Agenda item

This report provides an overview of the financial performance of the services within Priority 2 (Enable adults to live healthy, long and fulfilling lives) as at the end of quarter 2, 2017/18.

Beverley Tarka, Director of Adult Social Services, introduced the report and Paul Deeney, Business Partner, provided further information via presentation.

Mr Deeney commenced his presentation by providing an overview of the pressures and gaps facing Priority 2 (P2) in financial terms. It was noted this included all services managed by the Director of Adult Social Services and those adults-focused services managed by the Director of Public Health and the Assistant Director for Commissioning.

Information was then provided on a range of issues, set out on pages 1 – 13 of the agenda, including:

-       The Budget Build for P2 for 2017/18, including budget adjustments made during the year.

-       How the MTFS for P2 was being delivered

-       Details on the P2 Budget at Period 6 2017/18

-       Priority 2 savings at Period 6 2017/18  

During the discussion a number of issues were considered in relation to the fact, at the end of Period 6, the Council was projected to overspend by £6.4m in 2017/18. It was noted that the majority of the overspend in the general fund related to demand pressures in frontline services. The following points were noted in relation to the P2 Budget:

-       There was £98.7m forecast against a budget of £95.2m, an adverse movement of £1.9m on Period 5.

-       The £3.5m adverse variance was made up of £3.6m from Adult Social Care and an immaterial favourable variance of £0.1m from Public Health.

-       The in-year forecast had been mitigated through the release of provisions totalling £1.3m.

-       Key pressures for adult social care included the money that was being spent in relation to Osborne Grove and on care packages.

In response to questions, the Panel was informed that the budget pressure relating to Osborne Grove was projected at £1.0m for the following reasons: agency staff costs, loss of client contributions and health income. In terms of care packages the Panel was informed that a budget pressure of £4.3m was apparent due to:

-       Demand for younger clients with learning disability support needs and older clients with physical support needs being currently forecast above initial budget projections.

-       Savings related to re-provisioning costs being less than anticipated for those clients whose needs had previously been met through in-house services.

-       The fact that significant reductions, relating to the cost of care packages and to prevention and diversion, had not yet materialised. It was noted this approach had been anticipated to play an important role in delivering required savings. It was explained that proposals had tended to overstate what could be achieved, due to double-counting of effects across different interventions such as the use of Assistive Technology and Reviews. As a result, the Panel was informed a review would be undertaken to seek alternative ways to mitigate this.   

In response to questions, the Panel was informed that of the savings identified in years 1 and 2 of the MTFS, outlined on page 13 of the agenda, £5.6m was projected to be saved against a total of £7.97. It was noted that this included savings identified from additional management action plans, agreed at Period 6, which included a series of initiatives to curtail expenditure by £1m. These actions would be monitored regularly to ensure they made a positive impact. 

During the discussion on the P2 budget position, a range of issues were considered by the Panel, including:

-       The work that was taking place in relation to service design to make direct payments easier to access for service users.

-       The work that was taking place via the Member Working Group to develop a new model for home support. The Panel was informed work in this area was based on the experiences of a range of stakeholders including users, carers, frontline care workers and agencies. It was noted that the Working Group was looking at a number of themes including providing clients with continuity of care, reducing social isolation and the implications of signing up to UNISON's ethical care charter.

-       The fact some of the information provided in the report, relating to both current and projected overspends, was unclear. To ensure effective scrutiny, the Panel request clearer, and more detailed, information for future budget monitoring sessions.

-       Various issues in relation to the development of the market. This included a discussion relating to forward planning for clients with learning disabilities, especially those wishing to use Ermine Road as a Hub. In response to questions, officers provided further information on Area 51, a specialist college for young adults with severe or profound learning disabilities, and the importance of work that was continuing via community asset mapping.   

-       Issues concerning cuts to the voluntary sector. In response to questions, officers provided information on business rates relief for voluntary and community sector organisations occupying premises in Haringey.

Mr Deeney concluded his presentation by providing brief information on savings and costs associated with day care centre closures. This included summary information for the Haven, Grange, Roundway, Always, Birkbeck and Ermine Road concerning the number of clients, budget reductions, re-provisioning costs, net annual savings and redundancy costs (revenue and capital). Members were concerned further information was not available for consideration and agreed an item on day care re-provisioning costs, with input from Property Services, should be included in the Panel’s future work programme. Officers were asked to come back to the Panel in March 2018 with further information on a range of issues, including the client cost for an individual service such as the Haven, where clients had gone, care package costs, a full breakdown on actual savings made and any outgoing costs for different care for all client groups. In response to questions, it was noted Property Services would be able to provide information on the ongoing costs of looking after closed buildings and on the long term plan for their use. 

AGREED:

(a)   That the update on the financial position of Priority 2 services be noted.

(b)  That an item focusing on day care re-provisioning costs, with input from Property Services, be included in the Panel’s future work programme for March 2018.