Agenda and minutes

Apologies had been received from Councillors David Chambers, Lynn Denham and Jo Monk.

None.

Members of the public wishing to take part should notify the Democratic Governance and Scrutiny Manager (Interim Monitoring Officer) in writing or by e-mail indicating both the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case 20 January 2023).  Further details are available on the Council's website.  Enquiries can also be made through the telephone number/e-mail address listed in this agenda and on the website.

None.

Previously circulated

The Minutes of the Meeting held on 7 November 2022 were agreed as a correct record and signed by the Chairman.

The Deputy Chief Finance Officer gave an overview of the Council’s draft Budget and the consultation timetable before Council agreement on 16 February 2023.  Detail was also provided on the draft Budget specifically within the remit of the Panel.

In the ensuing discussion, the following main points were made and would be reported to the Overview and Scrutiny Performance Board at its meeting on 30 January 2023:

·        The service demand for Adult Social Care for 2023/24 was budgeted at £18.5m with a £16.4m net investment into Adult Social Care including Provider Services, funded by the 2% Adult Social Care Levy, other funding streams and savings identified relevant to Adult Social Care

·        Members welcomed the 2% Adult Social Care Levy for 2023/24 and were pleased to hear that the Cabinet Member and Officers  every opportunity to lobby Government for fair funding

·        The Panel was keen to know how Worcestershire spend in Adult Social Care compared to that of other local authorities.  It was agreed to provide benchmarking information to Members

·        The Council’s assumption for inflation was 5%, however, there were some contracts, mainly in highways and transport, where inflation was much higher.  In Adult Social Care, inflation was difficult to forecast as a number of contracts had zero uplift and would require renegotiation and also the retail price index changed monthly

·        In terms of how the Council mitigated if inflation rates remained high, the Panel was advised that there was a balance to be achieved and that most contracts had inflation built in.  However, spot contracts (care purchased at the time of need) were negotiated at the time of need.  There was currently around a 20% vacancy rate in Worcestershire Care Homes.  Costs for spot purchased beds would vary depending on supply at the time and client need, however, block purchased beds would likely be more economical if fully occupied, however, when not used, would still be charged for.  Members were reminded that the Council had statutory duties to meet.  In addition, patient choice was a huge and important factor for anyone requiring a Care Home placement, either on a short or long term basis

·        The Council had set a savings target of 6.5% across the organisation for vacancy management, enabling savings to be achieved between an employee leaving and their successor starting.  It was acknowledged that this target will not be achievable for some areas of the Council and reserves of £5m had been earmarked to mitigate for this

·        In addition, the People Directorate had a savings target of £661,000 for the delay in recruitment to vacant posts.  The Strategic Director assured the Panel that recruitment was a priority and that posts were not left unfilled to make savings.  Overall, there had been an underspend by the Directorate in this area this year and it was therefore prudent to account for this

·        Recruitment was of ongoing concern in health and social care.  The Council could advertise posts with salaries which could include Market Forces supplements, however, the pool of applicants  ...  view the full minutes text for item 459.

An overview of the Better Care Fund had been provided in the Agenda and was further explained as a national vehicle for driving health and social care integration.  Integrated Care Boards and local authorities were required to agree a joint plan, which was owned by the Health and Wellbeing Board.  The use of the Better Care Fund mandatory funding streams had to be agreed jointly and reflect local health and care priorities.  For 2022/23, national metrics included avoidable admissions to hospital, residential admissions, effectiveness of reablement and discharge to usual place of residence.

The Panel noted that since the Agenda had been published, the Better Care Fund Plans had been approved by NHS England.  The plans built on existing schemes to provide joined up care at the right time and in the most suitable setting and support individuals to remain in their own homes for longer and keep the highest possible level of independence for the longest time. 

The total Better Care Fund for 2022/23 was £69,456,193.  As part of this, the Disabled Facilities Grant was £6,163,577 and was passported directly to the six District Councils in accordance with the national funding formula.  In addition, the Council was allocated £1,987,188 from central government for adult social care discharge funding.

