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City of York Council |
Committee Minutes |
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Meeting |
Health, Housing and Adult Social Care Scrutiny Committee |
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Date |
9 October 2024 |
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Present |
Councillors J Burton (Chair), Vassie (Vice-Chair), Hook, Rose, Runciman, Smalley [to 7:08 pm], Wilson [to 7:54 pm], K Taylor (Substitute) [to 7:31 pm] and Whitcroft (Substitute) |
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Apologies |
Councillors Moroney and D Myers |
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In Attendance |
Councillor Pavlovic (Executive Member for Housing, Planning and Safer Communities) Councillor Steels-Walshaw (Executive Member for Health, Wellbeing and Adult Social Care) |
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Officers Present |
Sara Storey, Corporate Director of Adult Social Care and Integration Patrick Looker, Head of Service Finance Steve Tait, Finance Manager Denis Southall, Head of Housing Management and Housing Options Michael Melvin, Director of Adults Safeguarding |
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External Visitors |
Professor Nicholas Pleace, Centre for Housing Studies, University of York |
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18. Declarations of Interest (5:32 pm)
Members were asked to declare at this point in the meeting any disclosable pecuniary interests or other registerable interests they might have in respect of the business on the agenda, if they had not already done so in advance on the Register of Interests.
None were declared, although with reference to agenda item 4 (2024/25 Finance and Performance Monitor 1), the chair Cllr J Burton noted in the interests of transparency that she used the Be Independent service mentioned in the report.
19. Minutes (5:32 pm)
Resolved: That the minutes of the meeting held on 11 September 2024 be agreed as correct record and signed by the Chair.
20. Public Participation (5:33 pm)
It was reported that there had been no registrations to speak at the meeting under the Council’s Public Participation Scheme.
21. 2024/25 Finance and Performance Monitor 1 (5:34 pm)
Members considered a report setting out the projected 2024/25 financial position, the performance position for the period covering 1 April 2024 to 30 June 2024, and outturn information for 2023/24.
Officers provided an overview and responded to questions from the committee. It was noted that:
· The overall forecast overspend for 2024/25 of £3.4m was a significant improvement on the £11.4m forecast overspend at this stage last year, but there was a continuing need to deliver savings to safeguard the Council’s financial position. No Public Health finance information was included in the report as there were no significant variations for the first quarter.
· Any further pressures on the budget that might be incurred due to requests received from care providers for higher rates of inflation than currently agreed had to be balanced against the risk of provider failure, as the Council had a statutory responsibility to ensure people’s needs continued to be met regardless of eligibility. The evidence base would be closely examined in considering any such requests.
· With reference to the table at paragraph 13 of the report, the largest projected overspends were for Direct Payments and Supported Living. The position of the former had improved from the outturn as there was more ability to recover unused funds, and pressures on the latter were partly due to the full-year effect of a mid-year inflationary uplift for providers during 2023/24; ‘Other’ referred to the Adult Social Care grant received by the Council.
· Housing rent arrears had been broadly flat over the last year and work was being done through the housing team to ensure tenants were not getting into further debt. By the end of the last financial year arrears had increased by around £100,000; this was manageable given a total rent roll of around £30m. Officers would provide members with more detail on unpaid debts and uncollected charges in domiciliary care, and the approach taken to collecting these.
· The hospital discharge team was funded through the Better Care Fund. Integration and joint commissioning with health partners offered opportunities to reduce duplication, make efficiencies and improve outcomes; the benefits of this would likely be felt in future years. The Corporate Director for Adult Social Care and Integration was leading a project for the Integrated Care Board (ICB) on multidisciplinary integrated discharge hubs.
· Opportunities to work with the York and North Yorkshire Combined Authority were being explored, including around housing accessibility and workforce education and skills.
· Of the £7m growth received by Adult Social Care in 2024/25, beyond the allocations detailed in paragraph 15 of the report the remaining £3.8m had been used to relieve pressures on home and day support and residential care budgets.
