|
If these buttons don't work, try |
MINUTES OF THE MEETING BETWEEN
SOCIAL SERVICES NORTH WEST
AND THE LOCAL GOVERNMENT ASSOCIATION
SOCIAL AFFAIRS AND HEALTH EXECUTIVE
BOLTON TOWN HALL - WEDNESDAY, 11 OCTOBER 2000
Present:
Members:
Councillor Morris - Bolton (Chair)
Councillor Strett - Wigan (Vice Chair)
Councillor Stringfellow - LGA Social Affairs and Health Executive
Councillor Case - LGA Social Affairs and Health Executive
Councillor Knight - St Helens
Councillor Maguire - St Helens
Councillor Martinez Williams - St Helens
Councillor Keith - Knowsley
Councillor Beasley - Rochdale
County Councillor Proctor - Cheshire
Councillor Hudson - Salford
Councillor Bury - Blackburn with Darwen
Councillor Reid - Blackburn with Darwen
Councillor Joynes - Oldham
Councillor Dolan - Trafford
Councillor Trotman - Manchester
Councillor Cooley - Manchester
Councillor McInerny - Halton
County Councillor Holtom - Lancashire
Councillor Clare - Bolton
Councillor Howarth - Bolton
Councillor Robinson - Bolton
Councillor Byrne - Bolton
Councillor Rimmer - Sefton
Officers:
A Williams - Salford
A Marsland - Knowsley
M Siegal - Cumbria
R Jones - St Helens
K Foote - Blackburn with Darwen
S Lightup - Bolton
P Pattenden - Sefton
J Ransford - LGA
P J Hewitt - SSNW
P J Viggers - SSNW
Elaine Trotter - SSNW
Apologies:
Members: Councillors from Stockport and Wirral
Officers: H Stephens Stockport, K Miller Wirral
1. Opening of Meeting
The meeting was opened by Councillor Cliff Morris, Chair, Social Services North West. Councillor Morris officially
welcomed Councillor Rita Stringfellow, Chair of the Health and Social Affairs Executive; John Ransford, Head of
Social Affairs, Health and Housing at the Local Government Association, and Councillor Pat Case, another member
of the Executive. The meeting was organised to enable members of Social Services North West to meet representatives
of the Local Government Association and to express views and ask questions relating to the local government agenda
for social services and related matters.
Councillor Stringfellow started by thanking members for being given the opportunity to speak to what obviously
a very vibrant Association. She was at the meeting to listen to members' concerns, and would endeavour to answer
their questions on various matters. A series of Policy Statements was circulated, and each was introduced by representatives
of Social Services North West.
2. Working with the NHS
In introducing this topic, Councillor Morris recognised that the National Health Service was our principal partner
in delivering high-quality care to vulnerable people. There had been enormous changes, more so than in years. Social
Services was now an equal partner with the NHS.
In Bolton working with the NHS is a high priority, partnership was seen to be progress and new ways of working
together. New challenges across the board were expected, and the voice and expertise of local government should
be brought to the table. Reference was made to the financial pressures authorities were facing.
Councillor Rimmer explained to the meeting that he was concerned that Social Services charged for some services
and the NHS Service was free at the point of delivery. With the partnership of the NHS would this issue be affected
when working together.
Councillor Stringfellow responded that there was no one answer. Neither service can do it alone. Focussing on people's
care was the forefront and deciding what works best. It is not yet clear how much money would be available for
intermediate care during the winter. Local Government is driving the agenda and in many places partnerships are
working well. We in local government are skilled at broad-ranging strategy and community leadership. It is important
to track down where money is in the system - models of partnership are the key, the main issues being to make partnerships
work and make sure that all the finances are used appropriately, including the Health resources. This will have
to be worked out locally. Local government can drive the agenda, the time scale is exacting and ambitious, there
are many interesting developments and money will be available. Cllr Stringfellow advised that authorities register
their collaborative schemes under the Health Act on the DoH web site: Mr Hewitt said that by 18 August 2000 one
quarter of registered schemes were from the North West.
Mr Pattenden addressed the issues of the Care Trusts and approaching the DoH to obtain guidance regarding the partnership
and financial issues.
Councillor Strett answered by saying the way forward was to look at the strengths in the NHS Plan and maximise
the opportunity. By everyone co-operating and working together the partnership would strengthen.
Councillor Stringfellow responded that it would be a good idea to set up task groups to look at possible models.
The Health Executive was setting up a Task Group to look at Care Trusts, which can be developed to be what we want
them to be. Task groups could include Councillors who could bring ideas, and this would be an ideal opportunity
for authorities to volunteer information on how to make things better. Also by learning lessons from schemes that
do not work, there would be an opportunity to make sure that future schemes are set up in a way that is right for
that particular authority. We need to shape the agenda for the Care Trusts.
Councillor Case indicated that a close co-operation with Health Authorities was required and within this region
a lot of expertise has already been gained, for instance in NWASSA's working with the Health Authorities on the
resettlement of people with learning disabilities and on mental health issues.
Councillor Dolan asked about the new scrutiny functions of local authorities, to be taken over from CHCs. How would
it work in reality?
Councillor Stringfellow said that the LGA would urge local authorities to have talks with Community Health Councils
- each needs to work out the changeover locally. Talks are needed at national and local level. We do not wish to
lose the expertise of CHCs.
Mr Ransford made the point that Care Trusts mean integrated services locally that you agree to voluntarily. It
would be counterproductive to press for early Government guidance, which could be too prescriptive. The scrutiny
role of local government fits with the community leadership and strategic role of local authorities. This is a
major opportunity to work more flexibly, each authority is different. We are doing it: we know what works and what
does not. There was no single answer: we should work out what feels right locally, and shape it accordingly.
3. Performance Assessment and Quality
Councillor Joynes, in introducing the paper on this topic, said that we are committed to promoting good practice
in the personal social services and look for closer integration and consistency between the performance regimes
of NHS organisations and the personal social services. We also seek to address the continuing inconsistencies between
the services.
Mr Siegal asked how we could be pro-active and influence the performance assessment framework. He highlighted the
differences between the Social Services performance assessment and the Health Service's arrangements. What was
being done to make it more valuable and relevant to us, and to enable real progress to be made? There is a need
to put effort into models of partnership and models for joined up approaches.
Councillor Stringfellow informed members that the LGA and DoH had done a lot of work on indicators, but it was
recognised that more work was needed.
Mr Ransford explained that performance assessments were a means to an end and that they would become more coherent
and consistent. Too much data has tended to be collected, there should be a certain quantity of data and it should
be seen to be relevant to benchmarking and the management of comparative information. He informed members that
performance assessment was essential for 'Best Value' issues. £600M is spent each year on regulation and
there should be a measurable improvement in quality arising from this increased investment.
Councillor McInerney pointed out the considerable understaffing in social services. Voluntary services seem to
be attracting huge resources, a lot of staff for example had gone into voluntary sector for higher pay. Why was
this happening? Expertise was being lost.
Councillor Stringfellow cited an example of good practice in Tyneside and related this to the issue of workforce
planning. Some areas of worst performance were where unit costs were highest, therefore more money doesn't automatically
produce better results. One link is really important: a poor PAF result damages staff morale: this has a knock-on
effect on recruitment. There have been some good announcements from Government about workforce training.
Councillor Strett pointed out the problem of career grades for social workers and the tendency for the better ones
either to go into management or move out of social work even though this is what they are best at.
Councillor Reid raised the issue of the quality of inspections and inspectors and contrasted the compartmentalism
of the DH with the broader modernisation role of local government.
Councillor Stringfellow agreed this can be a concern and said that minority ethnic communities were often overlooked
in inspection reports. Chief Inspector Denise Platt was very good at understanding local government and governance
issues but this undeerstanding is not widespread in DH.
Mr Ransford said that the LGA can advise on "regulating the regulators". Their work is essential but
there is room for improvement. There are concerns about how good at joined-up work Government departments are,
but he believed the appointment of Nigel Crisp as head of both NHS and DH was good news, as he has a community
work background and understands the wider agenda.
Mr Jones made the point that Joint Reviews don't inspect to standards and PAF is a real issue for LGA/ADSS. There
are real anomalies re for instance Child Protection registers, and we need to keep the performance indicators developing
and make them relevant and accessible.
Councillor Keith referred again to staffing issues, particularly the shortage of occupational therapists and the
difficulties in delivering an effective service to disabled people. Councillor Stringfellow referred to how, in
North Tyneside, they had transformed the service, working jointly with Health.
4. Quality Protects and Children's Services:
In introducing this paper, Councillor Holtom said that for the past two years, since the launch of Quality Protects,
local authorities have been recognised as corporate parents. He referred to issues around Children's Rights Commissioner,
sharing information, external placements, secure accommodation and fostering, as well as the recruitment and training
of staff.
Councillor Stringfellow said that the LGA shared SSNW's view on the Children's Rights Commissioner. Workforce issues
are paricularly to the fore in children's services, and joint working and commissioning between authorities can
be a way forward.
Mr Ransford said that authorities should feel free to use the LGA's expertise and knowledge.
Councillor Proctor raised the question of National Standards and the definition of "fit to look after"
in relation to child minders.
Mr Ransford said LGA is not happy that registration and inspection will be going to OFSTED. If there are any problems
these will be followed up; standards can be very variable and it is important to keep the evidence coming in.
Councillor Knight said that there was a problem of finding and keeping foster carers; also, not every child benefits
from foster care; some need specialist residential care.
Councillor Stringfellow said this was not dissimilar to the adoption situation and referred to a recent report
which found that only 13% of adopters were former foster carers. More creative thinking was needed around this
issue. There are also post adoption support and allowance issues to consider. The Government has made it clear
that adoption should remain with local authorities. The Adoption Task Force will give more help and support, and
Minister John Huton had promised new money for new duties in this area.
Mrs Williams said that there were huge resource issues with an increase in the number of children in care as more
who come in stay in longer. Independent research has shown that this is not because the threshold is too low. There
is a sellers' market for external residential care because in-house resources are insufficient.
4. Financial Issues
Councillor Strett, in opening this topic, acknowledged the need to use the resources available for the personal
social services economically, efficiently and effectively. We are being very effective but we are under great pressure.
Jointly between the ADSS Branch and Social Services North West, we have undertaken a survey of the financial situation
in all 21 North West authorities and the situation is quite serious; the staffing issue also needs to be addressed.
Concern was also expressed about child care and the provision of foster care - there needs to be effective collaboration
between authorities. Social Services North West is looking for recognition of the financial pressures; funding
to the NHS must be matched and identified to avoid major problems with, for instance, delayed discharges. There
are concerns about the specific grant regimes, eg for Quality Protects, and about the Standard Spending Assessments
and Area Cost Adjustments.
Councillor Stringfellow said that Quality Protects was an important issue and, regarding care in the community,
people who are coming into care are living longer. There needs to be longer term funding than the initial three
year programme. Need is increasing, there is a problem which is having a knock-on effect. Regarding the future
of the SSA, the LGA regularly has robust talks with the Government and officials, and like to think that lobbying
has helped. Some of the LGA's concerns have bben addressed in the second Comprehensive Spending Review. The management
of specific grants can be helped by ring fencing, but this can also bring problems. This is a very interesting
time where we can focus on the issue of social care, but must realise that it is being integrated into the corporate
agenda.
Mr Ransford said there should be an increase in specific grants. The technical detail is enormous and this is addressed
by Richard Paver, Treasurer of Manchester on behalf of the LGA. Allocations are subject to area cost adjustment,
taking into account demography. The LGA cannot get involved too much in the detail, as there were inevitably going
to be winners and losers. At the present time more resources were being allocated to schools, for example the 10%
share of SSA for central educational services has now been reduced to 8%. The central thrust on school spnding
dominates all local authority finance.
Mr Walker said that spending in most authorities is above the SSA allocation and that 13 authorities were overspent
regarding children's agency placements. This is the most significant period of financial pressure that we have
ever experienced.
Councillor Rimmer said there was a great deal of confusion and was concerned about the financial input in running
our services. There was a lot of pressure and was there a way of the LGA putting the message across that we need
more money for the basic running of the service.
Mr Ransford said that the LGA does have people who understand SSA allocations. With the partnership of Social Services
and Health, it was anticipated that Health could bring money in to help address problems which we help them to
identify. But there would be no extra money unless there are clear signs of performance management.
Cllr Stringfellow said that it will be much more straight forward when we have Primary Care Trusts - the formula
should be clear, there should be some good news by next Friday.
Cllr McInerny again expressed great concern about the loss of social workers to the private/voluntary sector due
to better pay prospects and what could be done financially to keep them on board. The financial problems in his
authority were very severe.
Councillor Stringfellow - said that some new unitary authorities had experienced problems, but things would improve.
The pressure on schools for good results had also resulted in funds being transferred to Education. Morale of staff
has been affected but she said that matters would improve and we would come through this.
There is a lot more money in the public sector now: for instance Surestart pulls children out of the poverty trap;
though it is not made available via social services it still makes a big impact on children's well being. You cannot
separate social services funding from other agendas such as social inclusion, New Deal, training and employment,
which also have a positive impact on the quality of life of disadvantaged people. The LGA will do all it can to
represents our interests to Government, but there is plenty to be positive about.
Councillor Morris said there was a fundamental issue about retention of staff - could Social Services introduce
incentives to help them to improve their practice and obtain better posts. Then, he said, people would remain within
Social Services and not transfer to the voluntary sectors.
Councillor Reid said that regarding Joint Reviews, there had been a variation of Inspectors and standards varied.
She said that Inspectors do not always see the 'big picture' within which local authorities operate.
Councillor Stringfellow said that 600M was spent each year on inspection and regulation. As well as the SSI and
Audit Commission, there are now Housing Inspectors and Best Value Inspectors. There are points to be picked up.
Mr Ransford indicated that there has been an explosion in Regulations and the SSI and Joint Review Inspections
should be brought to a standard and regulations should be brought in and work to the standards.
Councillor Martinez-Williams asked whether it would be possible to set better performance indicators, and what
was the LGA position in this?
Councillor Stringfellow said that during the last year progress had been made and the outcome of inspections were
more positive. She also reiterated her belief that the position generally was a lot more positive compared to previous
years and that the LGA would do all it could to represent our interests and concerns.
Councillor Morris supported Cllr Stringfellow's positive comments. He thanked the LGA representatives for travelling
to be with us today, and all those present for their contributions. He then formally closed the meeting.
|
Clicking on these links will help you to use SSNWeb, |