To receive apologies for absence.

Apologies were received from Councillor Mrs E M Bew, J.W. Hope M.B.E and Ms G.A. Powell.

To receive details of any Member nominated to attend the meeting in place of a Member of the Committee

There were no named substitutes.

To receive any declarations of interest by Members in respect of items on this Agenda.

There were no declarations of interest.

To approve and sign the Minutes of the meeting held on 2nd December, 2005.

RESOLVED: That the minutes of the meeting held on 2nd December, 2005 be confirmed as a correct record and signed by the Chairman.

To consider suggestions from members of the public on issues the Committee could scrutinise in the future.

No suggestions were received.

To report on the current budget position in Adult Social Care and Strategic Housing.

The Committee considered the current budget position for Adult Social Care and Strategic Housing.

The report stated that the projected outturn for Adult Social Care, as described in paragraph 3 of the report was an overspend of £1,581,000 although if all identified risks materialised there was a worst case scenario that the overspend might increase to £1.75 million.

The projected outturn for Strategic Housing was now £652,000, a reduction on the figure reported to Cabinet in February.  The main cause of the overspend was expenditure on providing temporary accommodation for homeless people.  The appointment of two homelessness prevention officers had prevented a number of people going into temporary bed and breakfast accommodation and the projected overspend had reduced as a consequence.

In the course of discussion the following principal points were made:

·          It was requested that the Committee should be provided with more detail to enable it to scrutinise the reasons for the overspending. 

·          It was suggested that a seminar should be arranged to facilitate a more detailed analysis of the budget issues.

·          It was noted that the section 31 agreements for Mental Health and Learning Disability Services were being renegotiated.  It was requested that these agreements should also be discussed as part of the proposed seminar on the budget issues.

·          It was acknowledged that the strength of demand for services was such that it was difficult to control expenditure.  However, concern was expressed that over the last two years the gap between demand and provision in the base budget had increased significantly.

·          The Cabinet Member (Social Care Adults and Health) commented that there were some very serious funding issues which the Council as a whole would need to address.

The Committee then went on to discuss the future budget position.

To receive a presentation on the future budget position.

The Assistant County Treasurer and the Head of Business Services gave a presentation on the Adult Social Care and Strategic Housing Budget 2006/07.

The presentation covered the following principal points:

·          The 2006/07 budget set by Council had written off significant overspends from 2004/05 and 2005/06, adjusted ongoing base budget pressures, funded the most essential items of growth and created a contingency for social care.

·          The Adult Social Care budget for 2006/07 contained base budget additions of £1.288 million.  A contingency of £1.3 million for social care had also been established.  However, it was acknowledged that the identified pressures on the adult social care budget were significant.

·          Other budget issues included the negotiations with the Primary Care Trust over Section 31 pooled budgets, the requirement to find £600,000 of efficiency savings within the adult social care budget and the requirement to meet above inflation cost increases, for example in contracts with providers, from within existing budgets.

·          There had been a net addition to the Strategic Housing budget of £686,000.

·          In summary £1.974 million had been added to base budgets against pressures identified in presentations to the Budget Panel of £6.6 million on Social Care and £1.1 million on housing.

·          That the conclusion which had to be drawn was that the current pattern of spending could not continue and had to change.

Proposals for balancing the budget included:

·          Maximising efficiencies in procurement, commissioning of services and the operation of the service in terms of such things as performance management, absence management and concentrating resources on the front line.  However, the requirement to make efficiency savings of £600,000 year on year was a challenging target.

·          A fundamental review of service levels (including eligibility criteria), a focus on prevention, modernisation of provision, and a review of the long term demand for services for older people and learning disability services. 

·          That overall the budget settlement was positive but there was a need to remain vigilant in managing budgets and to develop options for consideration.

In the ensuing discussion concern was expressed that the contingency sum would not prove adequate in the face of the pressures which had been identified.  The base budget may not be sufficient and the Council faced a very serious situation to which Members needed to be alert.

In reply the Cabinet Member (Social Care, Adults and Health) acknowledged that the position was difficult.  However, the Council had made what provision it could for social care given the constraints and pressures on the Council’s budget as a whole.  The emphasis therefore had to be on finding new ways of delivering services within the available resources at the same time carefully weighing the potential effect of the Council’s actions on those in need of Services.  She added that the funding of social care was a national issue with the level of resources allocated to rural Counties being of particular concern.

RESOLVED:

That    (a) the report on Adult Social Care and Strategic Housing Performance and Budget be noted;

(b)           areas of concern continue to  ...  view the full minutes text for item 31.

To report on the performance indicators position and performance management initiatives for the Adult Social Care and Strategic Housing Divisions within the Adult and Community Services Directorate.

The Committee considered a report on current performance. 

