Agenda and minutes

Resolved:- That the minutes of the meeting held on 22^nd February 2010 be approved as a correct record.

Millennium Centre – Talking Newspapers

The Director of Health and Wellbeing reported that discussion had taken place with Talking Newspapers and it had been suggested that there was potential for them to stay at the Millennium Centre with our support or to move to a new building with our support.  She agreed to bring a report to the next meeting with the options available.

E-Learning Package

The Chair reported that all elected members had been made aware of the E-Learning package on Safeguarding and some had already undertaken it.  He urged his advisors and the other members present to make every effort to do it in their capacity as representatives for adult social care and health.

Shona McFarlane, Director of Health and Wellbeing presented the submitted report in respect of Personalisation, Self Directed Support.

Self Directed Support describes new approaches in the social care system that puts people in control and helps them to design their own personalised support.

A key part of the process was the introduction of a personal budget.  Building into the new system was a process for working out the level of resources a customer can access to pay for the support they require to meet their needs.  Exactly how the customer chooses to spend their personal budget was flexible and in their control and was documented in a support plan.

In order to fulfil the requirements of a SDS process, new documentation must be introduced; these documents would include:

• Individual Social Care Assessment
• A Resource Allocation System
• Support Plan
• Risk Policy

Individual Social Care Assessment (ICSA)

The ISCA is a needs based assessment tool which assesses eligibility under Fair Access to Care Services criteria.

To fulfil the duty to assess needs, the care manager will complete the ISCA with the customer. The document has been written in a way that ensures the customers needs, aspirations and desired outcomes were at the centre of the assessment.

The ISCA had been combined with the Resource Allocation System and therefore completion of the document allowed an indicative personal budget to be calculated.  This was an indication of the level of resources a customer may need to live life as an equal citizen and achieve some or all of their personal outcomes which sit within the ‘Outcomes for Adults’ framework.

Resource Allocation System

The aim of a Resource Allocation System (RAS) and Allocation Framework was to provide a clear and rational way to calculate the level of resources an eligible person was likely to need to arrange support.

It was not the intention for the RAS to give a precise allocation of funding but rather to be a tool which is sufficient to produce a ballpark figure for the majority of users.  The ‘indicative allocation’ calculated by the RAS can be adjusted up or down accordingly depending on individual circumstances.

The actual amount would not be agreed until a support plan that met the eligible social care needs was completed.

Support Plan

A customer’s needs and the outcomes they wished to achieve were identified during the assessment process and recorded within the ISCA.  The support plan would map how a person would meet their needs creatively to achieve their outcomes and who would support them in this.  It would also identify how the person would manage their resources.

A support plan must be agreed and signed off by the care manager.

Risk Policy

The risk policy would highlight the arrangements that RMBC Adult Social Care would put in place to address complex risk situations.  The policy would include a risk assessment tool and the process for managing risk which involved criteria for referring cases to a Risk Enablement Panel.

The risk panel would exist to  ...  view the full minutes text for item 98.

Mark Scarrott, Finance Manager (Adult Services), presented the submitted report which provided a financial forecast for the Adult Services Department within the Neighbourhoods and Adult Services Directorate to the end of March 2010 based on actual income and expenditure to the end of January 2010.

The approved net revenue budget for Adult Services for 2009/10 was £72.9m, which included additional funding for demographic and existing budget pressures together with a number of new investments and efficiency savings identified through the 2009/10 budget setting process.

The previous budget monitoring reports for Adult Services had identified  underlying pressures of £2.3m. However after taking account of a number of identified savings and management actions achieved these pressures had reduced and there was a forecast overall net overspend of £42k by the end of the financial year. 

The Directorate continued to review planned spend to identify any further potential opportunities to mitigate the remaining forecast overspend. 

The latest year end forecast showed the main budget pressures in the following areas:-

• Home Care as a result of delays in shifting the balance of provision to the independent sector (+£623k). The 70/30 split was achieved at the end of July 2009 and the balance had now moved beyond 70/30.
• Increase in residential and nursing care short stays over and above approved budget for clients with a physical and sensory disability (+£57k).
• Independent sector home care provision for Physical and Sensory Disability clients had increased by an additional 1110 hours since April 2009, a further 74 clients were now receiving a service. This was resulting in an overspend of £372k against the approved budget.
•  A significant increase above approved budget in clients receiving a Direct Payment within Physical and Sensory Disabilities and Older Peoples Services (+£473k), reduced by Social Care Reform Grant Allocation of (-£100k).
• Additional one-off expenditure was being incurred in respect of the costs of boarding up, removal of utilities and security costs at the former residential care homes prior to them transferring to the Council’s property bank (+£200k).
• Delays in the implementation of budget savings agreed as part of the budget setting process for 2009/10 in respect of meals on wheels (+£318k), laundry (+£160k) and the bathing service (+£40k).
• Increase in costs of Occupational Therapist contacts (+£120k).
• Continued pressure on the cost of day care  transport provision for Learning Disability Day care clients reduced by planned delays in recruitment to vacant posts (+£49k).

