(Vacant) Billingham) (Sue Williams) Older People's Services Family Support Services (Gillian Thomas) (Vacant) Care Management (OP) Children's Disability Services (Sue Williams) (Vacant) Home Care (OP) Child Protection (Vacant) (Vacant) Fostering and Adoption (Vacant) Residential Care (Vacant) Youth Support Services (Vacant) Early Years (Vacant) Education (Vacant) Legal Services (

1. Item No. 6
Report of the Corporate Director (Social Services)
Health, Social Care and Well Being Overview and Scrutiny Board
- 22nd June 2010
BRIEFING ON SOCIAL SERVICES ACTIVITIES AND KEY ISSUES
Purpose The purpose of this report is to provide an overview of the
arrangements that exist within the Social Services
Directorate along with key responsibilities.
Content The report describes the activities and context in which
Social Services is required to operate.
Councillors are Consider the report and to make comments and
being asked to observations as necessary.
Lead Councillor Nick Tregoning, Cabinet Member for Social
Councillor(s) Services.
Lead Officer(s) Chris Maggs, Corporate Director (Social Services)
Deborah Driffield, Head of Adult Services
Report Author Chris Maggs, Corporate Director (Social Services)
Telephone: (01792) 636245
Email: Chris.Maggs@swansea.gov.uk
1. INTRODUCTION
1.1 Social Services is one of the largest Directorates within the Local Authority,
measured by the size of the budget and the number of staff employed. The
net budget for Social Services in 2010 - 2011 is £93,633,000. Social
Services currently directly employ more than 2,000 staff in about 70
offices/locations.
1.2 Range of Activities
The range of responsibilities covered by Social Services is wide and complex.
These include:
• Children who are at risk of being harmed or whose development may be
impaired;
• Families who are having difficulty in coping with bringing up their children;

2. • Children who do not have a family or are unable to live with their own
family;
• Children with disabilities or mental health problems;
• Adults who need support because of:
o advancing age
o physical disability
o learning disability
o serious mental health problems
• Vulnerable adults who are at risk of being abused or exploited;
• People who are affected by HIV/AIDS;
• People who are terminally ill;
• People who are affected by the misuse of drugs or alcohol;
• Social Inclusion/ Welfare Rights
• Supporting People
A summary of relevant legislation and guidance for Child and Family Services
can be found in Appendix A. A summary of relevant legislation and guidance
for Adult Services can be found in Appendix B.
1.3 Partnership working
Partnership working is key to the delivery of Social Care services for both
policy and practical reasons. Social Services work closely with a range of
other agencies and organisations, including:
• The Health Service
• Education
• Housing
• Probation
• Police
• Independent Sector
• Care and Social Services Inspectorate Wales
1.4 Social Services and the wider Social Care economy in Swansea
Social Services purchase a range of services from the independent sector,
both private and not-for-profit organisations. Currently, over 40% of the
Social Services budget is spent in the independent sector. Social Services
has duties for the Social Care sector as a whole, and in addition to the staff it
employs, there are estimated to be about another 4,000 people engaged in
providing social care in Swansea.

3. 2. THE STRATEGIC CONTEXT FOR SOCIAL CARE
2.1 National Strategy for Social Care
A national ten-year Strategy for Social Services in Wales was launched in
February 2007, Fulfilled Lives, Supportive Communities. It outlines the role of
Social Services to:
• Promote social inclusion and independence
• Support people at times of difficulty distress, vulnerability or illness
• Protect people from harm, abuse or neglect
• Act as corporate champion in local government for the most vulnerable
and at-risk groups in their area
The vision outlined in the Strategy is of:
“Social services which are strong, accessible, and accountable, in tune with
citizens’ and communities’ needs and promote social inclusion, citizens’ rights
and good outcomes“.
2.2 Health Social Care and Wellbeing Strategy
The Local Authority has a duty to produce a Health Social Care and
Wellbeing (HSCWB) Strategy in conjunction with the Local Health Board.
This is one of the four strategies that the Local Authority is required to
produce.
2.3 Single Strategic Plan for Young People
The Local Authority has a duty to produce a single strategic Plan for Children
and Young People, aged 0-19. This is one of the four strategies that the
Local Authority is required to produce.
3. REGULATION, PERFORMANCE AND INSPECTION OF SOCIAL CARE
3.1 Care and Social Services Inspectorate Wales (CSSIW)
Social Care services are inspected and regulated by the CSSIW. The CSSIW
came about in April 2007 through the amalgamation of two different functions,
the Care Standards Inspectorate in Wales (CSIW), which regulated and
inspected a range of services including residential homes, domiciliary care
services, playgroups, childminders etc., and the Social Services Inspectorate
which inspected the way that Local Authorities carried out their
responsibilities to deliver Social Care.

4. 3.2 Regulation of individual care providers
The CSSIW currently regulates and inspects individual services and agencies
which are provided both by the independent sector and directly by the Local
Authority e.g. residential homes, domiciliary care agencies, playgroups,
childminders etc.
3.3 Inspection of the delivery of social care services by the Local Authority
The CSSIW also inspects the way that Local Authorities carry out their
responsibilities to deliver Social Care. The CSSIW carries out individual
service reviews as well as reviews of the way that Local Authorities deliver
their social care functions.
4. STRUCTURE OF SOCIAL SERVICES
4.1 Social Services are delivered through two Services, Adult Services and Child
and Family Services. The overall service is the responsibility of the
Corporate Director (Social Services) who is a member of the Corporate
Management Team. Some activities within the Directorate are managed
directly by the Corporate Director. The staffing structure for the Directorate is
provided at Appendix C.
4.2 In Adult Services the key areas of activity are Assessment and Care
management and directly provided services for each service area (Older
People, Disabled People, Mental Health Services, Learning Disability
Services). A structure chart for Adult Services is provided at Appendix D.
4.3 In the Child and Family Services the key areas of activity are Assessment
and Case management and directly provided services, there is also a
responsibility for the Youth offending Service. A structure chart for Child and
Family Services is provided in Appendix E.
4.4 The Directorate Services include the arrangements for the COASTAL Project,
Supporting People, Planning, Contracting, Social Inclusion Unit and activities
such as Finance, Payments and Financial Assessments.
5. Budget
5.1 The net budget for Social Services for 2010 - 2011 is: £93,633,000. This is
allocated across the Adult and Child and Family Services:
• Adult Services:
Older People / Younger Adults £39,676,000
Mental Health / Learning Disability £18,984,000

5. • Child and Family Services: £30,561,000
• Directorate Services £4,412,000
6. KEY ISSUES FOR SOCIAL SERVICES
6.1 There are a number of key issues for Social Services over the next couple of
years. These include:
• Child and Family Services – further improvement in delivery of services
ensure the requirements of the CSSIW are achieved.
• Review of Residential Services for Children – to implement the new
arrangements that have been approved.
• Older People’s Project – the reconfiguration of services for Older People
to ensure that they delivered as relevantly and effectively as possible.
• The restructuring of the NHS – and the effect on the delivery of health and
social care services locally.
• Remodelling of Health and Social Care Services in Swansea – this is part
of the strategic rebalancing of services from acute to community based
services that is identified through the Health, Social Care and Wellbeing
Strategy.
• Redevelopment of Mental Health Services in Swansea – there is a project
to redevelop Mental Health Services towards a more community based
delivery of support services.
• Continuing Health Care – this area of activity concerns those individuals
who are supported by Swansea Local Health Board.
• Workforce – ensuring sufficient skills and capacity to deliver high quality
social care services.
6.2 The Corporate Plan identifies the overall strategic direction that has been
approved by Council and the relevant sections are attached as Appendix F.
Background Papers:
Fulfilled Lives, Supportive Communities
http://wales.gov.uk/dhss/publications/socialcare/strategies/fulfilledlives/fulfilledlivese.
pdf?lang=en
Contact Officer: Chris Maggs
Corporate Director (Social Services)
 01792 636245 cm06023/sd
Legal Officer:Janet Hooper

6. APPENDIX A
Summary of Relevant Legislation – Child and Family Services
The Children Act 1989
The Children Act 1989 came into force on 14th October 1991 and brought together
most public and private law relating to children in England and Wales. It is the
primary piece of legislation governing the provision of services for children.
The Act drew together legislation concerning the care and upbringing of children
who were affected by a private dispute, such as divorce, and those who are in need
of help from a Local Authority. It also defines ‘children in need’ (see page 3) and
places a number of duties and responsibilities upon Local Authorities. The Act:
• Makes children’s welfare a priority
• Believes that children are best brought up within their families whenever
possible
• States that Local Authorities are to provide services which support children
and families in need
• Promotes partnership between children, parents and Local Authorities
The Act also deals with children’s homes and other residential accommodation,
fostering, child minding and day care for young children.
The full act can be found at
www.opsi.gov.uk/acts/acts1989/Ukpga_19890041_en_1.htm
Other legislation which affects the way parts of the service operate includes:
The Children (Leaving Care) Act 2000
The main purpose of this Act is to improve the life chances of young people living in
and leaving Local Authority care. It placed stronger obligations on local authorities to
ensure that care leavers were adequately prepared and supported.
The Carers and Disabled Children Act 2000
This Act gave Local Authorities the power to offer direct payments to sixteen and
seventeen year old disabled young people. The Local Authority makes the payment
instead of arranging the services it has assessed the disabled young person as
needing, and that young person uses the payment to secure the relevant services.
The Act also provides for Local Authorities to make direct payments to people with
parental responsibility for a disabled child to purchase services to meet the
assessed needs of the child’s family.

