SCRUTINY COMMITTEE HEALTH AND WELL BEING

20^TH JUNE, 2002.

Council Chamber, 3 Spilman Street, Carmarthen

10.00 a.m. - 12.20 p.m.

PRESENT: Councillors: N. Baker, J.D.G. Crossley, P.B. Davies(s), P.M. Hughes, J. Gibbin(s), P.E.M. Jones, K. Madge, K.B. Maynard, E. Morgan and Mrs. G. Thomas. Also Present: Councillor Mrs. P.J. Edmunds - Executive Board Member - Social Care and Health.

The following Officers were in attendance:

Mr. B. McLernon - Director of Social Care and Housing Mr. B. Collins - Head of Adult Services Mr. P. Thomas - Best Value and Scrutiny Manager Ms. M. Bell - Head of Policy and Finance Ms. B. Dolan - Senior Consultant, Corporate Consultancy Mr. L. Thomas - Monitoring Officer Mr. D. Eldred - Group Accountant Mr. K. Thomas - Committee Services Officer

Item No.	Subject / Decisions
1.	APOLOGIES Apologies for absence were received from Councillors I.W. Davies, J.R. Davies and W.G. Jones.
2.	DECLARATIONS OF PERSONAL INTERESTS No declarations of personal interest were made.
3.	APPOINTMENT OF CHAIR Nominations were sought for the appointment of Chair of the Committee for the 2002/2003 municipal year. Following the nominations of both Councillor N. Baker and Councillor K. Madge, a vote was taken as follows:- Councillor Baker - 5 votes Councillor Madge - 5 votes The Monitoring Officer advised the Committee that in the event of a tied vote for the appointment of Chair where there was no Presiding Chair, the appointment could only be determined by the "Toss of a Coin" or drawing "lots". Following the toss of a coin, Councillor N. Baker was declared Chair of the Committee for the 2002/2003 municipal year.

Item No.	Subject / Decisions
4.	APPOINTMENT OF VICE-CHAIR RESOLVED that Councillor P.M. Hughes be appointed Vice-Chair of the Committee for the 2002/2003 municipal year.
5.	BEST VALUE REVIEW OF SERVICES FOR OLDER PEOPLE: OPTIONS FOR THE FUTURE OF THE AUTHORITY'S RESIDENTIAL HOMES The Committee received the report on the Best Value Review being undertaken of services for older people, and to the options available for the future provision of the Authority's residential homes. It noted that a consultation exercise undertaken had overwhelmingly indicated the following two preferences for future service delivery:- (a) All stakeholders preferred, if possible, for the homes to remain "within" the Local Authority and for the Council to invest the necessary finance to achieve the required standards and improvement. (b) That should (a) above not be possible, consideration be given to the homes being operated by a not-for-profit organisation, preferably a Carmarthenshire Care Trust. The Head of Adult Services informed, the Committee that following the consultation exercise it was proposed that a joint officer/members working group be established to consider the above options for the future development of the homes to the level of the higher standard now required by legislation. That Working Group would consider issues as financing arrangements, number of homes, value for money etc.. The Committee noted that consultations on the proposals had been undertaken with all relevant Local Members; Town and Community Councils, Health and Social Care Partnership Board, Services for Older People Planning Group, staff and trade unions and the 14 homes in Council ownership. Members unanimously endorsed option (a) as their preferred option and stressed the need for the Working Group to have due regard to the financial element of the proposals, and for the requirement on the Council to incur expenditure of between £3m and £20m to raise the standards of its homes to between the minimum and maximum standards set out in legislation. Members felt that the final report to be presented to Council in November 2002 should contain options of the level of improvement which could be attained for varying levels of expenditure. Members further referred to current treasury proposals to amend legislation in respect of Local Authority borrowing power to finance the cost of improving homes, and stressed the importance for representations to be made to the

