Agenda item

To consider a report of the Strategic Director of Children, Families and Adults. (To Follow)

Members considered a report on the financial outturn of the Adult’s Department for 2011-12. This report built on the Mid Year Review of Financial Performance and provided further information on the mitigation strategies which were in place to help to reduce forecast overspends. Patrick Rhoden, Principal Accountant, reported that whilst the Three Quarter Financial position had yet to be finalised, the indication was that there would be a reduction in the overspend from the Mid Year position.

Lucia Scally, Head of Strategic Commissioning and Safeguarding, continued to go through each part of the Adult’s budget, highlighting the reasons for the overspend and what mitigation strategies had been put in place as a result. Members asked questions and made comments after each area.

Care4CE

Lucia Scally reported that there was a projected £1.1m overspend in this area and that this was due to the delay in delivering the rationalisation of building use and linked temporary decommissioning of ECT beds.

It was queried why there had been a delay in the rationalisation and what lessons had been learned. Councillor Roland Domleo, Portfolio Holder for Adult Services, commented that it was vital that the consultation process had been as comprehensive as possible and therefore the delay had been necessary. He also noted that the process of building valuation had taken longer than expected. In terms of what had been learned, Councillor Domleo noted that in future there would have to be a proper programme time plan on such a project.

It was questioned how long it would take to complete the Building Based Review and whether this would have an impact on the 2012/13 budget. A number of Members were doubtful that the proposed saving would be realised as the rationalisation process would not begin until after April 2012. Councillor Domleo stated that the saving would be incremental and Lucia Scally noted that the service would account for the savings profile once a final decision had been reached.

Attention was drawn to a point that had been made in a previous meeting regarding a purported disjoint between assets and adult social care which had a part to play in delaying the building base review thereby negating any potential savings for 2011/12. It was noted that this point would be reiterated when the final Building Base Review paper was submitted to scrutiny.

Individual Commissioning

Jacqui Evans, Head of Local Delivery/Independent Living Services, reported that there was a forecasted £3.241m overspend and that this position had not changed dramatically since the Mid Year Review. She explained that the overspend position was due to two main factors. Firstly, increased numbers in residential and nursing care, either because people were living longer in these settings or because individuals were increasingly depleting their own financial capital and as a result were turning to the Council for care cost support. Secondly, those in receipt of care were tending to require larger packages than individuals presenting for care previously. Jacqui Evans continued to outline ongoing initiatives which were in place to try and mitigate demand. These were linked to the preventative and re-ablement agendas and it was suggested that Scrutiny might receive a report detailing this work at a subsequent meeting.

A number of comments were made in support of the preventative work that the Council was doing in order to help reduce demand on services and it stated that this should be continued. Attention was drawn to assistive technology and in particular how important it was that information regarding this service was disseminated as widely as possible. It was suggested that putting on road shows would be a good way of achieving this. Jacqui Evans acknowledged that these were helpful comments and noted that the Council did advise people in terms of assistive technology on their first contact with the Council. She also reported that the Council was looking at a business case for employing more staff to communicate with partners and end users about the potential of assistive technology.

It was queried whether there was any update with regards to the money that was to be recouped from the Direct Payments budget. Jacqui Evans reported that this was an on-going process.

It was questioned whether there had been any impact on the respite budget as a result of the increasing trend of the elderly caring for the elderly. Jacqui Evans explained that this was being looked at as part of the Building Based Review. She acknowledged that the challenge for the Department was in how to provide both sufficient general respite and the more costly dementia respite care for which there was now a greater demand. She asserted that a balance was required but that it was likely that the number dementia respite beds would be increasing.

It was queried what the service was doing to evaluate the efficacy and appropriateness of care packages. Jacqui Evans drew attention to the on-going work to review care packages. She reported that this had saved approximately £4.4m by applying Fair Access to Care (FACS) criteria and by increasingly offering preventative and re-ablement options. Jacqui Evans also confirmed that work was being done to analyse why some money in the direct payments budget had not been spent.

Attention was drawn to the proposed savings in the adult transport budget. It was queried why the figure for transport was going up by £500k in 2012/13 and back down to the 2011/12 figure in 2013/14. Councillor Roland Domleo explained that there was a one-off cost required in 2012/13 in order to make transport efficiencies in the future. It was acknowledged that this did not explain why the 2013/14 figure had not decreased beyond that in 2011/12, even after money being spent to achieve efficiencies. Jacqui Evans agreed to explore this issue further at the next meeting.

Strategic Commissioning

Lucia Scally noted that there was an overspend of £0.785m projected for this area. She reported that the service had already taken remedial action using areas of underspend and savings.

It was queried whether the service had carried out an impact assessment as a result of the proposed welfare cuts from central government. Lucia reported that Alison McCudden, Commissioning Manager – Income Maximisation, had produced a paper on this issue which could possibly come to Scrutiny if required.

It was questioned how much of the re-ablement agenda was funded by the NHS. Jacqui Evans explained that the NHS funded the 6 week intermediate care package and that the department was looking at convergences and synergies with the Council’s own re-ablement services in order to create further efficiencies. It was requested that the Committee receive further explanation on the work around re-ablement agenda and what the impact of this had been and what it might be in the future.

In providing a final comment, Councillor Roland Domleo asserted that whilst the projected £4.1m overspend was disappointing, a lot of the reasons behind it were due to one-off and unavoidable costs. Therefore, if these costs were stripped away, the budget would nearly break even which was a significant achievement considering the growth pressures that were present.

RESOLVED –

a)    That the report be received.

b)    That a further budget paper be brought to the next meeting of the Committee and that this include:

a.    Further information on projected transport savings

b.    Further information on the work on-going around re-ablement.