Agenda item

To provide 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 1, 2019/20.

Paul Durrant, Head of Finance for People, and Sandra Robb, Adults and Health Business Partner, presented an overview to the Panel 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 1 of 2019/20.

Paul Durrant reported that there was currently a projected overspend of £3.6m which comprises of overspends of:

• £2.9m on adult social care
• £0.3m on Public Health
• £0.4m on Commissioning

The overspend in adult social care includes a £2.7m overspend on care packages which is an overachievement on the expected £3.9m overspend for this area once the net savings and growth have been applied. The £2.7m overspend is broken down as follows:

• £1.7m on Adult Placements
• £0.6m on Learning Disabilities Placements
• £0.4m on Mental Health Placements

The overspend on Osborne Grove Nursing Home was projected to be £0.2m. Although an additional £0.3m had been provided for this in the current financial year, delays in the consultation on the staffing structure have still resulted in the overall projected overspend.

The £0.4m projected overspend on Commissioning was due mainly to salaries and a savings objective which has not been achieved.

The £0.3m projected overspend on Public Health was due mainly to budget setting with some service charges being higher than anticipated.

Priority 2 has a capital budget of £8.6m divided over ten projects as set out in Appendix 3:

• Though project 208 (on supported living schemes) is currently showing zero spend for 2019/20, some spend is expected to be brought forward in year at some point and in the next financial year. This is because there has been other activity on the Linden House adaptation and on Canning Crescent assisted living (also shown in Appendix 3). Further programmes on supported living are being worked up, these just need to be programmed into the budget when possible.
• On project 209 (on assistive technology) there has been a pause in the delivery model and an update is expected in Quarter 2.
• On project 213 (on Canning Crescent assisted living) following the initial feasibility, architects are being appointed and moving forward to RIBA Stage 2 Concept Design and RIBA Stage 3 Developed Design by Spring next year. If there is slippage in 2019/20 then the capital budget can be carried forward to the following year.
• On project 215 (on Hornsey Town Hall supported living) this is now being funded through the Housing Revenue Account.

Asked about the expected capital spend on project 207 (new day opportunities offer), Charlotte Pomery, Assistant Director for Commissioning, said that there is a figure set aside (which is larger than the one shown in Appendix 3) to bring back into use the two properties in Waltheof Gardens. The capital outlay will be spent this year. Further spending in future years has not yet been identified and is not in the budget spreadsheet but she said that this is not necessarily reflective of wider ambitions and doesn’t mean that there won’t be further spending in this area in future years.

With regards to the delivery of savings on the revenue budget (as set out in Appendix 4), Paul Durrant said that the top three rows (on learning disabilities, mental health and physical support) are the core savings which are the toughest to deliver. All are reporting as ‘amber’ at present which means that there is confidence in delivering the majority of it but there is still a challenge to achieve overall delivery. Asked about the learning disability savings he said that it was anticipated that the achieved savings would be close to the £1.1m target.

Helena Kania asked why savings were being targeted at mental health when in fact there is an under-reporting of mental health problems at present. Beverley Tarka, Director of Adults & Health said that the majority of the spend is on existing care packages within adult social care and that the savings are targeted at reducing the cost of these existing care packages. Some mental health service users are placed in more high-needs arrangements than they need to be and could be ‘stepped down’ as they make progress. A review is in progress to see how many people can be ‘stepped down’ and this involves a thorough reassessment process. Increasing the range of supported living opportunities, as referred to earlier, will be important in achieving this stepping down to less expensive services.

Asked about a resilience reserve, Paul Durrant said that there was a specific resilience reserve of £2m applied to the Adults & Health budget last year but there is no specific reserve to be applied this year. Beverley Tarka added that it is important to separate the savings target from the underlying overspend in the budget caused by care package pressure. The £2m resilience reserve was applied to the Adults & Health budget last year but in this year that has been some accommodation for that reserve already built in to the Adults & Health budget for this year. She said that there is a collegiate approach to supporting adult social care across the Council and that corporate finance colleagues constantly review the budget and there is recognition of the stress that adult social care is under.

Cllr Connor requested that future budget updates identify any savings being achieved through ‘invest to save’ measures.

Asked to expand on the causes of the “reported pressures on the Commissioning budget”, as set out in paragraph 2.4 of the main report, Charlotte Pomery said that this largely related to staffing and rent payments from community organisations for Council premises. It does not include contracts or commissioned services which are generally funded from the care services budget.