· An overspend on Be Independent was due to financial problems inherited when the service was brought in-house which were still in the process of being addressed.
· Concerns were raised over the impact of the expiry of the Council’s contract for the provision of day clubs for older people with Age UK. The challenge faced by elderly people who had used the clubs was acknowledged, and it was noted that when savings had to be found from social care budgets there were few good options but that statutory services had to be prioritised. Those who had eligible needs would be supported and others could be signposted to alternative community services, including through Local Area Coordinators, although it was noted that not all wards were currently covered by the latter. It was anticipated that from November places would be available at half-day clubs, in addition to services the Council funded in partnership with the ICB, while the Dementia Day Clubs commissioned from Age UK were continuing.
· Given the extent of savings that were still required, it was noted that scrutiny could play a productive role in contributing to conversations around how this could be done while protecting services for the most vulnerable.
· The housing stock condition survey was nearly complete, and while emergency repairs had been carried out, it was anticipated that the percentage of dwellings failing to meet the decent homes standard was likely to rise due to historic problems not addressed in previous years. The survey results would be made available for consideration by the committee, and an action plan with resource implications would follow, with a goal of bringing the percentage down to as close to zero as possible.
· National and regional benchmarking data had been included where available in the indicators scorecard in the annex to the report.
Resolved:
i. To note the finance and performance information.
ii. To note that work will continue on identifying savings needed to fully mitigate the forecast overspend.
Reason: To ensure expenditure is kept within the approved budget.
22. Draft Homelessness and Rough Sleeping Strategy 2024-29 (6:25 pm)
Members considered the new draft Homelessness and Rough Sleeping Strategy 2024-29, ahead of it being presented to the Council Executive.
Officers were joined by the Executive Member for Housing, Planning and Safer Communities and Professor Nicholas Pleace of the University of York’s Centre for Housing Studies in introducing the report and responding to questions from the committee. It was noted that:
· The strategy built on existing successes and partnerships to offer pathways to suitable housing, sustained by high-quality and person-centred support, and giving focus and structure to the range of homelessness and rough sleeping services and initiatives across York. The strategy had been developed with a range of organisations and individuals and feedback from recent consultation work had been positive.
· A Housing First-led approach would focus on ending homelessness amongst those with high and complex needs. This population was relatively small but tended to incur the highest human and financial costs, including acute mental health problems and addiction issues, and accounted for the highest cost to local authorities, the NHS, and criminal justice.
· This approach would focusing on making specific interventions based on individual needs, including mental health support and support with managing money, to support people to live independently. There was cross-party support for Housing First and international evidence suggested that it was highly effective at ending homelessness among its target population, as well as being cost-effective.
· Rapid rehousing within 7-10 days would be utilised alongside Housing First. Research showed that 70% of those able to live in a tenancy with a lesser extent of floating support were in expensive tier 1 hostel accommodation; the longer people remained in a high and complex needs environment, the more likely they were to develop those needs; as such the focus was on getting people onto the right pathway as quickly as possible as a routine part of homelessness services.
· Research demonstrated that Housing First could be done in ways which were not cost-intensive; the focus was on an ethos and operational framework which cost no more, and over time should cost less, than existing services.
· Delivery could not happen overnight, but the emphasis was on a tailored, individual approach where triaging and rapid rehousing made homelessness rare, brief, and non-recurring. The potential of multiagency working with partners facing the same challenges and a boarder shift towards a community model of support were also highlighted.
· It was an ambition to work with partners in better identifying hidden homelessness, and there was a need to expand the supply of affordable housing. Spending on temporary accommodation was relatively contained in York in comparison to some areas, while the success of a Housing First approach could potentially free more resources for prevention, which should be a focus across Council services.
· In relation to young people, evidence suggested a challenge existed around managing the transition from being a looked-after child. A strategy was already in place for those aged 16-25, supported by Childrens’ Services and with specific protocols for care leavers, with the creation of a dedicated Ofsted-registered building included in the action plan.
