To receive a verbal presentation from the Director for Adult Social Care, Telford & Wrekin Council.
Minutes:
The Director: Adult Social Care provided the Committee with an update on the position of Adult Social Care within Telford & Wrekin. Members heard that the Adult Social Care Service Plan and Position Statement were informed of partners and strategies and underpinned by the Adult Social Care Charter. They highlighted the recently finished Autism consultation and the upcoming update to the Place Based Mental Health Strategy in conjunction with the Telford & Wrekin Integrated Place Partnership (TWIPP). Providing specialist and supported accommodation was key to keeping people in their own homes in their own community. The Director: Adult Social care advised that the quality assurance framework related to this could be provided following the meeting.
Post-Covid there had been an increase in demand and the complexity of the issues they were dealing with. In order to manage these challenges they had worked closely with Shropshire Providers in Care and the Making It Real Board. The experience of people with lived experience had also been invaluable. The Director: Adult Social Care informed the Committee that the lessons learnt through Covid had made them appreciate the role of their partners even more.
Members heard that workforce recruitment and staff retention continued to be key across the system. This had led to the commissioning of different types of care to manage those challenges. Enablement grants had allowed care providers to manage staffing gaps and the introduction of new technology had allowed for virtual visiting. This was all in aid of supporting people at home where possible. It was noted that the Independent Living Centre was closed during Covid but was now re-opened and providing bookable appointments and drop-in sessions with health professionals. The Council had been actively involved a dedicated recruitment campaign that included promotion of the 'you can care' social media campaign. It was noted that partnership working had been essential to support the care provider market to be more flexible.
The Director: Adult Social Care informed the Committee that they had worked with the Inter-Disciplinary Discharge Team based within SaTH to co-ordinate a 7 day hospital discharge service. This had ran into difficulty though when outbreaks had prevented 91% of care homes in the Borough from accepting people. It was advised that they were in a much better position now though. Members heard that the Health & Social Care Rapid Response Team had continued to receive an average of 55 referrals a week, which worked to avoid hospital admission through targeted support.
Looking to the future there was a number of upcoming consultations regarding the supporting older people strategy and the placed based carers strategy that the Director: Adult Social Care was happy to discuss with the Committee at a later date. Members heard that the first part of the Autism Strategy consultation had just come to an end and that an analysis report would be published by Autism West Midlands in May 2022 for further consultation. The learning disability strategy that was discussed at a previous meeting of the Committee subject to the Partnership Board. The Committee were informed that after listening to residents and families about where they wanted to live in the future they were not looking at creating quality accommodation and respite facilities for adults with learning disabilities. Two sites that were being explored were Lakewood Court and the Wellbeing Centre in Wellington.
The Committee heard that there were two recent White Papers that impacted Social care. The People at the Heart of Care: Adult Social Care Reform White Paper introduced the care cap and the Care Quality Commission's regulation of adult social care departments from 2023. They were advised that whilst there was still much to be done around charging and people contributions, the Council were in a good position in terms of providing a digital offering. The other White Paper which had an effect was Joining Up Care for People, Places and Populations. Members were informed that conversations had taken place with TWIPP regarding more integrated support. The Director: Adult Social Care advised that they were happy to take direction from the Committee regarding what they would like to look at in more detail.
Members of the Committee asked a number of questions
It was clear that a number of big changes were coming that we cannot overcome alone. Were we working with other Councils to find solutions?
Our regional and national connections have been invaluable. The Council regularly shared best practice and would come together with other Councils to find solutions where necessary. The Director: Adult Social Care mentioned that only earlier that day had they been involved in a regional webinar regarding the care cap.
Were we in a position financially to carry out our social care ambitions?
Cabinet had agreed further growth in adult social care. It would still be challenging but it was important that this commitment was made. Members heard that the Council would maximise their resources by finding creative ways to commission services and work with our partners to get the most for local people.
Were the thresholds for older people living with long-term conditions still too high?
The Care Act set out the eligibility criteria for meeting people's care needs. However, the wellbeing principles of delaying or preventing were also considered. Most of the services provided were not subject to threshold as resources had been dedicated to keeping people connected, reducing isolation and easily accessible community services. Members heard that a number of technological initiatives that were introduced during Covid had provided additional opportunities for residents to keep their independence.
Did Lakewood Court and the Wellbeing Centre belong to the Council currently?
The provider for both was My Options which was ran as a department within the Council.
Have we seen a rise in more complex requirements coming forward since Covid, and have we been able to meet the need for the different services required?
They had seen a marginal increase in adults with more complex needs. The Director: Adult Social Care advised that they were well placed to meet needs with the resources available. They noted that the challenge during Covid had been their ability to respond quickly due to absences.
The way people accessed the services had previously been changed which caused a number of issues. Had these issues since been resolved?
The Committee was reassured that these issues had been resolved. The system had been changed to prevent people from having to call multiple times to speak to different services. Instead there issue could be dealt with in one call. Members heard that they were continually asking what more could be done to improve the first point of contact. This had included a review of peoples thoughts on their experiences.
What was being done to support the welfare of both home carers and those employed in care homes?
They recognised the impact of Covid on carers. In conjunction with the Carers Partnership Board and the Carers Centre they have looked at the best ways to provide support.
Had the recruitment drive made up for the loss of staff in care homes?
The support the Council had provided towards the recruitment campaign had bolstered applicants. Additionally, the Quality Team had assisted homes to implement changes needed as a result of staff loses.
Given the likely shortfall in care packages given financial pressures and the increasing numbers of older people. What. How many care packages have been put in place over each of the last five years?
The Director: Adult Social Care advised that there had been a slight rise in the number of people referred to them for support. The majority of which were discharged from hospital. It was noted that there had been an increase in complexity, pace and demand which meant they needed to be flexible enough to meet needs. In order to keep people at home they were looking at potential virtual care homes combined with physical at home support.
How were micro providers monitored if they were not CQC registered?
They are not required to be CQC registered if they do not provide personal care. Typically they provide services such as shopping and cooking and activities to reduce isolation. Members heard that there services were used in lower level cases. The Director: Adult Social Care assured the Committee that there was a monitoring process for checking their providers.