Agenda item

The Health and Social Care Sub-Committee is provided with a Report on the Adult Social Care Transformation Programme. The Sub-Committee is asked to:

1.    To note delivery of the 2021/2024 Medium Term Financial Strategy savings.

2.    To note the progress of the Directorate’s transformation programme.

3.    To consider a focussed report on performance be brought to the January 2024 sub-committee meeting.

4.    To note the indicative strategic transformation forward plan being developed for the new medium term financial strategy period, April 2024 – March 2027.

The Sub-Committee considered a report set out on pages 61 to 72 of the agenda which provided an update on the budget and saving process in the Adult Social Care and Health.

Annette McPartland introduced the report that covered the Directorate’s performance in period 3 (April-June 2023). It was also noted that the report included information on preparation for the Local Government Association peer challenge due to happen in November 2023.

The first question considered the financial performance tables included in the report. It was explained that some figures were estimates based on (i) the costs that already occurred, and (ii) forecasts based on historical data. Actual to Date figures reflected what had been spend in period 3. Forecast Variance indicated the end-of-year prediction, which forecasted an overspend of £1.2 million. A supplementary question was asked about how the officers determined the spending predictions, and how the actual spending figure for period 3 compared to the last year prediction. It was explained that the officers looked at relevant economic factors, including market conditions and inflation. Also, it was stressed that different periods would have different funding, e.g. period 4 would have a larger budget due to the winter pressures, and that managing the markers and predicting the future spends was a very challenging tasks as the trends could change rapidly. When the market situation changed, the Council might need to adjust its activities. It was assured that there were robust processed in the Council to ensure that the overspend would not increase considerably.

The next question considered the impact of the forecasted working-age adults overspend in Croydon. It was explained that the overspend was expected to drop as a result of managing the demand. As in many other local authorities there was an underspend in staffing cost. This helped to balance the budget, however, it hindered the delivery of services. Recently, the Council recruited a considerable number of newly qualified social workers. In addition to that, the Council was successful in delivering various medium-term financial savings. Delivery of the disability provision savings have been challenging, however, a designated group was established to support it and to ensure compliance with the Care Act. Also, the Council introduced care cubed – a funding matrix to identify benchmark values to ensure value for money - to ensure that the service provider did not increase their prices by unjustifiable amount. In addition to that the Council worked on developing an alternative to the traditional form of care. However, it would take six to twelve months to implement. It was assured that the situation was generally positive.

It was highlighted that the working-age adult demand was not only higher, but also the cost per capita was higher. The question was asked whether the Council anticipated a decrease in number of adults who needed the required support or in the cost of the necessary support. It was explained that it was supposed to be a mixture of both. For many adults that were currently receiving support, other forms of support would be more appropriate. Also, it was assured that they worked closely with different departments (including transition and housing teams) to ensure that the savings would be delivered.

A question was asked about the risks and amount of case work for newly qualified social workers. It was assured that the workload was being constantly monitored. A supplementary question was asked about the capacity for complicated and multi-faceted cases. It was assured that there was sufficient capacity. However, it was added that the complexity of cases had been increasing. Therefore, a priority was to ensure that the right funding is available.

The next question considered the deep-dive exercises mentioned in the report. It was explained that those deep-dive exercises were aimed at providing a better understanding of the services and what would be a path of a service user. The pathway review included not only Council-provided services, but also signposting and services provided by the Council’s partners. This has been an ongoing piece of work that was necessary to transform and improve services. Another question considered how autism and broader neurodiversity fitted into the pathway mapping, and what was the impact of the Council’s autism strategy. It was explained that a lot of work had been done on autism and neurodiversity. One of the areas of focus was transitions for residents with learning disabilities, with an ongoing piece of work with learning disabilities teams from South West London and Croydon.

The final question asked about the internal assessment for the Care Quality Commission (CQC). It was explained that it was an internal document which was used to have a better understanding of the service areas, identify strengths and weaknesses, and to determine the plan of actions to improve those areas. In addition to that a Peer Challenge organised by the Local Government Association (LGA) was scheduled for November this year.

Action

Following its discussion of this item, the Sub-Committee agreed the following action to be followed up outside of the meeting: -

-       That further information on the  self-identified strength and weaknesses of adult social care and health services is provided to the Sub-Committee.