Agenda and minutes

Budget, Social Care & Health Scrutiny Committee
Wednesday, 22nd January, 2020 10.00 am

Venue: Chamber, County Hall, Carmarthen, SA31 1JP. View directions

Contact: Emma Bryer  01267 224029

Items
No. Item

1.

APOLOGIES FOR ABSENCE

Minutes:

There were no apologies for absence.

2.

DECLARATIONS OF PERSONAL INTERESTS INCLUDING ANY PARTY WHIPS ISSUED IN RELATION TO ANY AGENDA ITEM.

Minutes:

Councillor

Minute No (s)

Nature of Interest

Ken Lloyd

5. Communities Department Draft Business Plan 2019/20 – 2022.

Close family member is a carer in the Shared Lives Scheme.

 

There were no declarations of prohibited party whips.

3.

PUBLIC QUESTIONS (NONE RECEIVED)

Minutes:

The Chair advised that no public questions had been received.

4.

REVENUE BUDGET STRATEGY CONSULTATION 2020/21 to 2022/23 pdf icon PDF 294 KB

Additional documents:

Minutes:

The Committee considered the Revenue Budget Strategy 2020/21 to 2022/23 (Appendix A) which had been endorsed by the Executive Board for consultation purposes at its meeting on the 6th January 2020.  The report provided Members with the current view of the Revenue Budget for 2020/21 together with indicative figures for the 2022/23 financial years. The report was based on officers’ projections of spending requirements taking into account the provisional settlement issued by Welsh Government on 16th December 2019.

 

The Committee also considered the following detailed budget information appended to the Strategy relevant to its remit:

 

·         Appendix A(i) – Efficiency summary for the Social Care & Health Service

·         Appendix A(ii) – Growth Pressures summary for the Social Care & Health Service

·         Appendix B – Budget monitoring report for the Social Care & Health Service

·         Appendix C – Charging Digest for the Social Care & Health Service

 

The Head of Financial Services provided an overview of the report. Key points covered included:

 

The announced provisional settlement represented an increase of 4.3% as an average across Wales on the 19/20 settlement, Carmarthenshire had received an increase in Welsh Government grant of 4.4% (£11.5m) taking the Aggregate External Finance to £274. 159m for 2020/21. New responsibilities and transfers into the settlement included funding for Teachers Pensions and Pay, which were only partially funded within the settlement and accounted for £5.8m or 2.2% of the overall funding increase.

 

Details of the Welsh Government Service Specific Grants were also provided with many remaining at a similar level. The Committee was advised that the social care workforce grant had been increased from £30m to £40m across Wales (c £600K for Carmarthenshire).  Further clarification was being sought to understand whether the increase could be used in full towards unavoidable service pressures.

 

There was a forecast variance of £3.5m overspend for the Authority with £1m overspend for the Communities Department against the budget areas of Older People, Physical Disabilities and Learning Disabilities.

 

The budget proposals assumed the full delivery of all savings proposals, together with the identification and delivery of the shortfall in savings proposals for the 2021/22 and 2022/23 financial years.  Additional cost reduction would need to be identified and/or larger council tax increases agreed to deliver a balanced budget for the latter two years.  Given the scale of the pressures and forecasted budget gap, proposed council tax increases had been maintained at the previous Medium-Term Financial Plan (MTFP) levels of 4.89% in each of the three financial years which offered some mitigation to the savings proposals.

 

The Head of Financial Services advised that due to delays in receiving the provisional settlement, the consequential impact on Welsh Government’s budget finalisation and publication had been equally delayed.  Therefore, the final settlement was due to be published on 25th February 2020 and the County Council would set the final budget on 3rd March 2020.

 

It was also noted that members of the Committee had recently attended budget consultation events which had provided them with an opportunity to ask questions and  ...  view the full minutes text for item 4.

5.

COMMUNITIES DEPARTMENTAL DRAFT BUSINESS PLAN 2020 - 2023 pdf icon PDF 261 KB

Additional documents:

Minutes:

[NOTE: Cllr. K. Lloyd had earlier declared an interest in this item].

 

The Committee considered the Communities Departmental Draft Business Plan 2020 – 2023 in relation to those services falling within its remit:

 

·         Care and Support Services

·         Mental Health, Learning and Disability & Safeguarding

·         Integrated Services

·         Commissioning Services.

 

It was noted that further work would be undertaken on the draft business plan following comments and engagement by the Committee and Executive Board Members.  Additionally, feedback from staff groups to date had indicated greater emphasis would be welcomed on integrated wellbeing actions through divisional plans together with ensuring the sustainability of services through different methods in the face of growing demand.

 

The following issues/questions were raised on the report: -

 

·         It was asked what work was being done on developing the prevention agenda.

The Interim Head of Integrated Services advised that there was a focus on prevention and promotion of independence and that the Authority was engaged in a significant amount of work in this area. Examples provided included: the use of technology, Community Responders, working with GP practices, CUSP project, development of StayWell plans in conjunction with service users, re-engagement with the community and the Couch to 5k initiative.

·         The Committee asked for further information regarding the CUSP project.

