Professor Steven Broomhead Interim Chief Executive

Town Hall

Sankey Street Warrington WA1 1UH

Co-opted Members: Statutory Co opted Members Roman Catholic Representative: Mr D Littlewood Church of England Representative: Mr S Harrison Parent Governor Representative: Mr M Delooze Parent Governor Representative: Vacancy 9 September 2013

Scrutiny Committee

Tuesday, 17 September 2013 at 6.30pm Council Chamber, Town Hall, Sankey Street, Warrington, WA1 1UH Agenda prepared by Julian Joinson, Principal Democratic Services Officer – Telephone: (01925) 442112 Fax: (01925) 656278 E-mail: jjoinson@warrington.gov.uk

A G E N D A Part 1 Items during the consideration of which the meeting is expected to be open to members of the public (including the press) subject to any statutory right of exclusion. Item Page

Number 1.

Apologies for Absence To record any apologies received.

To: Members of the Scrutiny Committee

Councillors: Cllr T Higgins - Chair Cllr B Lines-Rowlands - Deputy Chair Cllrs C Fitzsimmons, G Friend, J Guthrie, L Hoyle, W Johnson, I Marks, H Mundry

Item

Page Number

2. Code of Conduct - Declarations of Interest Relevant Authorities (Disclosable Pecuniary Interests) Regulations 2012 Members are reminded of their responsibility to declare any disclosable pecuniary or non-pecuniary interest which they have in any item of business on the agenda no later than when the item is reached.

3. Minutes (attached) To confirm the minutes of the meeting held on 18 June 2013 as a correct record.

Pages 1 – 12

4. Statutory Adult Social Care Complaints (attached) To consider a report from Stephen Reddy, Interim Executive Director, Neighbourhood and Community Services, giving an overview of Warrington Borough Council’s adult social care complaints and representations process for 2012/13.

Pages 13 – 26

5. Statutory Children’s Social Work Complaints (attached) To consider a report from Ann McCormack, Assistant Director, Partnerships and Resources, Children and Young People’s Services, giving an overview of Warrington Borough Council’s children and young people’s social work complaints, compliments and representations process for 2012/13.

Pages 27 – 52

6. Healthwatch Warrington Update (attached) To consider a presentation on behalf of the Board of Healthwatch Warrington, following the establishment of Local Healthwatch from 1 April 2013 and an update report from Elaine Packer, Healthwatch Manager, on developments to date.

Pages 53 – 70

7. Work Programme 2013/14 and Monitoring of Actions/Recommendations 2012/13 – 2013/14 (attached) To consider a report of the Cllr Higgins, Chair of the Scrutiny Committee, as to progress on the Work Programme for 2013/14.

Pages 71 - 88

8. Date of Next Meeting

To note to the date of the next meeting of 10 December 2013.

Part 2 Items of a "confidential or other special nature" during which it is likely that the meeting will not be open to the public and press as there would be a disclosure of exempt information as defined in Section 100I of the Local Government Act 1972.

NIL

If you would like this information provided in another language or format, including large print, Braille, audio or British Sign Language, please call 01925 443322 or ask at the reception desk in Contact Warrington, Horsemarket Street,

Warrington.

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Agenda Item 3

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SCRUTINY COMMITTEE MEETING 24 JUNE 2013

Present: Councillor T Higgins – In the Chair Councillors C Fitzsimmons, G Friend, J Guthrie, L Hoyle, W Johnson, B Lines-Rowlands, I Marks and H Mundry. Co-optees: Mr D Littlewood Apologies Apologies were received from Mr M Delooze (Parent Governor Representative). SC14 Code of Conduct – Declarations of Interest Cllr Guthrie declared an interest in Agenda Item 8, on the basis of her position as Chair of Local Healthwatch SC15 Minutes Decision

That the minutes of the meeting held on 20 March 2013 be confirmed as a correct record.

SC16 Minutes of Various Overview and Scrutiny Committees The minutes of the former Overview and Scrutiny Committees (OSCs) were provided for information and legacy purposes. Decision

(1) That the minutes of the following Overview and Scrutiny Committees be received:-

Health and Wellbeing OSC – 18 September 2012

Children Young People and Skills OSC – 19 September 2012

Health and Wellbeing OSC – 10 October 2012

Children Young People and Skills OSC – 7 November 2012

Neighbourhood and Communities OSC – 13 November 2012

Economy and Resources OSC – 21 November 2012

Environment and Housing OSC – 4 December 2012; and (2) That the above minutes also be submitted, for information, to their most

appropriate successor Committee. SC17 Performance Report – Quarter 4 2012/13

Agenda Item 3

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The Committee considered a monitoring report from Councillor Terry O’Neill, Leader of the Council, and Professor Steven Broomhead, Interim Chief Executive, on the Council’s performance for Quarter 4 of 2012-13 (January to March 2013). The Committee was infomred that the final report for 2012-13 showed that there had been excellent progress in delivering the Council’s pledges to Warrington’s Residents, despite the council’s financial contraints and the current economic climate. The progress had been achieved by providing strong community leadership across the borough and working with partners, including other agencies and the private and vountary sector. Local residents had also been involved through consutations, volunteering and through participating in community events. Council services had focussed their efforts and resources towards delivering the Council’s three pledges. This had brought about positive outcomes as measured by the targets set and by the developments and outcomes that the Council had delivered. Although the Counicl and its partners had not met all of the targets set, there were clear indications that these would be met in 2013-14 as a result of the remedial actions taken in 2012-13. Decision

(1) To note the content of the report on the Quarter 4 performance and risk position up to end of March 2013;

(2) To endorse the decision of the Executive Board, at its meeting on 17

June 2013, which noted the performance and risk position and that the relevant Executive Board Members would liaise with their Executive Directors to discuss specific performance and risk items; and

(3) To acknowledge that the Committee has had an opportunity to ask

questions and to make comments or recommendations, as appropriate, to the Executive Board.

SC18 Revenue Budget Monitoring 2012/13 – Quarter 4 (Draft Outturn) The Committee considered a report from Councillor R Bowden, Executive Board Member, Corporate Resources and Assignments, and Lynton Green, Chief Finance Officer, on the forecast financial outturn for 2012/13 and on the delivery of the 2012/13 MTFP savings targets. The Committee was informed that, over the past three years, the Council had overcome major pressures in providing sustainable services for less against the backdrop of austerity measures and a decline in the economy. The Council had in place well embedded, robust budget monitoring arrangements and had adopted a thorough process to mitigate risks of overspending. The Council’s financial management arrangements acted as an early warning, which allowed a considered approach to address any anticipated pressures and underachievement of savings.

Agenda Item 3

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The 2012/13 MTFP savings target was £14.094m. This target arose from the Government’s four year comprehensive spending review (CSR) in 2010. The first year of the CSR last year saw the Council achieve just under £23m savings. The total target savings of £14.094m in 2012/13 had been achieved, with £9m achieved via the original means. Where the original savings proposals had not been realised, alternative Directorate savings initiatives had been found to meet the target. The 2012/13 financial forecast at the end of the year was an underspend of £16k representing 0.01% of the Council budget. During the year it had been anticipated that the Council would receive approval to capitalise early release costs (i.e. redundancies and pensions) paid in 2012/13. The Department for Communities and Local Government (DCLG) had given approval to capitalise these costs in previous years and the Council had not received any indication that this would not be the case in 2012/13. However, in May 2013 the Council had been informed that due to the Government’s economic pressures a capitalisation directive would not be allowed for 2012/13. The value of the early release costs for 2012/13 was £1.9m. This had resulted in a significant unforeseen pressure on the Council’s revenue account. Had the capitalisation directive been approved as expected, the outturn position for the Council would have resulted in an underspend of £1.9m. Members were informed that the final Statement of Accounts would be considered by the Audit and Corporate Governance Committee later in the year. Members debated the Government’s reasons for not capitalising early release costs and enquired if many other authorities had been affected. A small number of authorities had been similarly affected. Authorities with large reserves (which was not the case in Warrington) were not normally allowed to capitalise these costs. The Local Government Association had been unable to intercede on this occasion. However, an assurance had been received from DCLG that capitalisation bids would be accepted for 2013/14. The report highlighted that, over the past three years, the Council had made around £50m of savings. These had been achieved through service redesign, lean reviews, cutting non essential budgets and realigning the workforce to priorities. However, these ‘traditional’ approaches to mitigating cuts were no longer viable and, to mitigate future cuts, the Council needed to refresh its process for the achievement of savings. Members asked whether any ideas had yet been developed. Officers responded that discussions were on-going in Senior Management Team meetings. Decision

(1) To note the content of the report and the forecast underspend of £0.016m for the year;

(2) To note the achievement of the 2012/13 MTFP savings targets;

Agenda Item 3

4

(3) To endorse the decision of the Executive Board, at its meeting on 17 June 2013, which noted the draft outturn position of £0.016m underspend for 2012/13, noted the delivery of the 2012/13 MTFP savings targets and approved the transfer of the £0.06m to the MTFP reserve in anticipation of no further changes following the External Audit sign off of the Statement of Accounts; and

(4) To request that the Chief Finance Officer include a footnote in the

Statement of Accounts to explain the implications of the Department of Communities and Local Government not allowing the capitalisation of certain expenditure on redundancies and pensions.

SC19 Capital Programme 2012/13 Draft Outturn The Committee considered a report from Councillor R Bowden, Executive Board Member, Corporate Resources and Assignments, and Lynton Green, Chief Finance Officer, on the draft outturn position for the Council’s Capital Programme. The Committee was informed that the Executive Board had approved a projected Q3 capital programme budget of £79.092m at their meeting of 11 March 2013. Subsequently, the budget had been revised to take account of three changes, comprising:-

acceleration of expenditure on schemes of £484k;

new schemes added to the programme of £250k (Children’s Residences Maintenance Works, fully funded by grant); and

reprofiling into future years of £2.798m. The revised Q3 budget was therefore £77.028m. The actual level of capital expenditure for 2012/13 was £38.224 which equated to 50% of the revised budget. The major variances could largely be explained by slippage on three corporate/invest to save major schemes, as follows:-

the Council had not received a capitalisation directive to capitalise redundancy costs in 2012/13 (Minute SC18 refers), therefore the budget allocation of £5.780m had not been utilised in 2012/13;

the 2012/13 Capital Programme had budgeted for the investment with Muir Housing Group in the latter half of Quarter 4 of 2012/13, however this deal had not been concluded until Quarter 1 of 2013/14.

the additional investment through Lloyds banking group for First Time Buyer Mortgages, comprising the physical investment of a further £2m, had not taken place until Quarter 1 of 2013/14.

If these three budgets had been fully utilised in 2012/13, the percentage of capital spend would have been over 80%. Members were informed that the Council tried to be innovative regarding capital expenditure. Often the Capital Programme included very large schemes, which had the potential to slip. One consequence was that a significant underspend might be caused by slippage of a single capital project. It might be possible to explain this effect more clearly in future reports.

Agenda Item 3

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Councillor Hoyle enquired about whether there were any capital works planned in respect of youth, community, leisure or sports facilities in Croft. Mr Green undertook to submit a written reply. Decision

(1) To note the content of the report and the forecast capital position for the year; and

(2) To endorse the decision of the Executive Board, at its meeting on 17

June 2013, which noted the summary report and approved the changes to the 2012/13 capital programme contained within Annex 2 of Appendix 1 to this Committee’s report.

SC20 The Francis Inquiry into Mid Staffordshire NHS Foundation Trust –

Messages and Implications The Committee considered a report of Katherine Fairclough, Assistant Chief Executive, giving an overview of the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry and outlining the implications for Warrington. The Committee was informed that, on 6 February 2013, Robert Francis QC had published his long awaited report, examining the role of the culture and systems in the NHS and how they had failed to identify the appalling events at Stafford Hospital between January 2005 and March 2009. In total there were 290 recommendations covering the whole scope of the system from the Department of Health down to patient contact with primary care services. The key theme of the report was putting the patient first, with an NHS that should be centred on common values in order to drive up quality of care. The report identified that there was a culture of disrespect and appalling treatment to vulnerable people and that some people had died as a result of this culture. The report determined that the failings at Mid Staffordshire NHS Foundation Trust had primarily been caused by a serious failure on the part of the provider Trust Board. It had not listened sufficiently to its patients and staff or ensured the correction of deficiencies brought to the Trust’s attention. Above all, it had failed to tackle an insidious negative culture involving a tolerance of poor standards and a disengagement from managerial and leadership responsibilities. The failure had in part been as a consequence of allowing a focus on reaching national access targets, achieving financial balance and seeking foundation trust status, at the cost of delivering acceptable standards of care. The report also concluded that the NHS system included many checks and balances and organisations which should have prevented serious systemic failure of this sort, but that this had not occurred. In addition, there was a failure by the Trust and other organisations to engage with patients and the public.

Agenda Item 3

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The report concluded that the extent of the failure of the system suggested that a fundamental culture change was needed. This did not require a root and branch reorganisation, but it required changes which could largely be implemented within the system that had now been created by the new reforms. The Committee considered the overall findings of the Francis report in relation to Health Overview and Scrutiny and the six specific recommendations for action which link to Overview and Scrutiny. Information was also provided about the lessons which should be learned by other relevant bodies, including commissioners of services, Health and Wellbeing Boards, Local Healthwatch, Care Quality Commission (CQC). The Committee heard about the response to the Inquiry report by the Centre for Public Scrutiny (CfPS). Members also received information about the Government’s response to the Francis report, based upon the following 5 key themes:-

preventing problems;

detecting problems quickly;

taking action promptly;

ensuring robust accountability; and

ensuring staff were trained and motivated. The Government had reiterated scrutiny’s role in reviewing annual NHS Quality Accounts although, Members were asked to consider developing further mechanisms for reviewing the quality of care on a more regular basis. A key challenge for the Committee would be to know when to act as a ‘critical friend’ and when to act as a whistleblower. The former was important for building trust and transparency of dialogue with NHS partners, the latter was important for driving up quality and safeguarding the public. The correct balance might be difficult, but not impossible, to achieve. Health Scrutiny in Warrington had historically been a robust function of the Council. Much work had been carried out to build working relationships with partners and providers in a way that encouraged open respectful dialogue and when necessary allowed for detailed scrutiny and challenge. In a health landscape that had changed substantially this had been difficult to achieve and yet many of the recommendations made in the Francis report were being carried out to a greater or lesser degree by Warrington’s Health and Wellbeing OSC. Members were invited to consider how the new Scrutiny Committee and Policy Committee structure could be utilised to maximum effect in the scrutiny of quality health and care services. It was envisaged that this Committee would have the primary responsibility for scrutinising the delivery of quality care, which could be achieved through the following actions:-

strengthening links with CQC and the improving the exchange of information;

identifying additional sources of realistic information about quality, such as complaints, press articles and councillors having an ‘ear to the ground’;

Agenda Item 3

7

strengthening links with Local Healthwatch; and the Health and Wellbeing Board to ensure that roles were understood and scarce resources were used effectively;

improving access by members and officers to guidance information, support networks and development opportunities;

developing local protocols to allow scrutiny members to visit NHS providers and to follow up issues of concern;

being proactive in responding to Quality Accounts;

maintaining an open dialogue with health care providers, but having the confidence to challenge providers when appropriate.

Members discussed the need to maintain the levels of health scrutiny experience and good relationships with partners developed by the previous Committee. There was also a need to ensure that workloads were balanced. Members discussed the competing pressure to provide scrutiny of the wider social care sector and the level of expertise required. Engagement by the Committee with Local Healthwatch was seen as critical to receiving good intelligence about healthcare services. Councillor Guthrie explained that Local Healthwatch was the new consumer champion for local health and social care service users and had a role to listen to their concerns and complaints. It also had powers to visit a wide range of providers and would work more closely than its predecessor (LINk) with CQC, Warrington Clinical Commissioning Group and the Health and Wellbeing Board. Decision

(1) To note the report on the outcome of the Francis Inquiry; (2) To approve the Action Plan at Appendix 1; (3) To request that the Protecting the Most Vulnerable Policy Committee

uses its health related powers proactively, to help commissioners to develop policies and practices which promote and embed quality; and

(4) To request that representatives of Local Healthwatch be invited to the

next meeting of the Committee to provide a presentation as to progress on the development of the organisation.

SC21 Health Scrutiny in Warrington – Legacy Report The Committee considered a report of Katherine Fairclough, Assistant Chief Executive, on the outcome of the project undertaken by Warrington Borough Council with the Centre for Public Scrutiny as a Health Scrutiny Development Area. In 2012 Warrington had been successful in securing support under the Health and Social Care Programme funded by the Department of Health to be recognised as a Health Scrutiny Development Area (HSDA). The project in Warrington had centred around understanding how health scrutiny might evolve under the Council’s revised Scrutiny Committee and Policy Committee structure, particularly in the context of the

Agenda Item 3

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numerous structural and procedural changes to the health system brought about by the Health and Social Care Act 2012. The Act had introduced substantive changes to how the commissioning and accountability of local health services would be carried out in future, with changes ranging from national to local level including:-

the role of the Secretary of State;

the creation of NHS England through to the abolition of SHAs and PCTs

the creation of GP led Clinical Commissioning Groups;

the establishment of Public Health England;

the transfer of public health from the NHS to local authorities;

the creation of Healthwatch England and Local Healthwatch organisations to replace LINks;

changes to the Care Quality Commission and Monitor;

changes to foundation trusts; and

the establishment of local Health and Wellbeing Boards as committees of upper tier and unitary councils.

The HSDA project in Warrington had been led by the Health and Wellbeing Overview and Scrutiny Committee and the work had been undertaken between May 2012 and March 2013 supported and delivered by an Expert Adviser from the Centre for Public Scrutiny (CfPS), Rachel Harris. A Health Scrutiny in Warrington – Legacy Report had been produced following completion of the project. The CfPS had subsequently published a summary of its findings across the whole project, which involved 14 councils. The document: Spanning the System - Broader Horizons for Council Scrutiny could be found on the CfPS website. The Legacy Report highlighted the project journey, themes and findings from two workshop events and presented the following conclusions:- “

when considering systems for effective health scrutiny, the culture of the organisation is more important that the formal structures established;

Warrington has already developed strong relationships with health partners, but it may be worth exploring if there are any gaps;

health scrutiny can be the ‘glue’ to maintaining productive relationships with health partners in a time of significant structural change for the health sector;

the need to ensure that, when adapting to the new health landscape, health scrutiny does not lose sight of its key statutory roles (e.g. substantial variations/developments and Quality Accounts);

the need to maintain scrutiny’s independence to ensure accountability and transparency;

an acknowledgment that health scrutiny requires skilled Members and that these skills must not to be lost during transition to any new committee structure;

that collaboration on the Joint Strategic Needs Assessment (JSNA) and the Health and Wellbeing Strategy (HWBS) are central to achieving successful

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outcomes and that health scrutiny will need to develop its relationship with the HWB.”

The report then provided seven key recommendations for action based upon the above-mentioned findings, as follows:- “

to preserve current knowledge and assist with quantifying future scrutiny

activity, the new committee should expand on the work they have started by

bringing forward a wider stakeholder mapping exercise;

consider drawing up a mechanism for setting out the visions and priorities for

Warrington that partners recognise and prioritising the new work programme

against it;

visit and review the basic committee process such as preferred agenda layout,

minutes etc. to ensure that the committees work is transparent to both the

public and partners;

look to update or begin the process of putting in place the necessary protocols

with partners around the definition of substantive variations and clear

mandates for joint scrutiny arrangements;

establish or review with partners appropriate and clear dispute resolution

processes that all can sign up to;

review and consider how to ensure that all members understand the health

reforms and the developing role of scrutiny within the Council’s current training

framework for members; and

to further consider the next steps in building the committee’s working

relationship with the HWBB and the CCG.”

An Action Plan had been developed to tackle the issues identified in the report’s recommendations and it was proposed that progress against the Action Plan be monitored from time to time by the Committee. The Committee considered related information which sought to clarify the separation of health scrutiny responsibilities between this Committee and the Protecting the Most Vulnerable Policy Committee. A summary was also provided regarding the main changes to health scrutiny legislation brought about by the Act. Decision

(1) To note the report on completion of the Health Scrutiny Development Area project;

(2) To receive the CfPS HSDA final report Health Scrutiny in Warrington –

Legacy Report, at Appendix 1, and to note its recommendations; (3) To approve the Action Plan at Appendix 2 and to monitor progress from

time to time;

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(4) To note the summary of the division of health overview and scrutiny responsibilities between the Protecting the Most Vulnerable Policy Committee and the Scrutiny Committee, at Appendix 3; and

(5) To note the legislative changes to health scrutiny implemented with

effect from 1 April 2013, under the Health and Social Care Act 2012. SC22 Work Programme 2013/14 The Committee considered a report of its Chair, Cllr Higgins, as to progress on the Work Programme for 2013/14. Members were informed that some additional work was required to finalise scheduling for a number of topics. The report also included information on the progress of any actions proposed or recommendations made by the Committee. Decision

(1) To approve the Work Programme for 2013/14 at Appendix 1, subject to the inclusion of the following additional topics:-

Regular overview of the Work Programmes of the Policy Committees; and

Local Healthwatch to be invited to undertake a presentation at the meeting of the Committee scheduled for 17 September 2013 (Minute SC20(4) refers); and

(2) To note the progress on actions and recommendations at Appendix 2.

SC23 Date of Next Meeting To note that the next meeting of the Committee will be held on 17 September 2013.

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13

Agenda Item 4

WARRINGTON BOROUGH COUNCIL NEIGHBOURHOOD & COMMUNITY SERVICES

Adult Social Services

Make Your Experience Count

Concern, Comment, Compliment and Complaints

Annual Report 1 April 2012 – 31 March 2013

Susan Carr

Quality Monitoring Officer

Agenda Item 4

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WARRINGTON BOROUGH COUNCIL SCRUTINY COMMITTEE - 17 September 2013 Report of: Stephen Reddy - Interim Executive Director, Neighbourhood

and Communities Directorate Report Author: Susan Carr - Quality Monitoring Officer

Contact Details: Email Address:

carrs@warrington.gov.uk

Telephone: 01925 444240

Ward Members:

All

TITLE OF REPORT: SOCIAL CARE COMPLAINTS 1. PURPOSE

This report represents an overview of Warrington Borough Council’s Social Care complaints and representations process for 2012/13. It reviews the effectiveness of the complaints procedure and highlights areas for future development of the service. It fulfils the Council’s statutory duty to produce an annual complaints report. The report also takes account of and raises awareness of the many positive compliments which are received and which the service values.

2. CONFIDENTIAL OR EXEMPT

N/A

3. INTRODUCTION AND BACKGROUND

3.1 The Local Authorities Social Services Complaint (England) Regulations April

2009 “Making Experiences Count” require each local authority to appoint a Complaints Manager to ensure the provision of a robust social care complaints and representations procedure to eligible service users.

3.2 This report provides statistics on the number of statutory cases recorded and

actioned; the performance against timescales for handling complaints; complaint trends and outcomes; and learning and improvements resulting from complaints. Service users who receive a service from providers commissioned by the Department are entitled to access the Statutory Complaint Procedure and a summary of these cases is included in this report.

3.3 In 2006, the Government made a commitment to help NHS and Adult Social

Care Organisations improve the way they deal with complaints, in order to make services more effective, personal and safe. To achieve this, it was decided that a single approach would be introduced for dealing with complaints, to give organisations greater flexibility to respond and encourage

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a culture that seeks and then uses people’s experiences of care to improve quality.

3.4 The statutory complaints procedures state we “investigate the complaint in a

manner appropriate to resolve it speedily and efficiently and during the investigation, keep the complainant informed, as far as reasonably practicable, as to the progress of the investigation”.

3.5 Each complaint must be acknowledged by the Complaints Manager not later

than 3 working days after the day on which it is received. Complaints are then sent through electronically to the relevant Assistant Director. The Complaints Manager or the Investigating Officer must offer to discuss the complaint with the complainant, at a time to be agreed. If the complainant is agreeable, it may be discussed on the phone. The discussion must include the manner in which the complaint is to be handled and “the response period” within which the investigation is likely to be completed and when the response will be sent. This then forms the basis of the “Complaint Plan”. If at any time this response period cannot be later met, then the Investigating Officer or the Complaints Manager must agree an extension with the complainant.

3.6 Many clients receive care from more than one health and social care

organisation. If something goes wrong with that care and a complaint is made, it is important that the organisations involved provide a single point of contact and that the client receives a single response. Dealing with a wide range of health and social care organisations can be confusing for people. By bringing together the various organisations with one system, we provide a unified, responsive and effective service for complainants.

3.7 Along with the new regulations “Statutory Instrument 2009 No 309” The Local Authority Social Services and National Health Service Complaints (England) Regulations, the Department of Health have issued “A guide to better customer care” including Listening, Responding and Improving. This guide has been developed to help complaints professionals who are working with colleagues to make their organisations better at listening, responding and learning from peoples experiences when accessing services.

4. STATISTICAL ANALYSIS 4.1 In 2012/2013 a total of 7643 adults received a service from Adult Social Care.

Of that 2334 were aged 18-64 and 5309 were aged 65 and over. Whereas in 2011/2012 a total of 7642 adults received a service, of these 2433 were aged 18-64 and 5209 were aged 65 and over.

4.2 There were 198 registered compliments in 2012/13 compared with 221 in

2011/12. Compliments received provide evidence of the quality of services, high standards and performance delivered by members of staff throughout adult social care. Where a compliment refers to a specific worker or service this is shared with them. All compliments are included in the monthly Adult Social Care Staff Newsletter ‘Inform’ which supports the sharing of good practise. Appendix 1 summarises a sample of the compliments received.

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4.3 Older People and Occupational Therapy Services (OP/OT) received 40 compliments, Mental Health and Learning Disability Services (MH/LD) received 9 compliments, Social Care Provision (SCP) received 23 compliments, Intermediate Care Services (IC) received 123 compliments, Continuing Care (CC) received 1 compliment, Contracts and Procurement (C&P) received 1 compliment and Safeguarding and Quality Assurance (S&QA) received 1 compliment.

198 COMPLIMENTS RECEIVED FOR ADULT SOCIAL CARE 2012/13

0

20

40

60

80

100

120

140

OP/OT MH/LD SCP IC CC C&P S&QA

4.4 Adult Social Services received a total of 59 complaints compared with 64 complaints in 2011/12.

4.5 Older People and Occupational Therapy Services (OP/OT) received 14

complaints, Mental Health and Learning Disability Services (MH/LD) received 22 complaints, Social Care Provision (SCP) received 4 complaints, Intermediate Care Services (IC) received 13 complaints, Contracts and Procurement (C&P) received 5 complaints and Safeguarding and Quality Assurance (S&QA) received 1 complaint.

59 COMPLAINTS RECEIVED FOR ADULT SOCIAL CARE 2012/13

0

5

10

15

20

25

OP/OT MH/LD SCP IC C&P S&QA

4.6 100% of complaints were responded to within the agreed timescales which exceeded our target of 95%.

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4.7 The top four categories for complaint were:

Delivery of Service – 15 Financial issues – 11 Staff behaviour/attitude - 10 Dissatisfied with Decision - 10

The remaining categories for complaint were: Misc – 4 Assessment – 2 Care Package – 1 Care Plan – 1 Communication – 1 Confidentiality – 1 Direct Payments – 1 Equipment – 1 Family Dissatisfaction – 1

4.8 The outcomes of the complaints were:

Not Upheld – 14 Partly Upheld – 7 Upheld –23 Withdrawn – 4 Information only – 4 (this is when the complainant is given

information that actually resolves the complaint.

4.9 5 Complaints were joint complaints; 4 with Warrington and Halton Hospital NHS Foundation Trust (2 were subsequently withdrawn) and 1 with the 5 Borough’s Partnership NHS Foundation Trust. The complaints procedure embraces joint complaints and encourages partnerships between agencies. In 2010 the 5 Complaint Managers from Health and Social Care in Warrington signed up to a joint protocol for Warrington. The joint protocol was reviewed in 2012. This means the complainant only has to complain to one agency, has one lead person and gets one response, incorporating both health and social care issues.

4.10 If a complainant is unhappy with the response from the Council they have the

right to refer their complaint to the Local Government Ombudsman (LGO). In 2012/13 5 complaints were referred to the LGO. The LGO decided not to investigate two of the complaints and discontinued their investigations on the remaining 3 complaints.

4.11 27 complaints were recorded about services provided by Private & Voluntary

Agencies on behalf of the authority compared to 18 in 2011/12, 14 in 2010/11, 30 in 2009/10 and 24 in 2008/09. 100% of these were completed within agreed timescales. Our Care Quality Team regularly monitors services and work with providers to improve quality of care.

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5. EQUALITY OF ACCESS

5.1 Details relating to a client’s ethnicity, disability, age and gender are recorded in order to evidence that the process is accessible and responsive to any person wishing to raise a complaint, comment, concern or compliment and to assist in continually developing services to local people. The complaints manager asks for equality monitoring information from the actual referrer. This information is collected on the Warrington Borough Council standard Equality Monitoring Form when the complaint is acknowledged and includes sexual orientation. Sending the form out in this way has resulted in a higher response rate. Customers do not have to provide the information if they choose not to do so.

5.2 The service has continued to work to consolidate good practice so that vulnerable users are encouraged to express their views and to access the complaints procedure if they wish. 33 of the complaints were referred to the complaints procedure by relatives, 17 were self referrals and 9 were from friends, councillors/MPs or social services group staff.

5.3 Gender (all Adult Social Services and Private and Voluntary complaints)

Male

Female

Total

Older People and Occupational Therapy Services

8

6

14

Mental Health and Learning Disability Services

13

9

22

Social Care Provision

2

2

4

Intermediate Care Services

3

10

13

Contracts and Procurement

1

4

5

Safeguarding & Quality Ass

1

0

1

Private and Voluntary Sector

6

21

27

Total

34

(39.5%)

52

(60.5%)

86

Of the 7643 people using a service in 2012/13, 4802 (62.8%) people were female, 2841 (37.2%) people were male. Therefore the complaints gender ratio is very reflective of the social care population.

5.4 Age (all Adult Social Services and Private and Voluntary complaints)

Agenda Item 4

19

18-64

65+

Unknown

Total

Older People and Occupational Therapy Services

1

12

1

14

Mental Health and Learning Disability Services

15

3

4

22

Social Care Provision

1

1

2

4

Intermediate Care Services

0

13

0

13

Contracts and Procurement

0

5

0

5

Safeguarding & Quality Ass

0

0

1

1

Private and Voluntary Sector

6

20

1

27

Total

23

(27%)

54

(63%)

9

(10%)

86

Of the 7643 people using a service in 2012/13 2334 (30.5%) were aged 18-64 and 5309 (69.5%) were aged 65 and over. Again the profile is largely reflective of the service age band ratio, although 10% of the group were not recorded.