7. The Adoption & Children Act 2002
The Adoption & Children Act 2002 modernised the legal framework for both
domestic and inter-country adoption. Its provisions include making the needs of the
child the paramount consideration, providing better adoption support services and a
number of measures to encourage more potential adopters to come forward.
Along with the Children’s Cases (Amendment) (Wales) Regulations 2004, the Act
also led to new guidance for Independent Reviewing Officers. The role of such
independent officers is seen as an important safeguard to ensure that the local
authority has an appropriate, consistent and robust approach towards the corporate
parenting of children.
The guidance can be viewed at:
http://new.wales.gov.uk/topics/childrenyoungpeople/childrenfirst/publications/indepe
dantreviewingofficers?lang=en
The Children Act 2004
The Children Act 2004 covers both the universal services which every child
accesses, and more targeted services for those with additional needs. Its aim is to
encourage integrated planning, commissioning and delivery of services as well as to
improve multi-disciplinary working, remove duplication, and increase accountability.
Its focus is towards outcomes that children and young people themselves have said
are important, rather than prescribing organisational change.
The full Act can be found at:
www.opsi.gov.uk/acts/acts2004/ukpga_20040031_en_1
The Childcare Act 2006
This Act is the first to address specifically the provision of child care and other early
years activities. Responsibility for childcare provision is placed with local authorities,
who are expected to work with both public bodies and private companies to improve
quality and realise standards in both care and learning and to ensure that the view
of parents are taken into account so that the needs of local families are reflected in
the planning of new services.
The full Act can be found at
www.opsi.gov.uk/ACTS/acts2006/ukpga_20060021_en_1
The Stable Life Regulations 2007
These Regulations, issued by the Wales Assembly Government and contained in
the document Towards a Stable Life and a Brighter Future, provide a legislative
framework to strengthen the well-being of looked after children. It includes guidance
on placements, education, health and case reviews, as well as strengthening the
regulations for the management of children’s homes.
The regulations can be viewed at
http://new.wales.gov.uk/topics/childrenyoungpeople/publications/guidance/1549304
?lang=en

8. APPENDIX B.
Summary of Relevant Legislation – Adult Services
The legislation and guidance covering Adult Services is extensive and includes a
range of general powers and duties as well as service specific legislation and
guidance. The following gives a broad overview of the statutory frameworks
governing the delivery of social care to adults.
Key items of legislation and guidance covering adult services include:
• National Assistance Act (1948)
• Health Service & Public Health Act (1968)
• Chronically Sick and Disabled Persons Act (1970)
• National Health Service Act (1977)
• Mental Health Act (1983)
• The Disabled Persons (Services, Consultation and Representation) Act
(1986)
• National Health Service and Community Care Act (1990)
• Disability Discrimination Acts (1995)
• Carers (Recognition and Services) Act (1995)
• Community Care (Direct Payments) Act (1996)
• Care Standards Act (2000)
• The Carers and Disabled Children Act (2000 )
• Tackling Substance Misuse in Wales – A Partnership Approach (2000)
• In Safe Hands, Section 7 Guidance on Protection of Vulnerable Adults (2000)
• Local Government Act (2000), Section 93 (Statutory basis for Supporting
People)
• Health and Social Care Act (2001)
• National Service Framework for Adult Mental Health Services (2002)
• Promoting Partnerships in Care Section 7 Guidance on Commissioning
(2003)
• Carers (Equal Opportunities) Act (2004)
• The Community Care Services for Carers and Children’s Services (Direct
Payments) (Wales) Regulation (2004)

9. • Learning Disability Strategy Section 7 Guidance on Service Principles and
Service Responses (2004)
• Mental Capacity Act (2005)
• Disability Discrimination Acts (2005)
• National Service Framework for Older People in Wales (2006)
• NHS Wales Act (2006)
• Mental Health Act (2007)

