Agenda item

This report analyses the latest performance for 2021-22 and forecasts the financial outturn position by reference to the service plans and budgets for all relevant Adult Social Care and Public Health services falling under the responsibility of the Directors of Adult Social Care and Public Health.

Members considered a report that analysed the latest performance for 2021-22 and forecasted the financial outturn position by reference to the service plans and budgets for all relevant Adult Social Care (ASC) and Public Health services falling under the responsibility of the Directors of Adult Social Care and Public Health.

The Finance Manager, the Assistant Director of Public Health and the Corporate Director of Adult Services and Integration were in attendance to provide an update.

Members were informed that:

·      There was a projected overspend of £3m in the outturn position for Adult Social Care.

·        There were large overspends in older people’s residential and nursing care and also within the older people physical and sensory impairment budgets.

·        Placements in residential and nursing step up and step down (SUSD) beds had increased over the last three months and this budget was expected to overspend by £604k.

·        Adult Social Care had developed a plan to look at several areas where they felt there was scope to bring overspends down by the year end.

·        Public Health was expected to underspend by £224k. This would be transferred to earmarked Public Health reserves to fund further budget commitments.

Officers responded to a variety of questions from Members regarding temporary agency staff, cost inflations, long term residential and nursing care, waiting lists, overspends, safeguarding referrals, the Control Outbreak Management Funding and mental health provision.Members noted the following:

·        There was a national shortage of staff in social work and safeguarding.

·        To recruit and retain staff, the council had used a proportion of the workforce recruitment and retention fund.  Officers would continue to support recruitment drives and discussions would also continue around working conditions for long term agency staff. The Finance Manager agreed to circulate further information on the recruitment initiatives to Members.

·        A new staff structure in the Public Health team had been approved and there was currently only one vacancy left to be filled.

·        The cost of residential care had risen significantly and although the council had provided a 3% increase to providers, they were expecting further challenges. Providers had been offered to undertake an overbook accountancy exercise, to allow them to fully understand and recognise the pressures.

·        The council’s ambition was to support people to live independently in their own homes for as long as possible and Members requested that further context on the numbers of customers in long-term residential and nursing care be included in future reports.

·        Referrals into Adult Social Care had risen recently and more robust data on waiting lists could be shared in six months.

·        In future reports, the finance summary table would be more reader friendly and officers agreed to provide Members with an overview and breakdown of the Adult Social Care income figure total, as highlighted in table 1 of the report.

·        Following the easing of Covid restrictions, reports of adult safeguarding concerns had risen slightly around neglect and care. All safeguarding referrals were investigated and specific work was being undertaken with care homes that had been awarded ‘requires improvements’.

·        Several initiatives in mental health services were taking place to support adults who were in paid employment and those living independently, with or without support.Officers agreed to provide further details on these initiatives to Members.

·        The unspent 2020/21 Control Outbreak Management Funding (£2.4M), alongside further funding (£1.1m) would be used to offset the general overspends and cost pressures across the council.

·        Lateral flow test kits were no longer distributed by Public Health. 

·        The residential and nursing budget was being influenced by the current discharge requirements.  People were being discharged sooner and had a higher level of care and support needed than previously.

·        There had not been excessive delays in stepping people down into nursing and residential care and Social Workers had visited wards to ensure the right pathway for people were in place. A review would take place on the step up and step down placements.

·        Analysis was currently underway regarding the length of time that 24 hour care was needed and if people were prevented from returning home, due to higher care needs or lack of home care capacity in the city.Discussions were taking place to understand if any resource across the system could be redirected to address this growing pressure.

·        A suicide audit was last undertaken by Public Health in 2017 and real time data was received from Coroners. Men were a higher risk group and multifaceted work was ongoing to address the risk factors. Officers agreed to provide further information to Members, including age ranges and the impact of Covid. 

·        The projections in ASC assumed that a further £812k of savings would be made between now and the year end. Officers agreed to provide Members with a cost breakdown of these savings.

Officers were thanked for their report.

Resolved: That the report be noted.

Reason: To update the Committee on the latest financial and performance position for 2021-22.