Invitees:

Cllr Phil White, Cabinet Member – Social Services and Early Help;

Susan Cooper, Corporate Director – Social Services and Wellbeing;
Jackie Davies, Head of Adult Social Care;
Laura Kinsey, Head of Children's Social Care

The Scrutiny Officer introduced a report, the purpose of which was to present the draft Medium Term Financial Strategy (MTFS) 2018-19 to 2021-22, which set out the spending priorities of the Council, key investment objectives and budget areas targeted for necessary savings.  It also included a financial forecast for 2018-22 and a detailed draft revenue budget for 2018-19.

The Committee questioned the reason why no efficiency savings had been identified in the Social Services and Wellbeing Directorate.  The Corporate Director Social Services and Wellbeing informed the Committee that £330k of efficiency savings had been identified in 2 areas of the Directorate but the Directorate had an additional budget pressure of £2.2m carried over from 2017-2018 and hence why there were no further savings put forward for 2018-2019..  The Committee expressed concerns regarding the £2m savings proposals that were not realised and questioned the reasons for this.  The Corporate Director Social Services and Wellbeing stated that savings on prevention and wellbeing and children’s residential care had been put forward, however these savings had been very difficult to realise.  Prevention and wellbeing services relate to local area co-ordination, advice and assistance services and telecare, where it had been difficult to deliver savings.  There had instead, been cost avoidance where there had been a lessening in demand for these services.  The savings of £414k which had been achieved in children’s residential care were attributed to the remodeling of 2 children’s homes in the Borough and the development of therapeutic services.  She stated that the proposals had been the subject of extensive consultation and a report would be presented to Cabinet in February 2018 which would also include proposals for the development of the foster care service. 

The Committee questioned the impact of changes in the delivery of Learning Disability services to service users and on the budget.  The Corporate Director Social Services and Wellbeing informed the Committee that the changes to Learning Disability services had been successful, which had seen service users being brought into staffed houses.  The progression model which had been put in place had seen service users move to a greater level of independence with the support of staff.  The Committee also questioned the financial impact of the new model of service delivery in Learning Disability Services.  The Finance Manager informed the Committee that savings of over £200k had been made in Learning Disability services in the last 3 years. 

The Committee questioned whether there is flexibility in the charges levied and whether there is a cap on the extra care scheme.  The Corporate Director Social Services and Wellbeing informed the Committee that people living in extra care are eligible to claim benefit, those in receipt of domiciliary care are subject to a cap of £70 per week which is set by the Welsh Government.  She also informed the Committee that the amount of capital an individual can hold before being charged is to increase. 

The Committee referred to the budgetary pressures on the Communities Directorate which has had to make savings on maintaining the highway network and pavements, and questioned the impact on the Social Services and Wellbeing Directorate, whereby individuals who sustain injuries as a result of those cuts in services may need health care.  The Corporate Director Social Services and Wellbeing commented that the Communities Directorate provides visible services and as a member of the Corporate Management Board has to consider matters corporately.  She stated that her Directorate has a programme on falls prevention and provides assessments to prevent people from falling.  She also stated that there is a model of support in the community for adults in order to build up resilience.  An information hub had been developed where people can access information to gain support.  She stated that 60% of people who go through reablement no longer require further support.  The Directorate was also working with the Housing Department on developing new models of service. 

The Committee asked what could be done in order to share the burden and to ease budgetary pressures.  The Finance Manager stated that the Welsh Government could increase the cap in order to increase income.  The Corporate Director Social Services and Wellbeing stated that the Council could not charge more, despite the factthat some service users may be in a position to pay in excess of the cap of £70 per week.  The authority had attempted to sell residential care places to neighbouring authorities, but there had been a lack of take up at establishments such as Glyn Cynffig.  She informed the Committee that every single area of the service was being looked at, in order to explore the possibility of providing services differently.  Some work had already been done on the alternative delivery of services at Glyn Cynffig and would be presented to a future meeting of Cabinet and to Scrutiny.  Some services under the auspices of the Directorate were already subject to alternative delivery models, with Halo managing healthy living services as a social enterprise, Halo.  While Awen who manage arts and cultural facilities were now under the umbrella of the Directorate.  The Corporate Director Social Services and Wellbeing commented that £12m had been taken out of the Directorate’s budget in the last 3 years. 

The Committee recognised that Halo have a commercial background and asked whether the Directorate could take on a more commercial role, but still recognising social values.  The Corporate Director Social Services and Wellbeing commented that following the remodeling of the home care service, the independent sector now provides 70% of homecare in the Borough. 

