Agenda item

The Panel had been provided with performance information for Quarter 1 (April to June 2020) and financial information for period 3.

Performance

Officers reminded Members that the report was presented to them on a regular basis and indicators focussed on the key priorities of reducing long term care and keeping people living independently for as long as possible.  The four Adult Social Care Outcomes Framework (ASCOF) measures were reported nationally and reported on a rolling year basis, with the latest data available to June 2020.

As expected, due to the COVID-19 pandemic, there had been a reduction in Admissions to Permanent Care per 100,000 in both 18 to 64 years (ASCOF 2a(i)) and age 65+ (ASCOF 2a(ii)).  In comparison, although not shown, there had been an increase in demand for domiciliary care and an increase in hours provided over the period.  Historically, Worcestershire had a higher rate of admissions in comparison to other local authorities and it was pleasing to note the figure reducing.

The two indicators associated with reablement were showing positive trends.  ASCOF 2d, the % of people with no ongoing social care needs following reablement after hospital discharge, had always performed well, however from April 2020, provisional figures showed that numbers were down, attributed to new ways of working.  Likewise, with the % of 65+ at home following rehabilitation (ASCOF 2b), there was good performance against the target, although more fluctuation due to more complex cases going through the service.

The Panel heard that the indicator for Delayed Transfers of Care had been stopped nationally and discussions had been taking place on a replacement reporting measure.  Locally, discussions had continued with the Onward Care Team, who had reported that patient flow through the hospitals was working well.

The final performance indicator on Annual Care Packages Reviews Completed showed that the target of 95% had not been met for some time, however, there had been a slight improvement in Quarter 1.  Monitoring was in place, however, performance fluctuated across different teams due to the complex nature of some cases and funding reviews in light of the COVID-19 pandemic.

The Strategic Director for People would be looking at all performance indicators, with the expectation of introducing a set of measures which were outcome focussed and supported the People Directorate vision.

In the ensuing discussion, the following points were made:

·         With rolling year data potentially masking the true picture, it was agreed that month on month data for admissions to permanent care would be provided to the Panel to demonstrate an improvement over time

·         When asked whether Officers expected a decline in the use of Care Homes, it was reported that Worcestershire’s strategy was to keep people living in their own homes and as independently as possible for the longest time, with initiatives such as supported living and extra care designed to help.  Performance was going in the right direction, with improvements year on year

·         A Member asked about the interventions in place to improve the number of Annual Care Package Reviews Completed, querying whether telephone or video conferencing options were available to Staff.  Officers shared the view of looking at alternative ways of working, in line with the requirements of the Care Act, however also clarified that increasing numbers of cases were complex and time consuming

·         Moving forward, within Learning Disability services, Officers were considering moving towards a ‘named worker’ model which would potentially increase efficiency and, subject to Cabinet approval, the Mental Health social work team would be brought back in house in six months’ time which would result in direct control of the reviews.  In addition, an advert was being placed for 3 mental health social workers due to vacancies being held

·         When asked whether the Council was in breach of the Care Act by not achieving the 95% target, it was reported that nationally, anything over 90% was considered good performance.

Finance

The Head of Finance explained that due to the timing of the meeting, the Panel had been presented with information from the end of Quarter 1, Period 3 (June 2020).  At that point, there had been a forecasted year-end overspend of around £2m, however, senior leaders had been working to reduce that figure and the end of Period 5 position showed that the forecasted overspend had reduced significantly.

The impact of COVID-19 on the Council’s resources was balanced with a significant grant and funding from various central government departments and the Herefordshire and Worcestershire Clinical Commissioning Group.  Monies had been passported to providers for areas such as infection control and personal protective equipment.

In the discussion, Members asked the following questions:

·         A Member asked whether the assumption that external funding, either received or expected, was robust and would cover all COVID-19 related costs.  It was reported that senior leaders were content it would and although expenditure within adult social care was high, the income was sufficient

·         All assessments had been based on the information available at that time, however, assumptions had been made on there being no second wave of COVID-19, or if so, then predictions had been based on the knowledge and level of intervention during the first wave

·         Forecasts were based on the best intelligence available at a particular point in time, with opportunity to reflect as time progressed

·         A Member asked whether all funding had been received from central government.  It was noted that  £7.4m had been received for infection control (in the first wave) and following a government announcement, a further £6.8m to £7m was expected (with guidance awaited)

·         CCG funding was received in a different way due to internal audit processes and COVID-19 related claims were made to the CCG by the Council each month.  The Panel noted that overall, monies owed to the Council and monies owed to the CCG would hopefully be clarified by the respective Chief Financial Officers shortly

·         When asked whether there had been a pause to the savings programme, it was reported that Adult Social Care had been requested to make £4.4m savings in the current financial year of which £2.8m had either been delivered or was on target to be delivered by March 2021.  A further £0.5m would be potentially be delivered and around £1m was at risk of non-delivery, with 4 to 5 specific areas of activity having stalled due to the pandemic.  Some COVID-19 funding had been used to mitigate the £1m at risk saving target, however, Officers were hopeful to pick up the 4 to 5 areas towards the end of the financial year

·         In response to a query as to what the COVID-19 funding or grants had been used for, the Head of Finance listed items such as additional PPE, paying care providers a 5% top up to cover cleaning, staffing etc, implications of social distancing, such as signage, staffing and logistics, loss of income generation for libraries or archive services, investment in technology, including licences for Zoom and additional visits for those at risk or vulnerable.