Conwy Social Services Annual Report

Next Steps for the Conwy People’s Partnership and Groups

The Conwy People’s Partnership continues to be committed to the participation of children, young people, families and parents/carers in decision making and recognises the benefits of listening to service users.  The Conwy People’s Partnership Board and Conwy Outcome Groups will continue to listen to the ideas of service users to develop responsive and effective services.

We will continue to use our Communication Plan which illustrates systems and processes to underpin the Conwy People’s Partnership Board Working Agreement, which puts principles into practice to ensure a common understanding of the practicalities of working in partnership with multi-agency stakeholders in Conwy County Borough.

The partnership also recognises the importance of embedding the ‘Social Services and Wellbeing (Wales) Act 2014, the ‘Wellbeing of Future Generations (Wales) Act 2015’, and work with the newly formed Public Service Boards.

Conwy Outcome Group 8 – Carers Network

The Carers Network has worked with the Partnership Team to purchase 2000 trolley coins to be utilised during Carers ‘drop in’ sessions, Carers Week, Carers Rights Day and any promotional activities fulfilled by the Carers Team. The funding was received by Public Health Wales Wellbeing Activity Grant. The trolley coins will enable Carers of any age to have access to the relevant phone numbers and website details to ensure that they are able to access information, support and advice when required, and to target unknown Carers ensuring that they receive the contact details of where to get the right support when needed.

Conwy Outcome Group 7 – End of life care

COG 7 arranged an ‘End of Life Care Good Practice Learning Exchange’ in March 2016. Aimed at professionals to encourage them to have the confidence to begin having conversations regarding their last wishes, and raise awareness of ‘End of Life Care’ and ‘Bereavement Services’. The following information was presented on; Advance Care Planning, Deprivation of Liberty Safeguards, Byw Nawr/Live Now, ‘DeadSocial’ and Conwy End of Life Service. The event was well attended, an evaluation report has been completed and shared, and some of the attendee’s positive comments are listed below:

“I will take back to my group the latest info on the End of Life. We as a group are out on a limb & don’t always get to go to these events but I think it is essential to keep as up to date as we can to deliver a 100% service”.

“Improving my communication on death and dying – improving patient outcomes”,

“I will refer my patients to the Conwy End of Life Team”.

Coordination Group – Communication, monitoring, quality assurance, engagement

All the Chairs from Conwy Outcome Groups are members of the Co-ordination Group, the role of this group is to focus on communication, monitoring, quality assurance and engagement as well as their priority areas; Welsh Language, Information, Equalities and Transport.

The Communication Plan has been agreed and endorsed which outlines communication and reporting mechanisms between a variety of groups such as the CPP Board, COG groups and task and finish groups. Arrangements are also in place to ensure good working relationships are established with other groups such as the General Practitioners Clusters to ensure information is shared across all sectors in Conwy County.

Terms of Reference for the group has been agreed and includes citizen representation in order to ensure openness, transparency and accountability. Expressions of interest were sent out for a citizen representative and have now been selected and welcomed at a recent Co-ordination Group meeting.

Conwy Outcome Group 5 – Mental well-being, improve positive emotional well-being and good mental health

COG 5 identified a number of gaps in training around emotional wellbeing and mental health, the following approach was agreed:

  • Multi-agency partnership approach in delivery
  • Target appropriate staff for the right training
  • Ensure it is cost effective and utilise existing resources as much as possible.

Training courses were arranged and delivered in partnership; Mental Health First Aid and Connecting with People.

  • Mental Health First Aid – identified as an expensive course, an accredited partner delivered the course for free, utilised council premises and the resource books were purchased through the Public Health Wales Wellbeing Activity Grant.
  • Connecting with People – A particular training need was identified around front line employees requiring training and support on how to deal with individuals threatening suicide whilst on the phone with members of Conwy County Borough Council staff.

The partnership approach from COG 5 demonstrated positive results, in reducing costs, sharing resources and utilising knowledge and expertise, and a potential cash saving of £7280 to the Local Authority.

