To scrutinise the Draft 2022- 23 Budget.
a) Adult Services – 2pm to 3.30pm
b) Childrens Services – 3.30pm to 5pm
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(Attached)
(ii) A copy of the Mid Term Financial Strategy and Finance Resource Model (Appendices A andB)
(iii) A copy of Services' cost reduction proposals (AppendixC)
(iv) A copy of the Fees and Charges Report which provides an overview to Service proposals for income generation. (Appendices D and E)
(v) A copy of the Capital Strategy and the Treasury Management Strategy. (Appendix F)
(vi) A copy of the Reserves Policy (AppendixG)
(vii) A copy of the Budget Survey (Appendix H)
(viii) Individual Impact Assessments relating to the proposals under (iii) above (Appendix I – IA 22 -31 Childrens Services, IA 32 – 44 Adult Services)
(ix) Council wide Impact Assessment (Appendix J)
Minutes:
Documents:
· Draft Medium Term Financial Strategy, Draft Budget and Capital Programme
· Finance Resource Model
· Cost Reductions
· Register of Fees and Charges
· Register of Fees and Charges – report
· Capital Strategy and Treasury Management Strategy
· Reserves Policy
· Budget Survey – December 2021
· Service Impact Assessments
· Corporate Impact Assessment
Discussion:
Adult Services
Pressures
· The Head of Adult Services gave a presentation on the main pressures and proposed cost reductions
· The Service had been in business continuity since March 2020
· Demand for care was outstripping supply
· The Service was on target to deliver the majority of savings identified in the last budget
· The efficiencies expected by the Service represent 43% of the total Council efficiencies
· The biggest risk facing the Service was the workforce – there was uncertainty as to how long the pandemic would last. The Service has been operating in a crisis for two years and this is beginning to take its toll. The Powys Health Academy would be key to building resilience in the longer term.
· There had been excess deaths reported during the pandemic and it was questioned if this had been factored into the budget. This was difficult to model. Information from Daffodil, NHS and the Welsh Government had been used. The tail of demand will be felt by social care for a significant period after health services with the increase in demand for services expected to continue for some time.
· The budget reserve to address increased demand will be held corporately and only accessed if additional pressures materialise. Last year, less was drawn down than predicted as demand had been managed. Additional care requirements of 224 hours per week had been needed which would have cost over £1M. However, due to rightsizing, TEC etc the actual pressure was £786K.
· The Portfolio Holder reported that projects had been in hand to transform the service prior to the pandemic and this had helped manage pressures
· The Committee questioned the additional monies to fund legal support rather than buy in services and where the associated savings were recorded. At present there is no dedicated solicitor in the legal team and service is bought in as required. The funding will provide a dedicated solicitor in the Legal Team. The requirement for legal support is accelerating due to changes in legislation particularly around the change from Deprivation of Liberties.
· Capital Receipts had been used for transformation projects and it could be anticipated that savings would accrue from those projects. The Head of Service indicated that the main driver was to do the right thing in supporting residents and staff but that efficiencies may also be realised. Some staffing needs to be included within the mainstream budget and is shown as a pressure.
· The need for additional funding for a hospital discharge team was questioned as that work was currently being undertaken. The funding identified would be for a dedicated Team Manager and Patient Flow Co-ordinator. To date this has been managed within the community teams. but this is not sustainable. The Hospital Social Work Team needs management oversight. There is increased demand in this area and a dedicated resource is needed to deal with the pressure and will enable the service to move away from crisis management to a more sustainable and resilient system.
Efficiencies:
· The Chair asked for detail regarding the return on investment of match funding to Intermediate Care Funding. The Portfolio Holder indicated that ICF did not require match funding but was in place to support integrated working. A new Regional Intermediate Fund is to be put in place which will require 30% match funding. ICF has supported innovation in the service – projects have been identified through the ‘Dragon’s Den’ type approach which have developed transformation. New practices have arisen from successful pilot projects. Some certainty was now required in the base budget to enable those successful projects to continue. The Chair suggested that innovation and funding should be a topic for inclusion on the forward work programme.
· It was noted that more quality reviews were to be undertaken and Members questioned whether this would lead to more people being identified as needing more care. The strengths-based approach and moving with dignity efficiencies had been identified based on savings which have already been achieved. The risk status reflects the capacity to undertake the reviews due to increased demand at the front door and staff absence. Some funding has been identified to enable additional resource to reduce the backlog. The question of more people being identified for greater care is not out of the question but the service is not predicting that this will happen. More opportunities for right sizing might also be identified.
