Agenda item

This report provides a detailed view of outturn position for Public Health (PH) and Adult Social Care for 2022/23.

Members considered a report that provided a detailed view of the outturn position for Public Health (PH) and Adult Social Care for 2022/23.

The Finance Manager supporting Adult Social Care and the Strategic Support Manager supporting Adults and Public Health stated that the projected outturn position for Adult Social Care was an overspend of £1,750k. This assumed that £1.2m of savings and £2.8m of mitigations would be made by the end of the year. It was noted that some of the pressures were not reflected in the current projections and would add to the current overspend. Given the level of savings and mitigations still to be made, it was unlikely that further mitigations against these pressures would be achieved in year.

Public Health was expected to underspend by £117k which would be transferred to the earmarked Public Health reserve to fund future commitments, most notably, the investment in the Public Health Service and the pay award, if this was to be over and above what had already been forecasted.

The Corporate Director of Adult Services and Integration, the Finance Manager, the Director of Public Health and the Strategic Support Manager answered various questions raised by Members regarding mitigations, market prices, inflationary pressures, the workforce, adult safeguarding, dementia and service users. It was noted that:

·        Staffing continued to be one of the main pressures on the Adult Social Care budget, as well as the market prices for beds and the need to reduce the price of care, particularly in nursing and residential care for older people.

·        Mitigations were RAG (red, amber, green) rated and regularly presented to the Corporate Management Team to deliberate and where mitigations would not be achieved, replacement mitigations and savings would be considered to ensure the position did not deteriorate.

·        The market prices for beds were currently higher than the City of York Council’s (CYC) standard rates. CYC’s standard rates were agreed as a fair cost of care exercise with providers. 

·        Work was underway to stabilize the spot purchase market with health colleagues, as some current prices in the care market had inflated since Covid 19.

·        A nationwide exercise from Local Authorities was being undertaken and this would help inform a fair cost of care from April 2023.

·        An accounting exercise had been developed for home care agencies asking for increases.

·        To help reduce the use of agency staff and recruit more permanent staff, an improved career progression structure for Social Workers had been developed.

·        Several of the safeguarding issues reported were of a low concern and were around care being provided in a domestic setting.

·        Robust safeguarding processes were now in place and officers worked closely with Public Health to ensure all the care establishments were visited to assess the quality of the service they provided. 

·        Although York was within the upper quartile of performance amongst England’s Local Authorities, it was still a concern that only 40% of York’s carers had reported that they were extremely or very satisfied with the care and support they had received from services.

The Executive Member for Adult Social Care and Public Health confirmed thatCity of York Council’s Dementia Strategy was launched on Monday 26 September and one of the priorities being addressed was for better diagnoses. 

During discussion, the Finance Manager agreed to seek further clarification on:

·          Any provisions that had been made available to individuals and organisations experiencing fuel poverty. 

·          Whether care homes had been encouraged to retrofit, particularly inefficient heating and insulation systems.

·          York’s performance in the 2021-22 Carers’ Survey compared to the 2018-19 consultation, particularly in relation to how satisfied or dissatisfied carers were with the support.

The Director of Public Health confirmed that the impact of Covid 19 would cause variations within some of the performance data, including within the results of the 2021-22 survey of Adults Carers in England.

Members thanked officers for their report and update.

Resolved:

(i)  That the report and update be noted.

(ii) That further clarification be circulated to Members on the Carers’ Survey, retrofitting within care homes and fuel poverty support.

Reason: To update the Committee on the final financial and performance position for 2022-23.