Agendas, Meetings and Minutes - Agenda item

Agenda item

Budget Scrutiny: Draft 2019/20 Budget Adult Services and Public Health

Minutes:

The Cabinet Members and Directors responsible for Adult Services and Public Health had been invited to provide an overview of the draft budget for 2019/20 following a review of the 2018/19 budget position at the 6 November 2018 Panel meeting.

 

The Chief Financial Officer (CFO) provided the context to the budget consultation process and advised that comments from the Overview and Scrutiny Panels would be discussed by the Overview and Scrutiny Performance Board on 24 January and reported back to Council.

 

The key points included:

 

·         that the overall income from grants and council tax would increase by £6.2m in 2019/20

·         there was £35m of cost pressures from demand led services

·         the forecast outturn for 2018/19 at Period 7 was for a £3m overspend.

 

The CFO advised that since the 13 December 2018 Cabinet Report, the County Council and its six District Council partners had been successful in its application to be a 75% Business Rate Retention Pilot, resulting in a one-off cash allocation of £4.9 million in 2019/20 to be used on services to prevent or reduce the costs of adult and children’s social care across the County.

 

Members were reminded of the massive cost pressure the Council was experiencing as a whole and the specific pressures around adult social care, resulting in social care precept announcements and government one off grants to further support the rising costs of care.

 

Overall, the forecast of £14.1 million increase in the net base budget for 2019/20 included increased cost pressures of £11.4 million including care services for older people, allowing for increased caseload, more complex care needs, the National Living Wage for 2019/20, and those transferring from children to adult care.

 

During the discussion, the following main points were made:

 

·         Members were disappointed that the information before them was from the December Cabinet and that updated information was not available to Scrutiny for its January meetings and therefore the Panel was not scrutinising the most up to date information

·         The CFO reassured the Panel that no changes affecting Adult Services were expected in the budget information being presented to January Cabinet

·         Some assumptions were being made in relation to future government grants, however, it was confirmed that the social care precept was not continuing.  In addition, local authorities were waiting on the Adult Care Green Paper to be published to inform the future direction of travel

·         Despite some uncertainty about income, it was confirmed that the savings would be achieved this year. More savings, would however be required by the Council in 2020/21 and 2021/22

·         The CFO and the Director of Adult Services were congratulated on the due diligence carried out in respect of the budget proposals and the work done to establish the reliability of Adult Services savings proposals

·         In relation to the Business Rate Retention Pilot, Members were interested to learn more about how the £4.9m would be distributed across the County and how Districts could apply for funds.  The Panel was told that an Operational Board would be established and there would be a bidding process to apply for funding. The County Council would sign off all projects.   It was agreed that the Panel would be updated on the projects approved

·         It was confirmed that the Capital Programme was aligned to the Corporate Business Plan and Members were reminded that there had been a lot of capital investment in recent years, for example in assistive technology

·         As the Capital Programme was grant led, the latest forecast for the Capital Programme for 2021/22 and beyond wasn’t available as the Strategy was still developing

·         Members were disappointed to note that there was no plan to replace ‘The Grange’ and were informed that viable alternatives had not been forthcoming.  One Member suggested a vacant school site, to which the Cabinet Member was aware of, however, suggested that professional assessments of possible sites would provide a clear steer.  The Panel was informed of a Unit in Solihull, which when completed, could provide a useful visit opportunity for the Panel

·         In relation to prevention programmes, Members were informed that results were generally not instant, rather would be known in two or three years’ time, however, progress in assistive technology was very promising in keeping people independent and in their own homes for longer.  Equally, falls prevention was having an immediate positive impact

·         Savings from assistive technology since September 2018 was already in the region of £125,000 and Officers were planning a series of engagement events to communicate the benefits to the wider public.  It was felt that events could promote the wider health and well-being agenda 

·         Everyone agreed that prevention would be a generational shift and the Directorate was mapping all community resources to try and build a resource for community resilience

·         Although it was known that the population of Worcestershire was ageing and costs associated with this group were escalating, there was a bigger concern about the cost pressures around the budget for support of adults with learning disabilities.  Members learned that, in part, there was concern over adults with learning disabilities who were living with their increasingly elderly parents, who in turn would require social care.  The Directorate was very aware of these families and working proactively with them

·         Census information was used to inform decisions and the data suggested that Worcestershire would see a 40% increase in those aged over 85

·         In response to a question as to whether the provider market for nursing and domiciliary care was stable, it was reported that although it was fragile, it was sustainable and Worcestershire did not fall foul of problems arising with large providers.  In addition, the Directorate was due to carry out its annual negotiation process with providers and was confident that the Worcestershire offer would be fair.  A piece of work was also underway to look at homecare, which may result in providers extending their current offer

·         The Directorate was currently revising the Market Position statement

·         The Panel was advised that Adult Social Care was responding well to the usual winter pressures and working productively with partners to try and prevent admissions into hospital, although there was always room for improvement.  It was noted that the new Chief Executive of Worcestershire Acute Hospitals NHS Trust was now in place and Members hoped that alongside the substantive Chairman, the Trust had some stability

·         One Member stressed the importance of meaningful social engagement for well-being, citing that a fifteen minute domiciliary visit was not that.  There was a shift towards promoting active old age, something the Panel   supported.  It was also noted that a clear message needed to be given that many health issues in old age developed as a consequence of decisions made when younger

·         A concern was expressed about the financial benefit support available for elderly parents who cared for their adult children with learning disabilities, the Directorate was not able to resolve issues relating to benefits, but could signpost individuals to the correct information

·         The Director was pleased to report a positive outlook, delivering a budget and achieving savings and could see that initiatives such as the Three Conversations Model, was having a positive impact on the residents of Worcestershire.  Moving forward, prevention was a driver and transforming services was key to further success.

 

It was agreed that the Panel would be provided with the following information:

 

·         A briefing note following the annual contract negotiation process for domiciliary care providers

·         Details of the cost of care in Worcestershire, in comparison to other authorities

·         Quality Assurance update on residential care homes.

 

Following the meeting, the Panel's comments would be summarised and reported to the Overview and Scrutiny Performance Board on 24 January 2019.

Supporting documents: