Agenda item

The Director of Finance submits a draft report to Council on 21 February 2018, of the General Fund Revenue Budget 2018/19 to 2020/21. Scrutiny Commission Members are asked to note and comment on the report as they see fit.  The Strategic Director for Adult Social Care submits supplementary papers relating to adult social care funding to inform the Commissions discussion of the General Fund Revenue Budget.

The Director of Finance submitted the draft report to Council on 21 February 2018, of the General Fund Revenue Budget 2018/19 to 2020/21. Scrutiny Commission Members were asked to note and comment on the report as they saw fit. The Strategic Director for Adult Social Care submitted supplementary papers relating to adult social care funding to inform the Commission’s discussion of the General Fund Revenue Budget.

The Chair made reference to the wider issues associated with cuts in council funding, and the difficult decisions the council had to consider on services it continued to fund. She acknowledged the pressures on the ASC budget, and the strong evidence presented to the Commission over the past year that there were an increasing number of people of working age who needed help, with issues such as depression, and physical health issues such as diabetes. It was also noted that people were living longer than in the past and were receiving increased care for longer periods. The Chair referred to paragraphs 7.6 and 7.7 in the report, which highlighted the growing gap between Better Care Funding and the underlying demands for care.

The Chair made reference to the two documents attached from Association of Directors of Adult Social Services (ADASS) and the Local Government Association (LGA), and the warning from the LGA of a £5.8billion local government funding gap by 2020.

The Chair stated it was imperative that central government urgently provided a long term funding solution for adult social care and that it implemented and concluded the promised review as soon as possible. The Chair asked that the following recommendation be made to the Executive for consideration:

That the Assistant City Mayor for Adult Social Care and Wellbeing jointly write, with the Adult Social Care Scrutiny Commission, to the Secretary of State for Health and Social Care calling on him to:

·         Implement and conclude the promised review of social care funding by no later than Summer 2018;

·         Provide clarity beyond 2019/2020 for the funding of adult social care. 

The Assistant City Mayor for Adult Social Care and Wellbeing informed the meeting the council was doing its best to protect the service, but unless there was a huge increase in resources it would put pressure on services. She added that in terms of the budget, the council was working in exactly the same way as in previous years, and as issues came forward, officers would bring detailed proposals to the Scrutiny Commission in line with previous years and ask the Commission to comment before decisions were made.

The Strategic Director presented the draft budget report, the background national paper from ADASS and noted the LGA reported replicated much of the ADASS report. The Director believed the increased concern over the funding gap was reflected over the country as a whole, and it was relevant to have a conversation about the national picture.

The Strategic Director presented the ADASS report and drew Members’ attention to the following:

·         There was a £366million overspend in ASC in England for 2016/17, which will grow in future years, with insufficient funding to meet growing pressures;

·         IBCF monies have allowed departments only to stand still;

·         Demographic pressure relating to people with mental health needs were above the national average with a 6% growth in the city over the past year;

·         Increasing demographic pressures for physically disabled people were above the national average at around 3%;

·         Nationally Directors’ confidence in making savings was falling as it became harder to find efficiencies, and were finding it more difficult to invest in prevention;

·         CHC savings of £6million locally meant a budget pressure for ASC of estimated at approximately £1million.

·         S117 mental health care – there was no ability to charge for aftercare under S117. There was a growing list of people on S117, and the council was in the process of discussing with the NHS the proposal to remove people who no longer required aftercare under S117;

·         The care market in Leicester was ‘fragile’ but ‘stable’ in nature in comparison to other market places across England where there was much more volatility.

The Strategic Director stated that if Government was not forthcoming urgently from the summer review of adult social care funding, there would be an impending crisis in social care across England.

In answer to Members’ questions the following points were made:

·         National dataset information on projections for future adult social care needs were 10 years old and would not reflect the work undertaken by Adult Social Care locally to change the profile of services used and where we encourage and support more people to continue to live independently. Occupancy level rates were stable in terms of what beds were available and what were used. In some areas overprovision led to reduced quality, and required some self-observation.

·         Adult Social Care was not currently in this financial year part of the spending review programme. The reduction in the numbers of staff came in a change to workflow and had been handled in a positive way, though there was a natural level of anxiety. The department had just completed a HSE healthy workplace survey across the whole department, and across the board results had improved.

The Assistant City Mayor for Adult Social Care and Wellbeing said the Executive would look at possibilities for reconfiguring and making savings, whilst keeping a close eye on the pressures faced by the department, raising attention to issues at an early enough point for them to be managed appropriately.

Members noted that it had been known for a long time that ASC funding was at a crisis point, and that good national data on future demand for adult social care was essential to ensure long term funding for adults social care met emerging need.  They asked for a recommendation to be added to note that national datasets re population forecasts and population need should be more flexible to allow councils to plan in a timely way and accurately across the whole range of services.

Members also noted in the report they had been asked to agree a 5% increase in council tax, and agreed to support the increase. They also noted there had been a suggestion to raise the increase to 6%, but needed to recognise that even in work, some people might not be wealthy.

Members asked for an additional recommendation to ensure that when the Executive made their responses to STP proposals the National Health Service was putting forward that they very strongly made known the impacts on the ASC budget.

A suggestion was made by the Commission that whilst agreeing to the 4.99% increase in Council Tax the Executive be asked to recognise that the overall revenue budget reflected the demand-led Adult Social Care and Children’s Service budgets, which represented the most vulnerable people in society, impacting families on a day-to-day basis and that reserves should be used to support them for as long as possible.

Members also asked that when other services were looked at, impact assessments be undertaken to see how they might or should contribute to the work of Adult Social Care and Children and Young People’s Services budgets.

The Chair agreed to the above additional recommendations suggested by Members and asked for the Scrutiny Policy Officer to provide wording for the recommendations in consultation with the Chair.

The Chair thanked the Strategic Director, the Assistant City Mayor for Adult Social Care and Wellbeing, Director of Adult Social Care and Safeguarding and Director of Adult Social Care and Commissioning for the information contained in the report, and asked that they take the gratitude and thanks from the Scrutiny Commission back to their teams for what they did for the citizens of Leicester.

AGREED:

That:

1.    The report be received and noted;

2.    That the Assistant City Mayor for Adult Social Care jointly write, with the Adult Social Care Scrutiny Commission, to the Secretary of State for Health and Social Care calling on him to:

·         Implement and conclude the promised review of social care funding by no later than Summer 2018;

·         Provide clarity beyond 2019/2020 for the funding of adult social care. 

3.    Population forecasts and population need should be much more flexible to allow councils to plan in a timely way and accurately across the whole range of services.

4.    To ensure that when the executive responds to the STP we very strongly set out the implications of this funding for the ASC budgets and the clients who require these services.

5.    The Executive be asked to recognise that the overall revenue budget reflect the demand-led Adult Social Care and Children’s Service budgets, which represented the most vulnerable people in society, impacting families on a day to day basis, and that reserves should be used to support them for as long as possible.

6.    Impact assessments in other budgets should look at how they might or should contribute to the work of ASC and CYPS budgets.

7.    It be noted the Adult Social Care Scrutiny Commission agree to a 4.99% increase in the budget.