Agenda item

For the Panel to consider and provide recommendations to the Overview and Scrutiny Committee on the 2019-20 Draft Budget and on the MTFS 2019/20 – 2023/24 and savings proposals relating to the Panel’s remit.

Paul Durrant, Senior Business Partner, introduced the report on the 2019/20 Draft Budget, the Medium Term Financial Strategy (MTFS) for 2019/20 to 2023/24 and the savings proposals that relate to the Scrutiny Panels’ remit. Scrutiny panel recommendations would be referred to the Overview & Scrutiny Committee for discussion on 28^th January, then referred to Cabinet for discussion on 12^th February with final proposals put forward for consideration of Full Council on 25^th February.

The report refers to £6.5m of additional budget reductions for 2019/20 that are required on top of the £7m of budget reductions for 2019/20 already submitted to the four scrutiny panels. However, following the finalisation of the funding settlement this figure has reduced to £5.2m. Cllr Patrick Berryman, Cabinet Member for Finance, said that work was ongoing on how to resolve this £5.2m gap and present a balanced budget ahead of the Cabinet meeting in February.

The budget reduction proposals for Adult Services total £3.624m over five years. £2m of these were proposed for 2019/20, a further £1.049m in 2020/21, £195k in 2021/22, £280k in 2022/23 and £100k in 2023/24.

Asked about the previously identified savings Beverley Tarka, Director of Adults & Health, said that in the 2018/19 MTFS there had been a £2.4m savings target for 2019/20 based on demand management. An authorisation panel, chaired by either Beverley Tarka or John Everson, had been put in place to oversee care purchasing spend and ensure that the best outcomes and value for money were being obtained. The £2m of new savings for 2019/20 set out in the report is in addition to this £2.4m savings target.

John Everson, Assistant Director for Adults, introduced each of the budget reduction proposals for Priority 2. Questions from the panel members were responded to by Cllr Patrick Berryman, Beverley Tarka, Charlotte Pomery, John Everson and Paul Durrant.

PA1 - Charging for Managed Accounts

 

This proposal involves:

• introducing a new administration fee when the Council acts as an Appointee (managing benefits on behalf of someone who cannot manage their own affairs, for example because they lack capacity)
• introducing a new charge for people who fund their own care but choose to have their care package managed by the Council.

Panel members expressed concerns that those requiring an Appointeeship are likely to be the poorest and most vulnerable and queried whether this measure would be fair or equitable. Panel members observed that savings of £70,000 across 200 people identified under this proposal averaged an annual charge of £350 per person.

The panel was informed that the Equalities Impact Assessment was the tool used to identify these potential inequalities and to mitigate this and ensure that groups with protected characteristics are not disadvantaged. There are a number of people supported through an Appointeeship who do have significant funds so are not all necessarily among the poorest. People’s ability to pay will be assessed and legislative guidance applies to how these charges are levied. It was confirmed that clients paying the charge on a monthly basis would not pay any more than clients paying on an annual basis.

 

AGREED: That the Panel be provided with a copy of the relevant Equality Impact Assessment ahead of the Overview & Scrutiny Committee meeting on Jan 28th.

 

AGREED: That further information be provided to the Panel on the proposed annual charges compared to the equivalent annual charges levied by broadly comparable local authorities ahead of the Overview & Scrutiny Committee meeting on Jan 28th. This should include any known evidence about whether charges by other local authorities have caused any financial harm to individuals.

 

 

PA2 - Fast tracking financial assessments

 

This proposal involves speeding up the process of financial assessments so that charging starts as soon after the start of services as possible. This saving relies mainly on reducing debt levels and the cost of recovering overpayments.

 

Panel members queried whether it was appropriate to discuss someone’s needs at the same time as discussing the costs of those needs. The panel was informed that it was important to do so in a sensitive way but that the Council also had a responsibility to have these conversations early at an appropriate time rather than allowing a time lag which could sometimes result in costs to the Council that are not recouped. The needs assessment would be carried out first, followed shortly afterwards by the financial assessment.

 

 

PA3 - Capitalisation of CAS

 

This proposal involves capitalising the operating and equipment costs of Haringey’s Community Alarms Service but does not involve changing the service in any way.

 

 

PA4 - Housing Related support

 

This proposal involves funding housing advice and support through the new Flexible Homelessness Support Grant. This grant is provided for two years by the Ministry of Housing, Communities & Local Government (MHCLG) which has allocated sums of funding to individual local authorities to meet additional responsibilities under the new Homelessness Reduction Act. In response to questions from the panel it was confirmed that the posts supported by this proposal are based within Adults & Social Care directorate. The Homelessness Reduction Act is focused on prevention by supporting people who are considered likely to become homeless including by working with landlords, family members and others to find solutions.

 

 

PA5 - In-House Negotiator

 

This proposal builds on an approach already ongoing which involves a negotiator looking at market intelligence and liaising with care providers in relation to high-cost care packages of over £1,000 a week to ensure that the Council is getting a reasonable price for the care that has been commissioned and that the care services that have been paid are being delivered in full.