Members were invited to ask questions and in the subsequent discussion, the following key points were raised:

·       The Panel Chairman confirmed that the Health and Wellbeing Board had identified the use of the Disabled Facilities Grant as a key priority

·       The ‘Improved Better Care Fund’ referred to in the Agenda had been an additional funding stream, which was likely to be phased out and incorporated into the Better Care Fund

·       In response to a query as to how the money makes a difference to residents, it was reported that conversations with the Integrated Care Board were ongoing to ensure joint investments took place

·       A Member referred to the increasingly frail population and the need to not only promote mobility, but also foot care.  A number of Public Health initiatives were in place to promote movement, such as freely available resistance bands to improve core strength 

·       In response to a question as to how the Strategic Director influenced spend in other Council departments to enhance health and wellbeing, such as ensuring footways were maintained or bus services were retained, it was reported that conversations took place across the Council.  It was noted that some Adult Social Care budget had been passported to Public Health to facilitate such conversations.  Furthermore, with the Health and Wellbeing Board having District Council representation, it was hoped that broader conversations around good and specialist housing could take place 

·       The Panel Chairman referred to the ABCD (Asset Based Community Development) model as a positive way forward

·       A Member asked whether the Better Care Fund was a recurrent income to be informed that it was in the current budget and the draft budget for 2023/24.  Conversations with the ICB would continue and there could be some flexibility in further  ...  view the full minutes text for item 460.

Members were advised that Cabinet, at its meeting on 2 February 2023, was being asked to consider a proposed review of Adult Social Care charging.  The proposals were set out in the Agenda and the Panel was given the opportunity to comment in advance of any Cabinet decision.

In the ensuing discussion the following main points were made:

·       Current Council practice was to only charge for one care caller even if two were required.  The proposal of charging for double handed care home calls would affect 20 self-funding individuals

·       When asked why the Council was not already charging for double handed care when some other Councils were, it was reported that other local authorities had changed over time and that Worcestershire had not been an outlier for a long period of time

·       Increasingly, self-funding individuals were using the Council for services.  If personal circumstances changed, financial assessments could be requested and residents were able to informally check their status before asking for a formal financial assessment

·       It was hoped that further improvements could be made to the process, for example, the ability to view invoices through a secure portal enabling interaction with the Council around the clock

·       The Strategic Director advised that there was a host of regulations embedded in practice for charging for services, including a minimum income guarantee.  The proposals outlined would bring the Council in line with other local authorities and enhance the provision of personal budgets to provide care and support.

The Panel was unanimously supportive of the proposals as set out in the Agenda.  

Members were reminded of the decision made by the Cabinet Member with Responsibility for Adult Social Care on 13 December 2021 and the changes subsequently made to day opportunities for adults with a learning disability.

In the main, feedback had been positive and savings made were unexpected yet welcome. 

A Member asked for examples of the other financial commitments which the 5 closed properties continued to be responsible for.  One example given was space within Evesham Library, which was vacant, yet bills still required payment.

In response to a question about any negative feedback or concerns received, Members were advised that comments had been generally about the process rather than the outcome, examples given included queries over transportation or session times.  Individuals welcomed the element of choice in their communities and the range of provision.

A Member was disappointed to learn of the Centres closing, however was pleased to hear that clients were receiving positive experiences.  The Strategic Director responded to advise that although the decisions made were before his appointment, aspirations had changed and he believed the right decisions had been made.  Furthermore, thanks were given to the Assistant Director and the Team for successfully implementing the review.

In response to a query as to how affected Staff were supported, it was reported that where possible, staff were redeployed, however some staff chose not to take this opportunity and some redundancies were made alongside some retirements.  Officers agreed to provide further information outside of the meeting.

It was agreed that an Update on the Better Care Fund would be added to the Agenda for the July 2023 meeting.