Papers to follow
Minutes:
The panel was taken through the PSSEX1 return; this is the information which is provided to the Department of Health by the Directorate on an annual basis.
Noted that it is difficult to compare 05/06 and 06/07 as what is included in each cost centre may have changed. For example, Assessment and Care Management in 05/06 is shown as £3.6 million and in 06/07 it is shown as £6.7 million this is because the distribution of assessment costs was changed.
Over the past four years money has been incrementally moved from institutional based care to community based care, both internally and externally. This has included a reduction in residential care placements of over 220.
At the same time the number of people being supported in their own home has increased.
It is difficult to move more services at once as there is no parallel funding available. This is a challenge.
Out of a total spend of £40 million approximately only 5% if this is spent on preventative services.
Joint arrangements are those which are joint with the TPCT.
Points of discussion
The number of people receiving Meals on Wheels (MoW) has decreased. This is because historically MoW was not FACs tested. The decision to make this FACs tested was due to the increased cost of meals, for example kosher meals are more costly. The Council’s contribution therefore doesn’t take long to become a budget pressure. The use of FACs also ensures that the provision of the service is more transparent.
Equipment and adaptations are not costed to Older People’s services. These sit under Physical Disabilities; some is also costed to Homes for Haringey, Housing Associations and the Disabilities Facilities Grant. Therefore the costs which are incurred by Older People is not easily accessible due to the disparate sources.
Noted that the performance of equipment and adaptations has improved significantly. At the same time the increase in the number of assessments undertaken has resulted in long waiting times, this is due to the finite resources.
Query as to why Home Care costs have not increased whilst the numbers in residential care have decreased. Noted that there was an overall shift and the costs were incorporated into Assessment and Care Management. However this is not apparent from the breakdown.
Other Services includes areas such as transport to and from respite care, deep cleaning of properties. It also includes areas such as grants, e.g. for the Alzheimer’s society.
Part of this is budgeted for e.g. grants but some is based on need and therefore can not be predicted e.g. the deep clean service.
The reason for deep cleans varies – it can include homes which need the service as the tenant has had a quick onset of dementia and also in homes where there has been a choice not to clean and therefore the property has deteriorated.
Supporting People is for helping to maintain tenancies, services under Supporting People do not explicitly state this due to perceptions that this is only housing help. It is in fact much broader.
Services commissioned though Supporting People are monitored using the Quality Outcomes Framework.
Supporting People was highly commended by the Audit Commission at its last inspection for having a strong governance framework.
For future reference it is important to ensure that the meaning behind the headings are clear and acronyms are not used. This is especially important when engaging with the community who do not have a day to day knowledge of the areas.
Noted that there will be a Scrutiny Review into social care budgets in the next municipal year. This will include looking at spending streams and working from a zero base budget. Therefore further details of the spend analysis can be looked at there.