Agenda item

Adult Social Care - The Budget Forecast and Continued Improvement Plan Update

Cabinet Portfolio:-                Adult Social Care and Health

Strategic Directorate:-          Adult Care, Housing and Public Health

Minutes:

Consideration was given to a report submitted by the Strategic Director of Adult Care, Housing and Public Health which set out the position of the budget for Adult Social Care and provided an update on the improvement plan for the service. As the report was submitted immediately prior to the end of the financial year, it was noted that the overspend in the service had been brought down to £5.4m through a mixture of stopping or changing service provision and providing much more challenge on the activities of individual workers. This approach had led to a reduction of £3m over the course of the current financial year.

 

Members welcomed the update report and the level of detail provided on the change programme within Adult Social Care. It was recognised that the Target Operating Model would be key, but further information was dought on what the shape of that would be and how it would be different to current practices. In response, the Strategic Director confirmed that the major change would be largely cultural and a shift to using technology to aid conversations led by more skilled staff with service users. There would also be a move to a reablement approach, which health partners were open to supporting. Staff would have more autonomy within the system so that service users do not have to wait for anything else.

 

Following on the point in respect of cultural change in the service, Members recognised that there would need to be a tranche of social work staff who would require further training on how to apply strength based principles. In response, the Strategic Director confirmed that this was already happening and OSMB had previously heard from the Principal Social Worker about the specifics of her role, which was essentially about embedding good practice. The notion of cultural change revolved around getting people to think differently and focus on autonomy. Training was being provided on having difficult conversations and giving staff the confidence to deliver.

 

An update was sought on the progress made on the links between care homes, hospitals and social workers in respect of reducing pressures on hospital beds. In response, the Strategic Director explained that the hospital commissioned directly from winter beds and did so from homes that they choose to use. The approach to be adopted would focus on the principle of ‘Home First’, where people are kept out of hospital unless admission is absolutely necessary.

 

Assurances were sought from the Strategic Director in respect of the change in model and how managers would deliver the level of service anticipated and that residents deserved. In response, the Strategic Director advised that October 2019 would be a reasonable timescale for the implementation of the new structure, which formed part of the broader journey for adult social care which Members were familiar with. Managers would be absolutely key to the success of the new operating model and were the focus of a lot of development and support.

 

The Chair thanked the Strategic Director for the report and her responses to Members’ questions in respect of the direction that the service was following. Members would continue to monitor progress against key milestones and further conversations would be needed with the Strategic Director in respect of how that would be reported to scrutiny in future, with a particular focus on care assessments and packages.

 

Resolved:-

 

1.    That the update in respect of the financial position and improvement plan for Adult Social Care be noted.

 

2.    That the Chair of the Overview and Scrutiny Management Board agree the ongoing approach to scrutiny with the Strategic Director of Adult Care, Housing and Public Health and provide an update to the Board on the way forward with a focus on actions and clear milestones.

 

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