· Direct Payments enable a resident to have more choice, but the process is not straight forward and some issues were identified recently. The Chair asked how the service can ensure people were paid promptly and how the market had been analysed to ensure there were sufficient micro enterprises starting up to meet demand. The Head of Commissioning noted that the scheme was to support independence. The number of double handed care calls had been reduced from 40% to less than 30%. Direct Payments had increased over recent years but had now plateaued which is attributable to the general situation in the are market. There are new providers but there are also some leaving. The recent challenges in paying Personal Assistants was no more than a temporary issue and is being addressed with People Plus. A significant amount of work has been undertaken in respect of developing micro enterprises. There have been ongoing challenges in providing domiciliary care and strategic plans, including the Powys Pledge, have been developed. Community Catalysts have proved particularly successful. The risk rating for this efficiency was ‘green’ and the Head of Commissioning confirmed he was comfortable with this status. Direct Payments allowed a resident to have more independence, more control and was the right thing to do.
· Officers were asked if there was any evidence from service users that reducing double handed care was successful. It was considered to be more dignified to have fewer people in a resident’s home and there has been overwhelming support for the initiative.
· Day Centres have been closed throughout the pandemic and the savings accruing from those closures was questioned – there have been few savings as the buildings remain and the staff redeployed to support increase in demand elsewhere. There has also been a loss of income. A Member asked if the affect of the closures on service users had been assessed – service users have been assisted in different ways. An impact assessment had not been prepared as the closure had not been a policy decision but an instruction from the Welsh Government. The issue would be included in the forward work programme for monitoring
· Extra Care Housing – some efficiencies had been envisaged but theses projects would not be coming on-line until the 2023/24
Children’s Services
The Portfolio Holder identified that one of the highest risks was the resilience and capacity of the workforce. The service had been on an improvement journey for three years and was still on that journey.
The Head of Service noted that grant funding had benefited the service in responding to the demand and also recognised the crisis within the workforce.
Pressures
· The Committee asked how the projected increase in demand could be predicted given that the number of Children Looked After (CLA) was falling. The Head of Service reported that the number of CLA was falling year on year despite increasing demand at the front door. This shows that new practices regarding early intervention are working well. However, the increase at the front door had risen 85% in the year to December 2021. Child protection intervention had increased by 110% in the same period. There had been no increase in the number of social workers and the increased demand was being managed within existing staffing arrangements. At some point these pressures will translate into an increase in CLA. The additional pressure was not attributable to a predicted increase in the number of children in the County generally.
· The Head of Service was asked how additional monies for increased demand would be accounted for if pressures did not materialize. Further information would be provided.
· Members asked when savings would be realised following the costs of implementing the Grown Your Own initiative. The programme has been in existence for two years with the first social workers qualifying later this year. As they qualify, agency social workers will be released. However, additional support will be required for newly qualified social workers. Its is proposed to introduce a dedicated Project Officer to manage placements and administrative arrangements. In addition, there are course fees to pay and backfill arrangements to be put in place for those studying.
· The additional funding for Senior Managers On Call arrangements was questioned – this was standard practice and in line with single status requirements
· A further financial pressure is in relation to Special Guardianship Orders and members asked if there would be a reduction in the fostering budget. There needs to be an alignment with Kinship Orders. There may be savings across the wider service but there is an expectation by the Family Court that this will occur. In the longer term it is hoped it will further reduce the number of CLA which will lead to a need for fewer Independent Reviewing Officers. A small team may be required to support the change.
· There was a role for a Senior Commissioning Manager – this was not a new post but had been funded by grant monies to date and should now be included in the mainstream budget.
· Additional funding was required for complex adoptions. This was a statutory duty and there was an insufficient supply of placements within the county.
· The Committee were aware that there were costs associated with legacy issues arising from the Inspection. The Chair asked that further detail on this issue be provided to a future meeting to enable an assessment to be undertaking regarding how those cases were moving through the system.
Efficiencies
· Many of the proposals have a red RAG status. The Committee noted that there were a significant number of efficiencies and that historically, these had not always been achieved which had the potential to put the Council’s budget at risk. Savings will always carry an element of risk and there remains considerable uncertainty around the pandemic. However, efficiencies from the previous year had been achieved. The budget process had improved significantly and plans were thought to be robust.
· There were proposals to increase support to foster carers to support their own children. A lack of support in this area can lead to placement breakdown and an improvement in support will improve the resilience of foster carers and the ability to recruit.
Outcomes:
· Issues raised will be incorporated within a scrutiny report to Cabinet and Council
Supporting documents: