Agenda item

The Panel was presented with an overview of ‘Your Care and Support Doncaster: Adults, Health and Wellbeing Local Account 2023’.  It was reported that ‘Your Care and Support Doncaster’, had been coproduced by the Making it Real Board (MIRB) and provided strategic oversight to Adults, Health and Wellbeing, influencing and challenging decisions and agreeing priorities for improvements and developments.

Martin Walker from Making It Real Board, spoke about his role as an unpaid carer to an elderly parent and about what was helping them live a good life.  Martin also spoke about the honest and open conversations that had taken place through the development of the local account.

Glyn Butcher from Making It Real Board, spoke about the various roles he undertakes for a number of different people.  Glyn spoke about what he felt about Doncaster and what had been achieved as a Council and through working together.

It was noted that significant progress had been made around Social Work Assessment times.  It was recognised that there was a great deal of bureaucracy and that efforts would be made to reduce that.  It was questioned how people could begin to feel more connected and how existing barriers could be removed. It was noted that there had been a great deal of partnership working and changes made in the culture and the way we talk to each other.

Members were informed that a decision was being taken to Cabinet in March 2023.  It was explained that there was now a focused about people being able to remain in their own home, although it was seen that there was a need for more domiciliary support which could be achieved  within communities.

A discussion took place that included the following areas;

Feedback on Local Account – A Member questioned why the ‘voice’ had not featured more prominently in the report.  It was also felt that context was missing from areas that contained statistical information and may prove challenging for those it was targeted at.

It was explained that this was the first Local Account produced since 2015, and was not just about presenting statistics and plans but about how we felt we was doing against our South Yorkshire comparators.  Regarding statistical information, it was commented that some areas were not easy to understand and further clarification was sought.  Officers welcomed Members comments and noted that they would be considered as part of future Local Accounts.

Payment Policy (to those with Lived Experience) – In terms of how this worked, it was explained that the Council looked to reduce bureaucracy when making payments as part of the Adult Social Care payment policy.  Glyn Butcher explained that his involvement was paid through non-financial contributions to the People Focused Group (PFG), for example, through the provision of craft items and rooms.  Martin Walker supported how it was important for the Council to offer payments and recognise the work of those with lived experience that provided their time.  It was also commented that financial payments could impact benefits received by individuals and that there was uncertainty around how often such payment was applied.  It was noted that it could also be about supporting individuals to be involved and therefore needed a flexible approach.

Occupational Therapy (OT) Assessments – It was felt that Occupational Therapy assessments continued to take too long although it was recognised that significant progress had been made.  Members were informed that waiting list times had reduced by 44% since September 2022, although it was still considered as being too high.  It was noted that there had been a high number of referrals and requests for support being made through other areas.  Members were told that significant investment had been made in additional staff, there had been a recruitment campaign for Assessment Officers to support OTs and apprenticeships in this area were now available.  It was commented that it was also about communicating effectively with those on the waiting list.  Finally, Members were informed that a new model of working had just been launched and that there was confidence that further reductions would be seen in Quarter 4 2023/24 and Quarter 1 2024/25.

Members were informed of positive stories that demonstrated how communities were successfully working with OTs.  The Panel was informed that an update could be provided on what was happening around OTs as part of scrutiny’s future workplan.

Active and Supportive Communities – Concern was raised that Doncaster was ranked last place in the country and locally for this measure and it was asked how this could be improved.  It was felt that there were good examples taking place and Members felt that it was important to continue them across other parts of Doncaster.

It was responded that this was covered as part of the ‘openness and honesty’ element, which featured within the report.  Reference was made to social economic issues experienced within Doncaster and across South Yorkshire.  It was explained that the current model mainly processed people through some narrow considerations instead of looking at prevention and creating a better quality of life. 

Martin Walker spoke about how his parent used a befriender who had made the decision to bring others together who were identified as lonely, and this provided a new network as part of a broader community response.  Martin said he would welcome seeing such measures joined up more through working with the Council.  Glyn told the group about his own experiences and where he had benefited from support, he also spoke about how communities could benefit each other through having an understanding and providing the right help.

It was explained that it was about changing the narrative by looking at how we practice and the way we work to allow people to remain in their own homes and within their communities. 

Involvement with those with Lived Experiences - It was supported that Officers would like to work alongside a greater number of people at a strategic level in addition to what was currently in place.  It was also felt that it was about respecting those willing to be involved and appreciate that the voice element would broaden in time.

It was recognised that accessible information, communication and advice was also an area that needed to be considered.  Reference was made to work undertaken around access to care and support with the Sensory Social Team Workers and looking at how improvements could be made.  It was hoped that more work could be done to connect with the deaf community.  Glyn Butcher informed the Panel about the different groups that were being engaged with and the importance of how the community can continue to take this forward. There was a brief discussion about what else was available in the community

Parish Councils – In terms of Parish Councils, a Member commented how a community hall in their ward had been well utilised and felt that there was value in having a direct link with the Parish Council and Adult Social Care.  The Director of Health and Wellbeing commented on the role of the Joint Consultative Council for Parish Councils (JCCPC) and reference was made to the conversations that have taken place with Parish Councils around localities and how they can build on that going forward.   

Hospital Discharges – A Member welcomed the update that medical discharges would be speeded up although it could be quite complex.   Concern was also raised around language used and the term “medically fit for discharge”, which did not actually mean that the individual no longer required treatment in an acute bed. 

Views were shared around the term “medically fit for discharge” as it was not understood properly and was not encouraged to be used by social care staff.  Clarification was provided on the meaning and that nationally the term had been replaced it with ‘no right to reside’, which was also a term being challenged.  It was noted that there was good partnership working which was being used to push back on language around policy, and influencing and challenging where appropriate.  Glyn Butcher noted that this term was not used within SafeSpace.

Members heard that the MIRB had themselves risen the point that more needed to be heard about the experience of individuals going through a hospital discharge.  The Director of Health and Wellbeing commented that he would take that view back to NHS partners to find out more about peoples experiences.

Members were informed that for out of area issues, partners would come together as part of the Integrated Care Board (ICB), which was making a difference in how we were talking to each other.

Mid-Year Update for Scrutiny – The Panel welcomed a mid-year update and to be involved where Officers felt appropriate to ensure the report was as accessible and included as many resident voices as possible.

RESOLVED that the Panel;

•         Note the “Your Care and Support” priorities for 2023;

•         The Panel receive a mid-year update as part of the Overview and Scrutiny workplan.