The Cabinet Member (Social Care Adult) will comment on the key achievements or topics for improvement in the past year in her programme area as it relates to the Committee; what matters will need to be addressed in the coming year and issues with which she may wish to involve Scrutiny in the future.

The Head of Transformation provided a presentation on behalf of the Cabinet Member (Social Care Adults).

The Committee received a presentation on behalf of the Cabinet Member (Social Care Adults).  The Head of Transformation highlighted the following areas in particular:

·         That Herefordshire had been judged in 2007 by the Commission for Social Care Inspection (CSCI) to be a one star Authority with uncertain prospects for improvement – one of only 6 local authorities in this position.  As a result, there were a number of areas that had to be addressed:

·         Leadership and Direction in the context of increasing demand

·         Budget Management

·         Modernising Services

·         Strengthening integrated commissioning with the Primary Care Trust

·         Involvement of users and carers

·         Assessment and care management

·         Delivering the Learning Disability Improvement Plan

·         That Herefordshire had one of the most dispersed populations in England, with 0.8 people per hectare, and with a net influx of older people.  It was forecast that there would be a 100% rise in the number of people over 85 by 2026.

·         There was a significant trend of rising demand for services. Numbers of clients in community care were rising, whilst the number of those in residential care was falling.

• Leadership and management achievements for the year included:

·         improved communication through newsletters, Directors conferences and training

·         Increased management capacity

·         Increased investment and better value for money

·         Improved Business planning processes implemented through service and team plans

• The investment in the new IT system, Frameworki, which would provide new information for the Service, and would help to drive the work flow.

• Better control of budgets had meant that the out-turn for 2007-08 had resulted in an underspend of £153k.  The Directorate was determined to maintain this performance in the future.

• The Signposting scheme had been successful, with 40 agencies involved in the initiative.  There had been 3480 referrals which had helped to reduce the amount of duplication between the agencies involved.

• New Services were being developed that had meant that intermediate care service staff could be more effectively utilised by using internet based services when patrolling their areas as a roving night service.

• The changes meant that there was an 18% increase in non-residential intermediate care, and that 111 additional carers were now supported.  There were 138 people with individualised budgets, allowing them to live more independently.  There was a target of 10% of adult service users who would receive these budgets in 2008/09.

• Integrated commissioning had been strengthened, and the Directorate was working with The Care Services Efficiency Delivery Programmeto introduce an integrated commissioning structure across the Adult Social Care and Children’s Services.

The Cabinet Member (Social Care Adults) thanked the Head of Transformation for the presentation.   She reported that the CSCI inspection had taken place on 21 July, and that recommendations from this would be received later in October.

The Cabinet Member outlined a number of challenges before the Service:

• A good start had been made with the Improvement Programme, but that this would need to be sustained.  Evidence would need to be produced that what was being done was beneficial to the community. 

• The rising numbers of over 85 year olds.  This was a situation easier to deal with in an urban context, but harder in rural areas.

• There was a financial challenge, as there was no contingency available, and the base budget would have to be balanced in the current year.

• The operation of the new IT system would be challenging, and there would doubtless be issues to deal with in the first few weeks.

• The Modernisation Agenda had taken off, but the transformation would take some time.  Staff would be more stabilised, but there was a problem of low morale as a result of the recent changes.  The implementation of permanent contracts and posts would make a difference to this situation.

• There were problems with the position of carers, and there was still progress to be made to help individuals in the community. 

She added that the role of Scrutiny was very important, and she congratulated all members of staff in the Directorate for their efforts in improving the service.

The Director of Integrated Commissioning reported that the situation had moved very rapidly over the last 12 months.  The CSCI meeting had shown how much change had been achieved.  There was a good opportunity to build upon this as the team was being put together.  The benefits of the Primary Care Trust (PCT) and Council integration had to be made material in the area of Adult Social Care.  There was an opportunity to address funding issues as well as funding responsibilities.  A fundamental debate was required as to how resources were allocated. 

In reply to a question, the Improvement Manager reported that Performance Indicator D55 (Acceptable waiting time for assessments), had stood at 92%, and that assessments were undertaken within 48 hours.  Services were delivered within 28 days of the assessment.  The Head of Transformation added that the indicator had fallen as it was not possible to record delivery of the service until all the individual parts of the care package had been received.  The indicator could therefore give a false impression of the state of the service.

The Head of Transformation confirmed that Village Wardens were appointed by the Council.  She concurred with the view that local shopkeepers should be utilised wherever possible, and said that the Council did already deliver day care opportunities through pubs and post offices in order to help support villages.

A Member requested that consideration be given to appointing a Member of a Scrutiny Committee to the Integrated Commissioning Board.

The Chairman thanked the Cabinet Member for her presentation.