Conwy Outcome Group 4 – Long term care, people with disabilities and chronic conditions have the best quality of life possible

COG 4 has been made aware of the annual decline in uptake figures in Conwy County of the Welsh Adult Health Checks for individuals who have Learning Disabilities. COG 4 Co-Chair attended the General Practitioners Cluster meeting to highlight this in May. Following further discussion at the COG a task and finish group is to be established to identify the barriers to the take up of the Welsh Health Check. In addition the group will look to address issues around the use of gathering information during the health check process to inform service improvement.

The Communication Task and Finish Group have developed an ‘Accessible Communication Guide’ to inform individuals and their organisation of aspects of communication that are important to consider when in contact with people who have communication difficulties. Whether that is face to face or through other means of contact for example documents, posters, or letters etc. This guide is aimed at professionals working with individuals with disabilities; (including sensory impairment, deaf or hard of hearing, physical disabilities, learning disabilities, and chronic conditions). The next steps for COG 4 will be to embed the guide within Conwy County Borough Social Services induction processes and promote usage with other multi agency partners and organisations. The guide was shared with Board members and a very positive response was received.

Conwy Outcome Group 3 – Older people are safe and independent

COG 3 are continuing to work on their priorities; falls, dementia and social isolation. Falls prevention information pack has been produced, which provides advice and guidance for individuals at risk of falls to help them remain safe and independent. A ‘Dementia Drop in’ event was held at Llanrwst to raise awareness and gave the public an opportunity to have a chat with professionals on developing Llanrwst as a future dementia friendly community.

The Loneliness and Social Isolation Task and Finish Group are currently reviewing how people approach retirement. Information collated by the group highlighted a number of examples where people have moved to Conwy to retire with their partners but away from other family members. In some instances one partner may fall ill, or pass away which therefore leaves individuals at risk of becoming socially isolated due to loneliness, ill health or location. Subsequently the group have developed two questionnaires to gain a better understanding of how people plan for their retirement. One ‘pre-retirement questionnaire’ to establish if people plan, what age, and what for. The other questionnaire is ‘post retirement’ to gain an understanding of the views of those who have already retired. The results will enable employers and employees to gain an understanding of the reality of retirement not just the financial element, and encourage individuals before they retire to consider the emotional and wellbeing aspects of their future lives.

Conwy Outcome Group 2 – Prevent ill health and encourage healthy and active living

COG 2 are continuing to support a number of priorities linked to healthy living practices in Conwy and supported ‘Screening for Life’, ‘Flu Campaign’ and the following smoking cessation initiatives; ‘Stoptober’ in Conwy County Borough workplaces, the British Heart Foundation ‘Stop Smoking Day’ and the ‘Quit for you and Quit for Them’ campaign.

Smoking brief intervention training and alcohol prevention training has been delivered to professionals working with clients who want to quit smoking or reduce their alcohol intake. The majority of attendees strongly agreed that the training met their expectations. Participants highlighted some of the following comments;

“I work as an OT and recently ‘OT News’ had a featured article re: role of OT to aid smoking cessation – very timely – feel able to apply taught techniques!”

“Really good, thought provoking course”

“I learnt so much today and feel I have gained a much better understanding of the difficulties faced with stopping smoking”

“Alcohol scratch card are a great resource”

Conwy Youth Council chose sexual health as a priority and have worked with COG 2, a survey was sent out to schools and colleges on sexual health provision and education and over 500 responses were received. A number of questions were asked about different themes including information, contraception interaction with professionals and education;

“Do you have any ideas about what would make you more comfortable with going to see medical professionals about your sexual health?”

  • Be more certain of confidentiality (31) 36%
  • No communal waiting area or faster waiting times (12) 14%
  • Same gender Doctor (11) 13%
  • Relaxed Doctor  (9) 10%
  • Going alone (5) 6%
  • Going with friend or family (6) 7%
  • Non-judgemental Doctor (5)  6%
  • Make it a more open subject, talk about it in education (4) 5%

The main perception identified by the young people was confidentiality issues, the Conwy Youth Council produced a poster and this has been shared with schools, pharmacies and GP Surgeries, a short film has been produced following their journey and is available on YouTube:

Conwy Outcome Group 1 – Children and young people

COG 1 are continuing to work on their areas, membership has been reviewed and new working relationships established. Next steps in September 2016 is to review the existing service plan and priorities, and hold a workshop with members from COG 1 and sub-groups to consider and agree new work streams.