However, the above pressures had been reduced by :-

•  Additional income from continuing health care funding from NHS Rotherham (-£418k).

·        Overall underspend within Learning Disabilities Supported Living schemes mainly due to planned delays in the implementation of new schemes  (-£189k).

·        Savings within independent residential care due to an increase in income from property charges (-£709k) and slippage in intermediate care spot beds (-£40k).

·        Savings on the reconfiguration of Extra Care housing (-£340k).

·        Planned delay in developing rehabilitation and supported living facilities for clients with a physical and sensory disability (-£157k) plus agreed delay in developing respite care provision (-£157k).  ...  view the full minutes text for item 99.

Mark Scarrott, Finance Manager (Adult Services) presented the submitted report which informed members of the anticipated outturn against the approved Adult Services capital programme for the 2009/10 financial year.

Actual expenditure to the mid February 2010 was £464k against a revised programme of £1.2m for 2009/10. The approved schemes were funded from a variety of different funding sources including, unsupported borrowing, allocations from the capital receipts, Supported Capital Expenditure and specific capital grant funding.

A brief summary of the latest position on the main projects within each client group was provided.

Older People

The two new residential care homes opened in February 2009. The balance of funding (£230k) related to landscaping costs, outstanding fees and the cost of any final minor works.  

The Assistive Technology Grant (which included funding from NHS Rotherham) was being managed jointly and was being used to purchase Telehealth and Telecare equipment to enable people to live in their own homes. A procurement plan to spend the remaining NHSR funding was currently being finalised and woud now be procured in 2010/11. The RMBC funding was approved and included the purchase of lifeline connect alarms, low temperature sensors and fall detectors within peoples homes.

A small element of the Department of Health specific grant (£13.5k) issued in 2007/08 to improve the environment within residential care provision was carried forward into 2009/10.  The remaining balance of funding was being spent within in-house residential care services.

Learning Disabilities

The small balances of funding (£10k) carried forward from 2008/09 were to be used for the purchase of equipment for Parkhill Lodge and within existing supported living schemes.

The refurbishment at Addison Day Centre (Phase 2) was now complete and awaiting final invoices.

Work had now started on the refurbishment of the respite centre at Treefields funded from the Councils Strategic Maintenance Investments fund and would be completed in early May 2010. 

Mental Health

A small balance remained on the Cedar House capital budget and would be used for the purchase of additional equipment.

A large proportion of the Supported Capital Expenditure (SCE) allocation had been carried forward from previous years due to difficulties in finding suitable accommodation for the development of supported living schemes.

Suitable properties continued to be identified and spending plans were being developed jointly with RDASH.  The possibility of funding equipment purchased for direct payments was also being considered to reduce the current pressures on the mental health revenue budgets. Further options were also being considered to provide more intensive supported living schemes with a range of providers and to fund a range of new assistive technologies for mental health clients, which would support their independence with access to 24 hour support.

Management Information

The balance of the capital grant allocation (£85k) for Adult Social Care IT infrastructure was carried forward from 2008-09 and used with this years grant allocation (£92k) to fund the Adults Integrated Solution as part of introducing electronic care management. The integrated solution would be fully completed by the end of March.  ...  view the full minutes text for item 100.

Shona McFarlane, Director of Health and Wellbeing updated members on the inspection which had taken place on Monday 8^th March 2010.

She reported that a powerpoint presentation had been given to the officers from the CQC which drew specific attention to the improvements made:-

• Raising awareness of issues of potential abuse.  Campaigns had targeted people from the BME community and the Lesbian, Gay and Bisexual community.  As a result of work in this area awareness had increased by 19%.
• Safeguarding 
  • Multi agency plan in place
  • Learning Disabilities and Mental Health customers now mainstream – report on Swift system
• Quality audit on 5 care homes
• Quality Assurance
  • Case file Audits in place
  • Supervision Orders

• Training – Unqualified Social Workers were undertaking training they didn’t need to – now only doing first two sets
• Expanding work around physical disabilities
• Improved support for carers
  • Dedicated resources
  • New Carers Cente
  • Crossroads – new service

• Workforce Strategy in place
• Supervision Policy – more effective
• Updates on Personalisation

She confirmed that the inspection was well received and the CQC would continue to monitor progress.  A further inspection would take place in July 2010.