Issue - items at meetings - Finance Report

Report of Director of Finance (copy attached).

(1)       That the forecast outturn at month 9 for Adult Social Care and NHS Trust Managed S75 Budgets be noted.

(2)       That the agreed budget for Adult Social Care and NHS Trust Managed S75 Budgets for the 2013/14 financial year be noted.

48.1    The Committee considered a report of the Director of Finance which set out the forecast outturn position for the 2012/13 financial year at Month 9 for Adult Social Care and NHS Trust Managed S75 Budgets as reported to Policy & Resources on 14 February 2013.  The report also provided information on the agreed 2013/14 budget for Adult Care & Health and NHS Trust Managed S75 Budgets set by Budget Council on 28 February 2013.   

48.2    The Head of Business Engagement drew attention to paragraph 3.4 which related to NHS controlled S75 Partnership performance - being a projected underspend. More detail was contained in Appendix 1. The Targeted Budget Management reports would be brought to Adult Care & Health Committee roughly quarterly.  Paragraphs 3.5 to 3.8 related to the budget for 2013/14.  A colour pie chart showed the breakdown of net spend across Adult Care & Health.  The largest area was community care (£41,806,000).  Adults Provider was £13,706,000.   S75 community Care was £8,582,000. Commissioning was £5,203,000 and S75 Staffing and other costs £3,968,000.  

48.3    The Head of Business Engagement drew attention to the table on page 24 of the agenda, showing Adult Services - summary breakdown 2013/14 (net budgets).  This included a breakdown of community care in Brighton & Hove and out of area.  65 to 70% of placements were in Brighton & Hove.  Most of the out of area placements were in East and West Sussex.  A budget book would be made available to members within the next month. 

48.4    The Head of Business Engagement stated that she would bring regular monitoring reports to the committee relating to Adult Social Care and Public Health.  She would provide trend information shown against savings agreed by budget council. 

48.5    Councillor Meadows thanked the Head of Business Engagement and welcomed the budget information.  She referred to Appendix 1, page 19 which mentioned a risk of £400,000 against extra care housing.  She asked for more details about the risk.  Councillor Meadows referred to the net reduction in residential client numbers of 6WTE.  She asked if there would be redundancies. 

48.6    Councillor Meadows queried the overspend for under 65’s of £186,000 (page 20) and referred to the high cost of community care out of area (page 24).  She asked what steps were being taken to reduce the cost. 

48.7    The Head of Business Engagement explained that in relation to extra care housing, it was not expected that £400,000 savings could be made this year.  However, it had been possible to cover the shortfall through the savings made against community care and deliver within budget.   The net reduction in residential client places would not impact on staff numbers. 

48.8    The Head of Assessment Services explained that the £186,000 overspend for under 65’s related to people with complex needs.     There were currently a number of placements outside the city and the strategy was to look for alternatives in order to bring these clients back to the city. 

48.9    Councillor Mears thanked officers for the financial information.  She referred to the General Fund budget for 2013/14 agreed at Budget Council on 28 February and queried whether the £400,000 figure had been originally intended for sheltered housing in 2012.

48.10  Councillor Mears referred to the Budget Strategy for Adult Social Care & stated that this needed to be presented as a report to the Committee.    

48.11  Councillor Mears referred to the Section 75 budget and expressed concern that the council had had to pay the shortfall in the past.  With regard to Learning disabilities Councillor Mears asked for a more detailed paper at a future meeting.  

48.12  The Head of Business Engagement explained that the £400,000 had come from reducing residential placements. The savings of £1,640,000 in 2013/14 for Supported Living and Extra Care Housing were in addition to the £400,000.  This did not just relate to extra care housing and included other accommodation options.  She agreed that it might be necessary to give a more detailed briefing on this matter. 

48.13  The Head of Assessment Services stated that the £400,000 was met out the Community Care Budget. 

48.14  Councillor Norman commented that the table on page 24 showing the Summary Budget Breakdown 2013/14 was very useful.  He asked if officers could expand on the Extra Care Steering Group, and on the current position regarding troubled families.      

48.15  The Head of Assessment Services explained that the Steering Group was a joint housing and adult social care officer group. The troubled families work had just commenced and looked at families who cost most to the public purse.  The work would target households where there were issues such as joblessness and anti social behaviour. 

48.16  Councillor Marsh considered that the troubled families work should be extended to families without children.  She asked for an update.  The Head of Assessment Services replied that initially the work was targeted at families with children.  However the government had given local discretion to have other groups included in the regime.  An application had been made to government which related to the Brighton scene.  The government had accepted the application and there would be a three year programme with stages in each year to demonstrate work with families.  There would be part direct grant and part payment by results.  The Chair stated that there would be an interim report submitted to the next Committee on this matter.  

48.17  Councillor Jones stated that he would welcome a report on troubled families.  He hoped that there would be a change of criteria whereby people without children might be considered in the regime.  

48.18  The Head of Assessment Services explained that a targeted approach would address troubled adults. The criterion was people seeking work, a number of incidents of anti social behaviour and problems that were a considerable cost to the public purse.

48.19  Councillor Meadows referred to page 31 relating to the stretch target saving of £500,000 being attached to the community care budget.  She asked for more details.  Councillor Meadows referred to the Joint Commissioning provider arrangements and asked for details of savings and asked how many staff were involved and in what way.  She referred to page 32 in relation to services provided during the day for older people and older people with mental health needs.  Councillor Meadows was concerned that a 2 tier system was being proposed.      

48.20  The Head of Assessment Services explained that the £2.2m savings in relation to the community care budget was the continuation of a strategy adopted this year.  The aim of the stretch target was to further reduce the spend on the budget.  The £2.2m savings included the £500,000.   With regard to the Joint commissioning provider arrangements, 6 or 7 staff were affected.  The changes would be carried out in a way that avoided redundancies.  There was a report on Day Services later on the agenda.

48.21  The Chair stated that there was no intention of having a 2 tier day service system in terms of quality.   Some people would have building based services and others would receive a different type of service. 

48.22  RESOLVED - (1) That the forecast outturn at month 9 for Adult Social Care and NHS Trust Managed S75 Budgets be noted.

(2)       That the agreed budget for Adult Social Care and NHS Trust Managed S75 Budgets for the 2013/14 financial year be noted.