The Free School Task and Finish Group was commissioned following an identified gap in take up of free school meals in comparison to entitlement In Conwy schools. A whole school approach was introduced ‘Our School Lunch’ in order to be all inclusive, avoid stigma and ensure schools are responding to the Healthy Schools Measure (Wales) 2009.

Consultation took place with Head Teachers, Conwy Youth Council, and worked with the School Nutrition Action Group / Bwyd o Bwys (SNAG / BOBS) who are mentors that share knowledge and skills around healthy eating in schools.

The work of the Group has demonstrated that the inclusive approach involving all stakeholders generates positive results, in ensuring children and young people have a better understanding around food, nutrition and wellbeing to maximise their own development for their future.
It also contributed to reducing obesity and increasing attainment.

Subsequently Conwy Catering Department was nominated as one of the 7 most improved Catering Services on a National level in December 2015, through the Association of Public Service Excellence. This was due to a higher % (1.8%) of take up of eligible primary pupils having a free school meal in 2014/15 (82.3%), in comparison with 2012/13 (80.5%). Information has been shared with the Conwy People’s Partnership Board and COG 1 and the uptake of free school meals will continue to be monitored.

To find out more about the work of SNAG / BOBs at one of their Cooking Session in Ysgol y Creuddyn with David Preston, Cook in Charge, Ysgol Y Creuddyn

The Conwy People’s Partnership

Conwy People’s Partnership is a realigned partnership which is the merger of the Children and Young People’s Partnership and Conwy Joint Locality Partnerships based on guidance from the ‘Welsh Government Shared Purpose Shared Delivery’ on integrating partnerships and plans.
The first meeting of the Conwy People’s Partnership Board was held in April 2015, the board consists of multi-agency strategic cross-sector key partners to work on shared principles and priorities. The work of the Partnership informs the ‘One Conwy Single Integrated Plan – Working Together for a Better Future’. To assist in the delivery the Conwy Outcome Groups (COGs) and a number of task and finish groups were established.

Policy Development

Developing the Adult Safeguarding agenda

The Safeguarding Unit has had limited capacity to develop the work around Adult Safeguarding and this is a priority area over the next 12 months.

Implement the Signs of Safety Model across Case conference processes

The Safeguarding Unit is at the initial stages of the implementation of the SOS approach to Conference process. This is another practice area that work will be undertaken on over the next 12 months, across both Adults and Childrens case conferences.

Self Neglect / Hoarding

There have been two difficult cases this year that have highlighted to the service the need to develop our knowledge of and skills in working with people who self-neglect and hoard.

New practice initiatives

Getting a “When I Am Ready” (WIR) scheme set up by 1st April 2016

Each Local Authority had to prepare a WIR scheme by the 1st April 2016. Significant regional and local work has been developed in order to prepare for this new duty.

Creating an Accommodation and Support Strategy for Leaving Care

We have insufficient suitable accommodation / support for some Care Leavers and we need to reduce the number of temporary Bed and Breakfast accommodation that we access for Care Leavers and build a portfolio of placements based on the revised needs analysis and Strategy.

Challenges within the integrated delivery of secondary mental health services.

Secondary mental health services in Conwy remain challenging around the interface with the Betsi Cadwaladr University Health Board.

This has been heightened during the period of special measures that the Health Board are subject to and their interim staff structures.

There are multiple issues regarding variance in access and management procedures – of differing models of Home Treatment Services and access to in-patient beds.

Recording and communication of patient records has also been an area of concern and the future integrated Health and Social Care IT system should help this. .

Significant work has been undertaken to ensure robust commissioning processes are now embedded in practice ensuring the Social Care budget sees a reduction in the current overspend going forward.

Social Care’s Vulnerable People’s service is working with the Continuing Health Care team within the Health Board to develop a Section 117 protocol which will determine the appropriate levels of funding to be apportioned mutually.

Following a spike in the number of suicides over the period leading up to 2015 a critical incident review highlighted serious concerns.

In response to the concerns a joint improvement meeting was established for managers within Health and Social Care which has produced positive changes in supervision and induction.

