To receive apologies for absence.

Apologies were received from Councillors ME Cooper, BA Durkin and MJ Fishley.

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

Councillor Brigadier P Jones CBE substituted on behalf of Councillor MJ Fishley.

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

Councillor AE Gray declared a personal interest as a provider of provisions for people with learning disabilities.

To approve and sign the Minutes of the meeting held on 25 January 2010.

RESOLVED: That the Minutes of the meeting held on 25 January 2010 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.

There were no suggestions from Members of the public for issues for future scrutiny.

To provide an update on the Mental Health Procurement Project being undertaken by NHS Herefordshire and Herefordshire Council.

The Committee received an update on the Mental Health Procurement Project being undertaken by NHS Herefordshire and Herefordshire Council.

The Associate Director of Joint Commissioning reported that the current Mental Health Services were provided by NHS Herefordshire supported by the Council.  Whilst the services provided were satisfactory, the advantages of economies of scale offered by large specialist mental health providers were unavailable.  NHS Herefordshire has taken the view that these services would be best provided by a specialist mental health provider.

Bids had been submitted as part of a competitive tendering process, and presented to stakeholders from three successful bidders.  These were Gloucestershire Mental Health Trust, Worcestershire Mental Health Services and South Staffordshire and Shropshire Mental Health Trust.  The final tender stage was in place, and the contract would be awarded by the end of July 2010.  The Powerpoint presentations from the bidders, together with staffing number, would be circulated to the Committee as a briefing note.

In the ensuing discussion, the following points were made:

In reply to a question from a Member, the Associate Director of Joint Commissioning said that there were clear advantages to going down this route, as larger organisations could minimize costs.  It would also be possible to extend existing services and provide Memory Clinics in every market town, something that the existing Mental Health Service was unable to do through a lack of resources.

In reply to a further question, the Associate Director said that the commissioning intention was to focus on localities within the County, and that there was no intention that service delivery would be provided outside the County.

The Associate Director went on to say that as a result of this change there would be increased productivity for the same budget, rather than cuts to the Service.  By using resources from other organisations it would be possible to increase services such as memory and personality disorder clinics.

RESOLVED: That the report be noted.

To update the Committee on progress made since the action plan that was produced on the Review of Transition from Leaving Care to Adult life on 19 December 2008.

The Committee received a report on progress on the action plan that was produced on the Review of Transition from Leaving Care to Adult life on 19 December 2008.

RESOLVED:

That;

(a)         The Committee appreciates that there has been an almost complete change of management since the Review and that a new legal framework was currently being introduced.   But it feels that the response to the Review, together with the actions required to implement recommendations that had been made almost two years ago, have been markedly less than adequate;

and;

(b)         the report presented was a wish list of aspirations and promises with little in the way of clarity for action plans, designated responsibilities or time lines for delivery.  As such the Committee is not prepared to accept this report and requests that a more considered response be presented, with specific actions and clear lines of responsibility for delivery within a defined timescale, to its meeting on the 21 June 2010.

To consider Cabinet’s response to the recommendations made to it in the ScrutinyReview of Carers’ Services in Herefordshire.

The Committee received a report on Cabinet’s response to the recommendations made to it in the ScrutinyReview of Carers’ Services in Herefordshire.

The Chairman reported that all of the recommendations had been accepted apart from the first one, as it would be inappropriate for representations to be made to the Minister until after the forthcoming General Election.

RESOLVED:

THAT 

            (a)     Cabinet’s response to the findings of the Scrutiny Review of Carers’ Services in Herefordshire be noted; and

(b)          A further report on progress against the action plan be made after six months with consideration then being given to the need for any further report being made.

To advise members of the financial position for the Adult Social Care budget within the Joint Commissioning Directorate, and the Strategic Housing budget within the Regeneration Directorate for the period to 31^st January 2010.  The report provides the variations against budget and a projected outturn for the year.

The Committee received a report on the financial position for Adult Social Care and Strategic Housing revenue budgets for the period to 31 January 2010.

The Principal Accountant reported that the overspend for social care currently stood at £2.2m, which was a decrease of £400k from the previous month.  To date, recovery action had achieved savings of £522k as a result of the recovery of £147k from Direct Payment surpluses, £164k from Daycare voids, the use of £196k of capital funding, £10k from a hold on spend and £4k from Independent Living Funding income. A further saving of £1,088k was likely to be achieved.  The total saving for 2009/10 was £1,610k.

She went on to outline changes that had occurred since the report had been written:

• The Interim Director of Integrated Commissioning had met care providers in order to agree the principles for the new standard rate for residential care.  This would see a significant increase in the base rate and would eliminate the requirement for discretionary top-ups.  The rate would be effective from 1 April 2010.  

• A review of the contract with Shaw Healthcare was underway in order to ensure that the existing contract was fit for purpose. This contract had the largest number of residential and daycare voids and it was anticipated that the review would generate efficiencies.

• Recent changes to the conditions for receiving Independent Living Funds.  From 1^st May it would only be possible to claim for those under 65 who were employed for more than 16 hours per week and had a package funded by the Council of over £340 per week. This would reduce the Council’s capacity to raise funds in the future. Existing claims would not be affected.

The Principal Accountant went on to report on changes within the budget setting process for 2010/11:

• All budgets would be split between block and spot contracts.  Service managers would ensure maximum use of block contracts prior to use of the spot market according to assessed needs of the client.

• Budgets would be set according to existing commitments.  This would mean that service managers would have adequate budgets to work with, and monitoring would allow the Council to identify overspends as a result of a lack of funding or increased pressure on clients coming into the service. This would allow for a `credit` budget being applied to each service area which would be the shortfall in funding under each client group for social care.

• Budgets have been set using zero based principles and vacancy factors had been incorporated at 4%.

·         The new virement policy would allow budget movements within set limits, and add justification to the impact of future funding commitments. 

The Associate Director of Integrated Commissioning added that the Supporting People underspend had occurred only because funds had not initially been allocated appropriately. The budget had been treated as outlined in the report in order to ensure that it would be ring fenced.

In reply to a question from a Member, the Associate Director  ...  view the full minutes text for item 183.

To report on the national performance indicator positions and other performance management information for the Adult Social Care Division within the Joint Commissioning Directorate.

The Committee received a report on the national performance indicator positions and other performance management information for the Adult Social Care Division within the Joint Commissioning Directorate

The Associate Director of Joint Commissioning reported that the target for NI 130 (Social care clients receiving self directed support) appeared to be higher than performance, but it was an average across the West Midlands

She went on to say that NI 132 (Timeliness of social care assessments) had shown a drop in the autumn of 2009, as a result of significant safeguarding problems: three residential homes had required full reviews.  The severe weather in January had also had an affect on this indicator.

It was noted that NI 135 (Carers receiving a needs assessment or review and specific carer’s service or advice) had been affected by a fault in the Frameworki recording system.  This had been sorted out, and the indicator would be on target once the data performance staff had cleaned the data.

RESOLVED: That the report be noted.

To consider the Committee’s Work Programme

The Committee noted its Work Programme.

RESOLVED: That the work programme be approved and reported to the Overview and Scrutiny Committee.