10. APPENDIX C.
CORPORATE DIRECTOR (SOCIAL SERVICES)
Chris Maggs (6245)
Head of Adult Services Head of Child and Family Principal Officer - Senior Principal Officer Regional Principal Officer - Principal Officer -
Services Communication and - Commissioning and Project Director Supporting People Administration and
Strategic Management Partnership - COASTAL Support Services
Deborah Driffield Steve Walker Project Rachel Evans
6249 6248 Katrina Guntrip Richard Leggett 533703
6659 6947 Clive Prior Stephen Halfpenny
222691 6680
Service Provision (LD) Youth Offending Service Secretariat Planning (Heather Hughes) Transport
(Cathy Murray) (Eddie Isles) Supporting (Cathy Carroll)
Contracting (Ali Williams) People Team
Strategic
Care Management (LD) Case Management and LAC Management Payments, Procurement
(Carol Rea) (Mike Holding) Support Unit Performance Management and and Projects
(Fiona Broxton) Information (Sue Matthews)
Mental Health and Adult Assistant PO Case Management (John Grenfell)
Protection (Eira Howells) and LAC Estimates and Budgetary
(David Howes) Social Inclusion Unit Control
Disability Services (Vacant) (Don Isaac)
(Paul Littlewood) Safeguarding Children
(Martin Price) Information Technology Financial Assessments
Residential and Day Care (Tony Brindley) (Kim Husband)
Services (Vic Gregory) Child Disability
(Haydn Nelson) Substance Misuse Planning and Business Manager - Adult
Community and Intermediate Commissioning Manager Services
Care (Julia Crawley) A&I / Family Support (David Evans) (Lynda Morgan)
Julie Thomas
Care Management (OP) Staff Development and Training
(Colin Cribb) Accommodation (Hywel Jones)
(Richard Evans)
Health Services / Care Homes
(Gareth Powell) Administration cm92011/sd
(Bill Williams)

11. APPENDIX D.
HEAD OF ADULT SERVICES
Deborah Driffield (6249)
ASSESSMENT AND CARE MANAGEMENT PROVIDERS
Principal Officer - Principal Officer - Acting Principal Officer Principal Officer - Principal Officer - Principal Officer - Acting Principal Principal Officer -
Mental Health and Care - Care Management Health Services / Disability Services Service Provision Officer - Community and
Adult Protection Management (OP) Care Homes (LD) Residential and Intermediate Care
(LD) Day Care
Eira Howells Services
6271 Gareth Powell Paul Littlewood Cathy Murray Residential Homes
Julia Crawley
Carol Rea Colin Cribb 6204 312211 6273 Vic Gregory
Bonymaen 6433
6272 6262 (Angela Cook)
6213
Cartref
(Maria Demaid)
Hollies
(Helen Davies)
Adult Protection / Younger Adult Team Parkway
Community Support North Team Singleton Hospital Day Services Home Care
Domestic Abuse (Lynne Pritchard)
Teams (Team Leader (Team Leader Mary (Team Leader (Steve Cook) (Judith Goss)
(Meryl Williams) Dillwyn Jones) Rose Cross
(Team Leader Phil Eirian Davies) Heard)
Davies) Flexible Support (Gaynor Matthews) Service
CMHT 1 and 2 Occupational Therapy St. Johns
Intake Team and Central Morriston Hospital Service / Whitethorn Improvement
(Team Leader (Gill Campbell)
Direct Payments Team (Acting Team Leader (Helen St. John) Intensive Day Service (Anne Clare)
Chris Woods) Ty Waunarlwydd
Adult Family (Acting Team Leader - (Janette Jones)
Placement Andrea Preddy) Ffion Larsen) Suresprung Furnishers (Jane Thomas) Service and Staff
CMHT 3 and 4
Transition Joint Equipment Store Alternative Day Services Ty Cila Development
(Team Leader (Lyndon Tobin) (Steve Cook) (Rebecca Lane)
(Team Leader West Team EMI Team (Julie Butt)
Kate Reilly)
Vicki Davies) (Team Leader (Team Leader Sue
Jackie Turner) Field) Community Alarm Service Special Needs Services
Mental Health (Dave Powell) 5 x Day Care Centres
Service and Staff (Francis Hubbard)
Service Provision / Social Centres
Development Earlsmoor Care Home Team
Service and Staff
(Ceri Jones) (Emma Forester acting) (Team Leader Susan Maesglas Community
Development Support Unit
Williams)
(James Thomas) Respite Services
(Stephanie Atherton)
Swansea Vale Resource
Centre
(Jackie Whiteman)

12. APPENDIX E.
HEAD OF SERVICE - Steve Walker (636248) SECRETARY – Jeanette Crawford
(636243)
(CHILD AND FAMILY)
PRINCIPAL PRINCIPAL OFFICER PRINCIPAL OFFICER PRINCIPAL OFFICER SAFEGUARDING
OFFICER CHILD ACCOMMODATION PRINCIPAL ASSESSMENT AND ASSESSMENT AND CHILDREN’S
DISABILITY Richard Evans OFFICER CARE MANAGEMENT CARE CO-ORDINATOR
Haydn Nelson (636268) ASSESSMENT Mike Holding MANAGEMENT Martin Price
(636267) AND CARE (636605) David Howes (636266)
MANAGEMENT (635522)
Julie Thomas
(635171)
- Service Quality Team
- LAC - Foster Swansea
- Child Disability - Adoption Team - CORE Team
- Access & Child & Family
Team - Residential Homes Info Teams
- EDT (Blaenymaes and - Family (North & South)
- Asylum Seekers Cockett) Support
- CAST
IRO’s C.P
SSCB BUSINESS Conference Unit
DEVELOPMENT CO-
ORDINATOR
Lisa Hedley
YOUTH (637543)
CHILDREN’S OFFENDING
BUSINESS PARTNERSHIP TEAM
MANAGER CO-ORDINATOR MANAGER
Bill Williams Sian Bingham Eddie Isles
(636270) (612155) (522827)
- Operations Admin. Early Years
Team - Youth
Development Offending Team
- Innovation / Team
Performance Unit - Family Group
- Development Conferencing
Officers
cm06023/sd

13. APPENDIX F.
The Health, Social Care & Well-Being Strategy 2008/11
The Health Social Care & Well-Being (HSCWB) Strategy has been agreed by the City and County of Swansea and Swansea Local
Health Board. It has been developed in partnership with the Community Health Council, Swansea Council for Voluntary Services, the
local NHS Trust, the National Public Health Service and Swansea University.
The strategy sets out how partners aim to work with others to improve health and well being in Swansea. It adopts a twin track approach
- tackling the causes of ill health and aiming to deliver effective health and social care to consistently high standards. It is the second
strategy that has been developed by the partners above (known as the Health Challenge Swansea partnership). It builds upon progress
made between April 2005 and March 2008.
The second strategy reinforces the long term vision shared by partners, that by 2020 Swansea will be a place where:
• Everyone is supported to achieve the best level of health and well being possible, living longer healthier lives.
• Appropriate care is delivered in the best location at the right time by a range of organisations working together.
• Communities and individuals are well informed and take responsibility for their own health and well-being.
Our long term strategic aims are to:
• Promote healthy lifestyles and help people to take more responsibility for their health and well being.
• Reduce inequalities in health and well-being.
• Improve the protection of vulnerable people.
• Deliver better more accessible services.
• Increase people’s independence.

14. To work towards achieving our long term vision and aims, partners have agreed to focus on three key themes over the period
2008-2011. These are:
• Theme 1: To prevent ill health and reduce inequalities.
• Theme 2: To deliver better more accessible services that promote independence and protect vulnerable people.
• Theme 3: To develop our supporting infrastructure to support these changes.
For each of these key themes, priority areas have been identified for the coming three years.
Priority Areas and Key Actions 2008 / 2011
Theme 1 - Preventing ill health and reduce inequalities
Socio Economic Circumstances
• Income Maximisation
• Economic Activity
• Workplace Injuries
• Transport
• Community Health Development
Lifestyle
• Physical Activity and Nutrition
• Mental Health Promotion
Preventative Health and Social Care
• Reducing health inequalities in children – immunisations, oral health, childhood accidents
• Preventing Falls and Fractures

15. Theme 2 - Developing better more accessible services
Strategic Service Change
• Reshaping Social Care Services for Older People
• Developing Social Care Services for Children
• Reshaping Mental Health Services
• Redesigning Acute (Hospital) and Community Based Care
Improving Services for specific population groups
• Older People
• Children and Young People
• Children in Need
• Carers
• Children and Adolescents affected by Mental Health problems
• Those with a Physical Disability or Sensory Impairment
• Those with Learning Disabilities
• Those affected by Coronary Heart Disease
• Those affected by Diabetes
• Those affected by Substance Misuse problems
• Those affected by Sexual Health Problems
• Prisoners

16. Theme 3 - Developing our supporting Infrastructure
• Joining up planning, budgets and services
• Information Management and Technology
• Workforce Development
Included in the above priorities is work to re-design our social care, mental health, and hospital and community based services. These
are recognised as significant programmes in their own right. Our aims in redesigning services are to:
• Develop services which meet the future social care needs of both older people and children and families in Swansea.
• Ensure we have a modern mental health service fit for the 21st century.
• Develop a new model of care and pattern of services for hospital and community based care.
A HSCWB Strategy Year 2 action plan for delivery during 2009-10 is currently in development.
Key actions for the Council to deliver the HSCWB Strategy have been outlined within the Corporate Improvement Plan 2009-12 in the
pages that follow.
The relevant risks around the Health & Social Care key priorities are reviewed in the pages that follow under the Health &
Social Care aim.
A full copy of the full HSCWB strategy can be found at http://www.wales.nhs.uk/sites3/Documents/524/English.pdf

17. Health & Social Care
Improve Health and Social Care services for all so that the City & County supports and promotes good health
Community Strategy • Healthy Lifestyles
Shared Partnership • Health Inequalities between communities
Priorities
Key plans / strategies • Health, Social Care & Well-Being Strategy
• Climbing Higher physical activity strategy
Lead Strategic • Health Challenge Swansea
Partnership/s
Lead Corporate • Chris Maggs, Corporate Director (Social Services)
Director/s

18. Key Priority -
Reshape and reconfigure Health and related services in Swansea.
Reason why this is a It is important to modernise and rebalance health and social care services to achieve
Priority financial balance, deliver more accessible services and increase people’s independence.
Expected Outcome There are three main Strategic outcomes identified in the Strategy:
• Everyone is supported to achieve the best level of health and well being possible,
living longer healthier lives.
• Appropriate care is delivered in the best location at the right time by a range of
organisations working together.
• Communities and individuals are well informed and take responsibility for their own
health and well-being.

