management and directly provided services, there is also a responsibility for the Youth offending Service. A structure chart for Child and Family Services is provided in Appendix E.

4.4 The Directorate Services include the arrangements for the COASTAL Project, Supporting People, Planning, Contracting, Social Inclusion Unit and activities such as Finance, Payments and Financial Assessments.

5. Budget

5.1 The net budget for Social Services for 2010 - 2011 is: £93,633,000. This is allocated across the Adult and Child and Family Services:

Adult Services: Older People / Younger Adults £39,676,000Mental Health / Learning Disability £18,984,000

Child and Family Services: £30,561,000

Directorate Services £4,412,000

6. KEY ISSUES FOR SOCIAL SERVICES

6.1 There are a number of key issues for Social Services over the next couple of years. These include:

Child and Family Services – further improvement in delivery of services ensure the requirements of the CSSIW are achieved.

Review of Residential Services for Children – to implement the new arrangements that have been approved.

Older People’s Project – the reconfiguration of services for Older People to ensure that they delivered as relevantly and effectively as possible.

The restructuring of the NHS – and the effect on the delivery of health and social care services locally.

Remodelling of Health and Social Care Services in Swansea – this is part of the strategic rebalancing of services from acute to community based services that is identified through the Health, Social Care and Wellbeing Strategy.

Redevelopment of Mental Health Services in Swansea – there is a project to redevelop Mental Health Services towards a more community based delivery of support services.

Continuing Health Care – this area of activity concerns those individuals who are supported by Swansea Local Health Board.

Workforce – ensuring sufficient skills and capacity to deliver high quality social care services.

6.2 The Corporate Plan identifies the overall strategic direction that has been approved by Council and the relevant sections are attached as Appendix F.

Background Papers:Fulfilled Lives, Supportive Communitieshttp://wales.gov.uk/dhss/publications/socialcare/strategies/fulfilledlives/fulfilledlivese.pdf?lang=en

Contact Officer: Chris MaggsCorporate Director (Social Services) 01792 636245 cm06023/sd

Legal Officer:Janet Hooper

APPENDIX A

Summary of Relevant Legislation – Child and Family Services

The Children Act 1989

The Children Act 1989 came into force on 14th October 1991 and brought together most public and private law relating to children in England and Wales. It is the primary piece of legislation governing the provision of services for children.

The Act drew together legislation concerning the care and upbringing of children who were affected by a private dispute, such as divorce, and those who are in need of help from a Local Authority. It also defines ‘children in need’ (see page 3) and places a number of duties and responsibilities upon Local Authorities. The Act:

Makes children’s welfare a priority Believes that children are best brought up within their families whenever

possible States that Local Authorities are to provide services which support children

and families in need Promotes partnership between children, parents and Local Authorities

The Act also deals with children’s homes and other residential accommodation, fostering, child minding and day care for young children.

The full act can be found at www.opsi.gov.uk/acts/acts1989/Ukpga_19890041_en_1.htm

Other legislation which affects the way parts of the service operate includes:

The Children (Leaving Care) Act 2000The main purpose of this Act is to improve the life chances of young people living in and leaving Local Authority care. It placed stronger obligations on local authorities to ensure that care leavers were adequately prepared and supported.

The Carers and Disabled Children Act 2000This Act gave Local Authorities the power to offer direct payments to sixteen and seventeen year old disabled young people. The Local Authority makes the payment instead of arranging the services it has assessed the disabled young person as needing, and that young person uses the payment to secure the relevant services.

The Act also provides for Local Authorities to make direct payments to people with parental responsibility for a disabled child to purchase services to meet the assessed needs of the child’s family.

The Adoption & Children Act 2002The Adoption & Children Act 2002 modernised the legal framework for both domestic and inter-country adoption. Its provisions include making the needs of the child the paramount consideration, providing better adoption support services and a number of measures to encourage more potential adopters to come forward.

Along with the Children’s Cases (Amendment) (Wales) Regulations 2004, the Act also led to new guidance for Independent Reviewing Officers. The role of such independent officers is seen as an important safeguard to ensure that the local authority has an appropriate, consistent and robust approach towards the corporate parenting of children.

The guidance can be viewed at:http://new.wales.gov.uk/topics/childrenyoungpeople/childrenfirst/publications/indepedantreviewingofficers?lang=en

The Children Act 2004The Children Act 2004 covers both the universal services which every child accesses, and more targeted services for those with additional needs. Its aim is to encourage integrated planning, commissioning and delivery of services as well as to improve multi-disciplinary working, remove duplication, and increase accountability. Its focus is towards outcomes that children and young people themselves have said are important, rather than prescribing organisational change.

The full Act can be found at: www.opsi.gov.uk/acts/acts2004/ukpga_20040031_en_1

The Childcare Act 2006This Act is the first to address specifically the provision of child care and other early years activities. Responsibility for childcare provision is placed with local authorities, who are expected to work with both public bodies and private companies to improve quality and realise standards in both care and learning and to ensure that the view of parents are taken into account so that the needs of local families are reflected in the planning of new services.

The full Act can be found at www.opsi.gov.uk/ACTS/acts2006/ukpga_20060021_en_1

The Stable Life Regulations 2007These Regulations, issued by the Wales Assembly Government and contained in the document Towards a Stable Life and a Brighter Future, provide a legislative framework to strengthen the well-being of looked after children. It includes guidance on placements, education, health and case reviews, as well as strengthening the regulations for the management of children’s homes.

The regulations can be viewed athttp://new.wales.gov.uk/topics/childrenyoungpeople/publications/guidance/1549304?lang=en

APPENDIX B.

Summary of Relevant Legislation – Adult Services

The legislation and guidance covering Adult Services is extensive and includes a range of general powers and duties as well as service specific legislation and guidance. The following gives a broad overview of the statutory frameworks governing the delivery of social care to adults.

Key items of legislation and guidance covering adult services include:

National Assistance Act (1948)

Health Service & Public Health Act (1968)

Chronically Sick and Disabled Persons Act (1970)

National Health Service Act (1977)

Mental Health Act (1983)

The Disabled Persons (Services, Consultation and Representation) Act

(1986)

National Health Service and Community Care Act (1990)

Disability Discrimination Acts (1995)

Carers (Recognition and Services) Act (1995)

Community Care (Direct Payments) Act (1996)

Care Standards Act (2000)

The Carers and Disabled Children Act (2000 )

Tackling Substance Misuse in Wales – A Partnership Approach (2000)

In Safe Hands, Section 7 Guidance on Protection of Vulnerable Adults (2000)

Local Government Act (2000), Section 93 (Statutory basis for Supporting

People)

Health and Social Care Act (2001)

National Service Framework for Adult Mental Health Services (2002)

Promoting Partnerships in Care Section 7 Guidance on Commissioning

(2003)

Carers (Equal Opportunities) Act (2004)

The Community Care Services for Carers and Children’s Services (Direct

Payments) (Wales) Regulation (2004)

Learning Disability Strategy Section 7 Guidance on Service Principles and

Service Responses (2004)

Mental Capacity Act (2005)

Disability Discrimination Acts (2005)

National Service Framework for Older People in Wales (2006)

NHS Wales Act (2006)

Mental Health Act (2007)

APPENDIX C.

cm92011/sd

Principal Officer - Supporting People

Rachel Evans533703

Senior Principal Officer - Commissioning and Partnership

Richard Leggett6947

Principal Officer - Administration and Support Services

Stephen Halfpenny6680

Planning (Heather Hughes)

Contracting (Ali Williams)

Performance Management and Information (John Grenfell)

Social Inclusion Unit (Vacant)

Information Technology(Tony Brindley)

Substance Misuse Planning and Commissioning Manager(David Evans)

Staff Development and Training (Hywel Jones)

Transport (Cathy Carroll)

Payments, Procurement and Projects (Sue Matthews)

Estimates and Budgetary Control (Don Isaac)

Financial Assessments (Kim Husband)

Business Manager - Adult Services (Lynda Morgan)

CORPORATE DIRECTOR (SOCIAL SERVICES)Chris Maggs (6245)

Head of Child and Family Services

Steve Walker6248

Youth Offending Service (Eddie Isles)

Case Management and LAC(Mike Holding)

Assistant PO Case Management and LAC(David Howes)

Safeguarding Children (Martin Price)

Child Disability (Haydn Nelson)

A&I / Family SupportJulie Thomas

Accommodation (Richard Evans)

Administration(Bill Williams)

Service Provision (LD) (Cathy Murray)

Care Management (LD)(Carol Rea)

Mental Health and Adult Protection (Eira Howells)

Disability Services(Paul Littlewood)

Residential and Day Care Services (Vic Gregory)

Community and Intermediate Care (Julia Crawley)

Care Management (OP)(Colin Cribb)

Health Services / Care Homes (Gareth Powell)

Principal Officer - Communication and Strategic Management

Katrina Guntrip6659

Secretariat

Strategic Management Support Unit(Fiona Broxton)

Head of Adult Services

Deborah Driffield6249

Regional Project Director - COASTAL Project

Clive Prior222691

Supporting People Team

APPENDIX D.

HEAD OF ADULT SERVICESDeborah Driffield (6249)

Principal Officer - Mental Health and Adult Protection

Eira Howells6271

Principal Officer - Care Management (LD)

Carol Rea6272

Acting Principal Officer - Care Management (OP)

Colin Cribb 6262

Principal Officer - Health Services / Care Homes

Gareth Powell6204

Principal Officer - Service Provision (LD)

Cathy Murray6273

Acting Principal Officer - Residential and Day Care Services

Vic Gregory6213

Principal Officer - Community and Intermediate Care

Julia Crawley6433

Principal Officer - Disability Services

Paul Littlewood312211

Adult Protection / Domestic Abuse(Meryl Williams)

CMHT 1 and 2(Team LeaderChris Woods)

CMHT 3 and 4(Team LeaderKate Reilly)

Mental Health Service Provision / Service and Staff Development(James Thomas)

Home Care(Judith Goss)

Service Improvement(Anne Clare)

Service and Staff Development (Julie Butt)

Residential Homes Bonymaen(Angela Cook)Cartref(Maria Demaid)Hollies(Helen Davies)Parkway(Lynne Pritchard)Rose Cross(Gaynor Matthews)St. Johns(Gill Campbell)Ty Waunarlwydd(Jane Thomas)Ty Cila(Rebecca Lane)

5 x Day Care CentresSocial Centres

Day Services(Steve Cook)

Flexible Support Service / Whitethorn Intensive Day Service(Janette Jones)

Alternative Day Services(Steve Cook)

Special Needs Services (Francis Hubbard)

Maesglas Community Support UnitRespite Services(Stephanie Atherton)

Swansea Vale Resource Centre(Jackie Whiteman)

Younger Adult Team (Team Leader Dillwyn Jones)

Occupational Therapy (Helen St. John)

Suresprung FurnishersJoint Equipment Store (Lyndon Tobin)

Community Alarm Service (Dave Powell)

North Team(Team Leader Eirian Davies)

Intake Team and Central Team (Acting Team Leader Andrea Preddy)

West Team (Team Leader Jackie Turner)

Earlsmoor (Emma Forester acting)

Singleton Hospital (Team Leader Mary Heard)

Morriston Hospital (Acting Team Leader - Ffion Larsen)

EMI Team (Team Leader Sue Field)

Care Home Team(Team Leader Susan Williams)

Community Support Teams(Team Leader Phil Davies)

Direct PaymentsAdult Family PlacementTransition(Team LeaderVicki Davies)

Service and Staff Development (Ceri Jones)

ASSESSMENT AND CARE MANAGEMENT PROVIDERS

APPENDIX E.

cm06023/sd

HEAD OF SERVICE - Steve Walker (636248)(CHILD AND FAMILY)

- Operations Admin. Team

- Innovation / Performance Unit

- Development Officers

BUSINESS MANAGERBill Williams(636270)

YOUTH OFFENDING TEAM MANAGEREddie Isles(522827)

PRINCIPAL OFFICER ASSESSMENT AND CARE MANAGEMENTMike Holding(636605)

- LAC- Child

Disability Team

- EDT- Asylum

Seekers

PRINCIPAL OFFICER ASSESSMENT AND CARE MANAGEMENTDavid Howes(635522)

PRINCIPAL OFFICER ACCOMMODATIONRichard Evans(636268)

PRINCIPAL OFFICER CHILD DISABILITY Haydn Nelson(636267)

SAFEGUARDING CHILDREN’S CO-ORDINATORMartin Price(636266)

- Youth Offending Team - Family Group Conferencing

- CORE Team

- Service Quality Team

Child & Family Teams(North & South)

- Foster Swansea

- Adoption Team- Residential

Homes (Blaenymaes and Cockett)

- CASTIRO’s C.P

Conference Unit

PRINCIPAL OFFICERASSESSMENT AND CARE MANAGEMENTJulie Thomas(635171)

- Access & Info

- Family Support

CHILDREN’S PARTNERSHIPCO-ORDINATORSian Bingham(612155)

Early Years DevelopmentTeam

SSCB BUSINESS DEVELOPMENT CO-ORDINATORLisa Hedley(637543)

SECRETARY – Jeanette Crawford(636243)

APPENDIX F.

The Health, Social Care & Well-Being Strategy 2008/11

The Health Social Care & Well-Being (HSCWB) Strategy has been agreed by the City and County of Swansea and Swansea Local Health Board. It has been developed in partnership with the Community Health Council, Swansea Council for Voluntary Services, the local NHS Trust, the National Public Health Service and Swansea University.

The strategy sets out how partners aim to work with others to improve health and well being in Swansea. It adopts a twin track approach - tackling the causes of ill health and aiming to deliver effective health and social care to consistently high standards. It is the second strategy that has been developed by the partners above (known as the Health Challenge Swansea partnership). It builds upon progress made between April 2005 and March 2008.

The second strategy reinforces the long term vision shared by partners, that by 2020 Swansea will be a place where:

Everyone is supported to achieve the best level of health and well being possible, living longer healthier lives. Appropriate care is delivered in the best location at the right time by a range of organisations working together. Communities and individuals are well informed and take responsibility for their own health and well-being.

Our long term strategic aims are to:

Promote healthy lifestyles and help people to take more responsibility for their health and well being. Reduce inequalities in health and well-being. Improve the protection of vulnerable people. Deliver better more accessible services. Increase people’s independence.

To work towards achieving our long term vision and aims, partners have agreed to focus on three key themes over the period 2008-2011. These are:

Theme 1: To prevent ill health and reduce inequalities. Theme 2: To deliver better more accessible services that promote independence and protect vulnerable people. Theme 3: To develop our supporting infrastructure to support these changes.

For each of these key themes, priority areas have been identified for the coming three years.

Priority Areas and Key Actions 2008 / 2011

Theme 1 - Preventing ill health and reduce inequalities Socio Economic Circumstances

Income Maximisation Economic Activity Workplace Injuries Transport Community Health Development

Lifestyle Physical Activity and Nutrition Mental Health Promotion

Preventative Health and Social Care Reducing health inequalities in children – immunisations, oral health, childhood accidents Preventing Falls and Fractures

Theme 2 - Developing better more accessible servicesStrategic Service Change

Reshaping Social Care Services for Older People Developing Social Care Services for Children Reshaping Mental Health Services Redesigning Acute (Hospital) and Community Based Care

Improving Services for specific population groups Older People Children and Young People Children in Need Carers Children and Adolescents affected by Mental Health problems Those with a Physical Disability or Sensory Impairment Those with Learning Disabilities Those affected by Coronary Heart Disease Those affected by Diabetes Those affected by Substance Misuse problems Those affected by Sexual Health Problems Prisoners

Theme 3 - Developing our supporting Infrastructure Joining up planning, budgets and services Information Management and Technology Workforce Development

Included in the above priorities is work to re-design our social care, mental health, and hospital and community based services. These are recognised as significant programmes in their own right. Our aims in redesigning services are to:

Develop services which meet the future social care needs of both older people and children and families in Swansea. Ensure we have a modern mental health service fit for the 21st century. Develop a new model of care and pattern of services for hospital and community based care.

A HSCWB Strategy Year 2 action plan for delivery during 2009-10 is currently in development.

Key actions for the Council to deliver the HSCWB Strategy have been outlined within the Corporate Improvement Plan 2009-12 in the pages that follow.

The relevant risks around the Health & Social Care key priorities are reviewed in the pages that follow under the Health & Social Care aim.

A full copy of the full HSCWB strategy can be found at http://www.wales.nhs.uk/sites3/Documents/524/English.pdf

Health & Social Care

Improve Health and Social Care services for all so that the City & County supports and promotes good health

Community Strategy Shared Partnership Priorities

Healthy Lifestyles Health Inequalities between communities

Key plans / strategies Health, Social Care & Well-Being Strategy Climbing Higher physical activity strategy

Lead StrategicPartnership/s

Health Challenge Swansea

Lead Corporate Director/s

Chris Maggs, Corporate Director (Social Services)

Key Priority -

Reshape and reconfigure Health and related services in Swansea.

Reason why this is a Priority

It is important to modernise and rebalance health and social care services to achieve financial balance, deliver more accessible services and increase people’s independence.

Expected Outcome There are three main Strategic outcomes identified in the Strategy:

Everyone is supported to achieve the best level of health and well being possible, living longer healthier lives.

Appropriate care is delivered in the best location at the right time by a range of organisations working together.

Communities and individuals are well informed and take responsibility for their own health and well-being.

Summary - Reshape and reconfigure Health and related services in Swansea.

What We Have Done:

Developed a placement strategy for Looked After Children (LAC). Presented a report with proposals and option appraisals to HSCWB (Health Social Care and Well-Being)

Overview Board on redesigning Respite Care Services for Older People.

What We Intend to Do:

Redesign Respite Care Services for Older People. Redesign Social Care Services for Older People. Reshape Mental Health Services. Reshape Acute (Hospital) and Community Based Care.

Key Priority Risk Review 2008/09 to 2009/10

Risk Aspect 2008/09Summary

2008/09Risk

Status

2009/10 Risk

Status

2008/09 Mitigation

Adult Social Services - Access to Services

Care packages and assessments. Medium

Medium

Practice Handbook for Assessment and Care Management (ACM) teams in place.

2009/10 remaining mitigation measures

Review the ICT arrangements currently in place to record ACM information. Review the current assessment and reviewing documentation. Develop an outcomes focused / citizen centred approach to ACM. Dedicated hours allocated to practice development role. Collaborative approach to assessments being developed between health and local authority partners.

Risk Aspect 2008/09Summary

2008/09Risk

Status

2009/10 Risk

Status

2008/09 Mitigation

Adult Social Services - Range & Quality of

Services

Developing sustainable models of service to promote independent living.

Medium

Medium

Joint work with Swansea NHS Trust to provide appropriate services on discharge from hospital. Continuing to implement services that promote independence.

2009/10 remaining mitigation measuresFurther develop partnership and collaborative approaches to service development across Adult Social Services. Increased awareness of direct payments as an alternative. Development of day opportunities as alternative to building based services. Involvement of citizens in planning services and redesign. Use joint planning groups to scrutinise service developments. Consider community capacity building approach to address sustainability issues.

Risk Aspect 2008/09Summary

2008/09Risk

Status

2009/10 Risk

Status

2008/09 Mitigation

Adult Social Services - Arrangements for

protection of vulnerable people

Safeguarding vulnerable adults. Medium

Medium

Staff training reinforced.

2009/10 remaining mitigation measures

Raising awareness across communities and key stakeholders. Development of Escalating Concerns process to manage issues within care homes. Planned completion of self audit / inspection regarding staff competence and guidance compliance. Further training being developed around links between MCA and POVA. Development of a prevention framework regarding safeguarding. Additional resources in place re: the introduction of DOLS.

Key priority Performance Measures

Key Priority Performance Measures

PI Reference, Desired Direction of Travel & PI Description

Previous Year

2007/08

Target 2008/09

Actual 2008/09

Hit Target?

(Y/N)

Future Aspiration

2009/102010/11

Trend of Imp.

Comment

SCA/002a The rate of older people (aged 65 or over): supported in the community per 1000 population aged 65 or over at 31st March

98.67 105 90.18 N 2009/10 - 98

2010/11 - 102

Star Rating:

SCA/002b The rate of older people (aged 65 or over): whom the authority supports in care homes per 1000 population aged 65 or over at 31st March

20.1 22 20.9 Y 2009/10 - 22

2010/11 -22

Previous year’s result (20.10) unusually low due to changes to Continuing Health Care arrangements.

Star Rating: SCA/007 The percentage of clients with a care plan at 31st March whose care plans should have been reviewed that were reviewed during the4 year

63.0% 70% 67.6% N 2009/10 - 70%

2010/11 -75%

More robust processes around data capture have been put in place.

Star Rating:

Key Priority Performance Measures

PI Reference, Desired Direction of Travel & PI Description

Previous Year

2007/08

Target 2008/09

Actual 2008/09

Hit Target?

(Y/N)

Future Aspiration

2009/102010/11

Trend of

Imp.

Comment

SCA/010 The rate per 1000 adults clients assessed during the year who are provided with electronic assistive technology as part of a package of care

158.77 150 131.43 N 2009/10 - 130

2010/11 - 135

The target for 09/10 has been reviewed and set at a more realistic level as the previously high performance can be directly attributed to one off monies being made available to purchase lifelines over a specific period of time

Star Rating: SCA/015 (formerly SCA/006)The average number of working days taken from completion of the care plan to provision and/or installation of aids/equipment

Amended PI

10 Days

5 Days Y 2009/10 -5 days

2010/11 -4.5 days

N/A

SCA/017 (formerly SCA/009)The rate per 10,000 adult clients (aged 18+) supported in the community who receive a direct payment

Amended PI

150 183.58 Y 2009/10 -185

2010/11 -188

N/A

Key Priority Actions

Actions Responsible Officer Original Timescales

Current Timescales (or

completion date)

Original Key milestone

Current Key milestone (or completion date)

Redesigning Respite Care Services for Older People

Principal Officer Assessment and Care Management Services for Older People

February 2009 March 2010 Report with proposals and option appraisals are presented to HSCWB (Health Social Care and Well-Being) Overview Board.

Agree new model via the Health & Social Care Overview Board – Aug 09

Implement recommendations and action plan jointly with Health & Social Care Overview Board - March 2010.

Review Residential Services for Children

Principal Officer Child and Family Accommodation Services

December 2008 Superseded A strategic review of residential services is commissioned and reported to the Child and Family Service Senior Management Team

Work has been progressed but has now been superseded by the development of a placement strategy. There is a broader review of arrangements for looked after children in the Medium Term Financial Plan.

Actions Responsible Officer

Original Timescales

Current Timescales (or

completion date)

Original Key milestone

Current Key milestone (or

completion date)Redesigning Social Care Services for Older People

Head of Adult Services

March 2011 March 2011 Establishment of an extended assessment service for domiciliary care provided by the Local Authority.