5.5 Disability (all Adult Social Services and Private and Voluntary complaints)

Primary Client Group

Older

People and

Occupa-tional

Therapy Services

Mental Health

and Learning Disability Services

Social Care

Provision

Inter-mediate

Care Services

Contracts and

Procure-ment

Safe-guarding & Quality

Ass

Private

and Voluntary

Sector

Total

Physical Disability

10

6

0

5

2

0

17

40

(46.5%) Frail/Temp Illness

1

1

2

7

2

0

2

15

(17%) Learning Disability

0

8

0

0

0

0

2

10

(11.6%) Mental Health

1

3

0

0

0

0

1

5

(5.8%) Dementia

1

0

0

0

1

0

3

5

(5.8%) Not Known

1

4

2

1

0

1

2

11

(12.8%) Total

14

22 4 13 5

1

27 86

Of the 7643 people using a service in 2012/13:

Agenda Item 4

20

5131 (67%)had a primary client group of Physical Disability (this

includes frail and/or temporary illness, hearing impairment, visual impairment and dual sensory loss)

526 (6.9%) had a primary client group of Learning Disability 1884 (24.7%) had a primary client group of Mental Health (this

includes people with dementia) 49 (0.6%) had a primary client group of Substance Misuse 53 ((0.7%) had a primary client group of Other Vulnerable People

This shows that complaints relating to people with a learning disability (or their carer) are over represented and those relating to people with mental health problems less represented than within the service profile. One explanation for the higher level of complaints relating to people with a learning disability is the increased level of advocacy including family support and advocacy support commissioned by the council.

5.6 Ethnicity (all Adult Social Services and Private and Voluntary complaints)

White British

Pakistani Any Other Mixed

Not Stated

Total

Older People and Occupational Therapy Services

12

1

0

1

14

Mental Health and Learning Disability Services

17

0

1

4

22

Social Care Provision

2

0

0

2

4

Intermediate Care Services

12

0

0

1

13

Contracts and Procurement

5

0

0

0

5

Safeguarding & Quality Ass

0

0

0

1

1

Private and Voluntary Sector

26

0

0

1

27

Total

74

(86%)

1

(1.2%)

1

(1.2%)

10

(11.6%)

86

Of the 7643 people using an adult social care service in 2012/13, 7461 people (97.60%) where classed as White British. Although there is some missing ethnicity information within the complaints data, it is predictable that the majority of these will also be White British and the complaints ethnicity data is reflective of the profile of those receiving a service. The main issue is that people from BME groups are under represented in the people who receive social care services. Latest census figures (2011) suggest only 92.9% of the local population are White British and there is a greater proportion of people from BME groups than in the adult social care population.

5.7 Conclusion:

Agenda Item 4

21

The Equality of Access information shows that for gender, age and ethnicity the figures are fairly reflective of the social care population. However certain primary care groups are less likely to make a complaint than others. There may be a number of different factors which affect these figures. The council is committed to investigating the reasons for this and improving access to the complaints process for all service users.

6. MONITORING AND USE OF INFORMATION

6.1 Within the Community Services Directorate complaints are viewed positively.

The information is used constructively to improve the service offered.

6.2 When the response to a complaint includes an amendment to procedures or policy, staff training or any type of improvement to the service provided, an action plan is drawn up identifying tasks to be completed, who will complete them and a timeframe for completion. These are monitored by the Complaints Manager who ensures completion of same is evidenced.

6.3 Examples of improvements made to services as a result of complaints include:

A service user’s son complained that he had not received three of

his late mother’s invoices and that some of the invoices he had received were incorrect.

The complaint was partly upheld and the incorrect invoices were amended and re-issued.

We apologised for the errors and initiated a peer checking procedure for when an invoice is manually raised. This will help prevent such errors occurring in the future.

A relative of a service user complained about the unreliability of

their stair lift and also about the way that the complaint had been initially handled.

The complaint was upheld and an apology was issued.

It was agreed that a new lift would be provided. The operator who initially received the call also received training from the manager about how the call could have been handled better.

We received a complaint in relation to an incorrect invoice being

issued for care services and about the information and advice provided about care costs.

The complaint was partly upheld and an apology issued.

An advice sheet about non-residential social care charges has been produced which the social worker now hands to service users during their assessment. Staff in the finance team have been reminded to carefully

Agenda Item 4

22

check service user and provider information when dealing with clients’ or their representatives’ invoice queries and ensure they have checked all the relevant information when giving advice.

6.4 Warrington Borough Council is an active member of the North West

Complaint Managers Group. The aim of the group, which meets bi-monthly, is to provide a forum in which peer professionals can discuss and learn about regional and national issues. Here there are opportunities to develop local practice standards, discuss performance and problem solve. The group also discuss proposed changes to legislation and procedures and prepare consultation responses where necessary.

7. LOCAL PRIORITIES

Update on priorities for 2011-2012:

7.1 Prevention:

We said we would develop a more proactive resolution response that encourages people to communicate more readily with the council.

We have and continue to encourage proactive engagement that enables service users and carers to have a say about their services; and also to promote a culture where staff are encouraged to identify and address issues as they arise. In this way, the need for people to have to complain is reduced. This appears to have been successful as despite promoting awareness about how to complain, overall complaint numbers have slightly reduced from last year. (Down from 64 to 59). This work will continue to be promoted.

7.2 Awareness Raising:

We said we wanted to ensure service users and/or their carers were aware of their right to complain and to encourage feedback from them by ensuring they are supplied with a ‘Make Your Experience Count’ leaflet during their assessment or re-assessment.

Additional leaflets were printed and widely distributed including being given by hand during reviews and reassessments. Some specific work was undertaken to promote awareness with people with learning disability and their advocates. We worked with them to produce an easy read leaflet in July 2012, Tell Us What you Think.

7.3 Equality of Access:

Agenda Item 4

23

We said we would investigate why certain groups are under represented in the complaints process particularly BME groups, older people and people with mental health issues. We will work to ensure that all groups are able to easily access the complaints process.

We understand that people with mental health needs are less likely to complain nationally and also that they receive different levels and types of services. In relation to people from BME groups, we have identified that the issue is not so much about access to complaints, but about take up of service. This year’s figures do not suggest that older people are under represented. Work to ensure equality of access is ongoing.

7.4 Review working protocol with health:

This was completed – an updated joint working protocol was agreed by all agencies. In the coming year, this will need revisiting in the light of the NHS reform and any recommendations arising from the Francis Report.

7.5 Learning from Complaints:

We said we would strengthen our processes to ensure outcomes and recommendations are logged; actions are implemented, monitored, audited and reviewed; and this would be reported quarterly to Senior Leadership Team.

Quarterly reports go to the SLT. Heads of service complete a proforma which clearly indicates actions and desired outcomes. These are monitored proactively by the Complaints Manager.

Additional priorities for 2013-2014

7.6 Promoting Advocacy:

Following on from some very positive outcomes where advocates have been involved in assisting clients to make complaints/compliments and supporting them through the process, we will continue to work with the Speak Up advocacy service to improve access to the complaints process for all service user groups.

Agenda Item 4

24

7.7 Increasing customer awareness:

We will endeavour to increase staff awareness and general communication and customer care skills. We acknowledge from feedback that clients get the best outcomes when they feel that their complaint is being taken seriously and they are being listened to.

7.8 Simplifying the process for external provider complaints:

We will simplify the process for complaints about commissioned services (Private and Voluntary Providers). In future, to ensure that the process is more efficient and transparent, the provider will be asked to respond direct to the complainant with a copy provided to the council as commissioner. We will develop closer relationships with Providers and support them through this transition. We will regularly attend the bi monthly provider forums.

8. FINANCIAL CONSIDERATIONS

N/A

9. RISK ASSESSMENT

N/A

10. EQUALITY AND DIVERSITY / EQUALITY IMPACT ASSESSMENT

The statutory complaints process relating to Adult Social Care is designed to empower and protect some of the most vulnerable members of society.

11. CONSULTATION

All Health and Social Care Authorities were consulted prior to the new

regulations being implemented in April 2009.

12. RECOMMENDATION

That members note the contents of this report.

13. BACKGROUND PAPERS

Statutory Instruments 2009 No. 309 The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009. Listening, Responding, Improving – A guide to better customer care (D of H) 2009.

Contacts for Background Papers: Susan Carr

Name E-mail Telephone Susan Carr carrs@warrington.gov.uk 01925 444240

Agenda Item 4 – Appendix 1

25

A SAMPLE OF COMPLIMENTS RECEIVED DURING 2012-13

‘I would like you to know how very grateful I am to you for the work you put in on my fathers case. The situation my father, his wife and myself had found ourselves in was terrible and I do not know how I would have coped without you. Each time I spoke with you I felt you knew the case immediately, without having to look at files, and after speaking with you I felt confident you would do all you could to progress. It is very difficult to get somebody to understand a situation over the telephone, but you took the time to listen to everything I had to say and explained step by step what would happen and kept me updated every step of the way’. ‘I am writing this letter to say thank you to and all the team at Warrington Social Services who are, and who have been, involved in my care. The intervention of you and your team has made a massive difference to me and the help put in place has taken a tremendous amount of strain and stress off my husband’s shoulders’. ‘It seems so short a time since you came to our ‘rescue’ one Saturday morning. The previous day, my husband had fallen and hit his head and then collapsed later in the day. I did not expect to have any help in any way until Monday, when you suddenly appeared on SATURDAY. I cannot begin to thank you for your consideration and kindness – and getting my husband into a nursing home for a few days respite was a ‘miracle’ and a life saver for us. We shall always remember you with immense gratitude for your prompt help. ‘Just wanted to say a big THANK YOU for everything you have done for us and mum. It has been so difficult and we wouldn’t have got through it without you’ ‘Thank all staff for the quality of the care which was shown during the time which I spent as a resident. Every one was so kind and considerate and my stay most enjoyable’. ‘My husband received care in the community for a number of years. I would like to thank all those in your department whose support made it possible for my husband to stay at home for so long: The social worker and OT who have given us excellent professional support and the staff at the Day Centre who showed great kindness, patience and understanding of his needs which made a great difference to our lives by giving me a break from 24 hours care. I appreciate so much all the support I received from your department’. ‘Dear All, I am writing to express my appreciation and thanks for all the care and attention which I received during my six weeks period of care. The Team cannot be faulted for the work they did and for the kindness they showed at all times. With best wishes’. ‘I want to thank you for all your hard work, care and kindness you showed to me and our family, while finding the best care home for NN. I do know it was a difficult task, but you did it! He’s in the best place for him and I know that he’s safe and looked after. A load off my mind. Thank you. Best wishes’.

Agenda Item 4 – Appendix 1

26

‘We cannot thank you and your colleagues enough for the speedy help you gave us to move mum. Thank you, thank you, thank you, you have been fantastic to sort all this out in just over one week’ 'A big thank you for all the help you have given me and continuing to do so - you go beyond your job to make sure your client is ok and also encourage people to join activities to gain confidence. So a big thank you'.

1

WARRINGTON BOROUGH COUNCIL

SCRUTINY COMMITTEE

DATE: 17 September 2013

Report Sponsor Ann McCormack, Assistant Director, Partnerships & Resources Department

Report Author: Sarah Rayner, Children’s Complaints Manager

Forward To. n/a

File Reference:

(File location saved in secretariat folder as final version of the report)

TITLE OF REPORT: Statutory children’s social work complaints report 2012/13

1.0 PURPOSE 1.1 Warrington Borough Council receives feedback from customers about a

variety of issues inclusive of complaints, comments and compliments. The management and reporting of children’s social work complaints are subject to specific legislation and guidance.

1.2 This report represents an overview of Warrington Borough Council’s children and young people’s social work complaints, compliments and representations process for 2012/2013. It reviews the effectiveness of the complaints procedure and highlights areas for future developments of the service. It also fulfils the council’s statutory duty to produce an annual complaints report as stated in the 2006 regulation – Getting the Best from Complaints, Social Care Complaints and Representations for Children, Young People and Others.

2.0 CONFIDENTIAL OR EXEMPT 2.1 N/A

3. INTRODUCTION AND BACKGROUND 3.1 “A complaint may be defined as a written or verbal expression of

dissatisfaction about the standards of service provided by social care, the failure to act, or delay in taking action, which affect a service user”.

3.2 The complaint regulations 2006 require each local authority to appoint a

complaints manager to ensure the provision of a robust social care complaints and representations procedure to eligible service users.

3.3 This report provides statistics on the number of statutory complaints received,

the performance against timescales for handling complaints; complaint trends and outcomes; and learning and improvements resulting from the resolution of complaints. Service users who receive a service from providers

2

commissioned by the directorate are also entitled to access the statutory complaints procedure.

3.4 Children and young people’s targeted services department are committed to the effective management of complaints and compliments procedures as an important element in providing and assuring high quality services. The complaints system is valued as it:

• gives service users a voice and an opportunity to make their views known and ensures their inclusion in service review and development

• identifies ways of improving services through positive feedback or by addressing areas of concern

• provides valuable information to enable the directorate to plan, review and develop the services it provides to the children and young people of Warrington

4.0 THE COMPLAINTS PROCEDURE

4.1 The purpose of the complaints procedure is to provide a fair and open method

in which those dissatisfied with their experience or service can raise issues and receive a structured response. The aim is to resolve issues quickly and as near as possible to the point at which they arise. Children’s social work services are complex and often tackle emotional and difficult issues.

4.2 When initial concerns/issues are highlighted by service users, their families or

their advocates’ swift action by the staff involved is expected to enable them to be resolved quickly, without the need to register them as formal complaints. However when initial attempts to resolve the concerns/issues fail, the formal procedure is invoked.

4.3 The statutory complaints procedure 2006, has three stages with set timescales for resolving complaints at each stage:

Stage one - Local resolution: complaint is investigated and responded to by a principal manager. During the investigation the principal manager may meet with the child/young person/service user or other people involved with their care.

Stage two – Investigation: an independent investigator and independent person are appointed by the complaints manager (selected from an approved list provided by the North West complaints group) and a schedule of complaint is agreed with the complainant. The investigation is conducted and a report is produced by both investigators inclusive of recommendations. The assistant director, targeted services, acts as the adjudicating officer and produces a response letter which is sent to the complainant outlining the outcome of the investigation and confirming if any changes to service delivery, policy or procedure have or will occur as a result.

3

Stage three - Review panel: a panel of three independent persons must meet to re-examine the adjudication within 30 working days of the request being received. The panel will produce a report about whether the department dealt adequately with the complaint. If the panel decides that the department did not adequately deal with the complaint the assistant director must, within 15 working days of the notification of the panel’s decision, notify the complainant what, if any, action they propose to take and provide guidance to the complainant as to the power of the Local Government Ombudsman (LGO).

Statutory response timescales for complaints

Stage one Stage two Stage three

10 working days Can be extended to 20 working days if the complaint is “complex” in its nature or where there are specified reasons for the delay.

25 working days Can be extended to up to 65 working days as required and in agreement with the complainant.

30 working days to set up panel upon request. 5 days for the report to be issued and 15 working days for Executive Director to respond to the panel’s findings.

4.4 A child/young person, service user or their representative has the right to

request to have their complaint progressed to stage two of the procedure and/or pursue alternative solutions. Any request for a complaint to progress to stage two is considered by the appropriate service manager, supported by the complaints manager.

4.5 Whilst the aim is always to deal with complaints promptly and in line with the

statutory timescales there are on occasion, delays. Reasons are mixed and some examples are provided below.

4.6 Meeting the respective timescales is very important to the integrity of the

process it is notably influenced by the complainant and the service. 4.7 In some instances insufficient information is provided about the nature of the

complaint at the start. An example of this is when a complaint is made via a letter or by the completion and return of a feedback form which states that a child/young person or service user is unhappy with the service but does not provide specific examples. In this instance the staff member dealing with the complaint contacts the child/young person or service user to arrange a meeting in order to progress the complaint.

4.8 Usually one written request/reminder is enough to ensure clarification. If a

second written request/reminder does not produce relevant information the child/young person/service user is informed that the processing of the complaint will proceed on a limited basis according to the information already available.

4

4.9 There are also occasions when the complaint is so complex in its nature

and/or where there are specific or bespoke reasons which cause a delay in the service responding to a complaint. For example, complaints which are based on historic issues resulting in the reviewing of many files. In such circumstances an extension of a further 10 working days can be imposed (by agreement with the service manager and complaints manager). This is communicated to the complainant at the earliest opportunity.

