Accepts reports findings: Cllr Simon Hancock

A DAMNING report from Wales’s Social Services Inspectorate (CSSIW) and the Healthcare Inspectorate Wales (HIW) has exposed a series of scandalous and substantial shortcomings in the way Pembrokeshire County Council deals with people with learning disabilities, The Herald can reveal. 

The report’s authors conclude that there is a series of significant failings in the way the Council delivers its services for vulnerable adults with learning disabilities, and says that plans for improving the service are ‘aspirational or embryonic’.

The report goes on to say that some measures taken with the aim of improving the authority’s performance are ‘less effective than they could be because of the absence of an overarching strategy that drives improvement across all aspects of care and support for people with learning disabilities’.

While failings are noted at the front line of service delivery, the publication does not hold back in identifying those at fault, stating that ‘senior managers and other leaders must also accept final responsibility for the deficits in performance at the front line’.

The report finds that, while there have been historical issues about competence and performance in the Community Team for Learning Disability (CTLD), it would be a mistake for the authority to conclude that this is the main reason for the deficits in performance. Rather, inspectors concluded that care managers and others have not been well served by systems, processes and leadership in recent years.

The distinction between ‘senior management’ and ‘leadership’ is particularly telling for the authority and firmly points the finger at those considerably higher up the political and executive food chain.

The report criticised the absence of an explicit accommodation strategy for people with learning disabilities and found that there was ‘little sense that the local authority has effective processes in place that will enable it to predict demand, plan for the future and deliver sustainable and preventative solutions’.

Noting that the Health Collaborative, of which the Council is part, and its regional statement of intent have ‘the potential to provide a sound basis for progress’, inspectors found that it had ‘only marginal impact in Pembrokeshire’.

The deficiencies in the Council’s approach to dealing with the learning disabled appear to be systemic and widespread, to the extent that even fundamental care issues are not being addressed appropriately.

The inspectors note a ‘lack of any case file audit process’ and that ‘language and communication needs were not well-represented in the files examined by inspectors’. In one case, a learning disabled Welsh-speaker was compelled to communicate in English because no carer could be found who spoke Welsh.

As of September 30, 2015, there were 129 reviews that were overdue, i.e. outstanding for a year or more. This amounts to 35% of the cases that were described by the authority as either ‘active’, ‘review only’, or ‘open to review.’

In one case, there was no assessment of need or care plan on file, but there was reference to a plan having been completed FIVE years previously. In another instance, the care and support provided for a service user had not been reviewed by the authority for more than TWO years between 2013 (when a major adult protection incident was investigated) and July 2015.

It can scarcely be surprising, therefore, that the report’s authors found that: ‘The authority is not delivering information, advice, assistance and care planning to a consistently acceptable standard. Consequently it cannot be confident about the quality of outcomes for people… Most of the case files examined showed at least some aspects of practice that was either poor or required improvement’.

Pembrokeshire County Council’s Cabinet Member for Adult Services, Health and Well-Being and Equalities, Simon Hancock, told us: “We accept the findings in the inspection report which we acknowledge revealed a need for significant improvement.

“Indeed, prior to the inspection last December, we undertook a self-assessment of Learning Disability Services and identified a number of areas which required attention.

“As a result of that awareness, the management team drew up a comprehensive improvement plan which they and the staff have been following since the beginning of the year in order to ensure that the necessary improvements are put in place.”

Among the actions identified in the improvement plan was to appoint a Champion for Learning Disabilities services in Pembrokeshire, and Councillor Hancock took up this position in January.

In order to ensure service users and carers are involved in agreeing priorities and are helping shape the service, a Learning Disability Partnership Board has been set up and a number of engagement events with service users and carers have also been held so that the voice of the customer is heard.

Councillor Hancock added: “The improvement plan will not only help ensure that the recommendations from the CSSIW inspection process are met, but that service improvement is sustained.

“I am passionate in my role of Learning Disabilities Champion for Pembrokeshire and am satisfied that we are on target to deliver the changes required.”