Agendas, Meetings and Minutes - Agenda and draft minutes

Agenda and draft minutes

Venue: County Hall, Worcester

Contact: Emma James /Jo Weston  Overview & Scrutiny Officers

Items
No. Item

340.

Apologies and Welcome

Minutes:

Apologies had been received from Mr P Grove.

341.

Declarations of Interest

Minutes:

None.

342.

Public Participation

Members of the public wishing to take part should notify the Assistant Director for Legal and Governance, in writing or by email indicating the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case ----2019). Enquiries can be made through the telephone number/email address below.

Minutes:

None.

343.

Confirmation of the Minutes of the Previous Meeting

Previously circulated

Minutes:

The Minutes of the Meeting held on 6 November 2019 were agreed as a correct record and signed by the Chairman.

344.

Services for Adults with Learning Disabilities pdf icon PDF 96 KB

Additional documents:

Minutes:

Attending for this Item were:

Adrian Hardman, Cabinet Member with Responsibility for Adult Social Care

Elaine Carolan, Interim Director of People

Fran Kelsey, Lead Commissioner

 

The Panel received a report regarding a number of areas relating to adults with Learning Disabilities in Worcestershire.  This included an overview of packages of care for people with complex needs, an overview of the upcoming peer review of Adult Social Care, which has a learning disability and autism focus, and an overview of the Transforming Care Programme.

 

A presentation, circulated as part of the Agenda, was used as the basis of the discussion.  In summary, the following areas were highlighted:

 

Packages of Care

·         Of the overall £66m budget for Adults with Learning Disabilities, £26.4m was spent on residential and nursing care and £19.3m on supported living.  These were significant figures and demand was increasing

·         Costs per week were rising, but were generally around £850 per week on average across the 1,454 packages as of October 2019

·         However, 28 packages were over £3,000 per week and a further 211 between £1,501 and £3,000 per week.  1,215 packages were under £1,500 per week

·         Levels of support varied, but for those with very complex needs, it could involve up to 1:1 social care 24 hours a day, which would result in high staffing costs

·         In comparison, funded support could be day care opportunities, transport or access to different therapies

·         Actions were being taken, with partners, to further understand the situation and find possible solutions.

 

Peer Review

·         A Peer Review had been arranged between 5-7 February 2020 to support the Authority in its self-evaluation and service development.  The Peer Review Team from across the region was led by a Director of Adult Services and was an opportunity to gather intelligence and share ideas across the Council and its partners.

 

Transforming Care Programme

·         This Programme was focussed on care for people with a Learning Disability and/or Autism with the aim of developing sustainable community-based provision and avoid admission to inpatient locked and secure services 

·         It was recognised nationally as one of the best performing Transforming Care Programme’s in the Country

·         There were currently 11 inpatients, with 5 planned discharges in 6-9 months’ time

·         The complex needs pathway had been developed and agreed across all health and social care providers in the County.

 

In the ensuing discussion, the following key points were made:

 

Packages of Care

·         It was confirmed that all of the 1,454 packages of care were for social care provision, not continuing health care or for secure hospital provision.  However, in relation to funding for secure and locked hospital placements, there were various funding arrangements.  If the primary diagnosis was a Learning Disability, the Council would wholly fund the provision, however if partly mental health then the cost would be shared 50/50 with the Clinical Commissioning Groups

·         When asked whether the support available in Worcestershire was above the legal minimum, it was explained that the Care Act was very clear on who was eligible for support.  If there  ...  view the full minutes text for item 344.

345.

Budget Scrutiny: In-Year Performance and Draft 2020/21 Budget and Medium Term Financial Plan Update 2020-22 for Adult Services pdf icon PDF 89 KB

Additional documents:

Minutes:

Attending for this Item were:

Adrian Hardman, Cabinet Member with Responsibility for Adult Social Care

Elaine Carolan, Interim Director of People

Steph Simcox, Head of Finance

 

The Head of Finance alerted Members to the fact that the Agenda pack referenced the 13 December 2019 Cabinet Report, whereas revised figures were now available as part of the January 2020 Cabinet papers.

 

The position in respect of the Council’s overall financial position was set out.  Specifically, in relation to Adult Services, budget proposals included a commitment to invest £13.2m to meet the demand led Adult Social Care pressures.  This would be funded by various streams including the social care 2% precept, the new social care grant and £3.3m worth of efficiencies and savings.

 

These revenue efficiencies and savings would come from areas such as reviews of internal processes whilst transferring to a new People Directorate, demand management opportunities including effective commissioning of services and access to assistive technology and maximising and reviewing current care packages.

 

Members were alerted to Period 8, 2019/20, where a £2.7m overspend was forecast.  The most significant variance was £2.1m overspend in respect of Older People Residential and Nursing care costs due to cost of care and complexity of care.  However, the £8.8m savings programme was mostly on target at this point.

 

In the ensuing discussion, the following points were made:

·         The Government settlement for 2020/21 was welcome, in particular the additional £0.9m social care grant.  However, it was unclear whether this was for one year only

·         In 2019/20, £1.5m in reserves had been earmarked should the demand for adult social care exceed the amount budgeted for.  This had already been exhausted

·         The current projections do not assume any further growth in adult social care

·         Each year, based on current demand, there is £10m in additional costs to cover inflation and pay increases.  The additional funding had allowed services to be maintained at the same level, but had not factored in any growth

·         A Member asked about the affect of the UK leaving the European Union, to be informed that there had been a workforce concern when the decision was made, but now the concern was around access to equipment and medication

·         In response to a query as to why there was no Capital spend forecast for 2021/22/23, it was reported that the Directorate had reflected on this and schemes had been reprofiled in the January Cabinet report    

·         When asked whether there was a way of managing the overspend, it was suggested that Council wide, there were areas which were underspending, however, some of the pressures were outside of Council control, such as hospital acquired functional decline which had an impact on social care services

·         A Member asked whether fluctuations in the weather had an impact on services.  It was suggested that although this used to be the case, there was no longer any seasonal fluctuation

·         The average age of an adult in Worcestershire requiring adult social care was 82

·         The risk based approach to reserves, which the  ...  view the full minutes text for item 345.

346.

Work Programme pdf icon PDF 81 KB

Additional documents:

Minutes:

Members had nothing to note at this time, although the Cabinet Member suggested that the Panel may have the opportunity to meet the new Strategic Director of People at its summer meeting.