Agenda item

(The Chairman left the meeting and the Vice-Chairman chaired the rest of the meeting)

Financial Information (Period 4 2019/20)

The Head of Finance explained that period 4 information had been made available to the Panel, which was due to be considered by Cabinet. The Adult Services budget was forecasting an end of year overspend of £3.3m, which was 2.4% of the c£136m Adult Social care budget and the Agenda included a graph to indicate areas of under and overspend, as well as the reasons for the most significant variances. The main reasons for overspend related to Older people’s Residential and Nursing Care activity and one off pressures from the opening of The Burrows (Supported Living Scheme) and redundancy costs.

It was explained that in relation to Older people Residential and Nursing Services budget was not due to greater numbers of people, but an increased unit cost due to inflation, minimum wage, recruitment and retention issues.

The Directorate had a savings programme of just under £9m, which was pleasing to note, was mostly on target. The Directorate was also looking at ways to mitigate the £2.4m recurrent cost pressures.

At this point in time, the Head of Finance did not anticipate any dramatic changes to figures for period 5, although it was clarified that not everything could be anticipated.

It was clarified that the 108% increase in Support Services was income from clients and working better to collect income owed.

It was clarified that the 43% underspend in the Integrated Commissioning Unit budget was due to successive rounds of staff reductions within the Unit.

A Panel member asked whether there were any other approaches to tackling cost pressures which could be tried and the Head of Finance said that the Directorate was quite good at predicting numbers but could be better at predicting market direction. A number of proposals were being developed, including a proposal to increase community reablement which would not change unit costs but would reduce numbers of people going into residential care.

The Director of Adult Services spoke about the outcomes of a review of cases to understand why people were placed into care, and it was known that in 2 out of 5 cases the individuals were coming from health settings. It was important to try and ensure that someone coming into the system as a relatively simple case should then be going home as a relatively simple case. More work was needed to try and reach self-funded people at an earlier stage to encourage them to plan for the future.

The Assistant Director spoke about problems with staff vacancies in nursing homes, and homes closing due to high agency costs. Worcestershire was an attractive place to build luxury care homes, but there were insufficient staff. Therefore, applications for care homes were regularly turned down and there were ongoing conversations with district colleagues. It was also an issue for Worcestershire when people moved from other areas to care homes, and then required funded placements when they ran out of funds.

Performance Information (Quarter 1, April to June 2019)

The Director of Adult Services advised that overall performance figures were similar to the Panel’s previous monitoring session, with some now performing closer to the regional average.

The Director explained that performance had reduced slightly in respect of the completion of annual care package reviews because the frequency of review had increased from 15 to 12 months with the target maintained at 95%. However, a plan was in place to address this by reviews being picked up by each Area and Learning Disability team, rather than through a central reviewing team.

Regarding data against the percentage of people with no ongoing social care need following reablement after hospital discharge, it was explained that the Directorate’s stretch target had been reached in March 2019 and had therefore been increased.