Increased access to long term care for older people with mental health problems.

Implemented a new model of day opportunities which will support re-enablement and promote independence

Establishment of an extended assessment service for domiciliary care provided by the Local Authority.

Increased access to long term care for older people with mental health problems.

Implemented a new model of day opportunities which will support re-enablement and promote independence

Reshaping Mental Health Services

Head of Adult Services, in conjunction with lead Health personnel

March 2011 March 2011 Business cases for improvements to Mental Health services are submitted to and approved by the Welsh Assembly Government (WAG).

Business cases for improvements to Mental Health services are submitted to and approved by the Welsh Assembly Government (WAG).

Actions Responsible Officer Original Timescales

Current Timescales (or

completion date)

Original Key milestone

Current Key milestone (or

completion date)Reshaping Acute (Hospital) and Community Based Care

Corporate Director (Social Services), in conjunction with lead Health personnel

March 2011 March 2011 Local Care Units and Locality Care Teams are established.

A higher percentage of people are supported in their own homes.

Local Care Units and Locality Care Teams are established.

A higher percentage of people are supported in their own homes.

Improvement Agreement Outcome

Improvement Agreement Outcome – Health & Related Services in Swansea reshaped and reconfigured to achieve better levels of health and well being.

Improvement Agreement Actions 2008/09 Targets

2009/10 Targets

Redesign Respite Care Services

Health & Social Care (H&SC) Overview Board report H&SC Overview Board to meet Final Officers report with recommendations Undertake needs analysis/mapping/costing exercise Agree new model via H&SC Overview Board Implement recommendations and action plan jointly with H &SC Overview

Board

December 08January 09March 09April 09-

-

----August 09

March 2010

Improvement Agreement Outcome – Health & Related Services in Swansea reshaped and reconfigured to achieve better levels of health and well being.

Improvement Agreement Actions 2008/09 Targets 2009/10 Targets

Establish an Assessment and Re-ablement Service (Domiciliary Care)

H&SC Overview Board report Consultation key stakeholders Staff training Commence Implementation phase one (North Area) (reconfigure staff teams,

training evaluation etc) Commence Implementation phase two Commence Implementation phase three

November 08January 09February 09

March 09--

---

-Sep 09March 2010

Improvement Agreement Outcome – Health & Related Services in Swansea reshaped and reconfigured to achieve better levels of health and well being.

Improvement Agreement Actions 2008/09 Targets 2009/10 Targets

Implement a new model of day opportunities

Redesign social Centres Roll out pilot community preventative models Re-assess current service users Undertake needs analysis/mapping/costing exercise Agree new model via H&SC Overview Board Consultation Implement changes

Jan 09April 09-----

--June 09August 09Sep 09Nov 09Jan 10

Improvement Agreement Performance Measures

PI Reference, Desired Direction of Travel & PI Description

Previous Year

2007/08

Target 2008/09

Actual 2008/09

Hit Target?

(Y/N)

Future Aspiration

2009/102010/11

Trend of

Imp.

Comment

SCA/001 The rate of delayed transfers of care for social care reasons per 1,000 population aged 75 or over (Improvement Agreement)

6.78 Range between

6 & 8

4.95 Y 2009/10 - Range 6 8

2010/11 - 6

Star rating:

SCA/003a The percentage of clients, in the following age groups, who are supported in the community during the year:a) Aged 18-64 (Improvement Agreement)

95.36% Range between 90% & 93%

96.37% Y 2009/10 - Target to be agreed

2010/11 - To be

agreed

Star rating:

SCA/003b The percentage of clients, in the following age groups, who are supported in the community during the year:b) Aged 65+ (Improvement Agreement)

80.27% Range between 78% & 81%

82.07% Y 2009/10 - Target to be agreed

2010/11 - To be

agreed

Star rating:

Key Priority -

Implement the Health, Social Care and Well-being agenda.

