To discuss the Revenue Budget 2012/13 Provisional Spending Targets for Adult Social Care

The agenda item was introduced by the Executive Lead for Adult Social Care and Older People along with Chief Executive of Torbay Care Trust. The Executive Lead for Adults Social Care and Older People outlined to the Board the difficult climate and challenges faced with putting forward this year’s budget proposals.  The proposals have been compiled with a view of protecting the most vulnerable. The Board heard how a reduction in premises, as well as in the volume of services have contributed to the budget proposals which are outlined in the papers, as distributed at Council in December 2011.

In response to questioning the Board heard of Torbay Care Trust confidence in achieving the budget for the coming financial year is greater this year than last year. The Board heard of the challenges and difficulties faced in setting the budget against a background of reductions in government funding and a changing demographic profile within the Bay.

The Board were advised by the Chief Executive of Torbay Care Trust of a number of contingencies which would need to be looked at if the Care Trust was unable to balance the budget. Income generation lines proposed within the report were in line with Council policy. The Board heard how, at present, the Care Trust has a fully committed budget for the coming financial year.

In response to questioning the Board were advised of development items / cost pressures some of which are still in negotiation at the moment.

In response to questioning the Board were advised that there are areas which are grant funded and grants provided are subject to the same scrutiny as the rest of the budget.

The Board were advised that the level of recovery of income is subject to assessment. Details of this are outlined in the budget report issued in December 2011.

In response to questioning the Board heard how the majority of saving proposals had already been implemented / achieved but there were a few that have not. Two areas which had not yet been implemented or achieved involved a restructure of disability day care services and a proposed reduction in community alarms.

The Board heard how the proposals are an extension to the 2011/12 budget and centred on reducing the volume of care packages. In response to questioning the Board heard how consultation processes in relation to the proposals have been undertaken, or in some cases where budget proposals have not yet been implemented the consultation will take place in due course.  In response to questioning the Board heard how both NHS Act 2006 Section 242 duties and the NHS Act 2006 Section 244 duties have been met. The Board heard how some of the decisions in relation to consultation fell to the Health Overview and Scrutiny Board.

The Board were advised of some of the additional options for additional savings in the event of underachievement of proposals which included management of vacancies and in house support services. The Board heard how £500,000 savings had already been achieved in reducing non-front line services to include HR and training. The Board heard how the Trust employs around 1800 members of staff and that redeployment opportunities were relatively high when staff are displaced. The Board heard how care must be taken not to make short term changes which end up resulting in larger longer term problems.

In response to questioning the Board heard how the proposals outlined within the documentation were discussed at a number of various boards (such as group meetings and the Senior Leadership Board) including officers and members of the voluntary sector, service users and members of the public. Proposals and ideas were put forward / explored during these discussions in an attempt to try and minimise reductions or cuts. The Board were assured that no reductions had been made without thought and consideration of who the cut or reduction may impact upon and how.

In response to questioning the Board heard how the pressures faced by the Care Trust were not all new however the climate was different now in relation to the reduction in public sector funding.

In response to questioning the Board heard of a pro-active approach to referrals where alternative options for support and care were explored including whether there are members of family who can provide or would be best placed to support, whether an individual has the right access to benefits (as per their entitlement). The Board heard of the work of the FAB team, who listen to the needs of the individual, which often does not involve access to public funded services more signposting to information, it was acknowledged that more work could possibly be done in this area.

In response to questioning the Board heard of the minefield of pressures faced when setting the budget proposals which were described. The Board were advised that the Annual Strategic Assessment (ASA) is in draft format until approved by full council.

The Board questioned whether an earlier Health Overview and Scrutiny meeting needed to be arranged in view of the public consultation and debate and decision on whether the proposals constituted a substantial variation.  It was noted that the HOSC should meet earlier than March.

The Board questioned the reduction in client numbers and were advised of reducing pattern of usage of residential care settings, in addition to this central government changes also looked promising with regards to developments in stroke rehabilitation. The Board heard how the demand for day care services had begun to fall away and that it was now felt service users preferred to look alternative ways on this to ensure individual needs and value for money are achieved.

The Board questioned whether a longer term financial planning approach would prove useful, if adopted or recommended in budget setting process. In response to this the Board heard this approach to budget setting had in some circumstances already been adopted.

In response to questioning the Board heard how a potential closure of care home was likely to be put forward to full council for debate and decision, but the Care Trust were not in a position to further comment on this at the present time. 

Resolved:

1)    The board raised their concerns with the Mayor on the service achieving the budget.