19. Summary - Reshape and reconfigure Health and related services in Swansea.
What We Have Done:
• Developed a placement strategy for Looked After Children (LAC).
• Presented a report with proposals and option appraisals to HSCWB (Health Social Care and Well-Being)
Overview Board on redesigning Respite Care Services for Older People.
What We Intend to Do:
• Redesign Respite Care Services for Older People.
• Redesign Social Care Services for Older People.
• Reshape Mental Health Services.
• Reshape Acute (Hospital) and Community Based Care.

20. Key Priority Risk Review 2008/09 to 2009/10
Risk Aspect 2008/09 2008/09 2009/10 2008/09 Mitigation
Summary Risk Risk
Status Status
Adult Social Services - Care packages and assessments. Medium Medium Practice Handbook for Assessment
Access to Services   and Care Management (ACM) teams
  in place.
 
2009/10 remaining mitigation measures
Review the ICT arrangements currently in place to record ACM information. Review the current assessment and reviewing
documentation. Develop an outcomes focused / citizen centred approach to ACM. Dedicated hours allocated to practice
development role. Collaborative approach to assessments being developed between health and local authority partners.
Risk Aspect 2008/09 2008/09 2009/10 2008/09 Mitigation
Summary Risk Risk
Status Status
Adult Social Services - Developing sustainable models of Medium Medium Joint work with Swansea NHS Trust
Range & Quality of service to promote independent   to provide appropriate services on
Services living.   discharge from hospital. Continuing
  to implement services that promote
independence.
2009/10 remaining mitigation measures
Further develop partnership and collaborative approaches to service development across Adult Social Services. Increased
awareness of direct payments as an alternative. Development of day opportunities as alternative to building based services.
Involvement of citizens in planning services and redesign. Use joint planning groups to scrutinise service developments.
Consider community capacity building approach to address sustainability issues.

21. Risk Aspect 2008/09 2008/09 2009/10 2008/09 Mitigation
Summary Risk Risk
Status Status
Adult Social Services - Safeguarding vulnerable adults. Medium Medium Staff training reinforced.
Arrangements for  
protection of vulnerable  
people  
2009/10 remaining mitigation measures
Raising awareness across communities and key stakeholders. Development of Escalating Concerns process to manage issues
within care homes. Planned completion of self audit / inspection regarding staff competence and guidance compliance. Further
training being developed around links between MCA and POVA. Development of a prevention framework regarding
safeguarding. Additional resources in place re: the introduction of DOLS.

22. Key priority Performance Measures
Key Priority Performance Measures
PI Reference, Desired Previous Target Actual Hit Future Trend Comment
Direction of Travel & Year 2008/09 2008/09 Target? Aspiration of Imp.
PI Description 2007/08 (Y/N) 2009/10
2010/11
SCA/002a 
The rate of older people (aged
98.67 105 90.18 N 2009/10 -
98
 Star Rating: 
65 or over): supported in the
community per 1000 2010/11 -
population aged 65 or over at 102
31st March
SCA/002b  20.1 22 20.9 Y 2009/10 -  Previous year’s result
The rate of older people (aged 22 (20.10) unusually low due to
65 or over): whom the changes to Continuing
authority supports in care 2010/11 - Health Care arrangements.
homes per 1000 population
aged 65 or over at 31st March
22
Star Rating: 
SCA/007  63.0% 70% 67.6% N 2009/10 -  More robust processes
The percentage of clients with 70% around data capture have
a care plan at 31st March been put in place.
whose care plans should have
been reviewed that were
2010/11 -
75%
Star Rating: 
reviewed during the4 year

23. Key Priority Performance Measures
PI Reference, Desired Previous Target Actual Hit Future Trend Comment
Direction of Travel & Year 2008/0 2008/09 Target Aspiration of
PI Description 2007/08 9 ? (Y/N) 2009/10 Imp.
2010/11
SCA/010  158.77 150 131.43 N 2009/10 -  The target for 09/10 has been
The rate per 1000 adults clients 130 reviewed and set at a more
assessed during the year who realistic level as the
are provided with electronic 2010/11 - previously high performance
assistive technology as part of a 135 can be directly attributed to
package of care one off monies being made
available to purchase lifelines
over a specific period of time
Star Rating: 
SCA/015  (formerly SCA/006) Amended 10 5 Days Y 2009/10 - N/A
The average number of working PI Days 5 days
days taken from completion of
the care plan to provision and/or 2010/11 -
installation of aids/equipment 4.5 days
SCA/017  (formerly SCA/009) Amended 150 183.58 Y 2009/10 - N/A
The rate per 10,000 adult clients PI 185
(aged 18+) supported in the
community who receive a direct 2010/11 -
payment 188