4.10 The complainant is made aware that they may approach the LGO at any time

during the complaint process. However the advice from the complaints manager is always that the LGO will commonly not investigate a complaint until all stages of the statutory process have been completed by the council.

5.0 STATISTICAL ANALYSIS OF COMPLAINTS

5.1 As of 27 March 2011 Warrington was recorded as having a total population of

202,228. For 2011 census purposes, a usual resident of the UK is anyone who, on census day, was in the UK and had stayed or intended to stay in the UK for a period of 12 months or more, or had a permanent UK address and was outside the UK and intended to be outside the UK for less than 12 months.

Warrington population estimates 0-19yrs of Age

Age Male Female Total

0 – 4 6,256 6,053 12,309

5 – 9 5,979 5,576 11,555

10 – 14 6,322 5,974 12,296

15 – 19 6,559 5,948 12,507

Total: 25,116 23,551 48,667

Source: Office for National Statistics, 2011 Census: Usual resident population by five-year age group, local authorities in the United Kingdom - The release provides information for administrative areas within the United Kingdom as at census day, 27 March 2011. Published 21 March 2013. www.statistics.gov.uk, © Crown copyright reserved.

NB: 2011 Census: Usual resident population by five-year age group, local authorities in the United Kingdom was the most current data available from the source at the time of producing this report.

5.2 48,667 (24%) of the population were categorised as children and young

people aged 0 -19 of which:-

• 227 were recorded as children in care (on 31/03/2013) and

• 156 were recorded as subject to a child protection care plan (on 31/03/2013)

Source: Performance Analyst, Warrington Borough Council. Data based on information taken from CareFirst LIVE on 20/05/2013 as of 31/03/2013 and is subject to change

5

5.3 In 2012/13, a total of 2,322 children and young people received a service. These figures are based on all children who had an open children in need classification during the year 01/04/2012 to 31/03/2013. Data in respect of children who had a referral which resulted in no further action (i.e. those cases that opened and closed on the same day) have been excluded. This data is displayed by age and gender group below:

Children who received a service in 2012/13

Age

Group Female Male Unborn Total

Unborn 0 0 25 25

0-4 368 367 0 735

5-9 270 337 0 607

10-14 252 271 0 523

15-19 193 167 0 360

19+ 30 42 0 72

Total 1113 1184 25 2,322

Source: Performance Analyst, Warrington Borough Council. Data based on information taken from CareFirst LIVE on 20/05/2013 as of 31/03/2013 and is subject to change.

5.4 A slight decrease in volume of the number of children and young people who received a service in 2012/13 is found when compared with the figure of 2,706 in 2011/12.

6.0 VOLUME OF COMPLAINTS 6.1 Children’s Targeted Services social work teams received a total of 59

complaints during the reporting year of 2012/13 (April-March) compared with 80 complaints in 2011/12. On average a total of 4.7 complaints were received per month.

6.2 It is encouraging to report a decrease in the number of complaints received

considering the improvements that have been made around the accessibility of the complaints process i.e. increase in the amount of information and methods available. 56 complaints were received as stage one complaints, out of these one progressed to stage two; no complaints progressed to stage three. Of the remaining two stage two complaints, one moved directly to stage two at the complainant’s request (following agreement by the assistant director), and the other was approved for progression to stage two following the completion of stage one during the last reporting year (2011/12).

Year Number of complaints

received

Number

withdrawn

Responded to within

time, total (%)

2011/12 80 2 85%

2012/13 59 1 90%

6

6.3 The breakdown of stage one complaints received (by division) within the targeted services department is detailed in the table below:-

Division 2010/11 2011/12 2012/13

Children in Need 59 50 28

Children in Care 22 29 28

Total 81 79 56

6.4 The majority of complaints were received by the duty and assessment team

which is not dissimilar to the trend seen last year. The duty and assessment team deal with all new referrals into children’s social work services, the team are responsible for carrying out initial assessments and, if necessary, any child protection investigations (managed through to the child protection conference should this be the outcome).

6.5 The focus of the work is to provide support to children in need and their

families, often at times of crisis. The nature of the work means that it is inevitable that sometimes the intervention required is not welcomed by the children who are in need or by their families. A total of 10 of the complaints received related to ‘delivery of service’ however just one of these was upheld with a further complaint being upheld in part (see 4.14).

7.0 REQUESTS FOR PROGRESSION TO STAGE TWO 7.1 The department received a total of 10 requests for independent investigation

at stage two of the process:-

No. Outcome

1 moved directly to stage two at the complainant’s request (following agreement by the assistant director)

1 was approved for progression to stage two following the complainant remaining dissatisfaction upon completion of stage one

1 was approved for progression to stage two following the completion of stage one during the last reporting year (2011/12)

7 were considered by the appropriate service manager and the complaints manager

7.2 Upon consideration, if it is felt that stage two investigation would be unlikely to produce a demonstrably different outcome from that which the complainant received at stage one of the process, a request for progression to stage two will be refused. In such circumstances the council have the option of referring a case directly to the Local Government Ombudsman (LGO).

7

7.3 The LGO has the power to consider, if felt appropriate, complaints about councils and some other authorities, including education admissions appeal panels. It is a free service and they investigate complaints in a fair and independent way. Upon refusal of a request for progression to stage two details of how a complainant can make contact with the LGO are provided in the form of a leaflet. The leaflet is accompanied by a letter from the appropriate service manager which communicates the department’s decision and rationale. This is sent within 10 working days (following receipt of a request).

8.0 REFERALS TO THE LGO 8.1 During 2012/13 a total of two enquiries/complaints about children’s social work

services provided by the department were dealt with by the LGO both of which were responded to within timescales set by the LGO. One of these resulted from the department’s rejection of a request from the complainant for progression to stage two and the other related to the refusal to pay compensation following the completion of a stage two investigation which was upheld in part. In both cases the final decision of the Ombudsman found in favour of the department:-

9. RESPONDING WITHIN TIMESCALES 9.1 Overall, 53 (90%) complaints were responded to within timescales (inclusive

of stage one and stage two). This was a steady improvement on performance for 2011/12 when compliance with timescales was at 85% (see 4.3).

9.2 Of the 56 stage one complaints received:-

• 52 were responded to within timescales, 14 of which (27%) were completed following approval of extensions to timescales (additional 10 working days).

• 6 complaints were responded to outside of the statutory timescales, of these two (33%) had been granted extensions due to their complexity or unavailability of staff for interview.

9.3 At stage two of the process three investigations were conducted following the complainant’s dissatisfaction of the response received at stage one, two of

Case A - Formal decision advised that, following consideration of all information provided, the investigator considered that the council had already appropriately remedied the injustice caused and so decided to discontinue the investigation and close the complaint.

Case B - Formal decision advised that, following consideration of all information provided, the investigator considered that the Ombudsman should not pursue the complaint further as it could not accept a complaint from the complainant on behalf of the child (but not made by the child) as the child was no longer in their care and any investigation would not achieve anything practical for the complainant.

8

these investigations were responded to within timescales and one was responded to outside of timescales (67%).

9.4 Unfortunately the one stage two complaint that was completed outside of the

agreed timescales occurred despite extension to the maximum 65 working days. The delay was a result of a number of factors including; availability of staff for interview, availability of the young person’s advocate and foster carers to attend a meeting and the Christmas holiday period. The complaint was resolved to the young person’s satisfaction and verbally agreed at a meeting prior to the agreed complaint deadline. The outcome was not formally communicated to the complainant in writing until a later date, hence why it fell outside of the agreed timescales.

9.5 Overview of adherence to statutory timescales by division (inclusive of outcome at both stage one & two):-

Division In Time Out of time

Children in Need 27 2

Children in Care 26 4

Total 53 6

10 CATEGORIES OF COMPLAINTS

10.1 The stage one complaints received during 2012/13 fell in to nine main

categories as detailed in the table below:-

Category of complaint Total

2012/13 Upheld

Upheld

in Part

Not

Upheld

Delivery of service 24 5 9 10

Staff behaviour / attitude 8 1 1 6

Delay in response 1 - - 1

Dissatisfied with decision 13 2 5 6

Issues with assessment 1 - 1 -

Issues in relation to foster carers 2 - - 2

Inaccurate records 4 - 2 2

Communication 2 2 - -

Confidentiality issues 1 - - 1

Total 56 10 18 28

10.2 Comparison of category of complaints received during 2012/13 and 2011/12:-

9

0 10 20 30 40

Total 2012/13

Total 2011/12

Confidentiality issues

Care proceedings

Communication

Provision

Inaccurate records

Financial issues

Issues in relation to foster carers

Contact arrangements

Issues w ith assessment

Dissatisf ied w ith decision

Delay in response

Staff behaviour / attitude

Delivery of service

NB: complaints may fall into more than one of the categories listed above, however, for the purpose of reporting the most prominent area for each complaint has been categorised.

11.0 OUTCOME OF COMPLAINTS

11.1 Outcomes of the 56 complaints received at stage one:

• 28 complaints were not upheld (50%)

• 10 complaints were upheld (18%)

• 18 complaints were partly upheld (32%) 11.2 The upholding (in all or in part) of exactly half of the social work complaints

received is a strong indicator of the department’s commitment to deal with complaints in a fair and open manner accepting fault where appropriate.

11.3 Outcomes of the three complaints that progressed to stage two (two from 2011/12):

• 1 complaint was upheld (33%)

• 2 complaints were partly upheld (67%) 11.4 Where any aspect of a complaint is found to have substance, an apology

should be provided and the complaint will be classified as ‘partly upheld’. 11.5 Comparison between 2012/13 and 2011/12 – stage one & two:-

10

Children in Need

59%31%

10%

Children in Need

59%34%

7%

0

10

20

30

40

50

60

Number of

complaints

Up

he

ld

Up

he

ld i

n

Pa

rt No

t

Up

he

ld

2011/12

2012/13

11.6 Overview of outcome of complaints by division (inclusive of outcome at both

stage one & two):-

Division Upheld Partly Upheld Not Upheld Total

Children in Need 2 10 17 29

Children in Care 9 9 12 30

Children in Care

30%

40%30% Upheld

Partly Upheld

Not upheld

12. COMPLIMENTS

12.1 Compliments provide evidence of quality of service giving details of the high

standards and performance delivered by members of staff from all service areas – information in this section relates specifically to the targeted services department which is wider than social work. Management within the targeted services department are committed to ensuring that good practice is recognised and shared in order to inform continual improvement in services.

12.2 A total of 58 compliments were recorded in 2012/13 compared with 53 in

2011/12, a slight increase and an average of 5 compliments per month.

11

12.3 The compliments received were spilt by division as follows:-

Division 2011/12 2012/13

Children in Need 19 20

Children in Care 19 25

Preventative Family Support & Youth 9 8

Safeguarding and Quality Assurance 6 4

CYPS Directorate Management Team (joint) 0 1

Total 53 58

12.4 Of the 58 compliments received, 46 (79%) were from external sources.

12.5 Some examples of the highly positive compliments received directly from service users and/or their representatives are as follows (identifying details have been removed to ensure confidentiality):-

“(Social Worker) controlled herself with complete professionalism whilst showing a great deal of compassion whilst remaining patient with (Clients) over the long running of the (children’s) case, cannot thank (Social Worker) and her team enough and feel that without (Social Worker’s)help and support we would not of got through this time.” “(Social Worker) informed us the other day that she will no longer be our Supporting Social Worker. I just wanted to take this opportunity to tell you how much we have appreciated (Social Worker), she has been our counsellor, advisor, emotional support and kept us on the right path in our formative time as new Foster Carers. I understand there is a bigger picture and (Social Worker) is needed in other areas but we will miss her, she is professional and also personable, which has been much appreciated by myself and my husband.” “(Social Work Assistant) is by far the most fantastic social work assistant I've had the great fortune to meet and work with. (Social Work Assistant) has a delightful way with (child).” “Would just like to say a massive thank you for everything you have done for us as our social worker. We will be sorry to see you go. Nothing was too much trouble and you were there straight away with any issues we had. We always knew with you that we had support and back up and it meant a lot. Sometimes we go through some tough times with (child) and you helped us a great deal to work through ways of calming situations down as all teenagers can be very difficult at times. We hope to see you around and we wish there were more social workers around like you. You were the best.”

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“I am happy with the way (social worker) handled my case. (Social worker) was direct and thorough but very caring and considerate at the same time. (Child) agrees with this and we would both like to thank (social worker).” “To everyone who has helped us during the time we have been involved with Social Services' We want you all to know we are very grateful for everything you have done for us as a family. All your support has given us the strength to get through this very stressful time.” “Everyone has been really nice and helpful and have been very kind to us in this difficult time. (Child) is very happy at her foster placement and my social workers have made every effort to make sure we have regular contact with each other. Very Good :0).”

12.6 Examples of compliments from other professionals:- “Your support worker raised the issue on behalf of the young mum. (Social Worker) encouraged her to express her views and how she felt. Due to this being brought up we were able to offer an apology. Your worker has potentially prevented us receiving a complaint. Your worker was very professional and an excellent advocate for this mum who is obviously very vulnerable at the moment.” “The Guardian (court appointed) has requested that we should write to you to express their appreciation and admiration for the hard work carried out by your Social Work Team over a long period of time and in particular, the effort and dedication of the Social Worker.” (Specialist Nurse) was impressed by (Social Work Assistants) clear, direct and professional input whist maintaining good relations. Judge concluded by saying that she was very grateful to (Social Worker) for all the hard work she has put into this case and also praised the quality of the social work.

12.7 To highlight the value associated with compliments received from an external source, they are personally recognised by the assistant director via a letter of thanks to the appropriate officer/s. The letter places focus on the actions that have been completed by the officer/s and the impact that these have had on service users. Thanks are given for the officer/s efforts and continued commitment to their role in the future improvements in the delivery of services for the children and young people of Warrington. This process was introduced to give appropriate recognition to the volume of compliments received within the department which, as referred to at 5.1 of this report, has seen a slight increase.

12.8 Compliments received during 2012/13 fell in to 4 main categories with staff

professionalism / conduct / behaviour / attitude being recognised by 84% as detailed in the table below:-

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Category of compliment Total

Staff professionalism / conduct / behaviour / attitude 49

Quality of assessment 2

Delivery of service 6

Provision of training 1

Total 58

13.0 EQUALITY OF ACCESS

13.1 Details relating to a person’s ethnicity, gender and disability are recorded in order to evidence that the process is accessible and responsive to any person wishing to raise a complaint, comment, concern or compliment and to assist in continually developing services for local people. A child/young person or service user can choose not to provide this information if they wish.

13.2 Ethnicity

13.3 Ethnicity has continued to be monitored and recorded. The data has been compared against the makeup of the borough as a whole to ascertain if the complaints received have been representative. As expected the highest rate of complaints came from residents who described themselves as white British reflecting the high percentage of this group within the borough. The table below demonstrates the minority ethnic population of the borough against the complaints received and the ethnic breakdown of the service users referenced at 5.1 of this report.

Source: Office for National Statistics, 2011 Census: Ethnic group (write-in responses), local authorities in England and Wales - The release provides information for administrative areas within the United Kingdom as at census day, 27 March 2011. Published 21 March 2013. www.statistics.gov.uk, © Crown copyright reserved. NB: 2011 Census: Ethnic group (write-in responses), local authorities in England and Wales was the most current data available from the source at the time of producing this report

Resident population estimates by ethnic

group (%), 2009

Complaints

received

2012/13 (%)

Ethnic

breakdown of the

service users

2012/13

(as in 4.1) %

White 94.2 95 90.6

Mixed 1.2 3 3.1

Asian or Asian British 1.7 0 1.4

Black or Black British 0.4 0 0.1

Other Ethnic Groups 2.5 2 4.8

Totals: 100.0 100.0 100.0

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13.4 GENDER 13.5 Gender has continued to be monitored and recorded. The data has been

compared against the data as referred to at 5.3 of this report to ascertain if the complaints received have been representative. There was a fairly even split across gender as the table below demonstrates, this does not appear to be disproportionate when compared against the gender split of children who received a service:

2011/12 Male Female Unborn Total

Children who received a service 1,463 1,223 20 2,706

Complaints received in relation to child (by gender)

34 44 0 79

2012/13 Male Femal

e Unborn Total

Children who received a service 1,184 1,113 25 2,322

Complaints received in relation to child (by gender)

31 26 2 59

13.6 Disability

The table below shows a breakdown of complaints where the complaints log referenced that a child had been identified as having a disability.

