Agenda item

The Committee is asked to scrutinise the information provided with a view to:-

1.     Considering whether it is reassured about the delivery of the 2022-23 Adult Social Care Budget

2.     Gaining an understanding of the implications for Croydon from the Government’s social care reforms.

The Sub-Committee considered a report on Adult Social Care Budget and social care reform, as set out on pages 79 to 88 of the agenda, with a view to reassuring itself about the delivery of the 2022-23 Adult Social Care Budget and to understanding of the implications for Croydon from the Government’s social care reforms. The Corporate Director for Adult Social Care & Health provided an introduction to the report.

The Chair asked about any emerging risks or changes that had been identified since the report was written and heard that Adult Social Care was still predicted to come in on budget and that forecasting for peaks in demand in the winter had been undertaken. Pressures on Croydon University Hospital had been high throughout the year and there were a number of workstreams focussed on this, including hospital discharge and prevention work. Members heard that the department was working closely with partners, such as Virtual Wards, GPs and the voluntary sector, to mitigate and prevent hospitalisation. The NHS backlog and long waiting lists could lead residents to have contact with Adult Social Care who would normally not have. Members heard that increased isolation over the last two years as a result of the pandemic had also likely led to declines in the mental health of some individuals which had increased demands on the service. The Corporate Director for Adult Social Care & Health stated that the priorities of Adult Social Care were to meet statutory requirements, to manage demand, complete reviews in a timely way and to manage contracts and the market well. The importance with hearing the voice of every individual the service worked with was highlighted.

The Chair asked about IT systems that had been implemented in Adult Social Care and staff training on these systems. Members heard that the data coming out of ‘Liquid Logic’ and financial returns were improving with synergy between the two; these systems had been implemented just before the first lockdown in 2020 which had presented challenges. There was a performance board that looked at data for Adult Social Care, including the cost of care packages and the number of assessments and referrals. All managers had recently completed Chartered Institute of Public Finance and Accountancy (CIPFA) training, and there was ongoing training to ensure data could be pulled from Health and SLAM systems. The Corporate Director for Adult Social Care & Health explained that they were confident in the data, and that this would be reviewed by the CQC during their next inspection.

The Chair asked about the ‘Fair Cost of Care’ exercise and the challenges this could present to Croydon. The Head of Improvement explained that the exercise was to establish the fair cost of domiciliary and residential care in the Croydon market. Funding from the Department of Health and Social Care (DHSC) would be available in 2023 but the allocation that Croydon would receive would not be known until late in the financial planning period. On the Care Cap and setting up of Personal Care Accounts, Members heard that funding to implement these would also only be known late in the financial planning period. In preparation for this, a programme board had been set up and ‘Fair Cost of Care’ information had been submitted to DHSC on time. Members heard that identifying ‘self-funders’ was a challenge as the lower and upper limits on the definition would change; this created a potential for the Council to lose income or to incur increased costs. The Corporate Director for Adult Social Care & Health explained that the ‘Fair Cost of Care’, workforce and the Care Cap were considered to be the largest risks facing Adult Social Care across London. The Chair asked if the Sub-Committee had a view on whether they should write to the DHSC on delaying implementation of the ‘Fair Cost of Care’ and heard that ADASS and the Local Government Association (LGA) were already lobbying the department.

The Sub-Committee asked for clarification on the ‘Quantified Opportunities’ for the ‘ongoing Internal Review of Public Health Funding towards related expenses’ and the identified risk for the same amount under ‘Refocusing Public Health funding - New Youth & Wellbeing Offer’. The Corporate Director for Adult Social Care & Health explained that this was a Public Health grant and Public Health were looking at how this money was being used and had deemed it was not being correctly used to meet Public Health objectives. The Corporate Director for Adult Social Care & Health was looking at this with Public Health and the Section 151 Officer to see if there were other areas where this money could be used; the amount remained a risk as there was a possibility this could not be achieved.

The Sub-Committee asked about the at-risk savings identified under the Medium Term Financial Strategy and service user and staff involvement in the deep dive analysis of the budgets in Transitions, Disability Services, Older Peoples Services and Mental Health. The Head of Improvement explained that due to a lack of staff resource, efficiencies from case and waiting list reviews were not possible. The Corporate Director for Adult Social Care & Health explained that there were regular meetings with the CEO, Section 151 officers and lead finance officers and that staff were regularly involved, but as this was more around accounting, service users and residents were not involved.

Members enquired about the results of the self-assessment based on the preparation for inspection tool developed by the ADASS, with the support of an external advisor. The Sub-Committee heard that this could be shared with Members, but a new self-assessment was now being undertaken, meaning the version mentioned in the report would be out of date. It was agreed that the Sub-Committee would be sighted on the newest self-assessment.

The Sub-Committee asked how the individual would be considered in work to mitigate the Cost of Living Crisis. The Corporate Director for Adult Social Care & Health stated that there had been a small uplift in Personal Independence Payments but acknowledged that this was a very difficult time nationwide for staff and service users.

Conclusions

1.    The Sub-Committee was reassured that Adult Social Services were on track to deliver their budget.

2.    The Sub-Committee were reassured that the Council had done everything it could to prepare for the ‘Fair Cost of Care’ but recognised that this was still a risk to all local authorities and sought to write to the Department of Health and Social Care (DHSC) to ask that this was urgently reviewed to ensure risks were mitigated to avoid destabilisation of the care market and local authority budget setting.

3.    The Sub-Committee agreed it should be sighted on the newest the self-assessment based on the preparation for inspection tool developed by the ADASS, once completed.

Recommendations

The Sub-Committee recommended that future financial reports provide the most up to date budget figures for the most current period, even if these were only in draft.