The Committee had been informed in December that the Commission for Social Care Inspection had published its assessment of the Council’s Adult Social Care Services concluding that the Council was “serving some people well with uncertain prospects for improvement”.  The Commission had not, however, at that time issued a revised star rating for the Council, pending the Joint Area Review of Services the Council provided for Children and Young People and the Council’s Comprehensive Performance Assessment.  The Director of Adult and Community Services reported that the Council had subsequently been given a zero star rating for its social care services.

The Director informed the Committee that the Council had been required to submit an action plan to the Commission in response to the findings of the Joint Area Review.  Whilst there was no similar requirement for adult services, given the significance of the issues involved an improvement proposal/action plan was being developed with support from the Department of Health. The resource necessary to generate the required improvement was something the Council needed carefully to consider. 

He added that as part of the star rating process an Annual Review meeting with the Commission was provisionally scheduled for 29th August 2006.  Revised star ratings for all Councils with Social Services responsibilities were due to be published in the Autumn.

The report outlined a number of initiatives designed to improve overall performance.

It was reported that of the ten priority areas for social care, as set out at appendix 1 to the report, target C28 (Households receiving intensive home care per 1000 population aged 65 or over) would definitely not be achieved. 

In the course of discussion the following principal points were made:

·          In response to a question about target C32 (older people helped to live at home per 1000 population aged 65 or over) it was reported that it was likely that this would remain a difficult target for the Council to achieve, even though it was not as challenging as the target some other authorities set themselves.

·          A question was asked about the additional resources which would be needed to achieve target C28.  In reply it was said that C28 a rough estimate was that £800,000 would be needed to hit the target.

·          A question was asked about the effect on the budget of an increase in the number of adults and older people receiving direct payments enabling them to purchase their own Services.  In reply it was stated that the direction of the new Government White Paper – Our Health, Our Care, Our Say: a new direction for Community Services stated that increased choice would be underpinned by a direct payment or care budget and the Council could accordingly expect Government direction to increase direct payments.  Some initial work had been carried out which suggested that increasing direct payments might actually bring some reduction in service costs.  The Council did, however, have significant  investment in its buildings which would have to be  ...  view the full minutes text for item 32.

To report on progress of the Scrutiny Committee’s review of services for people with a learning disability.

The Committee considered a progress report on the review of services for people with a learning disability commissioned by the Committee following a presentation to it in December on the expected increase in demand for these services.

The review was focusing on three area project areas:  Assessment and Care Management, Accommodation and Support and Day Opportunities Modernisation, with a Group of Members assigned to each project.  The report outlined the issues and challenges facing each area of service and issues raised to date by Members.  Members discussed and explored some of their emerging thoughts in each area.

RESOLVED

That(a) the progress report be noted and a further report setting out clear recommendations for future service delivery be prepared for consideration;

                                    and

 (b) a visit be arranged to Barrs Court School, Hereford, to which members of the Children’s Services Committee should be invited to review transition issues.

To provide an update on progress to date with homelessness prevention in Herefordshire since the homelessness consultation event in October 2005.

The Committee received an update on progress to date with homelessness prevention in Herefordshire.

The Change Manager – Homelessness presented the report updating the position since his report to the Committee in December 2005.  He highlighted the success of the newly appointed homelessness prevention officers.  He noted that 25 successful homelessness prevention payments totalling £5,000 had been made from the spend to save fund between January and March, 2006 saving the Council an estimated £250,000.

It was noted that the Council would take back responsibility for the provision of homelessness and housing advice services by the end of March, 2006 and that arrangements for the Homelessness and Housing advice Steering Group were also in place.

In response to questions about the level of public awareness of the Council’s role and powers he said that it was intended to brief the press and public on how to access homelessness and housing advice services.

The Committee was also informed that the Office of the Deputy Prime Minister, having criticised the use of Bed and Breakfast accommodation, had now expressed the view that Councils should reduce the numbers in temporary accommodation by 50% by 2010.  This had led to the Council reviewing the need for a scheme for the provision of temporary accommodation in Leominster. 

The Chairman commented that there was a need for homelessness provision across the County.

RESOLVED:

That       (a)         the update be noted,

                                 and

                            (b)   the Committee be kept informed of progress on developments in homelessness prevention services and the work of the Homelessness & Housing Advice Steering Group after these services are transferred back in-house.

To advise Members of key messages emerging from the new White Paper “Our Health, Our Care, Our Say: A new direction for Community Services”. 

The Committee was informed of key messages emerging from the new White Paper “Our Health, Our Care, Our Say: A new direction for Community Services”. 

The report summarised the key areas for change identified in the White Paper.  The Director of Adult and Community Services noted that detailed implications would emerge as the Government issued detailed guidance to implement the proposals over what was expected to be a two year period.  He added that it would be important to monitor the funding implications.