24. Key Priority Actions
Actions Responsible Officer Original Current Original Key Current Key milestone
Timescales Timescales (or milestone (or completion date)
completion
date)
Redesigning Principal Officer February 2009 March 2010 Report with Agree new model via the
Respite Care Assessment and Care proposals and Health & Social Care
Services for Older Management Services option appraisals Overview Board – Aug 09
People for Older People are presented to
HSCWB (Health Implement
Social Care and recommendations and
Well-Being) action plan jointly with
Overview Board. Health & Social Care
Overview Board - March
2010.
Review Principal Officer Child December 2008 Superseded A strategic review of Work has been
Residential and Family residential services progressed but has now
Services for Accommodation is commissioned been superseded by the
Children Services and reported to the development of a
Child and Family placement strategy. There
Service Senior is a broader review of
Management Team arrangements for looked
after children in the
Medium Term Financial
Plan.

25. Actions Responsible Original Current Original Key Current Key
Officer Timescales Timescales (or milestone milestone (or
completion date) completion date)
Redesigning Social Head of Adult March 2011 March 2011 • Establishment of an • Establishment of
Care Services for Services extended an extended
Older People assessment service assessment
for domiciliary care service for
provided by the domiciliary care
Local Authority. provided by the
• Increased access to Local Authority.
long term care for • Increased access
older people with to long term care
mental health for older people
problems. with mental
• Implemented a new health problems.
model of day • Implemented a
opportunities which new model of
will support re- day
enablement and opportunities
promote which will
independence support re-
enablement and
promote
independence
Reshaping Mental Head of Adult March 2011 March 2011 Business cases for Business cases for
Health Services Services, in improvements to Mental improvements to
conjunction with Health services are Mental Health
lead Health submitted to and services are
personnel approved by the Welsh submitted to and
Assembly Government approved by the
(WAG). Welsh Assembly
Government (WAG).

26. Actions Responsible Officer Original Current Original Key Current Key
Timescales Timescales (or milestone milestone (or
completion date) completion date)
Reshaping Acute Corporate Director March 2011 March 2011 • Local Care Units • Local Care Units
(Hospital) and (Social Services), in and Locality Care and Locality Care
Community Based conjunction with lead Teams are Teams are
Care Health personnel established. established.
• A higher • A higher
percentage of percentage of
people are people are
supported in their supported in their
own homes. own homes.

27. Improvement Agreement Outcome
Improvement Agreement Outcome – Health & Related Services in Swansea reshaped and reconfigured to achieve better levels
of health and well being.
Improvement Agreement Actions 2008/09 2009/10
Targets Targets
Redesign Respite Care Services
• Health & Social Care (H&SC) Overview Board report December 08 -
• H&SC Overview Board to meet January 09 -
• Final Officers report with recommendations March 09 -
• Undertake needs analysis/mapping/costing exercise April 09 -
• Agree new model via H&SC Overview Board - August 09
• Implement recommendations and action plan jointly with H &SC Overview
Board - March 2010

28. Improvement Agreement Outcome – Health & Related Services in Swansea reshaped and reconfigured to achieve better levels
of health and well being.
Improvement Agreement Actions 2008/09 Targets 2009/10 Targets
Establish an Assessment and Re-ablement Service (Domiciliary Care)
• H&SC Overview Board report
• Consultation key stakeholders November 08 -
• Staff training January 09 -
• Commence Implementation phase one (North Area) (reconfigure staff teams, February 09 -
training evaluation etc)
• Commence Implementation phase two March 09 -
• Commence Implementation phase three - Sep 09
- March 2010

29. Improvement Agreement Outcome – Health & Related Services in Swansea reshaped and reconfigured to achieve better levels
of health and well being.
Improvement Agreement Actions 2008/09 Targets 2009/10 Targets
Implement a new model of day opportunities
• Redesign social Centres Jan 09 -
• Roll out pilot community preventative models April 09 -
• Re-assess current service users - June 09
• Undertake needs analysis/mapping/costing exercise - August 09
• Agree new model via H&SC Overview Board - Sep 09
• Consultation - Nov 09
- Jan 10
• Implement changes

