Agenda and minutes

The Chair led on introductions. It was noted that the item on the Hastings Road Day Care Centre will be taken first on the agenda, whilst the technical issue were resolved.

Apologies for absence had been received from Councillor Singh Johal.

Members are asked to declare any interests they may have in the business to be discussed.

The Chair declared that his wife worked in the Reablement Team at Leicester City Council.

The minutes of the meeting of the Adult Social Care Scrutiny Commission held on 8 December 2022 have been circulated and the Commission is asked to confirm them as a correct record.

The Chair took the opportunity to thank the Strategic Director for Social Care and Education for the informative briefing session arranged for Members of the Commission.

AGREED:

That the minutes of the meeting of the Adult Social Care Scrutiny Commission 8 December 2022 be confirmed as a correct record.

The Monitoring Officer to report on any petitions received.

The Monitoring Officer noted that none had been received.

The Monitoring Officer to report on any questions, representations or statements of case.

The Monitoring Officer noted that none had been received.

The Strategic Director for Social Care and Education will provide a verbal update on the Hastings Road Day Centre.

Members of the Commission are reccomended to note the update and pass any coments to the Strategic Director For Social Care and Education.

The Director for Adult Social Care and Commissioning introduced the item. It was noted that the consultation process had opened on 12 December 2022 and would be running for a 10-week period, this is following an intensive period of engagement earlier on in the year. It was also noted that all parents and carers of those who attend Hastings Road had been written to and notified of the consultation following which engagement sessions had been arranged for families and carers, which was well attended and a further 2 sessions arranged.

It was also noted that a session had been arranged in February for parents and carers to meet with alternative providers to see who else was available in the market place.

Additionally, a survey had been circulated to users and on the council website for additional engagement following which, analysis of the findings of the face to face sessions and survey responses would be used to produce a report which would go for a decision in the summer.

The Lead Commissioner noted that the session set up for family and carers with providers would allow for families and carers to talk directly to providers to  understand what services were available and what would best suit their needs as this was a niche group with profound learning disabilities and it was important for families and carers to be confident in the service that other providers had to offer.

As part of the discussions it was noted that:

·         No new referrals to the service had been received since 2016 due to people choosing a different model of services that best suited to serve for their loved ones

·         Due to the level of need for the service users, individual families had been consulted and managed to ensure that they understood what alternatives were available to ensure the level of service they require is met should the centre close

·         With individual plans developed carefully with families to make sure the level of need for the service users is met

·         Financial implications on the running of the day care centre were also a reason that had driven the consultation

·         Annual cost for the day centre was £1million with some users funded through CHC funding, with the health incomes declining the centre was overspending £142,000 in 2021 with a similar net spend for last year

·         The private provider alternatives commissioned would be £18.70 per hour which was the framework rate compared to the £37.00 per contract hour

It was further noted that, the relationships that the service users had developed with the staff over the years were important as the service users had been attending the day care centre for many years due to the severity of their disabilities. It would be vital to work slowly and sensitively with the families to make sure should alternatives need to be put in place, they were robust and of high quality for the service user and their families.

The Deputy City Mayor for Social Care and Anti Poverty  ...  view the full minutes text for item 27.

Draft Revenue Budget

The Head of Finance introduced the report and provided a summary of the Draft Revenue Budget in relation to the Adult Social Care Scrutiny Commission.

As part of the summary, it was noted that £33million of managed reserves helped bridge the gap of estimated expenditure in the coming financial year, but it would not be possible in 2024/25 to cover the £44million needed to cover the gap between expenditure and funding coming in, since there would only be £22million left in reserves at the beginning of that year. Work was ongoing to bridge the gap and realign expenditure with £6million identified in savings during the current financial year and savings would be brought forward with appropriate consultations to reduce the gap.