· Community enterprise models had been successful elsewhere and there was potential in exploring in exploring partnerships with local businesses including tourism. Successive administrations had found the ownership of city centre real estate by overseas pension funds a barrier to making fuller use of city centre buildings for housing. Options such as modular housebuilding and conversion of garage stock were under consideration and there were companies looking to invest.
· The importance of building relationships of trust with people experiencing long-term homelessness was emphasised; medical provision at hostels was highlighted and it was noted that Housing First offered more intensive one-to-one support with dedicated key workers than other approaches aimed at building confidence.
· With reference to ongoing funding, it was confirmed that ending homelessness was an administration priority, and while this work would take time, improvements should be seen year-on-year. The success of the strategy could open opportunities to reprofile elements of current spending on homelessness services.
Resolved: To support the Homelessness and Rough Sleeping Strategy 2024-29 as proposed.
Reason: To support the Council’s statutory obligation to have a homelessness strategy in place and the ambition to make homelessness rare, brief and non-recurring.
23. Adult Social Care Strategy Update (7:55 pm)
Members considered a report providing an update on work towards the codesign of the Adult Social Care Strategy.
Officers provided an overview and responded to questions from the committee. It was noted that:
· A ‘strategy on a page’ document had now been developed incorporating departmental priorities and reinforcing co-production. Engagement and feedback collection with key stakeholders and the public was underway, and officers were working alongside the National Development Team for Improvement (NDTi) in developing the codesign process.
· Members were invited to input into the codesign process, which was due to run until mid-November. This could include email correspondence between formal meetings of the committee, and suggestions from members around other ways to engage effectively were welcomed.
· Access challenges for those with lived experience of social care were acknowledged, and it was noted that a variety of methods including focus groups and targeted interviews were being used to gather feedback from a range of groups. Online questionnaires had been designed to be as accessible as possible with easy-read versions and BSL videos available.
· To ensure feedback was meaningful, the importance of finding people where they were was emphasised. Poppleton Luncheon Club was also suggested as a suitable place to gather feedback.
· Feedback was already gathered from social work staff, and officers would consider the feasibility of incorporating specific questions around the strategy in the feedback staff gathered on visits to people using social care services.
· The committee would receive a further update following completion of the strategy. The strategy was closely linked to the following agenda item (Adult Social Care Peer Review), and there would be opportunities to return to a discussion around assurance for CQC inspection.
Resolved: That members of the committee are included in the codesign process and receive an update following the completion of the codesign exercise prior to the final completion of the strategy.
Reason: To enable the committee to continue to contribute to the strategy through the process and enable a further discussion based on the analysis of a wide range of contributing stakeholders prior to the completion of the strategy.
24. Adult Social Care Peer Review (8:08 pm)
Members considered an update on preparation for CQC (Care Quality Commission) assessment following the peer review of Adult Social Care led by ADASS (Association of Directors of Adult Social Services).
It was noted that:
· The points suggested by the peer challenge team ‘for consideration’ were not necessarily weaknesses; several referred to strengthening or further embedding existing practices.
· Challenges around self-funding were common in many local authorities.
· The peer challenge team had noted that focusing on the fundamentals did not entail delaying impact on outcomes and finances; this was applicable more broadly across council services.
Resolved: To note the report.
Reason: To keep the committee updated on CQC preparation.
25. Work Plan (8:10 pm)
The committee considered its work plan for the 2024/25 municipal year.
Following earlier discussion of the Adult Social Care Strategy, it was suggested that the committee might receive a further update at its scheduled meeting in January. It was also noted that the work plan items which referred to the Autism and Neurodivergence Strategy should instead refer to the Autism and Neurodiversity Strategy.
Resolved: To note the work plan and request that a further update on the Adult Social Care Strategy be brought to the committee’s scheduled meeting in January.
Reason: To keep the committee’s work plan updated.
Cllr J Burton, Chair
[The meeting started at 5.31 pm and finished at 8.11 pm].