The Committee considered a joint report of the Director of Adults and Communities and Director of Corporate Resources which provided information on the proposed 2019/20 to 2022/23 Medium Term Financial Strategy (MTFS) as it related to the Adults and Communities Department. A copy of the report marked ‘Agenda Item 8’ is filed with these minutes.
The Chairman welcomed Mr R Blunt CC, Cabinet Lead Member, to the meeting for this item.
In introducing the report, the Director advised members of the financial challenges facing the Council and the demand and cost pressures facing adult social care services in dealing with an ageing population and an increased number of people with complex disabilities.
Arising from the comments and questions raised, the Committee was advised as follows:-
i) Work was progressing on the integration of services with Health and a report would be made to a future meeting on the new Home First service and the proposed development of primary care services for people with complex needs. These developments were aimed at helping more people to receive services in their own home.
Proposed Revenue Budget
ii) The revenue budget did not take into account any pay or price inflation. A contingency was held centrally and allocated in-year when the position became clearer. In the previous year a sum of £3.7 million had been transferred for price inflation and £1.5 million for pay and pension inflation.
iii) G10 – Transforming Care transfers from Health This growth was required to cater for additional cost the Department would incur for the 23 patients with very complex and challenging needs who would be ready to be discharged into the community over the next few years. The cost would be met by the NHS, social care and the Transforming Care Programme. Whilst the intention was for the Transforming Care Programme to come to an end soon, discussions were ongoing at a national level to ensure that mechanisms were in place to manage discharged along with funding.
iv) G12 – Transitions Four additional members of staff were required to assist with the work with the increased number of young people transitioning to adult services. A Development Manager post had also been established to look at how adult and children services could be better aligned. A report on this would be submitted to a future meeting of the Committee.
v) G6 and G7 – Increased demand from Older People and Learning Disabilities This growth recognised the increasing demands from demographic growth and the increasing complexity of care and fragility of some service users. A report was due to be presented to a future meeting of the Committee on how needs were being met and the impact on carers. It was noted that the demographics and the fact that people were living longer, but often with poorer health, required support to be provided to more people with complex needs.
Adult Social Care – Savings
vi) There were no new savings in this area of service.
vii) The proposed saving around staff absence was set to increase. The target was phased over two years to allow time for the improvements to take effect. Work was continuing within the Department to further reduce the level of staff absence.
Communities and Wellbeing – Savings
viii) There were no new savings in this area of service.
ix) The closure of the CareOnLine service had contributed to savings within this area of the department. A report would be presented to the March meeting of the Committee, post closure of the service, on how the provision of services had been reconfigured.
x) The options for the new Collections Hub, previously considered by the Cabinet, involved a significant capital outlay. Work on further options was being undertaken which sought to reduce the capital costs and these options would be presented during 2019/20. The Collections Hub would cover the Records Office Service and the Museum Collections and provide an opportunity for making the Collection more accessible. A report would be brought to the Committee on the proposed Hub and how the Collection was maintained and policies relating to acquisition and disposals. A site visit to one of the collection storage facilities would also be arranged.
Savings Under Development
xi) The development of Brookfield in Great Glen would cost approximately £2.5 million and would deliver annual savings of £50,000 plus net rental income of £150,000. Further work was currently underway to investigate the possibility of similar capital investment schemes.
xii) The proposed changes to the Target Operating Model would help to deliver a more efficient service. The initial assessment had identified potential savings opportunities. These projected savings had not been included in the current MTFS as the contract had yet to be let. Once work had commenced and there was a greater understanding of the scope and level of savings, it would then be reflected in the MTFS.
Health and Social Care Integration
xiii) Health and Social Care integration continued to be a top priority for the County Council and its NHS partners as it had the potential for delivering better outcomes for people whilst also reducing costs.
xiv) The Better Care Fund made a significant contribution to the revenue budget to support social care services. The BCF programme was due to cease in 2020 but the expectation was that it would continue in a different form and the funding for social care services would continue.
xv) The Capital Programme was noted.
a) That the report and information now provided be noted;
b) That the comments now made by forwarded to the Scrutiny Commission for consideration at its meeting on 28 January 2019.