The background behind the authority being in this situation was 10 years of austerity, the rising cost of social care, inadequate funding and moreover no additional funding for recent inflation. For example there was no additional funding in the settlement this year to address the future pay increases, the additional £10million estimate for additional energy costs and the Biffa Waste contract payments indexed to RPI. There was also the potential for further austerity beyond 2025.

Additional £12.6million that had been earmarked nationally for local implementation of reforms had been added to the budget to deal with current pressures, but it was noted that there was no systematic additional funding to address the underlying growth in demand. The estimated additional cost for Adult Social Care of £19million was estimated as being required for the growth in numbers of those who require care, the growth in the size of care packages to suit individual needs and the growth in the unit cost of care. Central government had allocated the funding based on the presumption that local authorities would raise council tax by 5%.

As part of the discussions with Members, it was noted that:

·         There were no tangible savings made in 2022/23, but the service did not see as much growth in demand as had been expected and the increase had been accounted for in the overall budget for 2022/23

·         The strength-based approach had slowed down the increase in expenditure and the budget for 2023/24 was based on the lower rate of increase

·         The average amount of care provided had increased faster than in the rest of the country, the number of people of working age that required care had been growing and the local demographics meant that the service were supporting a greater number of people but were focussed on a strength-based approach

The Strategic Director for Social Care and Education noted that the most efficient way to control the budget was to do the right thing with the right person at the right time and that over-providing care created a culture of dependency which resulted in a shorter and unhealthier life. Applying the strength-based practice was the best model that enabled staff to work with people where the outcome was not a service.

In response to  ...  view the full minutes text for item 28.

The Strategic Director for Social Care and Education submits an update report on the Procurement Plan 2021/23.

Members of the Commission are reccomended to note the report and pass any comments to the Strategic Director for consideration.

The Deputy City Mayor for Social Care and Anti-Poverty introduced the item on the Procurement Plan 2023/24.

The Strategic Director for Social Care and Education noted that the biggest spend was on externally commissioned service and a lean team was in place to manage this.

As part of the discussions, it was noted that:

·         Money was allocated in response to local needs

·         Contract lengths were sustainable with the market with longer contracts having break clauses

·         Each contract was considered on its own merit

·         During the length of the contract, providers would make request when contracts were coming to an end where there could be increase in cost due to pressures that can’t be anticipated

·         Contract extensions were based on the quality of service

·         Support was provided to the market during the pre-procurement process.

The Deputy City Mayor for Social Care and Anti-Poverty suggested that Members of the Commission could provide areas they would like to bring to Commission for scrutiny at future dates and suggestions were made by Members of the Commission that the item on Home Care be first to be added to the work programme for future scrutiny.

In further discussions it was noted that the Reablement Team was not being outsourced and that there was work being carried out to ensure appropriate settings were available to be discharged from LLR  

AGREED:

1)    Members of the Commission be requested to send particular items for consideration at future Commission meetings to Director for Adult Social Care and Commissioning

2)    That the Commission request for the item on Supported living be added to the Work Programme for the Commission

3)    Comments made by Commission Members be considered

4)    That the Strategic Director for Social Care and Education be requested to provide similar updates to future Commissions of the Adult Social Care Scrutiny Commission.

The current work programme for the Commission is attached.  The Commission is asked to consider this and make comments and/or amendments as it considers necessary.

Members be requested to forward any additional items for consideration at scrutiny to the Scrutiny Policy Officer.

The Strategic Director for Social Care and Education noted that although media reports in the fair cost of care and market sustainability were tru but not the whole truth. The CQC had carried out a number of inspections which had slowed down during the Covid pandemic. The CQC were now focussed on provisions they were concerned with.

It was further noted that less than 50% of inspections, 60% of which required improvements or were inadequate. 69% of residential homes were good or outstanding. Leicester was second lowest in the region and the region was the lowest in the country. Overall, the results were fair there was a way to go for the service to improve and to take learning from what was good practice and what learning can be taken from others to improve.

There being no other items of urgent business the meeting closed at 8.00pm.