Disability identified Disability not identified Total

5 54 59

14.0 Representations 14.1 The service has continued to work to consolidate good practice. Through the

development of a ‘Make your child’s experience count’ leaflet and commissioning of the National Youth Advocacy Service (NYAS), vulnerable children, young people, service users and their families are encouraged to express their views and to access the complaints procedure if they wish. The majority of complaints came from parents, guardians and people with sufficient interest in the welfare of the child/young person (75 %). The referral split at stage one is detailed in the table below:-

Referrer 2011/12 2012/13

Relative 64 43

Child / young person 1 7

Foster Carer 4 1

Advocate (NYAS) 3 5

Individual - 1

Friend 5 -

Total: 77 (2 withdrawn) 57

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14.2 The proportion of complaints received directly from children and young

people has significantly increased, as demonstrated in the table above. Promoting the complaints process amongst young people has continued to be a key area of focus and following the distribution of the “Shout Out” complaints leaflet a total of seven complaints were received directly from children/young people.

14.3 Regular contact meetings were held between the complaints manager and the

allocated NYAS advisor with increasing the number of representations made by children and young people being high on the agenda. A joint mailshot took place early in the reporting year where all children in care were provided with a copy of the new “Shout Out” complaints leaflet along with a leaflet promoting the free services of NYAS.

Source of complaint Upheld Partly upheld Not upheld

Child / young person 4 1 2

Advocate (NYAS) 2 - 3

Total 6 1 5

14.4 The new “child friendly” complaints leaflet saw the introduction of a designated children’s complaints email address, freepost address and a free phone complaints line. The method of contact is categorised when logging complaints, upon review it appears that these methods were not utilised by the children / young people who submitted complaints:-

14.5 Promoting the complaints process amongst young people will continue to be a

key area of focus for 2013/14. Although the contact methods available following the introduction of the “Shout Out” complaints leaflet may not have been utilised they do provide children & young people with an improved opportunity to access the service in order to make their views known and it is not proposed that any of the methods should be removed.

15.0 MONITORING AND USE OF INFORMATION

15.1 This section provides detail on arrangements for the oversight of complaints

data, trends and analysis of outcomes in terms of lessons to be learnt.

Method of contact Count

Telephone (not via designated Freephone number) 2

Letter (not via free post address) 2

Feedback form (not “Shout Out” version) 2

Personally 1

Total: 7

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15.2 As stated earlier children’s social work complaints are often complex in nature relating to important decisions surrounding sensitive issues which affect the lives of children and young people and their families. Complaints frequently highlight a number of issues at once i.e. dissatisfaction with the conduct of a social worker, a case decision made, agreed interventions and assessment outcomes.

15.3 The timescale for responding to children’s social work complaints at stage 1 is

10 working days, which as stated at 3.8 of this report can be extended to a maximum of 20 working days. Due to the complexities described above it is imperative that upon receipt complaints are allocated to an investigating officer promptly. To ensure the complaint is investigated by the most appropriate officer service managers are responsible for the allocation of complaints once they have been logged and acknowledged by the complaints manager.

15.4 The complaints manager provides a draft response template and requests that

a draft response is submitted within 8 working days to allow time for the approval by the service manager. The complaints manager sends reminder emails to investigating officers to alert them to the requirement to provide a draft response; these emails are copied to the appropriate service manager. The requirement to respond within statutory timescales is endorsed by the assistant director who has provided a clear direction to all appropriate staff in relation to the handling of complaints highlighting the expectation and importance of providing the draft response letter within 8 working days.

15.5 Once a draft response to a complaint has been completed it is returned to the

appropriate service manager for review and approval before it is signed by the investigating officer. Consideration should be given at this stage as to whether the issues raised have been adequately addressed and desired outcomes responded to appropriately. If any aspect of the complaint is upheld an apology should be provided including, where necessary, details of any learning or changes to process or policy as a direct result of the investigation and subsequent findings.

15.6 This final stage was introduced during the reporting year 2011/12 to monitor

all stage 1 responses. It was, and is still considered that by monitoring and quality assuring the responses to stage one complaints there will be a reduction in the number of requests for complaints to progress to stage two of the process. If such requests are received the quality assurance steps taken at stage one should increase the number of complainants satisfied with the response they receive and so limit the number of approvals for progression to independent investigation.

15.7 Children’s social work complaints continue to be allocated in a timely manner

(usually the day of receipt) and the majority of responses are being sent within timescales (90%), demonstrating that the adjustments to the process as described have had a positive effect.

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15.8 Further efforts are needed, as demonstrated by the six complaints (10%) that were responded to outside of the statutory timescales. It is important to note that of these six complaints, three investigations had been granted extensions to timescales due to complexity or staff unavailability for interview. Upon reflection the additional three complaints would have benefited from extensions to timescales with the responses being sent at 12, 16 and 16 working days respectively. This option should be considered and a request made to the complaints manager should the investigating officer feel it appropriate. In any event, to have a complaint fall outside of the statutory timescales is unacceptable, more so when an extension has been agreed. A recommendation is made in respect of this at 13.0 of this report.

15.9 To ensure the complaints process is embedded and informs service

development, performance in terms of compliance to timescales continues to be monitored on a daily basis by the complaints manager; details are also shared at monthly targeted services senior management team (TSSMT) performance meetings, chaired by the assistant director and attended by service managers. Reports shared at the monthly TSSMT performance meetings also include details in relation to requests for progression to stage two, LGO enquiries/complaints, compliments and lessons learned. Once reviewed at TSSMT the quality & assurance manager presents the report at the operational leadership team (OLT) meeting, attended by principal managers. A monthly and quarterly update is also uploaded onto EARs (in-house replacement for previous reporting system Performance Plus) and a full performance report is presented to the quarterly directorate management team performance board.

15.10 Action plans which are a direct result of a response to a complaint (often

following adjudication at stage two) are monitored by the complaints manager, the appropriate service manager and the assistant director to ensure actions are completed within agreed timescales. Where lessons have been learnt and/or service improvements have been highlighted actions are completed by staff as appropriate under the instruction and supervision of service managers and principal managers. Prompt action in relation to implementing actions which have been agreed in response to a complaint is worth identifying as a learning point. Managers are aware of the very positive impact prompt implementation of agreed actions can have in terms of the relationship with service users and the council’s reputation.

16.0 COMPLAINTS PROMPTING IMPROVEMENT 16.1 Children and young people’s targeted services are committed to providing an

effective complaints procedure. It is accepted that this is an important element in both providing and assuring the delivery of high quality services. As referred to within 4.14 exactly half of the social work complaints received were upheld or upheld in part.

16.2 The department’s commitment to deal with complaints in a fair and open

manner to ensure that service users are given the opportunity to make their

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views known is recognised as an important tool in identifying ways of improving services.

16.3 It is worth noting that overall the cases considered here are a small proportion

of the overall work of the department. The department seeks feedback from children and families in many different ways to ensure that practice and service delivery can be reviewed and improved and the complaints process is just one example.

16.4 Examples of improvements made to services as a result of complaints include:

Example one: - One theme across the reporting year related to recording which is not of the standard that would be expected and the impact that this has on families and their view of the department. From other feedback received from families, the department has learnt that difficult messages can be accepted by families where they feel they have been treated fairly and with respect. This in turn can go on to have an impact upon the effectiveness of services delivered at different stages of the department’s involvement. The importance of time built in to processes for checking documents cannot be underestimated. It is recognised that sending documents out within good timescales and, where possible, social workers spending time with families to go through documents to check accuracy and explain the content/issues will help to improve practice.

Example two: - This complaint related to a decision about a change of placement for a young person. The young person was initially unhappy at the planned move and was supported by NYAS to make a complaint. The local authority was clear that the move was in the young person’s best interests and through further discussion the young person accepted this. A further result of these discussions was that the young person was able to negotiate a different timescale for the move which they were happy with.

Example three: - One complaint related to confidential information being sent to the wrong postal address. A full investigation was conducted to establish how this happened and the process for distributing minutes was revised as a direct result. The admin processes surrounding the distribution of child protection conference minutes have been tightened with additional measures put in place. This information was disseminated to all appropriate staff via an email from the service manager, children in need.

Example four: - Another theme related to communication and the importance of the thorough and timely communication of information to families once the outcome of a child protection investigation is reached as well as during an investigation. Information has previously been circulated to staff in relation to the importance of ensuring that families have copies of reports & assessments which have been written about them. This clearly supports the development of an open and honest relationship and allows families to express their views and opinions and to correct any factual inaccuracies. There are very few situations where such documents would not be shared and staff have been advised to seek guidance if they are unsure.

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Example five: - A number of complaints, some partly upheld, related to the way in which information was recorded on a report prepared by a social worker. Where the complaint had been partly upheld it was found that some information had been poorly recorded and as a result gave a different impression than that which the worker had intended. This underlines the importance of reviewing documents once they are written to ensure that the content and meaning are as intended. In response further advice has been issued to all staff in respect of the department’s recording policy to ensure that all are clear about the importance of accurate and clear recording in conjunction with taking the time to review reports prior to authorisation and distribution.

16.5 Review of ‘delivery of service’ complaints - 24 of the complaints received

related to ‘delivery of service’ with four of these being upheld and seven being upheld in part. Below shows a review of a selection of the complaints that were upheld or upheld in part inclusive of the outcomes:

Nature of

complaint Finding Outcomes following investigation

Misplaced documents

Upheld in

part

The area upheld was in respect of loss of documentation. Full apology given with an explanation as to what had occurred and why.

Delays to processes

Upheld in

part

Acknowledged that the delivery of service could have been improved. Sincere apologies were provided as soon as the error was realised, these were echoed by the investigating officer.

Concerns about delivery of service

Upheld in

part

Upheld concerns in respect to delays to the completion of an assessment and a lack of clarity about the roles and responsibilities of professionals involved. An apology was given in respect of this element.

Change of social worker

Upheld

It was acknowledged that ideally an allocated worker would not change. Explained that unfortunately there are times when it is unavoidable to change an allocated worker for reasons beyond our control - for instance due to a worker leaving.

Delay in providing a service

Upheld Following investigation it was acknowledged that resources should have been ordered and an apology for the delay was provided

Inadequate communication

Upheld in

part

Investigations found that although case notes stated both parents had been consulted about decisions surrounding contact arrangements, the father was not in attendance at the meeting due to an arrangement to meet separately. Apology provided for oversight as the separate meeting did not take place.

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16.6 Complaints demonstrating the importance of listening to the voice of the child /

young person - below is an overview of four stage one complaints that have, following investigation, clearly demonstrated to the department the importance of listening to the voice of the child / young person:

Nature of

complaint Finding Outcomes following investigation

Mis- communication at a residential provision

Upheld

The investigator offered sincere apologises as to what appeared to be a miscommunication between staff and managers. Offered assurances in respect of services provided.

Processes followed by department to ensure timely comms

Upheld

Apologised for the anxiety caused by the delay in receiving written confirmation regarding the outcome of an investigation. Assured family that lessons would be learn and confirmed there would be a meeting between the practice manager and the social worker to review and reflect upon the impact of delayed communication with families.

Inadequate communication

Upheld in

part

The investigator's view was that there was a lack of evidence that the complainant was consulted or involved in the assessment process at an appropriate level. Apologies given and recommendations made in respect of actions to improve practice.

Meeting proceeded without complainant present

Upheld in

part

Investigator found that a meeting should not have gone ahead without the complainant present, acknowledged that this was not acceptable and provided an apology. A manager had asked for the meeting to proceed; this was not done with the intention cause upset but was intended to have been seen to be supportive for the complainant and the family.

Issues Positive outcome Lessons learnt

Different views in respect of when a planned move of placement should take place.

Following further discussion a compromise was reached.

The importance of listening to the wishes and feelings of children and young people and working towards this or a compromise where possible.

Allegations that children were being bullied.

Upon investigation it was found that the children were not raising concerns about the placement, furthermore they appeared happy there.

The value of offering assistance from NYAS – although on this occasion the young person did not feel it necessary and was able to communicate their wishes and feelings independently.

Staff behaviour / attitude

The young person’s views were listened to and the worker was encouraged to think about how they interact in the future.

The importance of workers thinking about the way they communicate to ensure that comments are not misinterpreted and that client’s feel respected and valued.

Conflict between wishes of individual, agreed care plan and views of other professionals.

The young person’s views were listened to and explanations were provided as to why changes were needed. The result was that the young person was fully involved in the required changes to the care plan.

Keeping the young person at the centre of all that we do especially with regard to decision making to ensure their inclusion in the process.

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16.7 Complaints demonstrating a positive outcome for children and young people - It can be difficult to find examples of complaints that demonstrate a positive outcome or change in decision for children or young people; this is primarily due to the nature of complaints that are received but also relates to the person who makes them – the referrer. As demonstrated in 6.4 and 6.5, although the proportion of complaints received directly from children and young people has significantly increased, the majority are still received from their relatives. The majority of complaints were about delivery of service of which 10 were not upheld (see 4.12) and out of the nine that were partly upheld the outcomes were often that the department accepted that the child/young person needed to be more fully involved however the overall outcome remained the same. Encouragingly the most significant example where a complaint has demonstrated a positive outcome for children and young people came directly from a young person, a review is provided below:-

Case Study A young person requested that their complaint, made with the support of a NYAS advocate, progressed directly to stage two of the process. The complaint stemmed from the department’s refusal to authorise the young person’s request to participate in a chosen activity. Following consideration, the request for Independent Investigation was approved and an independent investigator and independent person were appointed. The stage two independent investigation concluded that it had been possible to reach a local, mediated resolution as all parties were able to listen and take on board the points being put forward. Consideration had been initially made in respect of the perceived associated risks based on experiences of the decision makers and on the department’s shared responsibility to the young person as legal parent. An independent risk assessment in respect of the activity was commissioned which considered the potential risks to the young person’s health and safety, this being the department’s priority. In doing so the department felt they had demonstrated their duty to take the young person’s views and wishes seriously. Following the findings of the investigation, the assistant director found that it was reasonable to conclude that a risk assessment should have been carried out to ascertain the associated risks with the activity at the time the young person originally made the department aware of their wishes and views. It was acknowledged that this would have informed the decision making process where all the factors could have been thoroughly analysed and taken into account. The assistant director offered the young person sincere apologies for the efforts that they had to go to in order to pursue the matter. The young person was subsequently given permission to participate in the activity, as long as they adhered to agreed safety measures (as stipulated within the risk assessment). The young person confirmed their satisfaction with the outcome of the stage two investigation and the complaint file was closed.

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17. NATIONAL DEVELOPMENTS

17.1 A working group, representing both adults and children’s social work

complaints managers, was formed within the North West complaints group to review the social care complaint 2006 regulations. The aim was to feed findings into the national group agenda. The strengths and weaknesses of the 2006 regulations were considered by the group which will hopefully contribute to government policy. The findings of the working group were presented to the national group in December, 2012.

17.2 On 15 March 2013 a press release was issued outlining the details of a review into NHS complaints handling. The review is aimed at ensuring that all hospitals listen to and act upon the concerns of patients and was launched by secretary of state for health, Jeremy Hunt.

17.3 The review of NHS complaints handling was first announced by the prime minister in his response to Robert Francis’s report into failings at Mid Staffordshire NHS Foundation Trust. The review, led by Ann Clwyd, MP for Cynon Valley, and Professor Tricia Hart, Chief Executive of South Tees Hospitals NHS Foundation Trust was commissioned to engage with patients, their carers and representatives, staff and managers and other organisations involved in handling patient complaints to hear how trusts currently act when concerns and issues are raised. It will look to consider, among other factors, what common standards can be applied to the handling of complaints; how intelligence from concerns and complaints can be used to improve service delivery, and how this information can be made available to service users and commissioners.

17.4 The review will identify existing best practice for the handling of complaints, and make recommendations for a set of common standards by which all NHS hospitals will be assessed and held to account. The Review Team will report to the secretary of state for health by the parliamentary summer recess. It is anticipated that the findings of the review may have potential impact on the complaints processes for both adults and children’s social work complaints; this item is being closely monitored by both the national and North West complaints group.

17.5 The independent complaints advocacy service ceased on 31 March 2013. On 1 April, commissioning of NHS complaints advocacy services transferred to individual local authorities. Although the principles behind the 2009 regulations remain, there are changes in system architecture:-

• NHS commissioning functions will no longer be a single type of body (the PCT) but will instead be two bodies, the NHS commissioning board (NHSCB ) and local clinical commissioning groups (CCGs). The CCGs will commission secondary care, whilst the NHSCB will commission primary care and specialised services.

• LAs will be responsible for commissioning public health services.

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17.6 As is the case now, a complaint about service provision should be made to the commissioner of that service, which means that instead of cooperating only with the local PCT in these cases, a council may need to work with the NHSCB, local CCG, or even the public health complaints team in the relevant LA (often its own). In future, as the new system settles in, councils may need to review the way they currently organise the handling of public health complaints. This item will feature on meeting agenda’s for the North West complaints group to encourage complaints managers to share experiences and examples of best practice with their peers.

18.0 FINANCIAL CONSIDERATIONS

18.1 There are on-going costs associated with delivering an effective complaints

service. The designated children’s complaints Manager is a full time, permanent post within the directorate structure.

18.2 In addition costs surround stage two and three of the process due to the

requirement to appoint external independent investigating officers and independent persons. Cost of stage two investigations:-

Year Quantity Total Cost

2010/11 7 £13,246.60

2011/12 4 £11,244.40

2012/13 3 £ 4,101.60

18.3 To ensure that public resources are utilised in the most appropriate way the department will continue to quality assure responses at stage one in order to limit the number of complaints likely to be pursued to stage two.

19.0 RISK ASSESSMENT

19.1 It is recognised that an effective complaints process gives confidence to service users and can assist in identifying and minimising risks to the reputation of the council, for example through seeking resolution. As such there are potentially significant reputational risks to both the department and the local authority should the process not be sufficiently effective. Steps have been and will continue to be taken to mitigate identified risks:

• processes referred to at 7.2 of this report

• lessons to be learned from complaints are reviewed by the senior management team on a monthly basis and any identified amendments to procedures or policies are processed as necessary to ensure identified themes are addressed and therefore efforts made to not repeat these

• advice has been sought from the LGO in order to seek assurances / guidance to ensure that complaints are handled appropriately

24

• day to day advice and guidance provided by the complaints manager

• the complaints manager is supported to attend meetings of the North West complaints managers group in order to benefit from the sharing of good practice and to keep abreast of both regional and National developments

20.0 EQUALITY AND DIVERSITY / EQUALITY IMPACT ASSESSMENT

20.1 An equality impact assessment (EIA) is undertaken for each area of service and is reviewed every three years or in relation to any significant changes to service. An updated EIA was scheduled to be completed in October 2012; unfortunately due to capacity issues this has not yet taken place. Completion of an EIA will be a priority for June 2013.

20.2 Significant steps have been taken to ensure the process is accessible and

complainants now have a number of avenues through which to raise their concerns. Complaints are accepted via the telephone, an email, a written letter, the completion of a complaints form, a face to face meeting with the complaints manager either on site or at a suitable venue or via contact Warrington. As stated at 6.6 of this report, the “Shout Out” complaints leaflet also saw the introduction of a designated children’s complaints email address, freepost address and a free phone complaints line. Should interpretation services be required these would be arranged in accordance with contract arrangements.

21.0 CONSULTATION

21.1 Feedback continues to be sought by the complaints manager from investigating officers following the completion of stage two investigations in relation to their thoughts and experiences following involvement in the process.

21.2 Officers from the commissioning team will review the complaints process and

its application when visiting commissioned providers and will provide necessary feedback to the complaints manager. Consultation also takes place with independent reviewing officers (IROs) who often advocate on a child or young person’s behalf. IROs also conduct reg.33 visits to the department’s residential units. A reg.33 is a visit which is made by a person independent to the management of the home to review and quality assure all aspects of care provision. The IROs review the residential complaints book and will feedback any concerns or queries to the complaints manager for further investigation and action as appropriate.

21.3 The complaints manager also attends the North West complaints group which

consists of 23 constituent authorities, 11 of which provide their adult and children social work complaints function through one service. In total 20 authorities have been represented at meetings throughout the year. Member attendance has been good, fluctuating between 13 and 32 with an average of

25

19 per meeting. 2012/13 has been a challenging year for many within the public sector, and it has been no exception for the complaint managers within the social work function. Despite the pressures of both time and resources group members have prioritised attendance at the group meetings due to the valuable information and the good practice shared. A substantial amount of time is saved by sharing information in a group setting, by discussing challenging cases and learning from the LGO reports that are regularly reviewed at meetings. Information sharing following Ofsted inspections relating to complaint handling is also a regular area of discussion. The importance of both attending and contributing to group meetings is acknowledged by both the complaints manager and senior managers, sharing of information and experiences assists in ensuring good practice and consistent high standards of performance is achieved.

22.0 CONCLUSION 22.1 The majority of complaints were effectively managed and resolved at stage

one of the procedure with a small number (three) being dealt with at stage two. Exactly 50% of complaints were upheld (partly or fully) and there were no stage 3 complaints. This evidences the effectiveness of the systems which are in place for resolving complaints and the report reflects a positive direction of travel within the social work complaints function when compared to previous years. The improvements which were introduced in 2011/12 have continued and, where necessary, developed. The result is a mature and confident process that is progressive, accessible, open and fair.

23.0 RECOMMENDATIONS That the contents of this report are both considered and noted.

That a copy of this report is shared with all managers, social workers, social work assistants and other appropriate officers working within children in need, children in care and safeguarding and quality assurance divisions.

That all managers within the department reference the report and its

contents within staff at team meetings.

That, following the distribution of this report, the assistant director, targeted services will send an email to all social work staff to provide a reminder about the need to respond within timescales. The email will note the achievement of 90% of complaints responded to in timescales this year as an improvement on last year but will also emphasize the need to need to continue with good performance and aim for 100%.

26

24. BACKGROUND PAPERS N/A

25. Clearance Details Name Consulted Date

Approved

Yes No

Finance �

POI �

Legal �

Agenda Item 6

53

Healthwatch Warrington Report for Scrutiny

Town Hall

September 2013

Report Title

Healthwatch Warrington Update

Report Purpose

To update Scrutiny members on Healthwatch Warrington Development

Report author

Elaine Packer

Agenda Item 6

54

Contents

1. Background

2. Introduction

3. Update

4. Healthwatch Warrington Legacy Strategy

Agenda Item 6

55

1. Background

Healthwatch was created by the Health and Social Care Act 2012. The Act created a national body, Healthwatch England (instituted in September 2012), which is a committee of the Care Quality Commission – it provides leadership and support to Local Healthwatch and may make recommendations to local authorities. A local organisation, local Healthwatch (instituted in April 2013), for each local council in England with social care responsibilities. LHW is a corporate body commissioned by the council who have the duty to ensure that it fulfils its aims. Healthwatch is intended to strengthen the collective voice of users of health and social care services and members of the public, both nationally and locally. Local Healthwatch organisations have greater powers and responsibilities than their predecessors, Local Involvement Networks (LINks). The main roles and responsibilities of Healthwatch are:

It covers both health and social care services for both adults and children.

It is a statutory member of the local authority’s health and wellbeing board.

It is required to provide an information, advice and signposting service for the public, including informing people how they can make a complaint if things go wrong.

It has powers to request information from commissioners and providers of health and social care who must respond to its reports and recommendations, and to enter health and social care premises (except those providing care to children and young people).

It can alert the local authority, Healthwatch England and/or the Care Quality Commission to concerns about specific care providers and health and social providers.

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2. Introduction Following the recent changes to the way that health and social care are commissioned in England the role of Healthwatch is particularly important. It is the new independent consumer champion created to gather and represent the views of the public. Healthwatch will play a role at both national and local level and will make sure that the views of the public and people who use services are taken into account.

Healthwatch Warrington is the people’s voice. "We want to make sure that everyone in Warrington gets the chance to influence the health and social care available to them. Every local voice counts and we want to make sure that everything Healthwatch Warrington does is about improving the services. We will work to help local people get the best out of their local health and social care services. Whether it's improving them today or helping to shape them for tomorrow. We want to work along side Health and Social care providers to find how we can help to design the services for the future in our town. Healthwatch Warrington is all about local voices being able to influence the delivery and design of local services. Not just people who use them, but anyone who might need to in future. Our strategy of engagement is key to seeking the involvement of not just existing patients and carers but to seek the views of the general public as well. We hope that Healthwatch will become the consumer champion and everyone in

Warrington will know what we do. Judith Guthrie Chair The Warrington Team

Chair Judith Guthrie Vice Chair Director Pat Taylor Director Glen Maxwell Eileen Fitzgerald

Elaine Packer Healthwatch Manager

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3. Update

Progress to date

Board of Directors Healthwatch Warrington has appointed four Directors to date, from the four Directors a chair and vice chair have been appointed, it is at present looking to recruit three more Directors, and recruitment is underway. The posts are voluntary positions; out of pocket expenses are paid for the work carried out on behalf of the organisation. The Current Board is: Judith Guthrie – Chair Eileen Fitzgerald – Vice Chair Pat Taylor – Director Glen Maxwell- Director Stakeholder Group A new stakeholder group has been formed, it is in its infancy, but the members are keen. 21 representatives have been recruited to date, with a wide diversity of interests. The Stakeholder group will be responsible for Healthwatch activities, including Enter and View Visits and Work Plan prioritisation. This group will meet monthly. Young Peoples Reference Group The previous LINks young peoples reference group have signed to be apart of Healthwatch. There are 25 on the reference group to date. This group will not meet on a regular basis but will communicate via email. Office The Healthwatch Warrington office will be in the Gateway, Sankey St, Warrington. Healthwatch Advocacy This service has been regionally commissioned by councils across Cheshire, Merseyside and Manchester. Healthwatch Advocacy will operate a local hot desk in the Healthwatch Office; this will be one day a week. The detail is still to be arranged.

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4. Healthwatch Warrington Legacy Strategy Healthwatch Model Community Engagement / Stakeholder Involvement Care Navigation Enter and View

Reporting Systems

Partnership Working

Volunteer Support and Process Communication Databases and Directories

troduction Healthwatch Model Community Engagement Activity

Collecting Comments and Issues

Links to groups

Building on the success of Warrington LINk and to enable a smooth transition Healthwatch Warrington has adopted many of the policies and guidance developed by LINks.

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Wider Healthwatch Warrington Participation (Geographic and Thematic Groupings)

Healthwatch Model

Stakeholder Group Y. P Reference Group

Healthwatch Warrington Board

of Directors

Specialist sub

groups

Specialist Task Group

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Community Engagement

Healthwatch Warrington has a Community Engagement Strategy which emphasises the importance of community engagement to Healthwatch. The document focuses on:

The models and forms of engagement

Who should be engaged

Processes that are in place to achieve outcomes

Healthwatch Warrington has also agreed on a Priority Plan Document to agree on priorities from engagement work. Collecting Comments and Issues

Healthwatch England HWE gives a national voice to the key issues children, young people, adults and older people who use health and social care services. It develops an intelligent view of trends and consumer experiences at a national level, based on evidence gained from:

• views and experiences of people who use services locally and nationally • views and experiences gained by local Healthwatch • evidence gathered and shared by stakeholders and partners, including

charities, professional bodies and those who support vulnerable people

Healthwatch Warrington will pass information and recommendations to Healthwatch England; we are also committed in keeping updated with National developments and events. Healthwatch Hub The Hub will effectively capture and collect all the issues and concerns raised through community engagement work. Healthwatch Warrington has signed up to use the Healthwatch Hub, developed by Healthwatch England. The hub is a central, secure online information exchange with controlled access, where every Local Healthwatch will be able to store feedback comments they have received from the public and reports they have written. This locally-created information will then be available for sharing nationally with all other Local Healthwatch organisations, with Healthwatch England and with CQC. Local Healthwatch’s across Cheshire, Merseyside and Greater Manchester have signed up to use the hub. Care Quality Commission Healthwatch will continue quarterly meetings with Area Manager and local Inspector, to share information, discuss any concerns etc. They will feed in all comments received monthly via internet site, in the agreed template. Contact details for inspectors covering Warrington have been shared. Inspectors will contact Healthwatch staff team for any intelligence when they are undertaking reviews or inspections.

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Stakeholder Involvement All Healthwatch participants will receive regular information including newsletters, e bulletins, reports, and invites to events, conferences and focus groups; we will ensure the opportunity to feedback on services. Stakeholder Board Membership OPEG, Parents and Carers Forum, WIRED Adult and Young People’s Carers Support, Warrington Disability Partnership, Mental Health Forum, Footsteps, WECA, LGBT Warrington, Older Persons Forum, WBC Worker Traveller Community, five health champions representing long term conditions, acute care, mental health, visual impairment, older people, and six interested individuals with heath and social care background. A comprehensive ‘Who’s Who will be developed including background, skills and their involvement within Health and social care. Long Term Conditions Sub Groups This sub group was developed to work in partnership with Warrington Clinical Commissioning Group on improvements to services. Representation is from:

Local Diabetes Group

Warrington Disability Partnership

Parkinson’s Support

Older Persons Forum

CAB Homelink

Breathe Easy Support Group

Three individual health champions

OPEG

Suggestions for Future Engagement

Engaging with Communities Healthwatch Warrington intends to work hard to engage with the diverse communities of Warrington including ethnic communities, carers, disabled people, older people, young people, LGBT, homeless and mental health service users. Engagement / Involvement work in the past has included facilitating and attending focus groups, events and group meetings this will continue with Healthwatch. There is a firm commitment from Healthwatch that the voice of all citizens of Warrington counts. A comprehensive engagement / involvement strategy has been drafted. Mental Health Work to improve access to 5BPS Acute Care Pathway and the A&E Liaison Service at Warrington Hospital (report available) is on the Healthwatch workplan, comments / issues regarding accessing mental health service in a crisis, in particular the A&E Liaison Service at Warrington Hospital is problematic. A report has been produced in partnership with Warrington Mental Health Forum, the outcomes were:

The assessment room was changed with the involvement of service users

Referrals from Access and Advice will not need to be triaged

The staff team from the service were now more involved with hospital committees

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5BPS developed the Acute Care Pathway and the 24 hour Assessment Team in July 2012. A focus group was arranged to share appropriate referral routes and share experiences. From the focus group many actions were recorded, including further work on triaging patients, improved communication and staff training, the work is ongoing. (Notes from focus group are available).

Children and Young Peoples Health Experience Healthwatch will be working in partnership with Warrington CCG to engage with children and young people, this will be a specific piece of partnership work around GP services, and the suggestion is to obtain the views of C&YP on their health experience with GPs. The work will include engaging with the C&YP reference group and also other local young people groups, service user individuals. Healthwatch have also been involved in a PSHE (Personal, Social, and Health Education) workshop to discuss with children and young people experiences of accessing school health services, sexual health services and smoking cessation services. There is further potential to work with school Health Ambassadors. Maternity services – working with Warrington CCG Working with Warrington CCG to engage with new mums on their experience of maternity both pre and post natal. Building on relationships and networks already developed through previous LINk work. Long Term Conditions and Frail Elderly The LINk prioritised Long Term Conditions, putting a case to Warrington CCG to fund Expert Patient Programmes and in partnership with Public Health supported a funding application to develop expert patients programmes. The LINk development a LTC and Frail Elderly sub group in 2013 and the group is keen to continue to scrutinise Warrington CCG’s workplan and developments around LTC and Frail Elderly. Members of the group were keen to continue into Healthwatch. JSNA Involvement Healthwatch has a staff representative on the JSNA steering board, soft intelligence from service users etc is and will continue to be fed into the system on a quarterly basis. NHS Reforms The seat that Healthwatch has on WBC Health and Wellbeing Board is very important, with all the NHS Reforms and the significant changes from April 1st 2013, it is essential that Healthwatch have a mechanism for sharing patient and the public experiences into the Health and Wellbeing Board and Warrington CCG. Care Navigation - Information/advice on People’s Rights and Choices Warrington Local Involvement Network (LINk) was awarded pathfinder status to identify ways of how information and advice should function in Warrington. Healthwatch Warrington has continued with this service. Healthwatch aims to ensure that future demand for care navigation and information advice and signposting are met. It is recognised that there are some Third Sector organisations that have an advice and information function and it is important that duplication is avoided and partnership work encouraged. Care Navigation was the missing jigsaw piece within the already existing functions of the LINk.

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Advice and information has been welcomed at a community level, with the main ethos being “putting patients at the heart of the service”. Care Navigation is ensuring that patients and carers have easy access to the provision of professional high quality information and support. Any pertinent issues that arise from issues shared by individuals add to the bank of intelligence regularly shared with decision makers. The Care Navigation Officer receives contacts from individuals who found out about the service from diverse sources such as the job centre and local library as well as the more mainstream agencies such as the NHS, WBC and the Third Sector. The Care Navigation Officer focuses on the rights and choices of individuals who are in receipt of health and social care services while contributing to the core business of Healthwatch. This unique approach to supporting individuals with their rights and choices is now established; veering away from appointments based service. Contacts are made by phone, email, post and in person.

Enter and View Healthwatch staff and volunteers are committed to carrying on the regular visits LINks took part in. These are: Enter and View of Government funded establishments i.e. nursing homes, Residential homes, clinics and hospitals. Reports will be made available from the visits. There are also PLACE Visits, where the environment, cleanliness and food are inspected. These visits are national, annual visits which will take place in hospital and clinic settings. Scorings are agreed and sent nationally to the Department of Health. Health trusts will have a statutory obligation to invite Healthwatch representations to be involved. There is a briefing on the new system and documents are available. Healthwatch Enter and View Representatives will continue this process in 2014. Healthwatch Warrington may, in certain circumstances, enter health and social care premises to observe and assess the nature and quality of services and obtain the views of the people using those services. The overall aim is to enable ongoing service improvement. These visits will be properly conducted and coordinated visits, in line with the Healthwatch Warrington Code of Conduct, carried out as part of a constructive relationship between Healthwatch Warrington and organisations providing NHS health services and social care services. Healthwatch’s role is not to seek out faults with local services, but to consider the standards and provision of care services and how they may be improved. A Visit Pack and Process has been developed by Healthwatch Warrington to ensure the Enter and View activity is as effective as possible. The pack contains:

Visit Rationale

Best Practice – before the visit, during and after

Template questionnaire for visits

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Template introduction for members

Template Visit Report

Statutory Instrument

Code of Conducts

Feedback from training attended Training All visiting representatives will be offered training from WBC’s Safeguarding Team and Warrington Social Care Partnership on:

Safeguarding Adults

Communication and Record Keeping

Infection Control

Promoting Independence and Dignity

Healthier Foods Special Diets

External and in house training will be offered including report writing and speaking and responding to service users/ patients. Outcomes Representatives of Healthwatch will be encouraged to feedback any urgent issues to the appropriate staff on the visit or to feedback to Healthwatch staff for them to report any issues as soon as possible. De-briefing sessions after each visit will take place as will regular structured supervision sessions. All visit reports, with recommendations, were sent to the ward/ home etc and the appropriate health/ social care trust for a response within 20 working days. All reports were then sent to the appropriate CQC Inspector and fed through CQC’s website for analysis. A feedback/ outcomes form has been developed and agreed with CQC for this process. Healthwatch staff and volunteers will have regular meetings to feed in best practice, recommendations and outcomes of the visits for each health trust and social care service, these were:

Patient Experience and Safety – Warrington Clinical Commissioning Group

Patient Experience – Warrington and Halton Hospitals NHS Foundation Trust

Patient and Public Advisory Group - 5 Boroughs Partnership NHS Foundation Trust

Intelligence meeting – Warrington Borough Council

Adult Safeguarding Board

Reporting Systems

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Partnership working Care Quality Commission Healthwatch are committed to building on the relationship already developed by LINk with the Care Quality Commission. Staff/ Directors will hold quarterly meetings with the CQC Area Manager and Local Inspectors to share information, visit reports and discuss concerns. All comments and issues received will be feed in monthly via the CQC internet site, in an agreed template with outcomes. Healthwatch hold a database of Local Inspectors covering Warrington. Inspectors contact the staff team for any intelligence when they are undertaking reviews or inspections. All Healthwatch reports will be shared with the relevant Inspectors. Ofsted Healthwatch’s new remit within children and young people’s social care will see the need for a relationship to be built with Ofsted. Contact was initially made by LINks, but it proved difficult to sustain with change of staff and directorates with Ofsted. Processes of feeding in issues and concern and ensuring outcomes will need to be developed. Meetings and Boards Healthwatch has a place on Warrington’s Health and Wellbeing Board; meetings attended by the previous LINk have continued i.e. Partnership Boards, Safeguarding Boards. Statutory Sector Partnership working, and maintaining and enhancing the contacts already made are key to Healthwatch having an effective and influential feedback mechanism. Working with our statutory partners will continue, there is a commitment to build from the LINks legacy Voluntary Sector Partnership working has continued with a commitment to maintain and build.

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Volunteer process and Support The role and involvement of Healthwatch volunteers and lay members varies. Volunteer involvement includes:

Board of Directors

Stakeholder Board Representation

Enter and View Visiting Representations

Representation on decision making boards

Attendance on groups and at meetings

Community Engagement activities

Ad Hoc opportunities

Policies developed are:

Volunteering and Lay Member Strategy

Volunteer Portfolios to capture skills, background and their role within Healthwatch

Code of Conduct including the Nolan Principles

Travel Expenses Policy and Form

Feedback form to capture what meetings/ work has been undertaken with amount of hours

Feedback form from training attended

A ‘Who’s Who’ of volunteers including background, skills and meetings they attend representing Healthwatch

Training offered:

Induction training

Separate training for Enter And View Members

CQC Training

Safeguarding Adults

Communication and Record Keeping

Infection Control

Promoting Independence and Dignity

Healthier Foods Special Diets

In house training

External training e.g. basic mental health awareness (Public Health) and Report Writing

Support will be offered to all volunteers and lay members by staff and other members. De briefing sessions for Enter and View Representatives will be available and individual and group supervision session. Healthwatch will aim to celebrate the work of the volunteers holding an annual celebratory event during National Volunteering Week in June. Staff attend Warrington Voluntary Action volunteer network meetings to share best practice and learn from other local organisations supporting and working with volunteers.

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Communication Methods

Regular Email Bulletins

Facebook

Twitter

Website

Representation and attendance at a variety of meetings, committees and groups

Directories Directories that were produced by the Warrington LINk are still relevant and upto date and will be used by Healthwatch Warrington. Healthwatch Warrington will commit to maintaining the directories:

LINk Mapping of health and social care services, groups, organisations and structures in Warrington

Town Centre Mapping – health and social care service in Warrington Town Centre

Mental Health Directory of Services and Support Groups

Directory of support for people with mental health problems in accessing volunteering, employment and training

Care Navigation Database

External directories and databases:

Warrington Borough Council Resource Directory My Life, My Way

Warrington Voluntary Action’s Third Sector Database (includes JSNA Asset Mapping)

Families Information Service

BHA Service Directory (BME Community Organisation across North West)

Accessing Information and Advice For Warrington – WBC, CAB and Warrington Partnership

Database of GPs and Practice Managers

Database of Opticians

Database of Dentists (includes upto date information on those accepting NHS Patients – up dated monthly)

Database of Pharmacies (including bank holiday opening times)

Database of CQC Inspectors

Healthwatch England Hub – to include database of all service providers registered with CQC

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WARRINGTON BOROUGH COUNCIL SCRUTINY COMMITTEE – 17 September 2013 Report of the: Chairman, Cllr Tony Higgins Report Author: Julian Joinson, Principal Democratic Services Officer Contact Details: Email Address:

jjoinson@warrington.gov.uk Telephone: (01925) 442112

Ward Members:

All Wards

TITLE OF REPORT: Work Programme 2013/14 and Monitoring of

Actions/Recommendations 2013/14 1. PURPOSE 1.1 The purpose of the report is to provide an update and to review the work

programme for the municipal year 2013/14. 2. CONFIDENTIAL OR EXEMPT 2.1 Not applicable

3. INTRODUCTION AND BACKGROUND 3.1 The Committee agreed it substantive Work Programme for 2013/14 at its last

meeting on 20 March 2013. This is a ‘living document’ and a copy of the latest version is attached as Appendix 1. This report details the progress made regarding the implementation of the work programme.

3.2 The schedule at Appendix 2 provides an update as to progress on any

actions proposed or recommendations made by the Committee.

4. WORKING GROUP ACTIVITY

4.1 The Committee has not established any Working Groups to date. 5. FINANCIAL CONSIDERATIONS 5.1 When carrying out scrutiny activity Members are reminded of the general

financial climate and the Council’s commitment within the ‘One Team’ framework, “to be well run and efficient.”

6. RISK ASSESSMENT 6.1 The following potential risks have been identified: recommendations not

accepted by Executive Board, or not acted upon; partners unwilling to engage; insufficient capacity within Directorates to support scrutiny activity in the light of efficiency savings; selection of inappropriate topics, which have minimal

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impact or are undeliverable; insufficient capacity within the work programme to deal with matters arising.

6.2 Risks are regularly monitored and managed by the Chairs Forum, with the

advice and support of relevant officers. Links with Partnerships and Performance are being strengthened and the delivery of the Work Programme is routinely monitored.

7. EQUALITY AND DIVERSITY/EQUALITY IMPACT ASSESSMENT 7.1 Democratic and Member Services has an up to date Equality Impact

Assessment for its policies and services. 7.2 Equalities issues relating to policies, services and other topics under scrutiny

are the responsibility of the individual Directorates concerned. However, the committee will monitor the compliance by Directorates on equality and diversity issues when carrying out its functions.

8. CONSULTATION 8.1 Consultation with relevant stakeholders was undertaken. 9. RECOMMENDATION 9.1 To approve the Work Programme for 2013/14 at Appendix 1 9.2 To note the progress on actions and recommendations at Appendix 2. 10. BACKGROUND PAPERS

Nil

Contacts for Background Papers:

Name E-mail Telephone

Julian Joinson jjoinson@warrington.gov.uk 01925 442112

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17 September 2013 REPORT DEADLINE – FRIDAY 6 SEPTEMBER 2013

Issue Methodology, Details, Purpose Lead Officer(s)

Progress Further Action(s)

Healthwatch Monitoring

Rationale: To consider biannual update report from Healthwatch, including its findings in relation to the customer or patient experience of healthcare or adult social care in Warrington. To deal with any statutory referrals from Healthwatch. Anticipated Outcome: To gather intelligence from service users about the standards of health care and adult social care in Warrington and to make reports or recommendations to providers, as necessary.

Local Healthwatch

Adult Social Care Complaints

Rationale: To receive an annual report on the numbers and types of Social Care complaints received. Anticipated Outcome: To provide an assurance to service users that complaints are treated seriously and to identify any significant learning points or systemic failures which need to be addressed.

S Reddy/ M Maklin

Children’s Social Care Complaints

Rationale: To receive an annual report on the numbers and types of Social Care complaints received. Anticipated Outcome: To provide an assurance to service users that complaints are treated seriously and to identify any significant learning points or systemic failures which need to be addressed.

R Howell

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10 December 2013 REPORT DEADLINE – FRIDAY 29 NOVEMBER 2013

Issue Methodology, Details, Purpose Lead Officer(s)

Progress Further Action(s)

State of Warrington Report - Snapshot of Wellbeing Outcomes

Rationale: To receive a biannual high level monitoring report, also provided to the Health and Wellbeing Board, which includes overarching outcome measures for performance in the five thematic priority areas of the Warrington Strategy for Wellbeing (JHWS) Anticipated Outcome: To provide critical challenge to the Health and Wellbeing Board and an assurance to the public that health and wellbeing priorities are being met.

R Robertson

CQC Updates Rationale: To consider on a quarterly basis a summary of CQC inspection reports in relation to care provided in Warrington. To be local watchdog for any good and poor standards involving providers, so as to provide a conduit for intelligence from service users and other stakeholders to be fed back CQC. Anticipated Outcome: To hold local providers of care to account and to engage with the public about their experiences of care provision.

S Reddy

National spending plans and local pressures

Rationale: To receive a report to coincide with the Chancellor’s Autumn statement to provide an early indication of external and internal financial pressures on the Council’s future Budget Anticipated Outcome: To provide early context to the Committee about the financial environment prior to its in depth consideration of the draft Budget in February.

L Green and Portfolio Holder for Corporate Resources & Assignments

Homelessness Review (project with CfPS)

Rationale: To consider a report on New Homeless produced following a project with the Centre for Public Scrutiny looking at health scrutiny with a Return on Investment approach. Anticipated Outcome: To make a report and recommendations to the Executive Board on potential improvements to housing advice services for

T Date

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working families who have been affected adversely by the economic downturn and are at risk of homelessness.

Statutory Housing Services and Golden Gates Housing and other Registered Providers’ Annual Reports

Rationale: To receive a report on the delivery of the Council’s statutory housing function including annual reports on the performance of Golden Gates Housing Trust and other local Registered Providers, which show past performance and future priorities for those organisations. To be considered in conjunction with the Building Stronger Communities Policy Committee. Anticipated Outcome: To hold to account the principal provider of social housing in Warrington and to provide an assurance to tenants about standards of service.

Dave Cowley/ Golden Gates Housing Trust

Council’s Active Warrington Strategy and LiveWire Annual Report

Rationale: To receive a report on the delivery of the Council’s Active Warrington Strategy, including an annual report on the performance of LiveWire, which shows past performance and future priorities for the Trust. To be considered in conjunction with the Supporting the Local Economy Policy Committee. Anticipated Outcome: To hold to account the principal provider of leisure services in Warrington and to provide an assurance to the public about standards of service.

S Reddy/ S Duerden/J Souness

Cultural Strategy and Culture Warrington Annual Report

Rationale: To receive a report on the delivery of the Council’s Cultural Strategy, including an annual report on the performance of Culture Warrington, which shows past performance and future priorities for the Trust. To be considered in conjunction with the Supporting the Local Economy Policy Committee. Anticipated Outcome: To hold to account the principal provider of cultural services in Warrington and to provide an assurance to the public about standards of service.

S Reddy/ S Duerden/J Souness

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28 January 2014 REPORT DEADLINE – FRIDAY 17 JANUARY 2014

Issue Methodology, Details, Purpose Lead Officer(s)

Progress Further Action(s)

Scrutiny of the Medium Term Financial Plan and Council’s Budget

Rationale: To respond to the annual consultation on the MTFP and draft Council Budget Anticipated Outcome: To support the Executive Board and Council to develop a robust Budget which is aligned to Corporate priorities and to be a voice for comments and concerns expressed by the public and other stakeholders.

