Agenda and minutes

Consideration was given to the minutes of the previous meeting held on 26^th September, 2011.

Resolved:-  That the minutes of the previous meeting held on 26^th September, 2011, be approved as a correct record.

In accordance with Minute No. H17 of the 11^th July meeting, the Joint Commissioning Manager reported on the Equality Impact Assessment carried out in support of the Integrated Community Equipment Service Review recommendation to rationalise the standard stock item of equipment.

The rationalisation of the standard stock meant that the Integrated Community Equipment Service (ICES) would supply items of equipment based on assessed needs and that practitioners making recommendations would be required to indicate clear outcomes that were expected to be achieved by the customer/carer before issuing equipment.  All equipment would be based on assessed Needs.

A summary of the Equality Impact Assessment was set out in the report submitted.

Adhering to the assessment would ensure that all customers with an assessed need would be fully supported by the Service.  This also meant that efficiencies could be achieved by the Service through a reduction in cost related to the storage/delivery and collection of low cost and low impact items of equipment.

Service users/carers and various practitioners consulted as part of the assessment were fully supportive of the way the standard stock items of equipment had been rationalised.  A rigorous EIA action plan had been developed to be implemented alongside the Service Review action plan.

The Service budget was overspent each year by an average of 6.7% and in the current Service configuration was expected to continue.  This had been met each year by Health with no contribution from the Council required.  The contract value for 2011/12 had been reduced by 10% by the Council and 4% by NHSR.  As at July, 2011, the Service spend on standard equipment budget was 52.5%.  Rationalisation of the standard stock list would enable the Service to focus on meeting the needs of high risk customers within the existing budget.  This would contribute significantly towards reducing the risk of potential increase in waiting time for equipment during the later part of the financial year.

Resolved:-  (1)  That the completion of the Equality Impact Assessment pertinent to the rationalisation of the Integrated Community Equipment Service standard stock of equipment be noted.

(2)  That the proposal to rationalise the standard stock item of equipment, as set out in the report submitted, be approved.

Consideration was given to a report, presented by the Finance Manager (Adult Services), which provided a financial forecast for the Adult Services Department within the Neighbourhoods and Adult Services Directorate to the end of March, 2012 based on actual income and expenditure to the end of August, 2011. 

It was reported that the forecast for the financial year 2011/12 was a balanced budget against an approved net revenue budget of £76.725M.

It was explained that there were a number of underlying budget pressures which were at present being offset by a number of forecast underspends:-

The underlying budget pressures included:

·        an overall forecast overspend within Older Peoples’ Home Care Service mainly due to increased demand for maintenance care within the independent sector

·        pressure on independent home care within Physical and Sensory Disability Services due to continued increase in demand

·        shortfall in respect of income from charges within in-house residential care

·        additional employee costs due to high dependency levels and cover for vacancies and long term sickness within older people inhouse residential care

·        an overall forecast overspend on Direct Payments across all client groups due to increase in demand was being reduced by savings on independent and voluntary sector contracts as clients in those schemes moved to Direct Payments

·        recurrent budget pressure on Learning Disabilities Day Care transport including income from charges

These pressures had been offset by the following forecast underspends:-

·        Forecast net underspend on Older People independent sector residential and nursing care due to an increase in the average client contribution and additional income from property charges

·        Underspend on employee costs within Transport Unit plus income from increased activity

·        Forecast underspend within Learning Disabilities residential and nursing care due to slippage on transitions from Children’s Services and additional income from Health

·        Slippage on developing Supported Living Schemes within Physical and Sensory Disabilities

·        Review of care packages within Learning Disabilities Supported Living resulting in efficiency savings with external providers and additional funding from Health

·        One off slippage on vacant posts as part of restructure/reviews including voluntary early retirements

·        Underspend on Rothercare Direct due to slippage on vacant posts and a reduction in expenditure on equipment including leasing costs

·        Efficiency savings within Supporting People Contracts

·        Vacancies with Assessment and Care Management and Safeguarding Teams

Total expenditure on Agency staff for Adult Services so far was £187,880 compared with an actual cost of £180,328 for the same period last year.  The main costs were in respect of residential care and assessment and care management staff to cover vacancies and sickness.  There had been no expenditure on consultancy to date.

Careful scrutiny of expenditure and income together with close budget monitoring remained essential to ensure equity of service provision for adults across the Borough within existing budgets.  Any future reductions in continuing health care funding would have a significant impact on residential and domiciliary care budgets across Adult Social Care.

Discussion ensued on the report with the following issues raised:-

-        Recruitment to vacant Social Worker posts would be taking place shortly

-  ...  view the full minutes text for item 27.