The Deputy City Mayor for Social Care, Health
and Community Safety introduced the item, highlighting the efforts
of both senior and front-line staff and the complexity of the
budget. Work was now being undertaken on a new level to meet the
needs of people requiring support, whilst addressing the financial
challenges.
The Director for Adult Social Care
Commissioning submitted a report providing the commission with an
overview of the development and progress of the Adult Social Cost
Mitigation Programme. Key points noted were:
- The focus of the report was on
current project work taking place.
- Adult Social Care had embarked on
work with Ernst & Young in the Summer of 2023.
- Considerations on infrastructure and
routes to Lead Members had been made.
- A positive response had been
received throughout the department.
- An intensive work programme had
ensued to support an Early Action and Prevention model.
- There had been an emphasis on
reducing cost pressures.
- Initiatives including Leading Better
Lives had moved forward.
- A robust methodology had now been
developed for Adult Social Care.
- Workstreams were as follows:
1.
To reduce the costs of care, improve efficiency and examine
improvement opportunities.
2.
To reduce new entrants and manage demand.
3.
To improve efficiency with Adult Social Care.
4.
To emphasise partnership working.
- The lens was on delivering to
people’s requirements, maintaining independence and
appropriate costing.
- A Transport Sequencing project had
gained regional interest.
- The programme had been presented to
the City Mayor and the Executive for consideration. This confirmed
that the programme was on track concerning commissioning.
Recommendations included examination of opportunities for cost
mitigation.
- It was
noted that Leicester was not an affluent city, yet there remains a
statutory duty to provide social care. Key challenges were
identified, including the need to address underlying route issues.
Programme delivery commenced in November 2023 and it was
acknowledged that a completely new way of working had been
introduced.
- A delivery group was established,
meeting fortnightly to discuss matters concerning deliverance and
project progress.
- Outcomes for people requiring
support were of key focus with projects being reviewed to ensure
the best results.
- The programme enabled consideration
of resources, ensuring that these were targeted to make a
difference.
- People requiring Adult Social Care
support often came with complex needs and individual
circumstances.
- Children aging out of SEND care
often transitioned into Adult Social Care.
- It was noted that increased life
expectancy, combined with people living longer but in ill health
had contributed to growing pressures on Social Care Services.,
- There was considerable
cross-departmental work, with the mitigation programme running
alongside Adult Social Care. A holistic approach had been
encouraged.
- The Outcome Support Sequence
considered individual capabilities in order to form the appropriate
care package.
- The shared care record resulted in
quicker access to information.
- Observations had taken place to
ensure cost efficiency.
- Positive outcomes had included an
upward revision to expected income. This was due to grant income
being higher than expected and the joint-funded care package
income.
- Forecasting based on the last three
years of the Adult Social Care budget have proved useful, allowing
for contingency.
Questions and comments were welcomed by the
Chair and responses to note were:
- The cost of engaging Ernst &
Young was £80k. The work concluded in November 2023.
- Regarding transport sequencing for
children, priorities were examined across the social care
department, children were included in this. Leicester did not have
separate departments for Adult and Children’s Social Care,
unlike other local authorities. The Strategic Director of Social
Care and Education discussed complexities arising with the
children’s aspect and explained that learning was
ongoing.
- Extended life expectancy was cited
as a reason for the reduced budget target for care packages. Also,
figures showed a better delivery had been achieved than what had
been expected. It remained that there was a statutory duty of care
meaning that those in need would receive the support required.
- Considerable work had taken place
examining care options through family and community where
appropriate, rather than automatically offering care packages. A
close working relationship with the NHS helped to facilitate this.
This in turn allowed for different targets and could lead to annual
financial increases.
- It was anticipated that the
following three years would see increasing complexity of needs.
Levels of support for deprived communities would be a key focus.
The emphasis would be on early preventative action.
- Smart spending was expected to pay
dividends.
- It would be important to ensure that
cross services were aligned.
- The pathway for children coming to
Adult Social Care was important.
- Discussions amongst the committee on
the use of the phrase ‘leavers’ and it was agreed that
this language could be explored further.
- Regarding the observation work
carried out, it was clarified that this had been actioned with
sensitivity and had not caused disruption. The focus had generally
been on learning disabilities and good relationships had been
established with providers. Findings had shown that there could be
more effective ways of working. This was being fed back to
providers. Digital elements could come into use, but this would not
lead to the elimination of personal care.
Agreed:
1)
That the report be noted.
2)
That an item on loneliness be added to the Work
Programme.
3)
An item on increasing complexity of needs be added
to the Work Programme.
4)
An item on SEND children transitioning to Adult
Social Care be added to the Work Programme.
5)
Consideration of language to take place, in
particular to the use of the phrase ‘leavers’ when
referring to SEND children aging out of the children’s social
care phase.