L Green and Portfolio Holder for Corporate Resources & Assignments

May need to put back this date to early February align with timetable for budget development

Educational Achievement – Annual Report

Rationale: To receive a report on the educational achievement of pupils in Warrington and the performance of Warrington schools, including Academies and Free Schools. Anticipated Outcome: To hold to account providers of publicly funded education in Warrington so as to help drive up educational attainment by Warrington pupils.

S Edwards

Youth Strategy Forum Annual Report

Rationale: To receive an update report from the Youth Strategy Forum on its partnership activity in respect of young people in Warrington Anticipated Outcome: To provide critical challenge to partnership bodies about the delivery of multi-agency plans across Warrington.

F Waddington

Annual Report on Children’s Safeguarding

Rationale: To consider an annual report on Children’s Safeguarding and the Safeguarding Board’s Business Plan. Anticipated Outcome: To hold to account the executive and partners regarding arrangements for the protection of a specific vulnerable group and to provide an assurance to service users and their families about

F Waddington

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safeguarding issues

Annual Report on Adult Safeguarding

Rationale: To consider an annual report on Adult Safeguarding and the Safeguarding Board’s Business Plan. Anticipated Outcome: To hold to account the executive and partners regarding arrangements for the protection of a specific vulnerable group and to provide an assurance to service users and their families about safeguarding issues.

S Reddy

CQC Updates Rationale: To consider on a quarterly basis a summary of CQC inspection reports in relation to care provided in Warrington. To be local watchdog for any good and poor standards involving providers, so as to provide a conduit for intelligence from service users and other stakeholders to be fed back CQC. Anticipated Outcome: To hold local providers of care to account and to engage with the public about their experiences of care provision.

S Reddy

OFSTED Inspection of Fostering and Children’s Homes

Rationale: To consider the anticipated report of the Inspectorate in respect of vulnerable children. Anticipated Outcome: To provide assurance to the public that procedures are in place to learn from the findings of inspections to improve educational provision in Warrington.

F Waddington

19 March 2014 REPORT DEADLINE – MONDAY 10 MARCH 2014

Issue Methodology, Details, Purpose Lead Officer(s)

Progress Further Action(s)

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CQC Updates Rationale: To consider on a quarterly basis a summary of CQC inspection reports in relation to care provided in Warrington. To be local watchdog for any good and poor standards involving providers, so as to provide a conduit for intelligence from service users and other stakeholders to be fed back CQC. Anticipated Outcome: To hold local providers of care to account and to engage with the public about their experiences of care provision.

S Reddy

State of Warrington Report - Snapshot of Wellbeing Outcomes

Rationale: To receive a biannual high level monitoring report, also provided to the Health and Wellbeing Board, which includes overarching outcome measures for performance in the five thematic priority areas of the Warrington Strategy for Wellbeing (JHWS) Anticipated Outcome: To provide critical challenge to the Health and Wellbeing Board and an assurance to the public that health and wellbeing priorities are being met.

Rita Robertson

Healthwatch Monitoring

Rationale: To consider biannual update report from Healthwatch, including its findings in relation to the customer or patient experience of healthcare or adult social care in Warrington. To deal with any statutory referrals from Healthwatch. Anticipated Outcome: To gather intelligence from service users about the standards of health care and adult social care in Warrington and to make reports or recommendations to providers, as necessary.

Local Healthwatch

NHS Quality Accounts

Rationale: To receive any presentations from NHS providers about their annual Quality Accounts. Draft Quality Accounts will usually be circulated outside of the formal meetings for Members’ comments. Anticipated Outcome: To respond NHS bodies carrying out their statutory duty to consult Scrutiny, by holding NHS bodies to account for past performance and providing a conduit for the public to comment on future priorities.

WHHT, 5BPT, Bridgewater NHS Trust, Clatterbridge Cancer Trust, NWAS

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Work Programme Items (Not yet allocated) Issue Rationale Anticipated

Timescale

NHS Substantial Variation/Development of Service – Consultations

Rationale: To deal with any health service matters which in the view of the Committee constitute a substantial variation or development of service. NB. Cancer Services review anticipated in June 2014, likely to be a Joint Committee with other authorities in the region. Anticipated Outcome: To engage the public and service users and to provide challenge to health service commissioners and providers about significant changes to services to ensure that outcomes are in the interests of local health services. (WCCG and other NHS bodies, as appropriate)

TBA

Later Life Memory Service – Consultation (5 BPT)

Rationale: To consider a specific substantial variation issue being developed by 5BPT, which is likely to be the subject of formal consultation in 2013/14 Anticipated Outcome: To engage the public and service users and to provide critical challenge to 5BPT about the proposed changes to services to ensure that outcomes are in the interests of local health services. (Julian Eyre and Therese Patten - 5BPT)

TBA

OFSTED Reports Rationale: To consider any OFSTED reports in relation the authority or its 8 children’s centres and any action plans arising from such reports. To consider any issues from OFSTED inspections of Warrington schools, where the Council may be able to provide advice or support.

TBA

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Anticipated Outcome: To provide assurance to the public that procedures are in place to learn from the findings of inspections to improve educational provision in Warrington. (A McCormack/ F Waddington)

Warrington Partnership Annual Update

Rationale: To receive an update report from Warrington Partnership as to progress on the delivery Partnership priorities. Anticipated Outcome: To provide critical challenge to partnership bodies about the delivery of multi-agency plans across Warrington and to provide assurance to the public that the Council is leading on ‘place shaping’. (K Griffiths)

TBA

Items Deleted/Reallocated Quarterly performance monitoring

Rationale: To receive copies of the quarterly performance monitoring information after its consideration by the Executive Board. Details may need to be circulated outside of the formal Committee meetings to ensure information is current. Anticipated Outcome: To provide assurance to the public that the Council is meeting its key targets and to challenge poor performance. (K Griffiths)

Reported to Executive Board (Issues may be considered on request)

Quarterly financial monitoring

Rationale: To receive copies of the quarterly financial monitoring reports prior to its consideration by the Executive Board. Anticipated Outcome: To provide advice to the Executive Board about ongoing management of the budget and to provide an assurance to the public that the Council’s finances are on target. (S Halewood)

Reported to Executive Board and Audit and Corporate Governance Committee (Issues may be considered on request)

School Balances Rationale: To receive a report on the levels of balances held by maintained schools in Warrington. Anticipated Outcome: To hold to account schools for the management of their delegated budgets so as to ensure resources are used appropriately. (A McCormack)

Reported to Schools Forum

Agenda Item 7 – Appendix 1

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Local Account of Adult Social Care

Rationale: To receive a copy of the annual Local Account of Adult Social Care which shows past performance and future priorities for adult social care services Anticipated Outcome: To hold to account providers of services to a vulnerable group of adult residents and to comment on future priorities. (S Reddy)

Reported to Protecting the Most Vulnerable Policy Committee

Children and young People’s Services Annual Report (including Local Account of Children’s Social Care)

Rationale: To receive a copy of the annual Local Account of Children’s Social Care which shows past performance and future priorities for adult social care services Anticipated Outcome: To hold to account providers of services to a vulnerable group of children and to comment on future priorities. (F Waddington)

Reported to Protecting the Most Vulnerable Policy Committee

Items brought forward from previous Overview and Scrutiny Committees:

Homelessness Review (project with CfPS)

Schedule of Future Meeting Dates

Meeting Dates Where possible, draft documentation to be provided no later than

Final documentation to be provided no later than

2013 10 December Friday 22 November Friday 29 November

2014 28 January Friday 10 January Friday 17 January

19 March Monday 3 March Monday 10 March

Agenda Item 7 – Appendix 1

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Agenda Item 7 - Appendix 2

Progress Legend

Completed Progressing to target Early progress / just started Not started (lower priority) Complete – Immediate review programmed

Issues (exception)

NOTE: The Equality Act 2010 includes a number of protected characteristics which are as follows: - Age, disability, gender reassignment, marriage & civil partnership, pregnancy and maternity, race, religion & belief, sex and sexual orientation. For further information please refer to http://www.equalityhumanrights.com..

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Monitoring of Recommendations & Actions

Minute No & Date

Recommendation Referred to & Date

Action Progress

SC5 06/02/13

Cheshire and Merseyside Review of Vascular Services To authorise the Solicitor to the Council, in consultation with the Chair of the Committee, to determine the appropriate format for further engagement with the NHS, following discussions with representatives of Halton and St Helens.

T Date

Halton and St Helens have confirmed that further engagement should be carried out separately. NHS England have been invited to report to the Committee in September 2013. A request will reissued for December 2013

SC6 06/02/13

Work Programme 2012/13 (2) To ask the Solicitor to the Council, in consultation with the

Chair of the Committee, to look into the extent to which the Committee might scrutinise the matter of Arpley Landfill Site

T Date

An appeal has now been submitted. A limited role for the Committee has been identified. A briefing note to Members will be prepared shortly.

SC10 20/03/13

5 Boroughs Partnership NHS Foundation Trust

Agenda Item 7 - Appendix 2

Progress Legend

Completed Progressing to target Early progress / just started Not started (lower priority) Complete – Immediate review programmed

Issues (exception)

NOTE: The Equality Act 2010 includes a number of protected characteristics which are as follows: - Age, disability, gender reassignment, marriage & civil partnership, pregnancy and maternity, race, religion & belief, sex and sexual orientation. For further information please refer to http://www.equalityhumanrights.com..

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(3) To agree to receive regular reports or updates from the Trust, to participate in the development of its future priorities and to provide a platform for engagement with the Trust at future meetings of this Committee or, as appropriate, at the Protecting the Most Vulnerable Policy Committee;

(5) To agree that approach described at (4) above be applied to all requests received from NHS providers for comments on their Quality Accounts.

T Date T Date

Future engagement opportunities have been identified. Comments have been submitted on all other relevant providers’ Quality Accounts

SC11 20/03/13

State of Warrington Report (2) To agree to receive the report on a bi-annual basis to

facilitate the monitoring of performance against key local priorities for health and wellbeing.

R Robertson

Half Yearly monitoring reports will be provided (in colour)

SC16 24/06/13

Minutes of Various Overview and Scrutiny Committees (2) That the above minutes also be submitted, for information,

to their most appropriate successor Committee.

T Date

Relevant Committees have been requested to consider minutes

SC17 24/06/13

Performance Report – Quarter 4 2012/13 (1) To note the content of the report on the Quarter 4

K Griffiths

Noted

Agenda Item 7 - Appendix 2

Progress Legend

Completed Progressing to target Early progress / just started Not started (lower priority) Complete – Immediate review programmed

Issues (exception)

NOTE: The Equality Act 2010 includes a number of protected characteristics which are as follows: - Age, disability, gender reassignment, marriage & civil partnership, pregnancy and maternity, race, religion & belief, sex and sexual orientation. For further information please refer to http://www.equalityhumanrights.com..

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performance and risk position up to end of March 2013;

(2) To endorse the decision of the Executive Board, at its meeting on 17 June 2013, which noted the performance and risk position and that the relevant Executive Board Members would liaise with their Executive Directors to discuss specific performance and risk items; and

(3) To acknowledge that the Committee has had an opportunity

to ask questions and to make comments or recommendations, as appropriate, to the Executive Board.

K Griffiths K Griffiths

Noted Noted

SC18 24/06/13

Revenue Budget Monitoring 2012/13 – Quarter 4 (Draft Outturn) (1) To note the content of the report and the forecast

underspend of £0.016m for the year;

(2) To note the achievement of the 2012/13 MTFP savings targets;

(3) To endorse the decision of the Executive Board, at its

meeting on 17 June 2013, which noted the draft outturn position of £0.016m underspend for 2012/13, noted the delivery of the 2012/13 MTFP savings targets and approved the transfer of the £0.06m to the MTFP reserve in anticipation of no further changes following the External Audit sign off of the Statement of Accounts; and

(4) To request that the Chief Finance Officer include a footnote

L Green L Green L Green L Green

Noted Noted Noted To be considered in

Agenda Item 7 - Appendix 2

Progress Legend

Completed Progressing to target Early progress / just started Not started (lower priority) Complete – Immediate review programmed

Issues (exception)

NOTE: The Equality Act 2010 includes a number of protected characteristics which are as follows: - Age, disability, gender reassignment, marriage & civil partnership, pregnancy and maternity, race, religion & belief, sex and sexual orientation. For further information please refer to http://www.equalityhumanrights.com..

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in the Statement of Accounts to explain the implications of the Department of Communities and Local Government not allowing the capitalisation of certain expenditure on redundancies and pensions.

draft of Statement of Accounts

SC19 24/06/13

Capital Programme 2012/13 Draft Outturn

(1) To note the content of the report and the forecast capital position for the year; and

(2) To endorse the decision of the Executive Board, at its

meeting on 17 June 2013, which noted the summary report and approved the changes to the 2012/13 capital programme contained within Annex 2 of Appendix 1 to this Committee’s report.

L Green L Green

Noted Noted

SC20 24/06/13

The Francis Inquiry into Mid Staffordshire NHS Foundation Trust – Messages and Implications (1) To note the report on the outcome of the Francis Inquiry; (2) To approve the Action Plan at Appendix 1; (3) To request that the Protecting the Most Vulnerable Policy

Committee uses its health related powers proactively, to help commissioners to develop policies and practices which promote and embed quality; and

(4) To request that representatives of Local Healthwatch be

T Date T Date T Date T Date

Noted Detailed work yet to commence Request forwarded to the Committee Healthwatch now

Agenda Item 7 - Appendix 2

Progress Legend

Completed Progressing to target Early progress / just started Not started (lower priority) Complete – Immediate review programmed

Issues (exception)

NOTE: The Equality Act 2010 includes a number of protected characteristics which are as follows: - Age, disability, gender reassignment, marriage & civil partnership, pregnancy and maternity, race, religion & belief, sex and sexual orientation. For further information please refer to http://www.equalityhumanrights.com..

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invited to the next meeting of the Committee to provide a presentation as to progress on the development of the organisation.

invited to attend

SC21 24/06/13

Health Scrutiny in Warrington – Legacy Report (1) To note the report on completion of the Health Scrutiny

Development Area project; (2) To receive the CfPS HSDA final report Health Scrutiny in

Warrington – Legacy Report, at Appendix 1, and to note its recommendations;

(3) To approve the Action Plan at Appendix 2 and to monitor

progress from time to time; (4) To note the summary of the division of health overview and

scrutiny responsibilities between the Protecting the Most Vulnerable Policy Committee and the Scrutiny Committee, at Appendix 3; and

(5) To note the legislative changes to health scrutiny

implemented with effect from 1 April 2013, under the Health and Social Care Act 2012.

T Date T Date T Date T Date T Date

Noted Noted Detailed work yet to commence Noted Noted

SC22 24/06/13

Work Programme 2013/14 (1) To approve the Work Programme for 2013/14 at Appendix 1,

T Date

Noted. Considering format for reporting

Agenda Item 7 - Appendix 2

Progress Legend

Completed Progressing to target Early progress / just started Not started (lower priority) Complete – Immediate review programmed

Issues (exception)

NOTE: The Equality Act 2010 includes a number of protected characteristics which are as follows: - Age, disability, gender reassignment, marriage & civil partnership, pregnancy and maternity, race, religion & belief, sex and sexual orientation. For further information please refer to http://www.equalityhumanrights.com..

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subject to the inclusion of the following additional topics:-

Regular overview of the Work Programmes of the Policy Committees; and

Local Healthwatch to be invited to undertake a presentation at the meeting of the Committee scheduled for 17 September 2013 (Minute SC20(4) refers); and

(2) To note the progress on actions and recommendations at

Appendix 2.

T Date

Policy Committees’ Work Programmes Noted