30. Improvement Agreement Performance Measures
PI Reference, Desired Previous Target Actual Hit Future Tren Comment
Direction of Travel & Year 2008/09 2008/0 Target Aspiration d of
PI Description 2007/08 9 ? (Y/N) 2009/10 Imp.
2010/11
SCA/001
The rate of delayed transfers of
6.78 Range
between
4.95 Y 2009/10 -
Range 6 8
 Star rating: 
care for social care reasons per 6&8
1,000 population aged 75 or 2010/11 -
over (Improvement 6
Agreement)
SCA/003a 
The percentage of clients, in the
95.36% Range
between
96.37% Y 2009/10 -
Target to
 Star rating: 
following age groups, who are 90% & be agreed
supported in the community 93%
during the year: 2010/11 -
a) Aged 18-64 (Improvement To be
Agreement) agreed
SCA/003b 
The percentage of clients, in the
80.27% Range
between
82.07% Y 2009/10 -
Target to
 Star rating: 
following age groups, who are 78% & be agreed
supported in the community 81%
during the year: 2010/11 -
b) Aged 65+ (Improvement To be
Agreement) agreed

31. Key Priority -
Implement the Health, Social Care and Well-being agenda.
Reason why this is a There is a statutory requirement for the Local Authority and the Local Health Board to
Priority produce and implement a Health Social Care and Well-being Strategy. It is one of the Local
Authority’s four main plans, and outlines the intentions and priorities to lead the
improvement in Health and Well-being in Swansea.
Expected Outcome There are three main Strategic outcomes identified in the Strategy:
 Everyone is supported to achieve the best level of health and well being possible,
living longer healthier lives
 Appropriate care is delivered in the best location at the right time by a range of
organisations working together
 Communities and individuals are well informed and take responsibility for their own
health and well-being

32. Summary - Implement the Health, Social Care and Well-being agenda.
What We Have Done:
• Implemented the Older People Strategy development plan for 2008/09.
• Established a Telecare service.
• Put in place a Section 33 agreement to improve joint working across Health and Social Services.
• Worked with Health & Safety Executive to prevent and reduce the number of workplace injuries in Swansea.
• Produced a draft Healthy Weight Strategy to help decrease the prevalence of people overweight/obese people
in Swansea.
What We Intend to Do:
• Implement the Older People Strategy Development Plan for 2009/10.
• Further investigate the aims and objectives of the Welsh Assembly Government’s second Older Person’s
Strategy through the Community Plan, Heath Social Care & Well-Being Strategy and other strategies.
• Start to implement the assistive technology strategy and action plan.
• Review arrangements in relation to Intermediate Care Services and Continuing Health Care – Learning
Disability.
• Continue to work with the Health & Safety Executive to prevent and reduce the number of workplace injuries in
Swansea.
• Complete the Healthy Weight Strategy to help decrease the prevalence of people overweight/obese people in
Swansea.

33. Key Priority Risk Review 2008/09 to 2009/10
Risk Aspect 2008/09 2008/09 2009/10 2008/09 Mitigation
Summary Risk Risk
Status Status
Adult Social Services - Care packages and assessments. Medium Medium Practice Handbook for
Access to Services   Assessment and Care
  Management (ACM) teams in
  place.
2009/10 remaining mitigation measures
Review the ICT arrangements currently in place to record ACM information. Review the current assessment and reviewing
documentation. Develop an outcomes focused / citizen centred approach to ACM. Dedicated hours allocated to practice
development role. Collaborative approach to assessments being developed between health and local authority partners.
Risk Aspect 2008/09 2008/09 2009/10 2008/09 Mitigation
Summary Risk Risk
Status Status
Adult Social Services - Developing sustainable models of Medium Medium Joint work with Swansea NHS
Range & Quality of service to promote independent living.   Trust to provide appropriate
Services   services on discharge from
  hospital. Continuing to
implement services that
promote independence.
2009/10 remaining mitigation measures
Further develop partnership and collaborative approaches to service development across Adult Social Services. Increased
awareness of direct payments as an alternative. Development of day opportunities as alternative to building based services.
Involvement of citizens in planning services and redesign. Use joint planning groups to scrutinise service developments.
Consider community capacity building approach to address sustainability issues.

34. Risk Aspect 2008/09 2008/09 2009/10 2008/09 Mitigation
Summary Risk Risk
Status Status
Adult Social Services - Safeguarding vulnerable adults. Medium Medium Staff training reinforced.
Arrangements for  
protection of vulnerable  
people  
2009/10 remaining mitigation measures
Raising awareness across communities and key stakeholders. Development of Escalating Concerns process to manage issues
within care homes. Planned completion of self audit / inspection regarding staff competence and guidance compliance. Further
training being developed around links between MCA and POVA. Development of a prevention framework regarding
safeguarding. Additional resources in place re: the introduction of DOLS.
Risk Aspect 2008/09 2008/09 2009/10 2008/09 Mitigation
Summary Risk Risk
Status Status
Sport & Recreation Achieving WAG’s Climbing Higher Medium Medium Implement City & County of
physical activity strategy.   Swansea Climbing Higher
  Strategy.
 
2009/10 remaining mitigation measures
Implement Year 2 Climbing Higher Action Plan by 2010.