Agenda and minutes

Mark Scarrott, Service Accountant, to report.

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 July, 2011. 

It was reported that the forecast for the financial year 2011/12 was a balanced budget against an approved net revenue budget of £77.6M.

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 to cover vacancies and sickness within older people inhouse residential care

·        an overall forecast overspend on Direct Payments mainly within Mental Health and Physical and Sensory Disability Services

·        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 on  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 and voluntary early retirements

·        Forecast underspend within Mental Health in respect of slippage in a number of Service Level Agreements with external providers as clients moved to Direct Payments therefore reducing the overall pressure on Direct Payments budgets

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

Total expenditure on Agency staff for Adult Services so far was £152,117 compared with an actual cost of £144,080 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 had a significant impact on residential and domiciliary care budgets across Adult Social Care.

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

-        Were community groups receiving the correct support?

-        Overspend on Older People’s Home Care Service – continual pressure

-  ...  view the full minutes text for item 23.

The Director of Health and Wellbeing reported on the outcome of a fundamental review of the Extra Care Housing Care and Support that had been undertaken to evaluate the effectiveness of service provided at each scheme which indicated that there was a need to reconfigure the way in which support was provided to the tenants residing in the schemes.

A petition had been received and reported to the Cabinet Member for Adult Social Care and Health on 27^th April, 2009 (Minute No. 141 refers) from service users at Potteries Court and Oak Trees Extra Care Housing Schemes objecting to the proposed changes in relation to “care and support at home”.  Their main objection had been with regard to the proposed removal of the 24 hour on-site presence.  The Tenancy Agreement for the schemes did not specify that this was a requirement and, as such, could be legitimately removed.  This would be subject to a review of the individual care needs of tenants on site and appropriate support arrangements put into place. 

There were currently 3 schemes in operation in Rotherham – Oak Trees, Potteries Court and Bakersfield Court.  The separation of the Care and Housing Support was initiated in April, 2009, whereby the care enablers based at Potteries Court and Oak Trees were transferred to the Council’s registered Domiciliary Care Service.  The Housing Support Team was dedicated to providing services to customer across the 3 schemes to ensure that their Housing Support related needs were met. 

Since March, 2009, the Housing Support Team had concentrated on making customers at Bakersfield Court feel welcome and settling them into their new home.  The completion of support plans with each customer had been well received by customers in Bakersfield Court.  The Housing Support Team had also successfully introduced Housing Support Plans to Service Users at Potteries and Oak Trees.

The care delivered within Bakersfield Court was provided by a variety of providers including the mainstream community team overseen by Enabling Care Services.  A proportion of service users received care from an outside agency through Direct Payments.  The care was delivered in line with the care plan and Domiciliary Care provided their service from 7.00 a.m.-10.00 p.m., on and off-site dependent on the number of visits to each service user.  There was not a dedicated night team based on site.

At Potteries Court and Oak Trees there was a team of Care Enablers based on site covering 24 hours, 7 days a week.  There was also a dedicated team of night staff although no service users were in receipt of planned care or support through the night.  Customers at the 2 schemes were given an assurance when moving into their properties that there would be a 24-7 presence.  Whilst the staff currently did not provide any planned care throughout the night, there were occasions when they may be called upon to an emergency such as a fall.  From analysis undertaken as part of the review, the frequency of the emergency duties  ...  view the full minutes text for item 24.