Agenda item

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, 2014, based on actual income and expenditure to the end of July, 2013. 

It was reported that the forecast for the financial year 2013/14 was an overspend of £1.886M against an approved net revenue budget of £72.558M. The main budget pressures relate to slippage on a number of budget savings targets including continuing health care funding and implementing the review of in house residential care.  

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 slight underspend based on estimated charges 

Older People

·         A forecast overspend on In-House Residential Care due to slippage on implementation of budget savings target and recurrent budget pressure on Part III income

·         Recurrent budget pressures in Direct Payments

·         Underspend on In House Transport. 

·         Forecast underspend on Enabling Care and Sitting Service, Community Mental Health, Carers’ Services and slippage on the recruitment to vacant posts within Assessment and Care Management

·         Overspend on independent sector Home Care due to an increase in demand since April, 2013

·         Overspend on independent residential and nursing care due to an additional 10 admissions in July.  Additional income from property charges was reducing the overall overspend

·         Forecast savings on in-house day care due to vacant posts and moratorium on non-pay budgets

·         Overall underspend on Rothercare due to slippage in Service Review including options for replacement of alarms

Learning Disabilities

·         A forecast overspend on independent sector Residential Care budgets due to 3 new admissions in July and shortfall on Continuing Health Care income

·         Forecast overspend on Day Care due to slippage on implementation of Day Care Review including increase in fees and charges plus recurrent budget pressure on transport

·         Forecast overspend in independent sector Home Care due to increase in demand and slippage in meeting budget savings

·         High cost placements including transitions from Children’s Services in independent Day Care resulting in forecast overspend

·         High cost Community Support placements resulting in forecast overspend

·         Slippage on developing Supported Living Schemes including additional funding from Health and efficiency savings on Service Level Agreements for Advice and Information and Client Support Services was reducing the overall over spend.

Mental Health

·         Projected overspend on Residential Care budget offset by an underspend in Community Support Services

·         Budget pressure on Direct Payments and minor overspends on employees’ budgets due to lower staff turnover and additional overtime

Physical and Sensory Disabilities

·         Continued pressure on Independent Sector Domiciliary Care due to an increase in demand

·         Further increase in demand for Direct Payments

·         Underspend on Community Support as clients were redirected to Direct Payments and underspend on Residential and Nursing Care due to slippage in developing alternatives to residential provision

·         Reduction in contract with independent sector Day Care provider

·         Underspend on equipment and minor adaptations

·         Forecast savings on contracts with Voluntary Sector providers

Safeguarding

·         Overspend due to lower than expected staff turnover and use of agency support

Supporting People

·         Efficiency savings on subsidy contracts had already been identified against budget

Total expenditure on Agency staff for Adult Services to the end of July, 2013, was £188,805 (no off contract) compared with actual expenditure of £67,738 (no off contract) for the same period last year.  The main areas of spend were within Assessment and Care Management Teams, Residential Care and Safeguarding to cover front line vacancies and sickness.  There had been no expenditure on consultancy to date.

There had been £127,024 spent up to the end of July, 2013, on non-contractual overtime for Adult Services compared with expenditure of £94,223 for the same period last year.

Careful scrutiny of expenditure and income and close budget monitoring remained essential to ensure equity of Service provision for adults across the Borough within existing budgets particularly where the demand and spend was difficult to predict in a volatile social care market.  A potential risk was the future number and cost of transitional placements from Children’s Services into Learning Disability Services together with any future reductions in Continuing Health Care funding.

Regional benchmarking within the Yorkshire and Humberside region for the final quarter of 2012/13, showed that Rotherham remained below average on spend per head in respect of Continuing Health Care.

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

-          2013/14 Health Support Grant had been increased so it was not anticipated that Winter Pressure funding would be forthcoming

-          Continuing Health Care was one of the biggest budget pressures.  A workshop was to be held with the CCG to discuss the National Framework, processes, procedures and implementation thereof

-          Joint training had been organised for all staff (Council and NHS) on CHC assessments, the National Framework and Legislation, the quality and standards and consistency of decisions

-          Demographic pressures were now putting great strain on the budget even though the normal financial disciplines were still applied e.g. budget clinics, review of high cost of care package, consistency of assessments, essential spend only

Resolved:-  (1)  That the latest financial projection against budget for 2013/14 be noted.

(2)  That a briefing note be supplied to the Cabinet Member on the agency and consultancy spend.