To advise members of the committee of the financial position for Adult Social Care and Strategic Housing revenue budgets for the period to 31^st July 2010. The report lists the variations against budget at this stage in the year 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^st July 2010.

The Principal Accountant reported that the outturn position for Adult Social Care had benefited from the injection of £2.2m of contingencies and reserves from the central budget.  This additional funding was shown as a reduction in spend.  Within the budget, it represented a recurrent addition of £1.7m. The budget had not yet been fully allocated as the compliance process associated with the virements had yet to be finalised.

There remained a budget deficit of £2.2m which needed to be recovered by 31^st March 2011.  The outturn position already included a number of measures within the recovery plan and further work was required in order to achieve a balanced budget.

She went on to say that there were additional pressures within Home Care and Respite Care.  As a result, the Charging Group had met and was looking at ways of maximising the amount of money to be charged for services in order to be able to be in a position to recover all costs.  A paper outlining the proposals would be brought to the Committee at its next meeting.

The Principal Accountant went on to say that there had been amore effective use of contract voids with a reduction from the position reported in July.  As a result, savings of £13k had been made over the two month period to September.  Work was also being undertaken on out of County placements, and the Council had been successful in its appeal to the Home Secretary regarding a placement in North East Somerset for which that Authority had not accepted its responsibilities. It had assumed that the Council would be able to backdate and recover three years of costs for a client with physical disabilities who now resided in North East Somerset. It was ruled, however, that the claim could be backdated for five years, providing the Council with an additional £63k.

In reply to a question, the Acting Director of Adult Social Care said that local authorities were subject to ‘Ordinary residence’ regulations whereby if a service user placed in residential care in another (host) authority chose to become a resident (living in their own accommodation) in that other host authority the host authority were liable for their care package.  This had not been honoured by North East Somerset, and the Council had been forced to go through the Local Government Ombudsman to the Secretary of State in order to sort recompense.  The Council did not aggressively pursue ‘ordinary residence’ in its own region as there were more people placed in  the County from authorities in the West Midlands who had opted to move from Homes into the community, than people from Herefordshire placed into other local authorities..

The Principal Accountant went on to say that, when staff had been transferred to Shaw Healthcare, the Council were responsible for additional payments for job evaluations.  The payment would change as a result of staff turnover, and the Council only had a responsibility for those who continue on their existing terms and conditions.  It was anticipated that the commitment for the year would be reduced once this process had been completed.  The Accountancy team were working with Shaw Healthcare but were still awaiting essential payroll information.

She went on to say that further models of recovery within the service were being worked on.  These included the tightening up of procedures, changes in service delivery and disinvestment options.

In the ensuing discussion, the following points were made:

·                  That the disinvestment in Meals on Wheels mentioned in the report was in regard to a particular project, and the service would continue to be delivered in this area, but in a different way.

·                  That whilst any additional care packages would reduce the value of savings made in the budget, it was important that this should be mitigated against by investment into reablement services by the Joint Commissioning Team.

·                  That detailed modelling had been undertaken in order to understand how the costs built up in the Learning Disabilities care market.  There had been an increase in those taking up personalised budgets, and an overall decrease in those in residential care.  The vast majority of those with moderate needs had found alternative accommodation.  There was an increased number of people with complex needs coming into the system, and these packages could cost up to £3k a week.  There was an increase in the general level of need, as there were more people reaching adulthood with profound disabilities.  It also had to be borne in mind that as those with disabilities aged, their needs became more complex.

·                  The Acting Director said that the entire Social Care Service had been analysed for any further possible savings.  Areas that had been looked at included eligibility criteria, reablement care, and contract review to ensure that the correct care was being provided to the service user.  Even with these initiatives, it was unclear as to how the overspend could be reduced.

·                  That the day care voids in the Shaw Healthcare contract currently stood at around 40-50%.  There was no mechanism within it which allowed for termination of the thirty year contract except by poor performance on the part of Shaw Healthcare.  There was also no onus on Shaw Healthcare to close the gaps on the voids.  The initial contract had been set up as a property rather than a service contract.  Negotiations were in hand in order to change the nature of the service to one that would be used by service users who increasingly would have personalised budgets

·                  The Cabinet Member (Adult Social Care, Health and Wellbeing), added that she had spent the last four years trying to resolve this issue, and the matter was being handled by the Legal Department.

·                  The Cabinet Member went on to say that whilst the integration of services between Health and Social Care was progressing, it was clear that IT linked to this area would not be inexpensive, and that the outlay would continue to be significant.  It would be necessary to go over all decisions pertaining to IT in order to ensure that it functioned correctly at the different locales across the County.

·                  In reply to a question, the Acting Director said that the Council was planning for a cut in budgets of 25% for the coming year, and a reduction to Social Care of £6m over the next four years.  All possible avenues had been considered, and the only solution available for dealing with this was likely to be service cuts and staff redundancies

RESOLVED

That: 

a)      The Committee noted the efforts that were being made by the Service to stay within budget, but it was considered that the basic budget for this demand led service remained inadequate and it was unlikely that the deficit would be reduced significantly by the end of the financial year; and;

b)     The Committee noted with dismay and disappointment the length of time that discussions with Shaw Healthcare had taken; and;

c)      areas of concern continue to be monitored.