The Committee questioned whether ABMU send referrals to Glyn Gynffig.  The Corporate Director Social Services and Wellbeing stated that a number of people have dual diagnosis and complex mental health needs.  She stated that the facilities at Glyn Cynffig were now very dated and opportunities were being explored to remodel the facility. 

The Committee questioned the numbers of people who had taken up extra care within residential accommodation.  The Corporate Director Social Services and Wellbeing informed the Committee that a number of people in the Council run residential care homes now require nursing care but some assessments had indicated that there were a small number of people who would be able to manage the extra care facility whilst others would move into the residential provision within the extra care scheme.  She also stated she would provide the Committee with the numbers of people in extra care. 

The Committee questioned the support available to former armed service veterans.  The Corporate Director Social Services and Wellbeing informed the Committee that Halo offer free swimming opportunities to former armed service veterans.  The ARC offers opportunities to support residents and there is social work support along with that of housing to veterans. 

The Committee questioned the support available to assist people in their communities as a result of bus services.  She stated that the Directorate had been successful in gaining ICF monies to purchase 3 vehicles to be support lonely and isolated people within their own community.  She also informed the Committee that people with a learning disability had been supported to travel by bus through the use of I pads to plan their journeys. 

The Committee referred to the funding for Communities First ceasing in 2018 and questioned the impact it would have on the County Borough.  The Corporate Director Social Services and Wellbeing informed the Committee that the Chief Executive is currently undertaking a piece of work to manage changes across the Council as a result of the loss of grant funding. 

The Committee questioned whether there was scope for Member representation on the proposed Task and Finish Group to look at community transport.  The Corporate Director Social Services and Wellbeing commented that she would look into this.

The Committee questioned the cost of paying for agency staff and overtime payments to cover sickness absence for care staff.  The Corporate Director Social Services and Wellbeing commented that staff sickness has to be covered in the service and that sickness absence in the Directorate is showing a sustained improvement and is 13% less than for the same period last year.  She informed the Committee that she together with the two Heads of Service meets regularly with HR and there had been a concerted effort by managers to complete Return to Work interviews with staff.  Some costings had been made of the cost of sickness.  The Finance Manager stated that calculations could be made of the cost of sickness. 

The Committee asked whether the budget reduction proposal SSW2 related to Direct Payments.  The Corporate Director Social Services and Wellbeing confirmed that the budget reduction proposals is linked to Direct Payments and also confirmed the Direct Payments strategy had been updated.  She stated that an alternative delivery model was being looked at.  The status was red due to it being under development.  The Act allowed for services to be purchased from the authority. 

The Committee questioned the reason for budget reduction proposal ASC 18 on the development of extra care housing of £330k being shown as amber.  The Finance Manager informed the Committee that this proposal was still being costed and would not come into effect until September 2018, but expected the budget reduction proposal to be made.  The Corporate Director Social Services and Wellbeing informed the Committee that meetings had been held with staff and the families of residents on the proposals for the development of extra care facilities.  She stated that the next step in the process is for HR to meet with staff to determine which facility they would like to work. 

The Committee questioned the reason for the amber status of HL2 – Review of Healthy Living Partnership Contract.  The Finance Manager stated that the budget reduction proposal would be met, but the £20k had yet to be identified.

The Committee thanked the invitees for their contribution.

Conclusions        

In relation to the proposed cuts to transport services, Members voiced concerns of the possible effect this would have on service users’ independence and note the ongoing work of the Regional Partnership Board in securing funding for additional vehicles.  Following on from this, Members recommend that the work of the mentioned task and finish group include the Council’s Transport Unit and Scrutiny Members.           

In relation to the Directorate’s approach to offering services and placements to other local authorities and the independent sector, the Committee recommend that the Directorate take more of a commercial approach to ensure they exploit their assets and resources.

With reference to Sickness Absence, Members recommend that Corporate analysis be undertaken into the associated costs to absence,  to provide an actual figure to which can be related to as a budgetary pressure, specifically in the case of posts that require replacements.

Due to the issues in achieving income generation due to the Welsh Government cap of £70 per week for non-residential care, the Committee recommend that Cabinet lobby Welsh Government to consider the possibility of introducing a means tested cap that takes into account people who are able to pay supplementary monies.

Additional Information

Members requested information on the amount of people who have taken up the Extra Care Scheme.