Asked whether there was a risk that the Council could end up paying more in some cases or that levels of service could be reduced in response to payment reductions, the Panel was informed that this was unlikely to be a significant risk as these are very high cost packages and providers will be aimed to charge the amount they consider to be appropriate for their business. The proposal is predominantly about market negotiation. The reviewing of care packages is done on a very individual basis depending on the circumstances and so the Council does not always wait for an annual review, but if there is a change in the care package there is a six-week review as standard.

 

The projected savings are based on assumptions from the work already carried out by the negotiator in 2018/19. The proposal to recruit two care negotiators would be looked at flexibly as this may, in time, turn out not to be needed.

Panel members noted that the projected savings resulting from this proposal in the agenda pack does not match the figures provided in the supplementary sheet that had been provided to the Panel. A clarification would be provided in writing.

Asked whether there were any risks associated with this proposal, officers referred to the previously discussed points about needs/costs being assessed as higher in some cases, or that external economic factors such as inflation or consequences of Brexit could impact on the market.

 

AGREED: That the figures on the projected savings from this proposal be clarified in writing ahead of the Overview & Scrutiny Committee meeting on Jan 28th.

 

AGREED: That information on potential risks to this proposal, including modelling of potential savings and the number of clients be provided in writing ahead of the Overview & Scrutiny Committee meeting on Jan 28th.

 

 

PA6 - Transfer of High Cost Day Opportunities

 

This proposal involves reducing the costs of out of borough placements by bringing three ex-day centres in Haringey back into use and enabling some service users to transfer back to services within the borough. The three ex-day centres are the Haven, the Roundway and the Woodside. There is still some options appraisal work to do so, while there are likely to be some capital costs associated with this, these are not yet fixed. It was agreed that these capital costs be brought back to the panel at a future date when the full details become available. A full review of individuals that could transfer back into the borough would also be required on their potential transition as some individuals may be settled in their out of borough settings.

 

On whether service users and carers might feel nervous about this transition due to the changes being put forward in order to save money, there were a number of people who want to come back so the process would start with them. Individuals would be consulted on their needs. There is also a significant throughput of people coming through each year who could be provided with better value for money outcomes. In relation to individuals who want to stay where they are, their care package may still be subject to cost negotiation as set out previously under proposal PA5.

On whether the large projected savings of £525,000 in 2020/21 could prove to be unachievable or could be delayed the Panel was informed that benchmarking had been carried out using locally available day opportunities provision provided by the voluntary sector in Haringey compared to the costs of out of borough provision which were significantly higher. The high savings figure reflected the often high cost of some care packages.

 

AGREED: That the Panel notes its concerns about the potential risk of the savings not being delivered to the amount and/or timescale projected. This was due to concerns that some service users and their carers/families may be deterred from returning to services in Borough because of a perception that this was being carried out as part of a budget reduction process with lower cost services. The Panel recommends to Cabinet that these concerns be addressed.

AGREED: That full details of the capital costs associated with this proposal be brought back to a future Panel meeting when available.

 

 

PA7 - Public Health (Sexual Health)

 

This proposal involves projected savings based on efficiencies that are already beginning to be achieved though the delivery of different types of sexual health services including online home testing kits which provide more choice, anonymity and flexibility.

 

PA8 - Investment of drug and alcohol savings in preventative services for adults and families, targeting health inequalities

 

This proposal involves retendering of three substance misuse contracts which has created savings.

 

PA9 Further savings to be delivered by Adults Services

This item relates to additional savings of £720k over five years which would be achieved through operational business management.

 

Capital budget

The Panel was informed that the finance member of staff specialising in this area was unavailable and so questions would need to be responded to in writing. Questions from the Panel were:

• On capital scheme 213 (Canning Crescent Assisted Living) does the £6.7m identified include the CCG funding or is the CCG funding additional to this?
• On capital scheme 214 (Osborne Grove Nursing Home) there is £200k of capital spend identified for 2018/19 on the supplementary information sheet. What was this for?
• On capital scheme 214 (Osborne Grove Nursing Home) how has the figure of £10.75m been arrived at given that the feasibility study has not yet been completed.
• On capital scheme 215 (Hornsey Town Hall) how many affordable housing units will be purchased, will these be managed by Homes for Haringey and on what terms is the affordable housing available to people?

 

On the Osborne Grove Nursing Home consolidation, Beverley Tarka said that this did not involve additional capital costs and that by consolidating residents onto one floor this will reduce the staffing requirement which is expected to save about £400k per year. The feasibility study on the proposals for Osborne Grove Nursing Home is expected in February or March.

For future budget scrutiny meetings, the Chair of the panel recommended that the report received by the Panel could be improved by:

• including details of the previous year’s savings for the Panel’s priority area, to what extent these savings had been successfully achieved, whether any part of them had been carried forward to the following year’s budget and the total amount of savings therefore required in the future budget period that is being considered.
• including details of the overall capital budget for the Panel’s priority area including information about any underspend or overspend from the previous year and information about risks from any capital schemes to any project or to the revenue account.

 

AGREED: That the Panel’s questions on the capital budget be responded to in writing ahead of the Overview & Scrutiny Committee meeting on Jan 28th.

AGREED: That the Panel’s recommendations on future budget scrutiny reports be noted by officers.