The need for care and support is minimised and the escalation of need is prevented, whilst ensuring that the best possible outcomes for people are achieved
Strengthening Families Team
The purpose of the Strengthening Families Team is to work intensively with families to bring about change which effectively enables families to remain together at home, in safe and stable family environments, so that fewer children need to be taken into care. This is achieved by:
- Strengthening local practice systems to more effectively meet the needs of children and young people
- Developing services that build resilience in families
- Enabling social workers to manage risk more confidently, so children can stay safely within the home
During the first half of 2020-21 the team supported 141 children from 55 families. Referrals to the Strengthening Families Team are received from a variety of sources, however the majority are received from teams within the Local authority, CAMHS and Family Centres. For the period April to October 2020, 59 referrals were received.
Edge of Care and early intervention services
The Edge of Care service was historically set up to bring together professionals from a wide variety of teams. The Edge of Care meetings are now fully embedded into practice and meetings are held on a weekly basis. There is regular commitment from Child & Adolescent Mental Health Services (CAMHS), Family Centres, Youth Services, the Family Intervention Team, the Strengthening Families Team, and where appropriate, Youth Justice, Education, Kite, Housing and North Wales Police. This multi-disciplinary approach has facilitated improved co-working between teams and organisations.
Due to an increase seen in demand for managed care services over the last few years, in addition to the Edge of Care meetings, Early Intervention Multi-agency Consultation Panels are also convened on a monthly basis. The purpose of these meetings is to focus on how to support families on the brink of entering managed care services. These interventions can involve referrals to the Strengthening Families Team, or the Family Intervention Team, and working with the Family Centres.
During the period April to October 2020, 26 cases were prevented from going through to ‘managed care’ services and were supported by Family Centres and universal well-being services to remain at home.
Providing respite facilities for struggling families
Llys Gogarth is the combined residential service for children with disabilities. This service is provided to all children over 7 years who access Ysgol Gogarth as part of the extra-curricular offer and to children and their families who are eligible for respite to meet their wellbeing outcomes under the Act. Since March the service has been closed to children accessing the provision as part of the extra-curricular offer. It has remained open throughout the period for children with complex needs and their families. Initially this was provided for one child per night and only weekdays, with priority given to those with the most complex needs. As confidence in managing the risk has embedded in practice the service has returned to normal levels i.e. a 7-day service for three children. This has proven an invaluable service to these families. In addition Llys Gogarth has continued to offer emergency placement for children with disabilities who are on the edge of care or Looked After.
On a weekly basis we have worked with our education colleagues to identify the most vulnerable children and ensure that they are offered regular access to school provision.
Older People’s Domiciliary Care: Finance and Commissioning Review
In last year’s report we told you about the Older People’s Transformation Project and the various work streams in the scope. Part of this involved looking at how we commission services, with the aim of focusing on agreed outcomes for individuals.
To provide some context, the wider vision for Older People’s services aims to support the vision laid out in A Healthier Wales. We are focused on providing services to older people that are personalised and responsive, and key to delivering this type of service is ensuring that:
- Older people live in an environment of their own choice
- Carers in Conwy feel valued and supported
- Older people with dementia are supported to live well
- Older people have a well-planned and collaborative approach to meeting their needs
As part of this vision, it was agreed that a project should be established to review the current domiciliary care commissioning and finance model with the service, with the aim of commissioning by outcomes.
This project will specifically focus on reviewing the commissioning and finance process for domiciliary care within Older People’s services from start to finish to ensure that it’s leaner, more efficient and that care is commissioned by outcomes required rather than time and task.
A full review of existing processes within the following service areas will be undertaken to ensure the successful implementation of a new model of commissioning for Older People’s domiciliary care provision:
- Older People & Hospital Social Work Service area
- Social Care Finance
- Quality Standards and Commissioning Service area
Project Benefits
- Enabling the Older People and Hospital Social Work Service to manage increased demand with a reduced need for increased budget
- Improved lean financial and charging processes
- Enabling people to remain in their own homes for longer
- Improved service delivery and outcomes for individuals who receive care and support from us
- Continuation of the ‘reablement’ ethos when packages of care are delivered by external providers rather than in-house teams
- Increased support for carers of older people
- Enabling timely and safe hospital discharge
Progress to date
An internal project team has been established to start looking at the current commissioning arrangements within Older People’s Services.
A Business Case has been developed outlining the case for change and agreed by both the Project Board and Social Care & Education Integration Programme in December 2020.
A full options appraisal of potential commissioning models for the future is now underway, including a full evaluation of an outcome-focused pilot in the Plas Menai Community Resource Team in Llanfairfechan.
Next Steps
- Providers will be given an opportunity to attend a meet the buyer event that will be arranged in spring 2021 to discuss proposals in more detail.
- The results of the outcome-focused pilot evaluation will be shared to further inform our proposals.
- Ongoing consultation and engagement with Providers, Practitioners and Individuals in receipt of Domiciliary Care Services.
We want to reassure you that the services will continue to be commissioned regardless of the model we implement.
Maximising the St David’s Day Grant
This fund is made available to eligible young people aged between 16 and 25 and either still in local authority care or care leavers to help them progress towards independence. This year we sent out a survey to young people in our care, asking how they’d like to spend the grant. They requested that a panel be established to scrutinise requests put forward for the grant, and as a result, a weekly panel has been created. It comprises one young person, the project manager and the team manager; several young people take part on a rota basis.
The young people on the panel have provided a real insight into the thought processes behind applications and supported us to understand requests from their perspective.
What were the challenges?
Covid-19 provided an interesting challenge in determining how the panel would be set up. Initially we had anticipated that young people would attend in person, however digital involvement was the only way to proceed due to the social restrictions. This has proven to be a benefit because people are able to attend, regardless of where they are in the country.
What surprised us?
Perhaps the biggest surprise has been the level of scrutiny that the young people apply to requests. An example of this is in relation to requests for text books; previously we have authorised the purchase of text books without question, however the young people will approve with added recommendations, e.g. to attend the library, look for second-hand books, where to look for these etc. This has been really useful and ensures that young people are getting the most out of their St David’s Day Grant entitlement.
What’s next?
As a panel we would like for this to continue. It has been a really insightful process and has validated the decisions made in relation to the grant. This level of co-production is heavily underpinned by participation, as defined within the Social Services and Well-being (Wales) Act 2014.
Flexible accommodation for university students and young people approaching independence
In 2019 it became evident that there is a lack of accommodation for young people in university to live in during the holidays, as well as a lack of respite accommodation for When I’m Ready placements. This can sometimes result in the use of inappropriate bed and breakfast stays.
We looked at resources from across Europe, and in particular the sustainable element of single-unit accommodation. We reached out to housing associations and were able to link in with Cartrefi Conwy to be a part of their Passive Housing scheme; this is made up of eight single-person accommodation units. The Personal Advisor Team have trialled one unit, using the St David’s Day Fund to lease a safe one-bed unit (or pod) for people with low needs that require it as a base or for respite.
Excitingly, this is an incredibly sustainable project with heating coming from recycled body heat within the unit. This was also built by Creating Enterprise, a branch of Cartrefi Conwy established as a social enterprise.
Here are some photographs we took of the pod.
What were the challenges?
Again, the Covid-19 pandemic has resulted in delays, which have impacted on the use we’ve been able to make of the pod. However, keys were handed over at the beginning of February and furnishing has begun in readiness for the Easter holidays.
What’s next?
The St David’s Day Grant has been awarded for the next year and this will be our first full year of running the pod. We anticipate that there will be departmental savings, alongside offering a safe placement for young people.