Agenda item

Adult Social Care Cost Mitigation Programme

The Director for Adult Social Care and Commissioning submits a report to provide an overview of the development and progress of the Adult Social Cost Mitigation Programme. 

Minutes:

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.

 

 

Supporting documents: