Agenda item

Consideration was given to a report presented by Mark Scarrott, Finance Manager (Neighbourhoods and 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 January, 2014. 

It was reported that the forecast for the financial year 2013/14 was an overspend of £538,000 against an approved net revenue budget of £72.803M. The figures contained within the report included the recently approved funding for Winter pressures together with funding towards achieving Public Health outcomes.  Compensatory forecast underspends within the remaining NAS Directorate was reducing the overall forecast overspend further to £124,000.  The main budget pressures related to the delayed implementation of a number of budget saving targets including Continuing Health Care funding and the review of In-house Residential Care.  

Management actions continued to be developed by budget managers to bring the forecast overspend in line with the approved cash limited budget.

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

Adults General

·         A slight underspend based on estimated charges including savings on training budgets and additional funding for HIV

Older People

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

·         Recurrent budget pressures in Direct Payments, however, client numbers had reduced since April together with a reduction in the average cost of packages

·         Underspend on In House Transport

·         Forecast underspend on Enabling Care and Sitting Service, Community Mental Health, Carers’ Services, and planned delays on the recruitment to vacant posts within Assessment and Care Management and Community Support plus additional income from Health

·         Overspend on independent sector Home Care which had experienced an increase in demand since April

·         Overspend on independent residential and nursing care due to delays in achieving the savings target for additional Continuing Health Care income, however, 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 together with additional income plus Winter pressures funding for Telecare equipment

·         Minor underspends in other non-pay budgets due to moratorium on non-essential spend

Learning Disabilities

·         Slight underspend on independent sector Residential Care budgets due to review of high cost placements.  Work was ongoing with regard to Continuing Health Care applications and an internal review of all high cost placements

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

·         Pressures on residential and nursing care contracts with SYHA resulting in forecast overspend.  However, Service reconfiguration to Supporting  Living in February and March would reduce the pressure in 2014/15

·         Overspend in independent sector Home Care due to increase in demand over and above the budget savings target

·         High cost placements in independent Day Care resulting in a forecast overspend.  Pressures reduced due to additional Continuing Health Care funding and 1 client moving out of the area

·         High cost Community Support placements resulting in forecast overspend

·         Delay in developing Supported Living Schemes plus additional funding from Health resulting in a forecast underspend

·         Efficiency savings on Service Level Agreements for Advice and Information and Client Support Services

·         Lower than expected increase in demand for Direct Payments

·         Additional staffing costs and essential repairs within In-House Residential Care offset by planned delays in recruiting to vacant posts within Assessment and Care Management

Mental Health

·         Projected underspend on Residential Care budget. Additional placements in respect of substance misuse was being funded by a contribution from Public Health

·         Underspend in Community Support budget due to delays in clients moving from residential care

·         Underspend on Direct Payments - additional income recovery was offsetting the initial budget pressure

·         Pressures on employee budgets due to lower than expected staff turnover, additional overtime and agency cover offset by additional funding for substance and Alcohol Social Work posts

Physical and Sensory Disabilities

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

·         Forecast overspend due to further increase in demand for Direct Payments

·         Underspend on Community Support as clients moved to Direct Payments

·         Forecast underspend on Residential and Nursing Care due to planned delays in developing alternatives to respite provision

·         Reduction in contract with independent sector Day Care provider

·         Underspend on equipment and minor adaptations budgets

·         Forecast efficiency savings on contracts with Voluntary Sector providers and higher than forecast staff turnover

Safeguarding

·         Underspend due to higher than expected staff turnover and additional funding for Domestic Violence support

Supporting People

·         Efficiency savings on subsidy contracts identified against budget

Total expenditure on Agency staff for Adult Services to the end of January, 2014, was £281,903 (no off contract) compared with actual expenditure of £307,394 (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 £327,227 spent up to the end of January, 2014, on non-contractual overtime for Adult Services compared with expenditure of £329,783 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 with the following issues raised/clarified:-

-          Anticipated increase in spend on Direct Payments

-          The additional funding in Safeguarding would enable mainstreaming of the funding for the Independent Domestic Violence Advocates in accordance with the Scrutiny Review recommendation

-          Notice had been received that the Commissioning Support Unit was to provide training on a regional basis for Nurses.  This was contrary to the Joint Protocol previously agreed (Minute No. H78 of 17^th February, 2014, refers)

-          The CCG had employed the services of Emergency Consultants who reviewed what happened in an emergency department.  In line with their recommendations a “perfect week” was being held commencing 17^th March

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