Agenda and minutes

Consideration was given to the minutes of the meeting of the Cabinet Member for Health and Social Care held on 26^th April, 2010.

Resolved:- That the minutes of the previous meeting held on 26^th April, 2010 be approved as a correct record.

Mark Scarrott, Finance Manager (Adult Services) presented the submitted report relating to the Revenue Outturn position for Adult Services Department within the Neighbourhood and Adult Services Directorate for the financial year 2009/10.

The 2009/10 approved cash limited budget was £72,692,857, and the net Outturn for the service for 2009/10 was £72,608,110.  This resulted in an overall net overspend of £84,747 (-0.12%).  This represents an increase in the underspend compared with the last budget monitoring report largely due to additional income from continuing health care and a further underspend on extra care housing.

The key variations within each service area are as follows:

Commissioning and Partnerships (+£96k)

There were a number of under and overspends within this service area, mainly around the income budget pressures in respect of performance and planning posts transferred from Neighbourhoods.  These were reduced by a number of management actions including, non-recruitment to vacant posts, a general moratorium on non pay budgets and maximising grant funding.

Assessment & Care Management

Older People (Independent) (-£386k)

The overall underspend within this service area was in respect of a number of vacant social work posts, an overall underspend on the Intermediate Care pooled budget (-£61k) and an underspend on independent sector residential and nursing care due to additional income from health and increased income from property charges (-£684k).  However, the underspend was reduced by an overspend on the independent sector Home Care budget (+£192k) due to increased demand together with an increase in demand for Direct Payments (+£195k).

Physical and Sensory Disabilities (+£146k)

The main pressures during the year were a continued increase in both number (1110 hours) and cost of independent home care placements (+£312k) together with a further increase in demand for direct payments (+£170k).  These overspends were reduced further by management actions including  the delayed implementation of new investments to establish residential and respite care services within the borough (-£314k)

Safeguarding (+£64k)

The overspend on this head of account was due to agency staff costs and a loss on income from NHSR.

Independent Living (-£61k)

The underspend within this head of account was a result of the reconfiguration of Rothercare Direct and a recurrent underspend on Extra Care Housing provision after a review of the service.

Health and Well Being

Older People (In-House) (+£653k)

The main overspend during the year was within In-House Home Care services (+£514k) due to the initial delays in the implementation of shifting provision to the independent sector including an overspend on employee costs due to contracted hours being greater than hours of service delivered.  There were further overspends within in-house residential care due to the additional costs incurred as part of the de-commissioning of a number of former homes (+£280k) plus the final costs of closure of the laundry (+£166k) and meals on wheels services (+£305k) agreed as part of the 2009/10 budget setting process.

These overspends were reduced by underspends within Extra Care Housing (-£360k), Day care (-£118k) and Transport (-£158k) due to the general moratorium on vacant posts plus a reduction  ...  view the full minutes text for item 2.

Mark Scarrott, Finance Manager (Adult Services) presented the submitted report which informed Members of the Capital Outturn against approved budget for Adult Services for the 2009/10 financial year.

The Capital Outturn for Adult Services for the financial year 2009/10 was £645,275 against an approved budget of £1,194,070, resulting in an overall underspend of £548,695.  The main variations from budget were underspends on the landscaping works at the two new residential care homes at Rawmarsh and Dinnington, slippage on assistive technology equipment and developing supported living schemes within Mental Health Services.  This compared with a variance of £175,000 underspend which was previously reported.

The following information provided a brief summary of the Outturn position for each project:

Older People

The landscaping works at the two residential care homes did not commence until the end of March 2010 and therefore expenditure would be incurred in 2010/11 financial year.  The 2009/10 unspent balance would be rolled forward to fund these costs in 2010/11.

The spending profile for Assistive Technology was revised during the year and the balance of unspent funding (£87k) carried forward into 2010/11 to meet future commitments.

There remained a small balance from the specific grant for Improving the Care Home Environment for Older People allocated by the Department of Health to improve the environment within residential care provision.  The grant had been allocated mainly across the independent sector provider and would be fully committed in 2010/11.

Adult Services – Learning Disabilities

Small balances of funding remained for equipment within Parkhill Lodge and supported Living schemes which were not utilised in 2009/10 but commitments had been made against this funding for 2010/11.  The phase 2 refurbishment at Addison Day Centre was completed during the year funded from the Council’s Strategic Maintenance Investment fund.  In addition a programme of refurbishment at Treefields Close respite unit commenced in February and completed in May 2010.

Adult Services – Mental Health

A large proportion of the Supported Capital Expenditure (SCE) allocation had been carried forward due to difficulties in finding suitable accommodation for the development of supported living schemes.  Suitable properties were being explored, and revised models for providing supported living services continued to be developed.  Fabric alterations to premises for older people with mental health problems, services for Carers and developments in relation to Direct Payments had been assisted by the MHSCE.

Spending plans were being developed for 2010/13 with our partner, NHS Rotherham in relation to Intensive Supported Living schemes, the use of Telecare/Assistive Technology solutions for people of all ages with mental health problems which would allow people to live in the community with access to 24 hour support, the development of Dementia Cafes, the development of services for people under 65 years with dementia, user led service developments to assist people into employment and to provide peer support and continuing to support capital developments around Direct Payments.

Management Information

The Social Care IT Infrastructure grant was used during the year to fund the Adults Integrated Solution and the  ...  view the full minutes text for item 3.

The following item is likely to be considered in the absence of the press and public as being exempt under Paragraph 3 of Part 1 (as amended March 2006) of Schedule 12A to the Local Government Act 1972.

Resolved:- That, under Section 100A(4) of the Local Government Act 1972 of the Local Government Act 1972, the press and public be excluded from the meeting for the following items of business on the grounds that they involve the likely disclosure of exempt information as defined in Paragraph 3 of Part 1 of Schedule 12A to the Local Government Act 1972.

Shona McFarlane, Director for Health and Wellbeing presented the submitted report in respect of the outcome of consultation on the proposed Non residential charge increases.

On 4^th March 2010 members endorsed the council’s budget setting proposals which included proposals to increase non residential social care charges as follows:-

• The introduction of a new charge for day care of £6.00 per day
• A reduction in the disposable income allowance of 20%, currently 40%
• An increase in the hourly home care charge from £11.90 to £12.85

The proposals were subject to a consultation exercise and report back to the Cabinet Member.  The report set out the outcome of the consultation exercise.

The overall headlines were:-

• 10% responded and that although views were mixed there was still support for charges with the highest percentage opting for between a £2 and £4 charge for day services
• 49% of customers felt that it would be unfair to raise charges
• 57% of customers felt that it was fair to pay for care at a day centre
• 40% of customers agreed that a charge should be based on ability to pay.

Further information was circulated at the request of the Cabinet Member, which outlined the impact if the day care charge was reduced to £4.00 per day.  It was noted that in reducing the maximum charge it would only really affect people with high income or with savings greater than the £23,000 savings threshold.

Based on that model around 50 of the 770 people affected would be better off.  It would however result in income to the council being reduced by £8,000.

Resolved:- (1) That a new charge for day care of £4.00 per day be introduced

(2) That the disposable income allowance be reduced from 40% to 20%

(3) That the hourly home care charge be increased from £11.90 to £12.85.