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 February, 2014. 

It was reported that the forecast for the financial year 2013/14 was an underspend of £24k against an approved net revenue budget of £73.408M, a further reduction in the overspend of £562k since the last report. The report included the recently approved funding for winter pressures, funding towards achieving Public Health Outcomes together with additional Health funding to support patients being discharged from hospital.  The main budget pressures related to the delayed implementation of a number of budget savings targets including Continuing Health Care funding and implementing the review of In-house Residential Care and under-achievement against Continuing Health Care funding.  

Management actions together with additional Health funding had resulted in reducing the forecast overspend in line with the approved cash limited budget.

The latest year end forecast showed there remained a number of underlying budget pressures.  The main variations against approved budget for each Service area were as follows:-

Adults General

·         This area included the cross cutting budgets of Workforce planning and training and corporate charges and was forecasting an overall 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 due to 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 (an additional 74 clients receiving a service than forecast). Additional income from property charges and Health 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 delays in Service Review including options for replacement of alarms together with additional income plus winter pressures funding for Telecare equipment

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

Learning Disabilities

·         Independent sector Residential Care budgets now forecasting a slight underspend due to a review of high cost placements.  Work continued on reviewing all Continuing Health Care applications and 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 external transport

·         Pressures on Residential and Nursing Care contracts with SYHA resulting in an forecast overspend.  However, Service reconfiguration to Supported Living in February and March would reduce the pressure

·         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.  Pressure 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 with 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 were 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

·         Pressure on employee budgets due to lower than expected staff turnover, additional overtime and agency cover was being reduced 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 plus staff vacancies at Grafton House

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 original budget

Total expenditure on Agency staff for Adult Services to the end of February, 2014, was £296,767 (no off contract) compared with actual expenditure of £368,907 (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 £346,779 spent up to the end of February, 2014, on non-contractual overtime for Adult Services compared with expenditure of £354,923 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/clarified:-

-          Winter pressures funding of £220,000 had been received

-          Public Health had identified an underspend on the ring fenced grant and had been used to meet Public Health Outcomes in Mental Health Services

-          Unplanned delays in moving 3 clients from Residential Care to Supported Living

-          Significant investment in Learning and Development in the Dementia Pathway leading to a more person-centred service

-          Learning Disability transitions continued to be a risk area

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

(2)  That staff be congratulated on their hard work in monitoring and ensuring the Service’s financial targets were met for the 2013/14 budget.