Agenda and draft minutes

Consideration was given to the minutes of the previous meeting held on 28^th January, 2013.

Resolved:-  That the minutes of the previous meeting held on 28^th January, 2013, be approved as a correct record.

The minutes of the meeting of the Health and Wellbeing Board held on 16th January, 2013, were noted.

The Director of Health and Wellbeing reported that, as a result of the current changes to the NHS architecture and legal framework (Draft Care and Support Bill 2012), the Authority would need to review its current Strategy to ensure that it was able to meet the expected requirements and continue to deliver the best possible outcomes for carers.

Following consultation with service users and stakeholders, the Authority and the Rotherham Clinical Commissioning Group (CCG) had agreed a draft Carers’ Charter in 2012, demonstrating a joint commitment to deliver and improve services for all carers in Rotherham.  It had been used to develop a Joint Action Plan for Carers, which put the commitments into action and illustrated what would be delivered for carers over the next three years.

The draft Joint Action Plan had been out to consultation with a range of groups including carer representative groups, voluntary and community sector organisations and key stakeholders throughout December, 2012, and January, 2013.  The general consensus was that the priorities and actions were the right ones to deliver positive change and appropriate services for carers locally.  It had also highlighted a number of gaps which were subsequently built into the Plan.

Similar consultation with the voluntary and community sector had also highlighted the important and key role that the voluntary sector played in supporting carers and looked at how organisations were able to support delivery of the Action Plan.

It was important to have a clear, jointly agreed Plan for the commissioning and effective delivery of carers’ services in Rotherham, with clear and focused aims and priorities.  Having an appropriate Plan in place from April, 2013, would also ensure that the Authority was best placed to meet the requirements set out in the Health and Social Care Act and associated Legislation being developed through the Care and Support Bill.

Discussion ensued on the draft Plan and the following issues were raised and clarified: -

·         Governance and performance management of the Plan would sit with both the Local Authority and the Rotherham CCG, following both organisation’s adoption of the Plan;

·         It was requested that references to NHS Rotherham be removed and replaced with ‘ Rotherham Clinical Commissioning Group’;

·         The Plan should make greater reference to the support and commitment Rotherham had to its carers within the introduction section;

·         In relation to the Charter Commitments to improve the health and wellbeing of carers, the bullet point should read that ‘we will ensure all carers are kept as safe as possible’;

·         Communication of the Plan, including in G.P.’s surgeries and in the carer’s corners across the borough and the information available on the internet.  

Resolved:- (1)  That the Rotherham's Carers' Charter and Joint Action Plan be agreed, subject to the requested changes being made.

(2)  That the report be forwarded to the Health and Wellbeing Board and the Children, Young People and Families’ Partnership for information. 

The Strategic Commissioning Manager and the Adult Safeguarding Manager, submitted a quarterly update on the occupancy/vacancy levels in residential and nursing care homes for older people for the period 1^st October to 31^st December, 2012, highlighting:-

·         Slight decrease in occupancy and vacancy levels within the independent sector

·         Slight decrease in occupancy of Local Authority residential care

·         Currently 330 vacant beds available, sufficient to meet current demands and giving overall occupancy of 85.14%

·         Slight decrease in occupancy of intermediate care beds although the average length of stay had reduced from 21 to 17 days.  Admissions had increased to 171 admissions in Quarter 3 from 141 in Quarter 2

·         54 contract concerns relating to residential and/or nursing care had been closed relating to 19 individual providers

·         5 residential homes had a Default Notice of which 2 had suspension of placements

·         Work on-going on the current year’s Home from Home Reviews

·         Consultation undertaken in respect of 2013/14 fee setting

·         Continuing work on the single contract for Adult Residential Care – draft submitted to providers and their comments currently being considered

·         Discussion ensued and the following issues were raised: -

·         Working with different sector providers and large and small organisations;

·         Supporting service-users and their families and/or carers to select the best residential and nursing care homes based on the older person’s needs and requirements;

·         Sustainability and sufficiency of provision;

·         Training availability and take-up. 

Resolved: -  (1) That the report be noted.

(2)  That the report be submitted to the Contracting for Care Forum for information. 