Reason why this is a Priority

There is a statutory requirement for the Local Authority and the Local Health Board to produce and implement a Health Social Care and Well-being Strategy. It is one of the Local Authority’s four main plans, and outlines the intentions and priorities to lead the improvement in Health and Well-being in Swansea.

Expected Outcome There are three main Strategic outcomes identified in the Strategy:

Everyone is supported to achieve the best level of health and well being possible, living longer healthier lives

Appropriate care is delivered in the best location at the right time by a range of organisations working together

Communities and individuals are well informed and take responsibility for their own health and well-being

Summary - Implement the Health, Social Care and Well-being agenda.

What We Have Done:

Implemented the Older People Strategy development plan for 2008/09. Established a Telecare service. Put in place a Section 33 agreement to improve joint working across Health and Social Services. Worked with Health & Safety Executive to prevent and reduce the number of workplace injuries in Swansea. Produced a draft Healthy Weight Strategy to help decrease the prevalence of people overweight/obese people

in Swansea.

What We Intend to Do:

Implement the Older People Strategy Development Plan for 2009/10. Further investigate the aims and objectives of the Welsh Assembly Government’s second Older Person’s

Strategy through the Community Plan, Heath Social Care & Well-Being Strategy and other strategies. Start to implement the assistive technology strategy and action plan. Review arrangements in relation to Intermediate Care Services and Continuing Health Care – Learning

Disability. Continue to work with the Health & Safety Executive to prevent and reduce the number of workplace injuries in

Swansea. Complete the Healthy Weight Strategy to help decrease the prevalence of people overweight/obese people in

Swansea.

Key Priority Risk Review 2008/09 to 2009/10

Risk Aspect 2008/09Summary

2008/09Risk

Status

2009/10 Risk

Status

2008/09 Mitigation

Adult Social Services - Access to Services

Care packages and assessments. Medium

Medium

Practice Handbook for Assessment and Care Management (ACM) teams in place.

2009/10 remaining mitigation measures

Review the ICT arrangements currently in place to record ACM information. Review the current assessment and reviewing documentation. Develop an outcomes focused / citizen centred approach to ACM. Dedicated hours allocated to practice development role. Collaborative approach to assessments being developed between health and local authority partners.

Risk Aspect 2008/09Summary

2008/09Risk

Status

2009/10 Risk

Status

2008/09 Mitigation

Adult Social Services - Range & Quality of

Services

Developing sustainable models of service to promote independent living.

Medium

Medium

Joint work with Swansea NHS Trust to provide appropriate services on discharge from hospital. Continuing to implement services that promote independence.

2009/10 remaining mitigation measuresFurther develop partnership and collaborative approaches to service development across Adult Social Services. Increased awareness of direct payments as an alternative. Development of day opportunities as alternative to building based services. Involvement of citizens in planning services and redesign. Use joint planning groups to scrutinise service developments. Consider community capacity building approach to address sustainability issues.

Risk Aspect 2008/09Summary

2008/09Risk

Status

2009/10 Risk

Status

2008/09 Mitigation

Adult Social Services - Arrangements for

protection of vulnerable people

Safeguarding vulnerable adults. Medium

Medium

Staff training reinforced.

2009/10 remaining mitigation measures

Raising awareness across communities and key stakeholders. Development of Escalating Concerns process to manage issues within care homes. Planned completion of self audit / inspection regarding staff competence and guidance compliance. Further training being developed around links between MCA and POVA. Development of a prevention framework regarding safeguarding. Additional resources in place re: the introduction of DOLS.

Risk Aspect 2008/09Summary

2008/09Risk

Status

2009/10 Risk

Status

2008/09 Mitigation

Sport & Recreation Achieving WAG’s Climbing Higher physical activity strategy.

Medium

Medium

Implement City & County of Swansea Climbing Higher Strategy.

2009/10 remaining mitigation measures

Implement Year 2 Climbing Higher Action Plan by 2010.