Agenda item

Mr Ian Kavanagh, the Council’s Head of Business Intelligence, advised that it had appeared that the Council had not previously had the highest levels of transparency with regard to performance.  Moving forward, the Committee would receive performance update reports every six months.

Ms Sandra Taylor, the Council’s Corporate Director of Adult Social Care and Health, noted that the information included in the report had been gathered from a range of sources including surveys, Association of Directors of Adult Social Services and the Adult Social Care Outcomes Framework.  Some of the data included had been from 2023/24 whilst other data was more recent.  The survey results could be a little tricky (new data was expected in December 2025) and the staff turnover had proved to be way below the London average (lower was better). 

Demand for social care services seemed to be relentless with increases in learning disability mental health services and older adults needing nursing dementia support.  Although the contracts were being stabilised and the number of older people being supported was flattening, the number of people being supported with complex mental health needs was significant.  Safeguarding referrals were also still very high but the number converting to Section 42 enquiries had been steady and reasonable, indicating that partners had been referring correctly.  Artificial Intelligence tools were being used to help manage demand and Power BI dashboards had been created to provide insights into the data. 

It was noted that learning disability (LD) mental health clients started using social care services from a young age and for the duration of their life which then proved quite costly.  There were currently around 5½k active services in adult social care being received by about 3½k individuals (which was quite stable).  There tended to be lower numbers receiving home care and higher numbers receiving direct payments whereby they were able to choose their own care (home care and reablement would always be the local authority’s first choice wherever possible).  Investigations were currently underway to identify the reason as to why there was such a high number of LD clients in the Borough compared to other authorities. 

Members were advised that after triage was undertaken, there were around 1,000 assessments completed each month (with a 28 day target).  Whilst most of these did not need to be provided with any adult social care services, they might be referred to third sector partners for additional support. 

Where services were needed, reablement was often the most appropriate intervention.  Ms Taylor noted that reablement was a very effective tool for cost avoidance and had been funded through the discharge grant work that had been undertaken with the NHS.  Reablement was classed as intermediate care and around 30% of referrals came from the community (e.g., GPs, self, referral, etc) so it was free to these individuals until ‘aim achieved’. 

Ms Taylor advised that she was the Senior Responsible Officer for the reactive care programme on the Hillingdon Health and Care Partners partnership which aimed to prevent hospital admission.  This was particularly important in relation to residents in care homes as, once admitted, older frail people tended to need to spend longer in hospital and would then need longer periods of rehabilitation (this would be helped by the introduction of mobile diagnostics).

It was noted that direct payments were self-directed support.  Officers made assessments and individuals might then be given a personal budget allocated for their care needs.  They might then choose to have their care delivered by an agency that the Council did not use or appoint a Personal Assistant that would meet their needs.  They were provided with a monthly pre-paid card (plus contingency) and were offered advice and support with regard to things like HMRC and payroll.  The carer element was needed for those not able to arrange these things for themselves.

Members were pleased with the format of the report but noted that it had stated “The council demonstrated robust governance structures and clear accountability mechanisms, ensuring transparency and responsiveness in service provision.”  This was contrary to the information that the Committee had received at a previous meeting in relation to accountability and governance.  This information had stated that the structures were adequate but not fully mature or fully embedded and therefore consistent performance data and embedding of learning from reviews needed improvement.  If this performance management tool had been developed to help the local authority take responsibility for its performance, then it would be important to reflect this.  Ms Taylor acknowledged that this needed to be as clear as possible and would ensure that it was corrected. 

RESOLVED:  That:

1.    the Annual Performance Report for 2024/25 be noted; and

2.    the Committee’s comments be drafted and presented to full Council in November alongside the Annual Performance Report for information.