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, 2013, based on actual income and expenditure to the end of December, 2012. 

It was reported that the forecast for the financial year 2012/13 was an underspend of £182,000 against an approved net revenue budget of £71.915M.  At the end of Quarter 3, the underspend represented -0.25% of the total budget available. 

The latest year end forecast showed a number of underlying budget pressures which were being offset by a number of forecast underspends:-

Adults General Management and Training

·         A forecast overspend mainly due to recurrent pressures on ICT budgets

Older People

·         A forecast overspend on In-House Residential Care, further increase in demand for Direct Payments and In House Transport

·         Offset by underspends within Enabling Care, Independent Sector Home Care, independent residential and nursing care, Community Mental Health, Carers’ Services and slippage on Assistive Technology and recruitment to vacant posts within Assessment and Care Management

·         Savings now being realised from the Review of Day Care Provision

·         Forecast shortfall in Rothercare income plus additional staffing costs

Learning Disabilities

·         A forecast overspend on independent sector Residential Care budgets due to increase in clients and average cost of care packages plus loss of income from Health

·         Underspends within Supported Living Schemes due to Continuing Health Care income, use of one-off grant funding and vacant posts

·         Recurrent budget pressure on Day Care Transport

·         Increase in demand for Direct Payment over and above budget

·         Forecast overspend in independent sector Home Care

·         3 new high cost placements in Independent Day Care

·         Increase in Community Support placements

·         Use of Health funding to support overspend on SYHA residential care costs

·         Saving on premises costs and slippage on vacant posts

Mental Health

·         Projected slight overspend on Residential Care budget and budget pressure on Direct Payments offset by savings on Community Support Services

·         Overspends on employees’ budgets due to unmet vacancy factor and use of agency staff

Physical and Sensory Disabilities

·         Continued pressure on Independent Sector Domiciliary Care, loss of Continuing Health Care funding for one client being challenged, increase in demand for Direct Payments and forecast overspend on Residential and Nursing Care offset by slippage in developing alternatives to residential provision

·         Offset by underspend on Crossroads as clients were redirected to Direct Payments

·         Vacant posts within Resource Centre and Occupational Therapists

·         Underspend on Equipment budget and savings due to vacant part-time post at Grafton House

·         Review of contracts with independent Day Care providers

·         Forecast savings on contracts with Voluntary Sector providers

Safeguarding

·         Underspend on employee budgets due to vacant post plus additional forecast income from Court of Protection fees

Supporting People

·         Efficiency savings on subsidy contracts offset against Commissioning savings targets not reported within Adult Services

Total expenditure on Agency staff for Adult Services so far was £254,984 compared with an actual cost of £255,383 for the same period last year.  The main costs  ...  view the full minutes text for item 63.

Resolved:-  That, under Section 100A(4) of the Local Government Act 1972, the press and public be excluded from the meeting for the following item of business on the grounds that it involves the likely disclosure of exempt information as defined in Paragraph 3 of Part 1 of Schedule 12A to the Local Government Act 1972 (as amended March 2006) (information relating to the financial or business affairs of any particular individual (including the Council).

The Director of Health and Wellbeing submitted proposals to increase the fees to the Independent Sector Residential and Nursing Care Providers (People Over 65 Years) for the financial year 2013/14.

The report contained two options which had been presented to the sector for consultation.

The report noted that, since 2009/10, the Council’s Home from Home Programme had applied discretionary Quality Premium Payments to the care homes that were assessed as ‘good’ and ‘excellent’.  Assessment of the Programme had been undertaken in 2012/13 and had been found to improve the quality of homes and embed contract assurance practices.  From 2013/14, all homes entering into a contractual relationship with the Council were expected to deliver a ‘good’ service as a minimum.   

Resolved:-  (1)  That a fee increase for Residential and Nursing Care Homes for People Over 65 Years be approved of 1.66% for 2013/14, set out at Option 1  in the report submitted, with additional provision that providing discretionary Quality Premium Payments to the care homes assessed as Good be continued for each Rotherham-funded bed. 

(2)  That the report be referred to the Contracting for Care Forum for information.