Agenda item

To receive the Adults Services Quarter 4 & Year End 2022/23 - Key Performance Indicators.

Lisa Evans, Head of Complex Care and Support Service, and Lorna Pearce, Head of Safeguarding, presented the Adults Services Quarter 4 and Year End 2022/23 Key Performance Indicators.

During the discussion of this item, the following points were made:

·       The cost of living crisis, high inflation, and Adult Social Care being historically underfunded created a challenging environment.

·       Some providers had experienced financial viability problems.  This was a national issue.

·       Members were advised that 71% of targets had been achieved over the year.  Over the whole year there were no areas that were significantly below target.

·       There had been some slowing down in Quarter 4.  However, overall performance was strong.

·       Lisa Evans drew the Committee’s attention to the Hatch Farm accommodation project, for which the Council and its partners had won a national award for the Best Social Housing initiative.

·       Members were informed that it was highly likely that Adult Social Care would be subject to a CQC inspection, and this was being planned for.

·       Officers were aware of where the Council did not perform quite so well, and an ambitious transformation plan was in place.  This included a redesign of the Adult Social Care pathway, by September.

·       Members questioned why AS2 Social work assessments allocated to commence within 28 days of the request (counted at point of allocation) was red.  Lisa Evans indicated that this was a locally set target and was quite ambitious.  26% of people were waiting longer than 6 months for an allocation.  Aside from the last quarter the target had been met over the year.  An increased complexity in cases was being seen since Covid, which created increased pressure on waitlists.  It was hoped that improvement would be seen in the next quarter.

·       The Committee was informed that workforce continued to be an issue and that a Workforce Strategy was in place.  Adult Social Care was looking to grow its own and apprenticeships were being offered in Occupational Therapy for the first time. Recruitment campaigns had been reevaluated to understand how to best attract people to the Council into high pressure areas.

·       A Member questioned what type of providers were experiencing issues with financial viability, and how residents would be impacted.  Lorna Pearce indicated that it was often the domiciliary care market.  However, relations with providers had strengthened over the pandemic, and that officers talked to them early when they were experiencing difficulties.  Unexpected provider failure was therefore unlikely.  In the case of failure Adult Social Care would work with the provider to manage the transfer of customers to alternative provision.  Lorna Pearce explained how the Care Quality Governance Framework and the Provider Failure Framework operated.

·       Lisa Evans added that there were some problems in the Learning Disability Market relating to residential care.  The costs had escalated significantly which had placed pressure on the viability of providers.

·       Lorna Pearce commented that nationally there was a shortage in domiciliary care, however, there was reasonable capacity in the Borough.  Some providers may not be receiving the volume of business that they were anticipating.  A Member asked about the rates.

·       In response to a Member question regarding the number of social worker vacancies in the Council, Lisa Evans commented that there were approximately 10-15 vacancies across an Adult Social Care team of 170.  The Council was in a better position in terms of retention and recruitment than some other councils.  However, there was little contingency in the system.  Agency staff had been used where necessary, but effort was being made to minimise this.

·       A Member noted that the aim was to reduce the number of long-term admissions to care homes.  Nevertheless, he had heard that the Borough was 360 beds short in care homes and questioned whether this was likely to change.  Lisa Evans commented that residential nursing placements and dementia placements were under pressure.  The Council was sometimes forced to go outside of the Borough for placements.  There was a desire to keep residents at home where possible and there had been significant investment in the reablement service.  Lorna Pearce commented that care home developers would also be looking at the self funding market.

·       Members queried the 76% increase in safeguarding referrals, and out of scope of referrals.  Lorna Pearce indicated that referrals had increased significantly.  The actual in scope safeguarding referrals were more complex.  Many of the out scope referrals were those from the emergency services.  Some of that received were purely referrals for adult social care assessments.  The volume received meant that it had sometimes been difficult to quickly determine those referrals which required prompt action.  The Council was part of the West of Berkshire Safeguarding Board which had worked with the emergency services to change the way these referrals came in.  Since December all emergency services referrals (South Central Ambulance Service and Thames Valley Police) came through the main front door and were then triaged.  Education sessions were being undertaken with frequent referrers.  A pathway for commissioned services to make care quality referrals or safeguarding referrals, had also been introduced. 

·       Members questioned the timescales for responding to a safeguarding referrals, and were informed that nationally there were no statutory timescales for adult safeguarding.  However, in the West of Berkshire officers aimed to apply a decision within 48 hours.  In Wokingham an additional BRAG (black, red, amber, green) rating had been introduced.  Wokingham had a Safeguarding Hub, a single point of access for safeguarding referrals, and if a referral was received, it was quickly BRAG rated.

·       The Committee thanked officers for their hard work and were of the view that improvements were being made.

·       A Member raised the issue of supported childcare for adult social care workers.  Lisa Evans suggested that an update be sought from HR.

·       Members asked for an update about future care home planning.

RESOLVED:  That the Adults Services Quarter 4 and Year End 2022/23 Key Performance Indicators, be noted.