To approve the principles for the spend of additional social care funding announced in the spring budget 2017.

The report was introduced by the cabinet member for health and wellbeing. Herefordshire council had been granted an additional £7.3m funding for adult social care over the three years 2017/18 to 2019/20. The additional funding had been announced after the council had set its budget for 2017/18. The cabinet member noted that the adult social care system was under pressure and that any additional funds were welcome.

The director for adults and wellbeing summarised the report. He highlighted that:

·         the social care system was under pressure due to a number of factors including the rise in the population of over 75s and those of working age with a disability

·         due to reductions in funding, 25% fewer people were receiving care in their own homes

·         the rise in the national living wage and pension requirements stretched available funding and with high levels of employment it was hard to find staff willing to do the work for the living wage

·         the additional funding was required to be spent on top of the budget which had already been set by the council

·         Herefordshire would receive £3.6m to be spent in 2017/18 with a similar sum spread over the following two years

·         conditions were attached to the additional funding by the government as set out in the appendix to the report and the government would monitor the council’s use of the additional funding.

The director gave some examples of the projects under consideration for use of the additional funds. These included:

·         expanding the capacity of the community connectors team to help make better use of resources available in their local area;

·         expanding the in house rapid response service;

·         working to improve resilience of care providers;

·         developing better use of data to predict demand; and

·         expanding physiotherapy capacity and the falls prevention service.

The director explained that it was a decision for the council how to spend the additional funds, within the conditions set by the government. The health service had to agree how the money was spent but did not have a veto on it.

As the funding was non-recurrent and had to be spent within the financial year it was allocated for, approval was being sought from cabinet to delegate decision making on expenditure of the funds to the director for adults and wellbeing. Consultation would take place with the cabinet member for health and wellbeing and the section 151 officer on any decisions taken by the director.

In the discussion that followed the following points were raised.

A group leader noted the increasing emphasis on community support and asked what policies were in place to encourage family members of those in need of care to take more responsibility. The director of adults and wellbeing highlighted a pilot scheme in Leominster which aimed to raise awareness of support available in the community and connect those in need of support with these services and voluntary groups. It was intended that this approach be rolled out across the county.

The potential role of parishes to help co-ordinate support services within local communities and the importance of the involvement of health partners was noted. Policies that would prevent or delay the need for formal care or hospital admission were seen as the best way to reduce demand on the care system.

A scrutiny chair noted that any extra funding was welcome, even if it came with strings attached. However volunteers could not completely take on the role of the council.

The cabinet member for infrastructure noted the difficulty in spending the money allocated for the current financial year within the specified conditions. He asked whether some funding could support voluntary groups. He also noted that it could be difficult to get value for money across the county.

The leader stated that as the additional funding was a one off payment there was an inherent problem in making payments to volunteers as the council would not be able to sustain this in subsequent years.

The director of adults and wellbeing highlighted work done to increase the percentage of care users receiving direct payments which allowed them to make choices about where they sourced their services. Where care users received direct payments they were more likely to spend that money on services within their local community. Some very small sums of money might be allocated to help support community groups.

A group leader noted that in kind help could be as useful for community groups as financial support. She asked whether the council was struggling with care packages being handed back through lack of funding and whether the additional funding would increase the amount being given to care providers?

The director for adults and wellbeing responded that the council had very few care packages handed back but that it did take longer than the council would like for some packages to be picked up in the first place. He went on to say that there had to be a balance between paying a fair rate for care and paying a rate that worked for the council. The rates offered by the council allowed employers to meet their responsibilities under the national living wage and in relation to pension entitlements, however fewer staff were currently willing to do the work at national living wage rates. As the additional funding was non recurrent it was not intended that it be used to increase hourly rates as this could not be sustained for future years.

The cabinet member for health and wellbeing stated that the home care market and care home market was fragile and that increasing rates of pay would increase ongoing costs. Investment in other ways such as improving use of technology would support providers without increasing ongoing pay costs.

A cabinet support member suggested that the council could look to use some of the additional funding to support training and bursaries as a way to support recruitment and retention in the care sector. The director of adults and wellbeing responded that the council would be looking at investments in this area. Evidence showed care homes with a full time qualified manager were more likely to be rated as good. The council would be looking at ways to support training, for example by backfilling staff when they were on training courses. The council would also be looking at using the apprenticeship levy to support apprentices working in care homes.

A group leader asked how councillors would be kept up to date with how the additional funding had been used. The cabinet member for health and wellbeing replied that it would be included in the text of the normal quarterly report presented to cabinet.

Resolved that:

·           To support market development and sustainability for social care providers in Herefordshire

·           To support short term health initiatives that demonstrate future benefit to residents, and across the health and social care system

·           To integrate services through joint pathways and not building functions and services silos

·           To utilise a pilot approach to new initiatives to enable the evidence of benefits and learn from what works in practice 

·           To invest in systems to identify and track individuals to demonstrate the evidence of need and outcomes

·           To invest in initiatives that prevent or delay the need for formal care and prevent hospital admission