However fundamental and systemic issues remain a barrier to secondary mental health services working optimally currently.

Changes to reporting requirements

The new Act has introduced a major overhaul of the performance information we collect in social care.  We will now be required to report on 5 sections of information relating to adults social care:

  • Performance measures that consider things like meeting statutory timescales
  • Assessments – the number of people we asses at different stages
  • Services
  • Charges
  • Safeguarding

There are 4 sections addressing social care for children:

  • Performance Measures
  • Care and Support
  • Assessments
  • Child Protection

The challenges this brings includes making sure we record all the information required to gather these data sets, writing new reports to extract the right information from our database, and testing, to ensure the data is robust.  Along with this, we are consulting with key stakeholders to ensure they know about and understand the changes.

We are also discussing with our colleagues which of the old measures we can leave behind, which ones we need to keep, and which of the new ones we’ll need to drill down for further information, to enrich our intelligence.

There is also a qualitative aspect to the information collected, which will require significant resource to coordinate.

Challenges over the coming year for Family Support & Intervention

With the implementation of the SSWBA, Family Support and Intervention service (FS&I) faces the significant challenge of mobilizing existing resources to comply with the principles of the ‘preventative agenda’.   Prevention in the first instance refers to the challenges presented in empowering families to make changes initially through Information, Advice and Assistance and whilst FS&I will not necessarily lead on these services there will be an important interface to develop with partner agencies, particularly Team around the Family (TAF), Youth Justice, Education and Health.

When families present with assessed needs requiring managed care, FS&I will be required to provide effective care and support packages with the aim to facilitate change and progression with clear outcome based results preventing an escalation through the services to ‘high end’ interventions through child protection and care proceedings.

When care proceedings present as inevitable FS&I are committed to explore every option to place children within a family environment first and foremost with family & friends and only when this is not possible through Foster Care and adoption.

In order to respond effectively to the changes in legislation and codes of practice the service will need to internally review existing resources and develop a skilled workforce to meet the challenge and promote the principles of prevention and empowerment.  Including in the service plan to deliver change:

  • Develop simple and complex assessment processes locally and contribute to regional and national developments
  • Care and Support packages are implemented according to assessed need
  • Review current structure to ensure that workforce is deployed effectively to meet needs of the children and their families to maximise opportunities for positive change
  • Upskill workforce to deliver effective interventions and work with families through outcome based and partnership approaches
  • Develop participation tools to ensure that the customer voice is heard and responded to and can inform practice and service delivery
  • Develop partnership forums with partner agencies in order to strengthen integrated working
  • Continually evaluate and review effectiveness of the service and interventions

The most significant challenge for a social care workforce will inevitably be to make capacity to take the time out of every day work schedules, for reflection and consideration of new practice initiatives to respond to the needs of the service users within a changing landscape.  As an evolving service we need to assume a collective responsibility to ensure that this element of development can be facilitated through models of supervision, team days and service development opportunities.

Staffing – deployment of existing resources

All Frontline Disability Services

Recruitment of suitable staff is increasingly problematic for community support frontline posts, with very few applicants for advertised jobs.

Realignment of the Disability Service

Realignment of the teams, managing change, uncertainty for staff, accounting for staff preferences and striving to achieve this for them fairly across the service.

Ensuring the workforce is trained to deliver the Act

The capacity of trainers on the national training framework to train the workforce in Conwy.

Regional Learning & Development

Welsh Government are seeking to achieve one Learning and Development plan for the whole North Wales region, via the Social Care Workforce Development Partnership (SCWDP).

DOLs

Deprivation of Liberty Safeguards became law on the 1st April 2009. The Supreme Court Judgement of the 19th March 2014 has clarified the DoLS threshold. The criteria has been greatly reduced, which has impacted on Conwy’s ability to meet its statutory legal requirements. The impact of the judgement is that there is now a waiting list of 337 people awaiting DoLS assessments. The number of people estimated to need a DoLS assessment is expected to increase gradually year on year in line with demographic trends.

Conwy has responded by training twelve Social Work/Occupational Therapy professionals in total to carry out assessments. Each assessor has to carry out one assessment per month, this is additional of their usual case load and consists of six separate assessments per service user. There are also three permanent Best Interest Assessors all undergoing training in Chester University. (Graduation May 2016).These Assessors are dedicated to DOL’s service.

The legal requirements of the new case law cannot be met in the short term due to a lack of resources and this leaves the department open to litigation challenge from families and from people who have been deprived of their liberty without the legal safeguards being applied.

Social Services & Wellbeing Act

Under the new Act, it will be a challenge to ensure an equitable and fair approach to those people who have been in receipt of services for some time, and in addition, those who will become new service users after April.

Financial challenges

Reduction in Families First grant AND LAP Grant for Flying Start

There has been an 11.7% reduction in grant for 2016-17 which is resulting in some loss of services (Participation Officer under consultation) plus a reduction in grant under SLA’s for external delivery. These are challenging times for Let’s Get Working / Rural Families First.

The cut in LAP (Language and Play grant) is resulting in the loss of a great teacher who currently undertakes this role for Flying Start.

Equitable Services

Having realigned teams to create a Disability Service the inequitable allocation of resources remains a challenge in particularly between people with Physical Disabilities and/or sensory impairment and people with Learning Disabilities.

Managing Resources

The Social Care budget is facing unprecedented challenges. There is increased demand across all service areas which resulted in an overspend at the close of accounts for 2015/16 in excess of £1 million.

There are a range of factors that have caused this, many of which were reported through the political process in 2015/16. However a range of additional costs further affected the overall outturn for 2015/16. The department had in the latter months of 2015/16 predicted the increase overspend and the opportunity to use the reserves was a solution.

The 2016/ 17 budget is under further pressure as it has had to agree additional funding for the Residential, Domiciliary and Supported Living (24/7) care sector to the sum of £0.75m, over and above the funding made available through business cases.  The supported living projects (24/7) are further affected by the introduction of the National Living Wage (NLW). It is clear that the policy decision taken nationally to introduce the NLW has had significant financial consequences locally. This is however not unique to Conwy.

In addition there has been an increased demand for independent placements for Looked After Children (LAC), with the independent sector seeking an uplift in fees as a result of the National Living Wage.  Both of these factors are creating additional budget pressures and a projected overspend.

In respect of LAC, pressures are due to the lack of availability of foster placements within the county and within independent providers across the region. Due to this lack of placement choice, it is sometimes necessary for some young people to be placed in higher cost residential settings, particularly where behaviours escalate and Foster carers cannot meet their needs. It’s is accepted that the introduction of the National Living Wage will hopefully address some recruitment and retention issues within the sector and make it a more attractive sector to work within. In turn, this will hopefully assist with the drive for improved quality and sustainability. However the disparity between the business cases agreed and the funding required for National Living Wage alone has resulted in a deficit.

The department has benefited from additional funding via the business cases route to the sum of £6.2m over the last 5 years and has achieved £9.4m efficiencies as part of the councils efficiency drive over the same period.

As of the 1st of April 2016 the £1.436m value of the efficiencies that were approved by Council for 2016/17 have been removed from the budget. A failure to achieve any of these initiatives will only further increase the departments overspend.

The position in 2017/18 will worsen with further increases and demand expected within the service. The worse -case scenario of the NLW is that it raises to £9.00 per hour in April 2017 which would place additional demands of £2.3m for Residential/Nursing, £1.05m for Domiciliary Care and £1.2m for Supported Living. This is on top of the potential resource shortfall for 2016/17 and that will roll forward and further pressures experienced by the care sector as a result of other council initiatives.

Current Challenges

The Social Services and Wellbeing (Wales) Act 2014 continues to be the major driver of change. Our transformation programme successfully redefined our service structures to be better aligned to meet the needs of the Act, and we’re now at a point where established services are seeking to optimise or balance their resources against the demand, and new services are developing effective models of working, that are appropriate to people’s needs.

Our current challenges can be grouped into four categories:

  • Financial challenges vs new demand
  • Staffing – deployment of existing resources
  • New practice initiatives
  • Policy development

Visit our main website

For more information about Social Services in Conwy, please visit www.conwy.gov.uk/socialservices

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Contact Social Services

General Enquiries for Adult Services: 0300 456 1111
General Enquiries for Children’s Services: 01492 575111

email: [email protected]

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