Agenda and minutes

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 October, 2011. 

It was reported that the forecast for the financial year 2011/12 was an underspend of £100,000 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

·        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

·        Slippage on recruitment to vacant posts within Older People’s Assessment and Care Management Teams

·        Underspend on Older People’s Day Care due to slippage on vacant posts plus additional grant income

·        Slippage on developing support services for carers

·        Underspend on preserved rights clients within residential care and nursing care

Total expenditure on Agency staff for Adult Services so far was £244,178 compared with an actual cost of £240,864 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 with the following issues raised/clarified:-

-        Council-wide moratorium on  ...  view the full minutes text for item 34.

Dave Roddis, Performance and Quality Manager, presented Rotherham’s first local account for Adult Social Care which set out how services were performing in Rotherham, focussing mainly on 2010/11, but did provide up-to-date information where possible.

The local account described how the Service was meeting the needs of its customers and improving outcomes for the people of Rotherham.  This was evidenced through the reporting of key performance information, being open about the money spent on services, feeding back judgements received about how services were viewed externally and an analysis of local customer feedback and real customer case studies. The Local Account provided an opportunity to highlight the things done well and areas where there had been improvement

Key achievements included:-

·        6,800 people supported to live in the community and 2,300 carers supported – 1,400 more than the previous year

·        97% of customers were satisfied with the care and support services they received

·        31% reduction in complaints

·        2,300 carers received an assessment of their needs and provided with a carer service or information and advice – 300 more than the previous year and rated Rotherham in the best 25% of Councils in England

·        689 customers’ needs reviewed – 7,330 in total

·        98% of customers were satisfied they got the service promised – an increase from 96% in 2009/10

·        85% of customers in receipt of Intermediate Care Service following hospital discharge were still living at home when surveyed 3 months later – rated in best 25% of comparable Councils

·        Through raising awareness of adult abuse, alerts in Rotherham increased by 47%

·        CQC assessed the Council as “Best Performing” for how well it supported customers at the first point of contact

·        50% of customers received self-directed support which exceeded the national target of 30% - placed in the best 25% in the country

Rotherham’s Local Account has been shaped following a self assessment against the new Adult Social Care Outcomes Framework.  Based on this self-assessment the Council believed that the overall local account demonstrated it was continuing to deliver excellent services within the resources available.  The local account provided over 30 case studies demonstrating the impact of the services delivered and the outcomes they achieved for their customers. 

The full document, which had been developed in conjunction with customers and members, would be published as a ‘virtual glossy’ with a small number printed initially for key stakeholders.  It would also be available through the website and to customers on request.

Customers would have the opportunity to feedback directly to the Council via the web link as well as e-mail, letter and direct telephone access.  It was intended to produce monthly ‘one page’ updates, via the website, on progress on performance and on improvement actions.

With councils now responsible for their own improvement, there was a collective responsibility for the performance of the sector as a whole.  A Promoting Excellence in Councils Adult Social Care Programme Board had been established by key representatives from the sector, chaired by Richard Jones (ADASS) and had  ...  view the full minutes text for item 35.

The Strategic Director, Neighbourhoods and Adult Services, submitted the draft response to the national consultation exercise, launched on 15^th September, 2011, on the Future of Adult Social Care – Caring for the Future – an engagement with people who used Care and Support Services, local councils, care providers and the voluntary sector about the priorities for improving care and support.

Caring for Our future was an opportunity to bring together the recommendations from the Law Commission and the Commission on Funding of Care and Support with the Government’s Vision for Adult Social Care and to discuss with stakeholders what the priorities for reform should be.

Last November the Government published its Vision for Adult Social Care setting out the principles for a modern system of care and support.  They wanted to see a care and support system where care was personalised, people had choice in how their needs and ambitions were met and carers were supported.  Active strong community should help people maintain their independence and high quality care should be delivered by a diverse range of providers and a skilled workforce that could provide care and support with compassion and imagination.  People must be confident that they were protected against poor standards and abuse.

The Commission on the Funding of Care and Support, led by Andrew Dilnot, recommended that the amount that people had to spend on care over their lifetimes should be capped although people in care homes should continue to pay a contribution towards their living costs, sometimes known as ‘hotel’ costs such as food and building based costs.  The Commission also recommended that the current system of means tested support should be extended so that more people could get additional help in paying for care.

The Government would publish a White Paper in Spring 2012 alongside a progress report on funding reform.  The White Paper would set out the approach to reform to start the process of transforming the care and support system.  It was important that the Council responded to this engagement process which was broken down into the following discussion areas:-

-        Improving quality and developing the workforce

-        Increased personalisation and choice

-        Ensuring services were better integrated around people’s needs

-        Supporting greater prevention and early intervention

-        Creating a more diverse and responsive care market

-        The role of the financial services sector in supporting users, carers and their families

It was noted that the consultation had been considered by both the Health and Improving Lives Select Commissions.

In order to comply with the deadline, the Cabinet Member had agreed the response earlier.

Resolved:-  (1)  That the background to the national consultation exercise be noted.

(2)  That the Council’s response be endorsed.