The Interim Head of Integrated Services advised that the CSUP project was started about 18 months ago in collaboration with the third sector.  The CUSP service aimed to support people over the age of 18 years to maintain independence or become independent. Advice and support was provided on whatever was significant to the individual and could include areas such as financial management and gardening.  The CUSP service is provided free of charge however some users may choose to purchase the services of private companies following referrals. The Head of Mental Health and Learning Disabilities advised that there was focus on the preventative agenda and advised that when someone finds themselves in a difficult position, they need to speak to someone as early as possible to prevent escalation.  The crisis centre (Twilight Sanctuary) had been opened in Llanelli to help these people.

·         It was asked how the public were being made aware of the service provided by the Twilight Sanctuary.

The Head of Mental Health and Learning Disabilities advised that there had been a lot publicity and that the service would be advertised wider when the service was fully established.  The Committee was also advised that there was a possibility that a centre would be opened in Carmarthen.

·         An update was asked regarding how joint working with partners such as the Health Board and the third sector was progressing.

The Head of Mental Health and Learning Disabilities advised that historically there had been concerns however, partnerships were now working well.  Committee was advised that Carmarthenshire was very involved with the transformation programme and was working closely with the Health Board.  While work was continuing, it was not at the pace hoped for however projects were aligned with the transformation vision of a single  ...  view the full minutes text for item 5.

6.

REVENUE & CAPITAL BUDGET MONITORING REPORT 2019/20 pdf icon PDF 296 KB

Additional documents:

Minutes:

The Committee considered the Revenue and Capital Budget Monitoring Report in relation to the Social Care and Health Service, which provided an update on the latest budgetary position as at 31st October 2019, in respect of the 2019/20 financial year.

 

The Social Care & Health Service was projecting an overspend of £986K on the revenue budget and net variance of £4K against the 2019/20 approved capital budget.

 

Amongst the questions / observations raised during consideration of the report were the following:

 

Appendix A – Summary Position

·         It was noted that the August figure of £816K overspend had increased to £986K in October.  It was asked if there was an indication of the current position.

The Group Accountant advised that there are a variety of factors to consider but that previous years’ trends would indicate the possibility of a reduction in the figure.

 

Appendix B – Main Variances

·         Reference was made to the overspend on agency staff and how this was also an issue for the Health Board.

The Head of Mental Health and Learning Disabilities confirmed that this was a particular issue for residential care, however a significant amount of work had been done in this area and that a reduction had been seen.  Agency staff would only typically be used if first line services were at risk.

·         Reference was made to the increase of Direct Payments for physical disabilities.  It was asked how payments were being monitored to ensure that payments remained relevant.

The Senior Business Support Manager advised that care management reviews were undertaken. The Audit and Compliance Team ensured payments were being used correctly and any issues identified raised with care management.  The Committee was informed that a direct payments report was in the process of being developed.

·         It was asked if there was evidence that direct payments were being misused and if clients were being taken advantage of.

The Senior Business Support Manager advised that Direct Payments was higher risk than engaging with regulated providers, however there were safeguards in place to limit risks.

·         Clarification was asked regarding the £1,000 administration fee charged to individuals who were self-funding residential placements.

The Senior Business Support Manager advised that the proposal is yet to be approved by Council.  The fee would be an annual fee and that neighbouring authorities were already charging.  The fee would be charged to individuals who were self-funding but not confident in procuring the services themselves.  Under the Social Care and Well-Being Act when the Local Authority is approached, people are entitled to have their placement commissioned through the Authority.  The Authority had agreed sustainable rates with providers however potentially the charges to service users could be more through the Authority than through commissioning directly with service providers.

 

Appendix F – Detailed Variances

·         Officers were asked how the Authority ensured that service users weren’t suffering due to the reduction in double handed care.

The Interim Head of Integrated Services advised that multi-disciplinary teams undertook assessments after discharge from hospital as it was found that  ...  view the full minutes text for item 6.

7.

EXPLANATION FOR NON-SUBMISSION OF SCRUTINY REPORT pdf icon PDF 103 KB

Minutes:

The Committee received an explanation for the non-submission of the following scrutiny reports:

 

·         Learning Disability Strategy (2018/2023)

·         Services and Support for Children and Young People (Multi Agency Forum Update)

·         5-year Capital Programme Budget Consultation

 

The Committee was advised that the Services and Support for Children and Young People (Multi Agency Forum Update) would be more appropriate for the Education & Children Scrutiny Committee.  The Head of Mental Health and Learning Disabilities was waiting for confirmation from the Chair on whether he was happy to add the item to their Forward Work Programme.

 

RESOLVED that the explanation for the non-submission be noted.

8.

SOCIAL CARE & HEALTH SCRUTINY COMMITTEE ACTIONS & REFERRALS UPDATE pdf icon PDF 291 KB

Additional documents:

Minutes:

The Committee considered the update report detailing progress in relation to actions, requests and referrals emerging from previous meetings.

 

UNANAMOUSLY RESOLVED that the report be received.

9.

FORTHCOMING ITEMS pdf icon PDF 156 KB

Additional documents:

Minutes:

RESOLVED that the list of forthcoming items to be considered at the next scheduled meeting on the 5th March, 2020 be noted.

10.

MINUTES OF THE MEETING HELD ON THE 21ST NOVEMBER, 2019 pdf icon PDF 335 KB

Minutes:

UNANAMOUSLY RESOLVED that the minutes of the meeting of the Committee held on the 21st November, 2019 be signed as a correct record.

 

The Committee was asked to note that the Chair had received excellent feedback regarding the standard of care provided by Y Bwthyn care home.