Agenda for Adult Social Care & Housing Overview & Scrutiny Committee on Thursday, 21st January, 2010, 3.00pm
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Agenda and minutes
Venue: Banqueting Room, Hove Town Hall. View directions
Contact: Giles Rossington, Senior Scrutiny Officer
39A. Declarations of Substitutes
39.1 Councillor Brian Oxley announced that he was attending as substitute for Councillor Geoff Wells; Councillor Bill Randall announced that he was attending as substitute for Councillor Georgia Wrighton.
39B. Declarations of Interest
39.2 Councillor Randall declared a personal interest due to his involvement with the Local Delivery Vehicle.
39C. Declarations of Party Whip
39.3 There were none.
39D. Exclusion of Press and Public
39.4 In accordance with section 100A(4) of the Local Government Act 1972, it was considered whether the press and public should be excluded from the meeting during the consideration of any items contained in the agenda, having regard to the nature of the business to be transacted and the nature of the proceedings and the likelihood as to whether, if members of the press and public were present, there would be disclosure to them of confidential or exempt information as defined in section 100I (1) of the said Act.
39.5 RESOLVED – That the press and public be not excluded from the meeting.
Report of the Director of Strategy and Governance.
40.1 Councillor Ken Norman, Cabinet Member for Adult Social Care and Health, introduced the Adult Social Care (ASC) section of this item. Councillor Maria Caulfield, Cabinet Member for Housing, introduced the sections relating to the Housing Revenue Account (HRA), to Housing Strategy and Supporting People (SP), and to Learning Disabilities (LD).
40.2 In response to a query about savings identified in terms of the LD budget, Councillor Caulfield told members that the healthcare element of care for some learning disabled people was chargeable to the local Primary Care Trust (PCT), but had formerly not been pursued by the council. This money was now being collected, with the result that there were considerable extra funds available to the service, facilitating a reduction in the council’s LD budget allocation.
40.3 In answer to questions relating to savings to be made via the ‘personalisation’ of ASC (and to a more limited degree the introduction of personalisation and personal budgets to LD services), Councillors Norman and Caulfield informed members that national research offered robust evidence that significant savings were possible via the roll-out of personal budgeting, and that these savings should grow as the roll-out progressed. Joy Hollister, Director of Adult Social Care and Housing, added that Brighton & Hove was in a fortunate position, having not been one of the earliest adopters of personal budgets, as we were able to learn from both the good and bad practice of ‘pilot’ authorities. There was strong evidence that, by following the best emerging practice (particularly in terms of best practice resource allocation systems), personalisation could deliver significant savings.
40.4 In response to a question about negotiations with the Sussex Partnership NHS Foundation Trust (SPFT) over the council’s commissioning of their services, members were told that discussions had been very positive, with the trust recognising that the council’s 0% uplift in funding was in fact generous given the national financial situation (all the more so because the council had agreed extra funding to reflect demographic changes in the city which would result in extra work for SPFT).
40.5 Asked to explain how personalisation might deliver savings, Joy Hollister referred to the example of assessing people’s needs. Formerly, a great deal of staff time and resources might have been spent on professional assessment of a client’s needs, even in situations where that client’s support requirements were minimal. With personalisation, it should, in many instances, be possible for clients to assess their own support requirements (with a degree of input from professionals – termed ‘co-production’), leading to a very significant reduction in the costs of assessment.
40.6 In response to questions about the anticipated re-design of day services and possible cost savings and risks involved in this process, Councillor Norman told members that day service provision would be the subject of a forth-coming public consultation, and no decisions in regard to these services could be made until the results of this consultation were analysed. Joy Hollister noted that council-provided day services were currently delivered at a very high unit cost, as occupancy rates were typically very poor. In contrast, some city day services provided by the 3rd sector operated at a much lower unit cost as these services were full or over-subscribed. There was therefore a very clear argument for favouring these cost-effective services over services which provided poor value for money, and the council was planning accordingly. However, some council day services were of such a specialist nature (e.g. offering significant therapeutic benefits to attendees) that it was not considered appropriate to consider their replacement with mainstream 3rd sector-provided services.
