Agenda item

Cabinet Portfolio:                 Adult Social Care and Health

Strategic Directorate:           Adult Care, Housing and Public Health

Consideration was given to a report from the Strategic Director of Adult Care, Housing and Public Health to update Members on the budget forecast and continued Improvement Plan in Adult Social Care.

It was reported that original projections estimated the Directorate overspend to be £8.646m. In the year-to-date there had been £1.422m savings achieved in adult social care, with additional savings support from other service areas within the Directorate of £660K. This had reduced the projected overspend to £6,564m with £343K of savings still to be secured. It was further reported that the care package review programme, supported by the promotion of Direct Payments, was on target to achieve the additional £343K required and reduce the 2018/19 overspend to £6.221m. Members noted that other projects were in place to ensure known areas of risk for unplanned, high cost spend were mitigated.

It was further reported that of the 19 key areas of accountability contained within the improvement plan:-

·         8 had progressed on to become routine activity;

·         9 had formed part of the Medium Term Financial Strategy (MTFS) project plans, either directly or as an enabler to delivery;

·         2 had become the focus of DLT challenge sessions - Commissioning and Safeguarding Adults

In presenting the report, the Strategic Director of Adult Care, Housing and Public Health confirmed that good progress was being made in terms of the budget and performance, however focus had moved onto issues that had arisen in recent weeks to ensure that safeguarding was prioritised following closures of residential homes. Transforming care continued to be a high risk for the service because it impacted on the most vulnerable people with very complex needs. The service was working with the CCG to identify specialist placements for those individuals but that presented a significant financial risk, as well as operational risk, in terms of placing those individuals in the right location and service.

Members sought assurances that the overspend against the service would continue to fall. In response, the Strategic Director advised that the overspend remained a challenge for the service, but she felt that it was on the right direction of travel with the level of the overspend decreasing each month since September 2017. The challenge for the service was to increase the pace at which the overspend could be further reduced without increasing risk. Following on, the Strategic Director confirmed that she expected the overspend to reduce significantly in the coming years.

Members sought assurances that the service was capturing positive outcomes from the transformation of adult social care services. It was confirmed that data was being captured from the Wellbeing Forum and it was recognised that more could be done to produce good news stories and disseminate them across the service.

Clarification was sought from Members in respect of the difference between reviews and reassessments and the timescales for both. The Strategic Director explained that a review was undertaken to check whether support plans were still adequate and appropriate, whereas a reassessment was effectively restarting the process and based on need following changes to circumstances. The Strategic Director added that the Council was not out of kilter with other local authorities, with 145 reassessments undertaken in the year, but it remained a significant challenge and all would be done in the next 18 months. Responding to Members’ concerns around pace and meeting targets, the Strategic Director indicated that she would return with a specific activity report to provide assurances to Members and also an overview of the requirements of the Care Act 2014 in respect of reviews and reassessments.

Members referred to mental health reviews and what the position was in respect of this area of service. The Strategic Director confirmed that this was an area where relationships needed to be built and suggested that the new Assistant Director of Adult Social Care should return to the Board in 2019 with a report on this area.

Responding to a question in respect of direct payments, the Strategic Director confirmed that there was not a target, but the focus had been on enabling people to make a choice and there had been more of a move towards direct payments. It was further confirmed that a lot of work had been done with staff in respect of understanding and promoting direct payments and this had led to an increase in confidence in that area. The Strategic Director confirmed that the service could present a paper to Members on direct payments. Members indicated that they would welcome information in respect of the cost of commissioning training on direct payments from Active Independence.

Resolved:-

1.    That the outcomes and performance data from the Excellence in Social Work LGA review be shared with Members of Overview and Scrutiny Management Board.

2.    That an update be provided on the Commissioning Strategy.

3.    That the Improvement Plan be updated with clear dates and milestones

4.    That the Strategic Director of Adult Care, Housing and Public Health liaise with the Scrutiny Team in respect of specific timescales for future reports arising from the discussion in the meeting.