Item No.	Subject / Decisions
	government to make a decision with regard thereto as early as possible. RECOMMENDED in order for the Council to plan and commit resources by December 2002 to meet the new National Minimum Standards set by the Care Standards Act 2000, that,
	5.1	A Joint Officer/Member Working Group be established to consider the future development of the Council's Residential Homes to the level of the higher standard by maintaining the homes within Local Authority Control or entering into a partnership with a not for profit organisation including the possibility of a newly formed Carmarthenshire Care Trust.
	5.2	That the remit of the Working Group include for the provision of detailed plans covering.
	5.2.1	how sufficient investment in the homes would be achieved under both options in the context of the overall demands on capital for the Authority.
	5.2.2	the immediate and on-going costs to the Authority and the impact on existing departmental budgets of implementation of either option.
	5.3.3	a development programme for the homes to the level of the higher standards including costs, timescales and if any closure of the existing homes would be required to allow re-investment in alternative sites.
	5.3	That a report on the findings of the Working Group be submitted to Council in November 2002.
6. 6.1	YEAR END POSITION 2001/2002 BUDGET MONITORING AND PERFORMANCE INDICATOR MONITORING The Committee received for Scrutiny a report on the above issues. It noted that, as the reports related to the internal budget monitoring arrangements of the Social Care and Housing Department and the department's performance indicators, no consultations were necessary to be undertaken with local members, Community Councils, relevant partners and staff side representatives. Budget Monitoring Members referred to the £122,000 overspend, on the department budget for 2001/2002 which had been offset by a contribution from reserves, and sought clarification on the level of reserves currently remaining. They further sought information on what additional resources, if any, had been made available to the department, and to the progress being achieved on the 5 year plan to address overspends within social care. The Head of Policy and Finance advised that prior to the use of reserves to support the 2001/2002 budget the department had the sum of £130,000 in its reserve account. That had now been reduced to approximately £8,000.

Item No.

Subject / Decisions

6.2

With regard to additional resources the department had received £900,000 to offset demands for adult care, a £200,000 performance incentive grant had been received, together with a transfer of resources for the preserved right for people living in homes prior to 1993. The implementation of the 5 year plan had proved difficult due to increased demands placed for elderly services. That plan was now being re-visited. The Director of Social Care and Housing reported that, on an all Wales basis, the 22 Unitary Authorities had reported an overall overspend of £9m in the social care budgets, and had estimated that an additional £130m or 6% budget increase would be required to achieve a standstill budget for 2003/2004. RECOMMENDED that the budget monitoring report be received. Performance indicator monitoring Members received the report of the year end performance indicator reports for Social Care and sought clarification for the reductions in performance indicators 7.1.2.0, 3.9 and 9.3.3.2.. The Head of Policy and Finance reported that indicator 7.1.2.0. had been based on the outcome of a survey undertaken on users/carers who said they received help promptly. Whilst the results of the survey were disappointing recording a 74% satisfaction level compared to a 90% target, the reasons for the performance were difficult to quantify without further research, but it may reflect increased demand on teams and their capacity to respond. The Head of Adult Services referred to indicator 3.9 - adult clients receiving a written statement of needs. Whilst the result of the indicator was disappointing, it was envisaged the process of statementing would be improved with the introduction of a new countywide computer system, successfully piloted in Llanelli. In response to a members' inquiry he advised that it was possible as recruitment difficulties could be impacting upon indicator 9.3.3.2. - people with physical disabilities helped to live at home. However, there were other issues relating to bed blocking and delays in introducing a home care package which also needed to be taken into consideration. The Head of Policy and Finance advised that the definition of indicator 9.3.3.2 had recently been amended, which had also contributed to the reduction in performance. RECOMMENDED that the report be received.

Item No.	Subject / Decisions
7.	URGENT ITEM The Chair reported that pursuant to Section 100B(4)(b) of the Local Government Act 1972 he had decided to allow item 7 below to be considered at the meeting as a matter of urgency due to members concern.
8.	FREQUENCY OF MEETINGS Members referred to the bi-monthly frequency of Scrutiny meetings and the fact the next meeting of the Committee was not scheduled until the 3rd October, 2002. They considered a special meeting should be convened prior to October to discuss issues of concern to members. RECOMMENDED that arrangements be made for a special meeting of the Committee to be convened prior to the next scheduled meeting.