Agenda item

This report analyses the latest performance for 2018/19 and forecasts the financial outturn position by reference to the service plans and budgets for all of the services falling under the responsibility of the Corporate Director of Health, Housing & Adult Social Care.

Members received the Quarter 3 Finance and Performance report for Health, Housing and Adult Social Care.

Officers informed the committee that there was a discrepancy between the table shown on page 19 and paragraph 3 of the report.  The figure of £830k was the correct figure regarding mitigations.

In response to Members’ questions regarding whether anything would be approached differently with the budget for 2019/20, officers stated that the bulk of the overspend within the directorate sat with Adult Social Care. The officer added that an additional £4 million pounds of funding was being attributed to Adult Social Care in the budget for 2019/20 with a particular focus on counteracting contract price inflation, the two home closures and demographic growth, particularly picking up the issue of young people transitioning from Children’s Services to Adult Services.

The officer also noted that the council has established a service risk fund as a one off budget of 800k for the purpose of services coming forward with invest to save proposals.

Members asked officers to elaborate on the missed savings of £227k in the learning disability working age residential budget. Officers explained that these savings were still expected but due to delays in starting some initiatives in this area, these savings would hopefully be delivered in 2019.

Members expressed concern regarding not recruiting to posts as a potential mitigation and were worried that undue pressure may be applied to services to not recruit to vacant posts that need filling. Officers stated that this would be a minority of posts and examples include where the authority may have recruited with temporary posts which come at a higher cost to the authority. Officers also added that whenever a vacancy presents itself, it is an opportunity to consider that post and scrutinise whether it could be managed differently.

Members questioned the statistics on the percentage of the population that were offered, and subsequently took up, health checks. Officers informed the committee that this was an area for concern. However, it was also noted that the context to these statistics was important. A health check was only offered once every 5 years to the eligible population (in York c. 55,000) and these will be staggered across the 5 year contract. The Director of Public Health did note that performance in this area was poor and that it was a concern.

In response to member questions regarding smoking and alcohol in pregnant mothers, officers stated that:

-         Statistics on smoking are based purely on answers given to midwives and that no data was collected regarding drinking during pregnancy.

-         The most recent trends relating to alcohol related illnesses across the city were worsening and that this was an area of concern for Public Health.

Members questioned officers on whether it was perhaps necessary to budget for exceptional placement cases within the Adult Social Care system, with one particular case costing over £200k and whether the two home closures could have been budgeted for. The Officer stated that York is not unique in this area and that all authorities will experience cases in which they have an individual who has highly complex care needs. With regards to the home closures, Officers stated that the two homes that had closed agreed to the council’s cost of care, so the authority was paying them at the normal rate. The budget had been affected this year as a consequence of trying to find homes for the people who had been displaced, which came at an increased cost to the Council. Officers assured Members that there had been constant communication with the independent care sector regarding the agreed cost of care and that capacity would be helped in the future with the major development with the Older Person’s Accommodation Programme.

Members were also questioned on the impact of 7 day working for social workers in hospitals and whether an effect had been seen with relation to Delayed Transfers of Care (DTOC). Officers stated that there should always be caution in trying to predict improvements in DTOC statistics as they are so volatile and can depend on a multitude of factors. However the qualitative feedback implied that social worker presence across the weekend had been a benefit for families and had begun to spread cases out across the week, rather than a backlog on a Monday.

In response to Member questions on statistics regarding dementia, Officers stated that the figures were based on estimates of prevalence nationally. Members questioned whether dementia prevalence was uniform across the nation and officers suggested that perhaps colleagues from Public Health England would be better placed to explain how the national prevalence was calculated and offered to take this up on behalf of the committee and report back.

Members asked officers why there had been a delay in delivering savings in the Supported Living for Learning Disability customers and who had taken the decision to delay. Officers highlighted that it was not a decision to delay but that it had taken longer than expected to bring together intelligence of the associated costs of this service and how they could be delivered more efficiently. Officers also stated that the savings would be made but just not within this financial year, noting that in any area where an individual’s care is being scrutinised, decisions must be taken very carefully.

Finally, officers also responded to a question from a member of the public regarding the £10 million that has been given to build more council houses, including when will they be available and whether they would be for rent, without the option to buy, as rent to buy had dramatically reduced the number of council housing stock. The following answer was read out on behalf of the Assistant Director for Housing and Community Safety.

“The Housing Development Programme will deliver over 600 homes in a 5 year period at various sites around the city. The type of property will be decided on a site by site basis however typically the tenure mix will be 60% market sale and 40% affordable. The affordable will be half social rent and half for affordable home ownership product (such as shared ownership). The tenants of the social rent properties will have the right to buy, however for the first 15 years the authority will be able to recover its costs. By selling properties for market sale, the authority will be able to generate sufficient receipts to ensure that the programme is sustainable in the long term. The first site to be developed is Lowfield Green, starting in February. The Council will be building 140 homes and there will also be 19 ‘Community build’ homes and 6 ‘self build’. A report was presented to the Executive in January 2019 that provides further information”