Agenda item

In attendance for this item were:

·       Paula Furnival, Strategic Director for People

·       Kerry McCrossan, Assistant Director for Adult Social Care

• Steph Simcox, Head of Finance
• Adrian Hardman, Cabinet Member with Responsibility for Adult Social Care

In place of the Principal Management Information Analyst, who was unable to attend, the Assistant Director provided a summary of the performance information relating to quarter 4 (January to March 2021).

Indicator: Long-term support needs of younger adults met by admission to residential and nursing care homes, per 100,000 population (ASCOF 2a (i) – the data for Worcestershire was 14.4 (49 young people) for young people in the year to end March 2021, against comparator authorities 14.7 although benchmarking data would only be available from the Autumn.

Indicator: Long term support needs of older adults met by admission to residential and nursing care homes (ASCOF 2a (ii)

At the end of last year, numbers had previously been much higher, and had reduced significantly, however had since increased and it was important to note that a number of people had been discharged from hospital particularly in March as ‘discharge to assess’ and had been in a care home for a period of around six weeks and during Covid, these timescales had been quite significantly extended which had led to more people remaining. Certainly, the Council would continue its work to work with individuals and families to support people to maintain their independence at home. As part of system-wide work to reduce these numbers, there was also a strong focus on early advice and information so that people were aware of their options.

Indicator: Proportion of people with no ongoing social care needs following a reablement service (ASCOF 2d) – performance for 2021 was 76%, a slight drop but comparably very good during the pandemic and the fact that community reablement had only started in 2020.

Indicator: Older people remaining at home following hospital discharge and a reablement service (Ascof 2b) - performance for 2020-21 was 81.8, slightly lower than the previous year but a good result during the pandemic.

Indicator: Annual care package reviews completed  in those 12 months or whose review is in progress at that point – this very important priority had a target of 95%, with current overall performance of 85.8%; there was more work to do and quite a difference across different client groups, with improvements being sought for mental health and learning disabilities. It was important to note that many welfare checks had also been carried out and these were not captured here.

The Chairman invited discussion and the following main points were raised:

·       The Officers undertook to check whether there was any data available about the speed of deterioration of those with dementia living in care homes compared to in their own homes.

·       The format of the information provided was praised.

·       The Officers confirmed that the Directorate regularly liaised with colleagues at a regional and national level to share learning and to pursue any examples of excellence, and Officers undertook to check whether there were any particular local authorities whether there were any particular local authorities which Scrutiny could learn from.

·       The Cabinet Member with Responsibility (CMR) for Adult Social Care explained that he also kept abreast of comparison data with neighbouring areas.

·       When asked about the implications for greater support (including to address long Covid) within the community for increased numbers of people with no on-going needs following reablement, the Strategic Director advised that Worcestershire had previously had high numbers of people admitted to residential/nursing care due to a lack of care in the community. However, agreement had just been reached with the Clinical Commissioning Group to invest in reablement and a £4m growth in the Better Care Fund would be entirely invested, which was tremendous, and for which substantial recruitment would take place. This would be an area of focus and a heavy workload was anticipated. The local service response for long Covid was led by health and included a range of support.

·       A member referred to the very different patterns of admissions to permanent care pre and during the pandemic and sought assurance about what had happened to those who had not gone into care. The Officers explained that pathways and funding streams had changed during COVID-19 as well as behaviours and the continued trend would not necessarily be clear for some months. Care home vacancies were high, regionally and nationally and Officers predicted more people would continue to receive care at home, although whether this was a long-term trend was not yet clear. There had been some deaths but no one had been ‘lost’.

·       Care homes were at risk both regionally and nationally, and while the care home market in Worcestershire was buoyant because of demographic assets, individual care homes were more at risk as grant funding during Covid came to an end. The Officers viewed this change as positive and it was important that people were able to make decisions about their care in an informed way, nonetheless the Council worked with the market about care requirements.

·       In response to a question, Officers would contact Worcestershire Children First to request information about the impact on young people who may have increased caring responsibilities during Covid.

Financial Update: Year End Position 2020/21

The Head of Financesummarised the information included in theAgenda and explained that the indicative position was a £300k underspend, compared with a £1m overspend in 2019/20, largely due to transformational change from the People Services Strategy to support ongoing efficiencies and demand management.

The Chairman invited discussion and the following main points were made:

·       The Directorate was congratulated on balancing the budget.

·       Regarding the level of confidence in balancing the budget post Covid, the Head of Finance agreed that demand forecast was often difficult and especially so after a very untypical 12 months, nonetheless the Directorate was investing in services and looking at different ways of service delivery and demand management. She therefore felt the Directorate was in a very good place with good plans and leadership, although the situation would continue to be monitored.

·       A member sought assurances about capacity to respond to potential increased demand for mental health services and the Director advised demand had already increased from both adults and children, and that Officers were working closely with health colleagues. Part of the integrated wellbeing offer was to promote local connectivity, since mental health did not start at the crisis stage, and this was not yet as good as it could be. The change in delivery of adult social care mental health provided the Council with greater perspective and included crisis care. The long-term impact of Covid remained to be seen but the Council was ahead of the curve.

·       Whilst the budget underspend was an achievement, a member asked how the Council compared with others and the Head of Finance would see if comparative analysis could be incorporated for the September update.