Agenda item

The Sub-Committee considered a report and an accompanying presentation providing an overview of the financial performance of Adult Social Care. The Sub-Committee was asked to review the information provided to reassure itself that the budget was being effectively managed.

During the introductory presentation for this item, delivered by the Cabinet Member for Families, Health & Social Care, Councillor Janet Campbell, and assorted Council officers, the following points were noted.

·         The spend for Adult Social Care was larger than any other Council service, equating to 31% of the total Council budget.

·         Although the service experienced many of the same pressures as other local authorities delivering social care across the country, it was recognised that the cost base was too high locally. As such all areas of the Adult Social Care budget were being reviewed to bring the service within the available resources, which would mean changing how services were delivered.

·         The aim was to reduce the Council activity and expenditure on adult social care to the London average or below by March 2024.

·         Taking into account £28.9m of growth and £10.7m savings, the net budget for 2021-22 was £114.342m.

·         A detailed savings programme had been developed to ensure the savings of £10.7m would be delivered. Although it was early in the year, progress to date had been good, with transformational funding used to provide capacity adding pace to the programme. A robust tracking system had been introduced to ensure that progress on the savings programme could be closely monitored and areas of concern identified at an early stage.

·         The priority area for savings was reviewing care packages to identify spend reduction. There had also been an options appraisal of provider services which had been approved by the Cabinet and was in the process of being implemented. There were other reviews, such as the Living Independently for Everyone (LIFE) service and the hospital discharge process that were likely to lead to further savings.

·         The total package of care savings equated to 7.5% of the budget and advice from the LGA had indicated that although this was achievable, particularly the first 5%, to achieve the full 7.5% would be a challenge.

Following the introduction the Sub-Committee was given the opportunity to ask questions about the information provided. The first question concerned the level of spend on care packages with it confirmed that the Council’s spend was the second highest in London for 18-25 year olds and higher than the national average for older adults.

As it had been confirmed that to date 120 care packages had been reviewed, it was questioned how many reviews were still to be completed. It was advised that 560 care packages had been targeted for review, which would include looking at where individuals are placed and the cost of living.  It was confirmed that 400 people were currently in supported living arrangements and were not with a registered provider. Work was underway to identify best practice in this area. It was also confirmed that possible alternative solutions delivered with the voluntary sector were being explored.

In response to a request for reassurance that budget holders had a firm grasp of their budgets, it was advised that service and team managers met with their respective accountants on a monthly basis to review their budget and forecasting for the remainder of the year. This approach helped to ensure that there was increased understanding and responsibility for budgets than there may have been in previous years.

It was questioned whether the care plan reviews carried out to date were delivering the expected savings. In response it was advised that it was essential to closely monitor the funds both coming into and going out of the service. Adult Social Care was not a static service and managing the budget required service demand to be managed.

There was concern about how the drive to deliver savings would impact upon the care packages provided, with it questioned whether staff would feel comfortable requesting an increase in package needs, should these be identified. It was highlighted that the Council had a duty of care to its service users and staff were empowered to advocate on their behalf.

It was noted that there was a £1.6m overspend in the Transitions service, with it questioned how this deficit would be re-cooped. It was advised that the previous budget for Transitions had been £4m, but due to an over spend of approximately £1.5m in the previous year growth had been added to the budget, increasing it to £5m. Although there was an over spend, the team was confident that this would be dramatically reduced during the year.

The Cabinet Member was asked how she assured herself that the budget was being delivered and that the Council continued to meet the needs of vulnerable people. The Cabinet Member advised that she met with the team on a monthly basis to review progress made with delivering the budget. This was a multi-disciplinary meeting, which allowed the Cabinet Member to gain an understanding of the challenges across the service. The Cabinet Member also met regularly with Council Safeguarding Leads to discuss any issues. There was also a performance framework of indicators that was reviewed by the Cabinet Member on a regular basis.

It was highlighted that there had been a recent judgement against Norfolk County Council’s charging policy for non-residential services, which had been found to be discriminatory. As such it was questioned whether this decision would have any implications for Croydon. It was advised that a letter had been sent to all councils to advise them of the judgement, which made clear what the implications were. There had been a challenge submitted on the outcome, which was being reviewed.

It was questioned whether there was scope for a service user to be involved with the recruitment of the new Director of Adult Social Services. The Cabinet Member indicated that she was supportive of this request and would investigate whether it would be possible with officers outside of the meeting.

Concern was raised about the vaccination rates for care home staff, with further information requested on the work to increase take-up.  It was advised that it was an ongoing process to encourage take up of the vaccine amongst care home staff. There had been challenges within specific homes, but there had also been successes leading to full vaccination at certain homes after initial reluctance. It was highlighted that this issue was not unique to Croydon, with similar rates across London.  It was confirmed that mandatory vaccinations for care home staff had not yet been introduced and there was concern about the practicalities of this being enforced.