40.7 In response to questions about home care, Joy Hollister told members that the council had re-designed its services in response to the re-ablement agenda, with mainstream home care now commissioned from the independent sector, allowing the council’s in-house home care team to be re-deployed in the specialist task of delivering re-ablement care. This was the best possible use of resources, given that it would simply not be possible within existing budget constraints for the council to deliver its re-ablement commitments and its mainstream home care commitments via the use of in-house staff. Whilst independent sector care providers are cheaper than in-house provision, all providers used by the council are rated as either ‘good’ or ‘excellent’.
40.8 In answer to a question about anticipated increases in client contributions to care costs, Joy Hollister explained that this related to quicker financial assessment of clients, meaning that clients who were required to self-fund their care could be billed more promptly (clients may not be charged for care until their finances have been assessed, nor can charges be back-dated).
40.9 In response to questions about supported housing, Councillor Caulfield agreed that more supported housing was needed in the city, but stressed that this was difficult to achieve in the current financial climate, with little or no capital funding available. However, the council was exploring alternative measures, including looking at ‘moving on’ supported housing clients who could be returned to general needs housing, encouraging independent sector providers to take a greater interest in this sector, and investigating the possible use of undeveloped housing land for future developments.
40.10 Councillor Caulfield also told members that the council was committed to working with clients to ensure that they accessed all the benefits to which they were entitled. This is a priority for Housing Management, and pilot schemes around the city have proved extremely successful. The Welfare Rights team will seek to train other council teams in maximising benefit take-up and the council is also working closely on this issue with the Department of Work and Pensions and with the MacMillan cancer charity (i.e. on encouraging people with cancer to access the benefits to which they are entitled). Members noted that there might be a case for increasing resources here, as the cost benefits of maximising benefit uptake are likely to far outweigh any extra costs to the council.
40.11 In response to questions regarding the ASC and housing workforce, members were told that there were no plans for redundancies in housing or LD services. In ASC there may be some redundancies, although the figures quoted in the budget strategy report represent a worse case scenario and the council will endeavour to minimise the negative impact of essential workforce re-organisation. There is no intention to make compulsory redundancies. If staff cuts are made, it is likely that they will be focused on day services and on the home care team.
40.12 Asked what percentage of the £1 million allocated to possible redundancy payments across the council had been ear-marked for ASC, Joy Hollister told members that she did not have the figures to hand but would endeavour to pass them on.
40.13 In response to queries regarding the Local Delivery Vehicle (LDV), Councillor Caulfield told members that there had been thorough consultation with tenants over this issue (particularly via Housing Management Consultative Committee – HMCC), and the consensus was that the council should continue to actively pursue LDV options while the original LDV bid was being considered by the Government. The council faced stringent penalties if it failed to meet Decent Homes standards, and there was therefore still considerable value in pursuing LDV options, particularly as recent developments in financial markets might mean that the returns on the LDV could be higher than initially assumed (original financial projections were made at the nadir of the financial crisis and might prove over-cautious should markets improve). More funding (in the form of a loan from general reserves) will be required to facilitate re-modelling of the LDV finances, but this money will be repaid once the LDV is operational.
40.14 In reply to members’ questions regarding the future of the Adult Social Care and Housing Directorate, members were told that this was a question which should be addressed to the council’s Chief Executive as no one present was in a position to provide a definitive answer.
40.15 The Chair thanked the officers and members who had answered questions and expressed her good wishes for Joy Hollister in her new post with the City of London.
Items to go forward to Cabinet or the relevant Cabinet Member Meeting
To note that comments will be forwarded to 26 January Overview and Scrutiny Commission and to 11 February Cabinet.
41.1 There were none.