Agenda and minutes

Adults and Health Committee - Monday, 22nd January, 2024 10.00 am

Venue: Committee Suite 1,2 & 3, Westfields, Middlewich Road, Sandbach CW11 1HZ. View directions

Contact: Karen Shuker  Tel: 01270 686549 Email:

Link: listen to audio of meeting

No. Item


Apologies for Absence

To note any apologies for absence from Members.


Apologies for absence were received from Councillor A Burton and Councillor C Bulman attended as a substitute.


Declarations of Interest

To provide an opportunity for Members and Officers to declare any disclosable pecuniary interests, other registerable interests, and non-registerable interests in any item on the agenda..


In the interests of openness and transparency the following declarations were made:


Councillor L Wardlaw declared that she occasionally worked for the Cheshire and Wirral Partnership NHS Foundation Trust.


Councillor J Place declared that he was a member of the Together Trust in Cheadle.


Minutes of Previous Meeting pdf icon PDF 148 KB

To approve as a correct record the minutes of the previous meeting held on 20 November 2023.




That the minutes of the meeting held on 20 November 2023 be approved as a correct record


Public Speaking/Open Session

In accordance with paragraph 2.24 of the Council’s Committee Procedure Rules and Appendix on Public Speaking, set out in the Constitution, a total period of 15 minutes is allocated for members of the public to put questions to the committee on any matter relating to this agenda. Each member of the public will be allowed up to two minutes each to speak, and the Chair will have discretion to vary this where they consider it appropriate.


Members of the public wishing to speak are required to provide notice of this at least three clear working days’ in advance of the meeting.



There were no members of the public present.


Third Financial Review of 2023/24 pdf icon PDF 131 KB

To consider a report on the third review of the Cheshire East Council forecast outturn for the financial year 2023/24.

Additional documents:


Cllr A Moran joined the meeting during consideration of this item.


The Committee received a report which provided the third review of the Cheshire East Council forecast outturn for the financial year 2023/24.


Members were asked to consider the serious financial challenges being experienced by the Council (and other councils) and to recognise the important activities outlined which aimed at minimising the impact on services.


Officers reported that there were two key things that were driving the overspend which were inflation on placements which was primarily residential nursing care and supported living placements and an increase in people with more complex and greater needs than there was prior to the pandemic. It was thought that two of the reasons for that were due to the way the pandemic had affected people's mental health and an aging population.


In response to Members comments and questions officers reported that


-      A short stay bed was more expensive than a long-term package of care, so the decision was taken not to sustain the 200 short stay beds. The Council would go back to pre-pandemic levels that worked out at 50 short term beds and the costings around that were calculated last year in preparation for 23/24 budget. This would achieve savings as a result of a mixture of less care in some cases where that had been the assessed need, lower cost care such as care at home, or more income as people had moved from a short stay bed into a long stay bed.

-      The Council was currently out to consultation on a new Direct Payment strategy. It had increased the payment that it was making for direct payments so that it would become a more attractive option because overall that was a cheaper way of delivering care than either through commissioned domiciliary care or through a bed.

-      In respect of the home care provision there were currently no individuals waiting for home care which indicated that the strategic approach to increase capacity was working.

-      There were issues in terms of international recruitment, which the Council was supporting providers with alongside government funding.

-      The Cared Cubed tool used national benchmarking data in respect of cost of care and there was lots of data available for the Council to use in comparison with its neighbours, regionally and nationally.

-      Work was underway with legal colleagues to review the recovery of debt which was over 6 months.

-      In respect of being able to identify potential clients in advance there was data and projections that were built into the forecast. There was also a Preparing for Adulthood program that is developing projections in terms of young people who will transition into adult social care.

-      The interface between the provision of social care and NHS care and the respective criteria for each, is under constant review and work was ongoing.


An amendment to the recommendations in the report was moved and seconded which sought to amend the word ‘consider’ to  ...  view the full minutes text for item 45.


Safeguarding Adults Board Annual Report 2022 - 2023 pdf icon PDF 137 KB

To receive the 2022/23 Annual Report of the Local Safeguarding Adults Board.

Additional documents:


The Committee received the annual report of the Local safeguarding Adults Board 2022/2023 which described the role, structure, and governance of the Safeguarding Board. During the last 12 months Kevin Bennett had been appointed as the Independent Chair and the 3-year strategy had been updated which reflected the vision, aims and objectives for the Board going forward from 2022 to 2025 respectively.


Following questions and comments from members, officers reported that


  • Future reports would include progress in comparison to previous years, long term successes and work would be carried out around the template used for the report.
  • Cheshire East figures mirrored those nationally.
  • The Board had sought scrutiny from SERCO in respect of hotels for asylum seekers and professionals who provide services in Cheshire East and had gained confidence following the information that had been presented to the Board.
  • Work was being undertaken with the Community Development Team to help support those hard-to-reach groups.
  • The reference to funding and budgets was not in respect of the Adults Safeguarding Board it was a reflection of how demand for care and pressure on social care budgets and the NHS are driving behaviours and activities that were leaving some vulnerable adults at greater risk.
  • The issue of carer stress is included within the Carers Strategy
  • The issue of on-line abuse and scams is fed into the Safer Cheshire East Partnership and related boards.


