To scrutinise the Draft 2020-21 Budget.
Attached, in relation to the Cabinet’s Budget proposals to Council are the following documents:
(i) A copy of the Cabinet report to provide the overall context for the budget setting process (Appendix 1)
(ii) A copy of the Service's cost reduction proposals which are relevant to the scrutiny committee (Appendix 2)
(iii) Individual Impact Assessments relating to the proposals under (ii) above
(iv) A copy of the Fees and Charges Report which provides an overview to Service proposals for income generation. (Appendices 3A and 3B)
(v) A copy of the Capital Programme for the next 10 years. (Appendices 4A and 4B)
(vi) A copy of the Budget Simulator Public Consultation Exercise (Appendix 5)
Minutes:
Documents:
· Cabinet report - Budget 2020-21
· Service Cost reductions proposals
· Individual Impact Assessment
· Fees and Charges Report
· Capital Programme
· Budget Simulator Public Consultation Exercise
Adult Services
The Head of Service introduced the proposals by reiterating the Service’s commitment to strengths-based delivery. It was confirmed that the proposals aligned with the priorities for health and care in Vision 2025 and current legislation. The long-term aim is to collaborate with partners to ensure residents are in the right place, prevention of problems occurring or worsening. Self-care will be promoted. Residents’ wishes will be considered alongside available resources and what can be done to bridge any gaps. This is integral to the improvement journey.
Discussion:
· Impact assessments had not all had the impacts completed – these should be completed whether there is a positive or negative impact
· There was a lack of information on the budget overall with discussion limited to savings proposals. The Committee would like greater detail on where money is spent to enable them to assess whether the right savings were being made.
· AS02 – Direct Payments - savings of £300K were proposed but the impact assessment indicates that there will be no impact elsewhere and that consultation was not necessary. It could be considered that there would be an impact on the 3rd sector and they should be consulted. The Head of Service indicated that the proposal was to enable direct payments to be more flexible in how care can be delivered and so be more cost effective. There is a need to make direct payments as administratively attractive as possible. The service works closely with the 3rd sector and it is hoped that micro enterprises will be developed but this could be high risk. The Corporate Director informed the Committee that a threshold unit rate for direct payments had been set at £10.90. It is hoped to move the authority away from this arbitrary threshold and develop a service which will help people source their own care in a more creative way.
· AS07 – the Corporate Director advised that discussion of the following should be confidential due to the commercially sensitive nature of elements of the proposal:
RESOLVED to exclude the public for the following item of business on the grounds that there would be disclosure to them of exempt information under category 3 of The Local Authorities (Access to Information) (Variation) (Wales) Order 2007).
· The Committee was briefed on the proposals
· There was some concern that savings could be made during the financial year if these were dependent on third party involvement
The Committee returned to open session.
· AS09 – Recommissioning/Decommissioning – the narrative could have been clearer in indicating that the proposal relates to changing commissioning practices to reflect person-centred care. The Committee asked how many services were due to be recommissioned in the next year and questioned whether savings would only be generated for part of the year. The Head of Service indicated that there were several different pieces of work ongoing into the next financial year. For example, a number of packages were for meal preparation only and it was considered that this could be delivered more effectively. Officers would be revisiting the strategy regarding domiciliary care rates which may result in fee uplifts and this will shape markets and generate efficiencies. This will be further considered by the Adult Services Working Group in due course. The Corporate Director stated that the proposal was not about stopping services but incentivising the right areas of the market which could lead, for example, to a reduction in spot bed purchases. More emphasis would be on community-based services to enable residents to remain at home.
· AS08 – Strengths based reviews – a request was made for an explanation of strengths-based services. It has been the case that practitioners have made an assumption when carrying out reviews that needs would not have changed. Under a strengths-based approach individual circumstances are reviewed. As a result of services provided, an individual may be more independent. The review would cover what the individual can do, what other people can do to support them and whether there were any gaps in provision. A multi-disciplinary approach is taken which for example, could see Occupational Therapists undertaking reviews to assess whether double handled care can be reduced to single handled care with assistive technology. This is less intrusive for the individual and can free up carers for other areas. The fragility of the domiciliary care market is recognised.
· Members questioned how savings could be quantified given the crossover between technology enabled care and double to single handling, for example. The budget was complex and interrelated and robust programme management was required. Each programme has a lead officer who meet monthly to ensure that links are made between the programmes and double counting does not take place. The proposal relating to double handling had been brought to managers by practitioners as one example of how improvements could be made which also lead to better cost efficiency.
· There are challenges for the Authority in how travel is dealt with. An opportunity exists to demonstrate how well services can be delivered in a rural authority. A rural cost analysis has been completed. Virtual assessments are already in place where appropriate for both the practitioner and resident. Although there was some concern regarding the social isolation of residents, proposals around technology enabled care would not replace personal care.
Children’s Services
A strengths-based approach was also taken in Children’s Services to ensure families are kept together wherever possible with local authority care being a last resort. A restructure has been completed and early intervention has been introduced. There is ongoing work to recruit more foster carers.
Discussion:
· CH03 – Changes in service provision - effect of pump priming– more detail was sought on the ‘various proposals’ totalling £1.226M. This would include the development of children’s homes in Powys and increased foster provision to bring children closer to home.
· The Committee accepted the proposals but were concerned that the Service had a history of not achieving savings. Considering the complexities of acquiring properties, the achievability of these savings was questioned in the next financial year. There would need to be significant investment before savings could be achieved. The Head of Service informed the Committee that an infrastructure was needed within communities to provide placements closer to home and a range of proposals was being considered.