The Board and the officers are thanked for all their hard work.




That the Cheshire East Safeguarding Adults Board Annual Report 2022-23

be noted.



Minutes of the Cheshire East Health and Wellbeing Board pdf icon PDF 128 KB

To receive the minutes of the Cheshire East Health and Wellbeing Board – 22 November 2023.


Following questions and comments from members, the Director of Public Health reported that:


-      Numbers of COVID had spiked over the Christmas period but numbers had come back down.

-      Numbers of influenza had increased slightly over the Christmas period and were continuing to increase as would be expected, but levels were lower than previous flu seasons and there was nothing that would be unexpected for this time of year.

-      Steps were being taken within the local health protection system to try and increase the uptake of the MMR vaccine following the announcement that measles had been declared a national incident over the weekend by the UK Health Security Agency.

-      Pharmaceutical Needs Assessments were routinely undertaken, and the Council had a statutory duty to assess whether or not the need was adequate, but pharmaceutical services were provided by NHS England, not by the Council or the Public Health team.




That the minutes of the Cheshire East Health and Wellbeing Board be received and noted.



Work Programme pdf icon PDF 286 KB

To consider the Work Programme and determine any required amendments.


The Committee considered the work programme. It was agreed that officers would work on bringing reports to committee which would provide a review of implementation for those 2022/23 strategies which the Committee had previously approved and these would be for scrutiny rather than for decision.


Members requested that consideration be given to:-


·         Learning Disabilities Board – Members requested to see a report in respect of the work carried out by the Learning Disabilities Board.


·         A review of the SARs which had previously been discussed at Committee – It was agreed that this would come to the March Committee.


·         A request for a report which would enable Committee to provide scrutiny in respect of Care4CE and the service it delivers.


·         A request for a report which would enable Committee to provide scrutiny in respect of the Supported Employment Programme the Council provided.





That the work programme be noted.


Reporting of Urgent Decisions pdf icon PDF 206 KB

To note an urgent decision taken on behalf of the Committee.




That the Committee noted that an urgent decision was taken under Procedure Rules 2.10 and 2.11 by the Chief Executive on 29th November 2023 to accept a grant for the Local Authority Urgent and Emergency Care support fund 2023/24 to strengthen performance and resilience this winter.


The Committee adjourned for a short break.


Adults, Health and Integration - MTFS budget presentation pdf icon PDF 502 KB

To receive a presentation on the Medium Term Financial Strategy in respect of Adults, Health and Integration.


The Committee received a presentation which outlined the budget challenges faced within Cheshire East Adult Social Care. The primary cause of the financial pressures were due to inflation, demand and interest rates.


It was proposed that the budget for Adult Social Care for 2024/25 would be £4.5m less than anticipated in February 2023. That would mean that instead of a proposed budget of £142.4m there would be a proposed budget of £137.7m. Therefore, savings had to be identified to bring it back down to the proposed budget. It was noted that this is less than the department is currently spending.


The options available to achieve net budget reductions were outlined which included increasing Council tax and increasing charges, focusing on reducing and eliminating subsidies for services and doing things differently for less, which could result in reducing the level of service provided.


The Council had set up a CE Budget Emergency Response Team (CEBERT) whose purpose was to update on progress towards financial stability, make decisions and set out next steps and co-ordinate activity to reduce net spending.


High level business cases were being prepared as part of the budget process which would be discussed at the full Council meeting in February 2024.


Additional work had been undertaken to bring the pressure on the budget down. A list of activities which had already been delivered was outlined and discussions with health colleagues had taken place to try and seek savings  collectively.


The majority of the adult social care budget (70%) went on commissioned care, and approximately 25% went on the Council’s employed workforce which meant that focus needed to be on commissioned care if overall spend was to be reduced. There were 3 areas to focus on to reduce spend in Adult Social Care


• Services and contracts to be cost efficient and increase productivity

• Diverse service offers to ensure service mix is cost effective

• Change traditional models of care


The focus of the proposals would be around making services and contracts more efficient and increase productivity and diversify the service offer. Other savings included the following areas


  • Client contribution yield offsetting growth
  • Maximisation of Supported Living
  • Fees and Charges currently subject to the outcome of consultation
  • Older People - Reduce, Prevent, Delay
  • Working Age Adults - Prevent, Reduce, Delay


A list of activities was outlined which would not identify cashable savings but would concentrate more on cost avoidance.


• Preparing for Adulthood - Prevent, Reduce, Delay

– Investment in new accommodation

– Investment in new models

– Investigation of alternative funding approaches

• Pricing for care – Care Cubed and Joseph Rowntree Foundation

• Extra care




That the presentation be noted.