County Councillor J M Williams left the meeting at 11:50
· There were considerable costs in having a child in care. The Service currently relies on provision by the private sector across the UK and a local infrastructure is needed to bring children closer to their homes to enable local links to be maintained and improve the viability of them being able to return home. This is a key part of the strategy.
· The number of Children Looked After (CLA) is reducing due to early intervention
· There were 239 CLA which had reduced from 250
· Members questioned why the numbers remained high as they had been at 160 three years previously. Increasing numbers was a national problem and Members were of the opinion that research should be undertaken into the root cause of the problem to enable it to be addressed on a national basis. The Corporate Director informed the Committee that this was a priority of the First Minister and a piece of work has been commissioned, supported by the WLGA, to understand why there has been an increase in numbers. The Committee asked to be kept informed of the results of this work.
· It was noted that the numbers of CLA had been affected by the CIW Inspection. The service has an aspirational target of 230 CLA by the end of March but the Committee was reminded of the statutory duty to protect children. Prior to the Inspection some children had been left in dangerous situations and were now in care. Legacy issues have to be managed at the same time as new policies and processes are implemented and this will continue in the short term. The new structure focuses on early intervention and prevention. The Edge of Care Service has actively kept 78 children out of care and stepped down 33 children to less costly provision.
· The service is more proactive replacing the previous reactive approach
· It was not possible to compare Adult and Children’s Services as Children’s Services operated under a different regime to and was more heavily regulated
· There were 80 children currently out of county. Some of these were just over the border and some in-house foster carers also lived over the border. This number includes children living with family members.
· The length of time taken to recruit foster carers is now monitored
· The detail of figures contained within CH03 had not been quantified. If there has been a business case, it should be available to the Children’s Services Working Group. The Committee required justification that the capital expenditure will result in the stated savings. The Head of Finance informed Members that a business case was essential before any proposal could be included in the capital programme. Once a strategic outline case is approved, an outline business case is prepared which would give a much greater level of detail. Funds will not be released into the capital programme until the outline business case is approved
· A further issue regarding the capacity of proposed children’s homes going forward was also raised given the introduction of early intervention work
· The Service are committed to achieving the savings identified within the next financial year.
· CH03 is the only impact assessment which notes that consultation with foster carers is required due to proposed changes to the financial offer. There is a move across Wales to harmonise terms for foster carers.
· CH01 - Shared Costs with PTHB for Placements for Children who are Looked After – the Corporate Director indicated that this item was commercially sensitive and may impact on the Authority’s ability to negotiate
RESOLVED to exclude the public for the following item of business on the grounds that there would be disclosure to them of exempt information under category 3 of The Local Authorities (Access to Information) (Variation) (Wales) Order 2007).
· The Committee was briefed on the proposals
The Committee returned to open session
· The Committee had focussed on savings of £2.2M but there was an increase in budget of £5.7M proposed
· There was no justification provided for the increase and no scrutiny of this amount. The Head of Finance advised that the increase met the ongoing costs of current commitments and inflationary pressures
· The Corporate Director noted that there had been a £6M overspend in 2018 when she took up post which reflected part year pressures from 2017. In 2019 a deficit of £2.3M was forecast. There was a much more rigorous process for setting the current budget.
· The Chair reported that the cost of providing Children’s Services was approximately 20-25% higher per child than in comparator authorities and questioned how the Committee could have confidence in the proposed budget. Previous work had not been funded. The right infrastructure was now in place, but existing children are still in the system and need to be funded whilst investing in new preventative services. However, the service was now open and transparent, the numbers of CLA were falling, the number of step- downs was increasing and there was a reduction in numbers on the Child Protection Register. All indicators are going in the right direction and the Head of Service was confident this would continue.
· The Corporate Director and Head of Service were asked if they had been as rigorous as they could be in setting the budget or had an element for contingencies been included. The Corporate Director indicated that all measures were being taken to keep children at home and reduce the cost burden on the authority. Commissioning had not been in place previously but was now in place. Powys had a significantly higher number of step-downs than other authorities. She was confident that the service could deliver what has been stated and mitigate against the unexpected.
· Members remained concerned that the increase to the budget would deflect from the debate and that reporting a net figure could minimise adverse comment. The Head of Finance reported that both sides of the equation would be reported for clarity and transparency.
· Members asked how much of the increase could be attributed to agency staff. This was £1.2M based on the current cohort. The Head of Service was pleased to report that all Team Managers were now permanent members of staff. The solution was to make people want to work for Powys and this will improve as the service improves. Relationships with universities are being broadened to help grow our own social workers. Retention payments are being introduced in some areas. A health care apprenticeship scheme is also being launched.
· £2M had been retained within the current year’s corporate budget to offset the risk inherent in the budget. This will support the current overspend in Children’s Services. It was suggested that the service should have a contingency budget or a reserve to meet unexpected pressures.
Outcomes:
· Committee’s comments would be included in a report to be considered by Cabinet alongside comments by other scrutiny committees
· Further information would be provided on the welsh government work on the numbers of Children Looked After
· A business case for children’s homes would be considered by the Children’s Services Working Group when available
· A report compiled by the Lead in Continuing Health Care will be considered by the Committee or the Adult Services Working Group in due course
· The protocol that arises from the findings of the report to be considered by Committee the Adult Services Working Group
· The protocol to be reviewed 6 months after implementation
Supporting documents: