Agenda item

The Cabinet Member(s) will update the Panel on any relevant issues. Panel members may ask questions on the update provided.

The Cabinet Member for Adult Services, Councillor Alison Born addressed the Panel, a summary of her update is set out below and will be attached as an online appendix to these minutes.

Adult Social Care Performance at end of December 2023

The number of people with long-term services funded by Adult Social Care (ASC) at the end of December was 1,818.  This was a reduction of 53 on the previous figure of 1,872 because there were more people on interim funding at that time. Those individuals are likely to become ASC funded once their interim funding comes to an end.

601 carers were identified as receiving support from services that are funded wholly or in part by Adult Social Care. This shows a significant increase from 406 carers reported previously as we are now including people supported through the carers centre in our figures.

Occupational Therapy assessments continue to be a focus of high demand however through robust waiting list management the numbers waiting has reduced from 247 people waiting to 194 people the lowest figure for 18 months.  All referrals are risk rated and prioritised accordingly and people waiting have a point of contact should their needs become more urgent.

Finance

The ASC savings target for 23/24 was £5.45m, all of which has been achieved apart from a proportion of the savings earmarked for the LD pool where savings have been contingent on a review process that we continue to work through. The actions taken to reduce expenditure since Q2 have improved the budget position for Adult Social Care. We will be making some use of reserves and are now forecasting an overspend of £1.389m at year end.

This year’s budget setting has been extremely challenging because funding for Council’s falls far short of what is required to meet needs. However, both adults and children’s services are receiving a net investment in revenue budgets in 2024/5 to reflect cost pressures and rising demand; together with significant capital investment that will enable more services to be provided within the local area.

Since the January meeting, additional short term funding has been identified to enable a full review of commissioned services to inform any proposed reductions to funding for third sector provision. We are aware of the government’s recent announcement of an additional £500m funding for social care, but no further information has been forthcoming so we do not know what impact this may have on budgets within Bath and North East Somerset.

Workforce

We are not recruiting new staff to the three care homes and the 5 extra care facilities while we await the outcome of the consultation on the three care homes. This is to ensure that we have roles for all our staff if the decision should be taken to close the remaining 10 beds at Charlton House.

We continue to need more Occupational Therapists and have just begun an Occupational Therapy apprenticeship to help grow our own staff.

ASC Provider Services Update

United Care B&NES Home Care service (UCB) was developed in 2021/22 due to the lack of capacity in the Domiciliary care market and the high number of people delayed in hospital.

However, since 2022 the local home care market has changed, there is more provision available now and the providers are in competition for work.

There are 18 people currently using the UCB and the pilot which is due to end in June is being reviewed. It is unlikely to continue as both the NHS and the Council are able to meet demand for home care through the independent sector. 

Councillor Liz Hardman said that it was good that a full review of commissioned services was due to take place and would welcome the Panel receiving further information as it progresses. She said that this was important as they provide some of our statutory services.

She also referred to the Community & Wellbeing Hub and its current funding status until the end of March 2025. She asked who would be involved in the discussion over its future, strongly suggested that representatives from 3SG should be involved and said that adequate timing must be given so that those involved are aware of the future plans.

Councillor Born replied that the review would take place over the next year and had always been planned ahead of the recent budget decisions. She stated the Council has every intention to work with the third sector on these upcoming proposals.

The Director of Adult Social Care added that the Council needs to maintain its Care Act compliance and will work with the third sector to ensure that. She added that the Council as a whole does not have the same amount of funds in place as previous years and said that savings would still need to be made to the budget for commissioned services, but they were looking to lessen it as much as possible.

She explained that since the January meeting they had managed to reduce the proposed savings from £802k to £400k and would be working with partners to consider what options can be pursued. She added that there is no intention for this to be a ‘cliff edge’ saving.

Kevin Burnett asked if the lack of Occupational Therapists was having any impact on hospital discharge figures.

The Director of Adult Social Care replied that the B&NES right to reside figures were the best in the BSW footprint and were not affected by delays to Occupational Health Assessments. She added that the main source of delay was around equipment, that a plan is in place with HCRG and that numbers are reducing.

The Assistant Director – Operations added that the Occupational Therapy apprenticeship programme should enable an increase in staffing.

Kevin Burnett referred to the United Care B&NES Home Care service and asked why had the market changed and is it a premature decision to end the pilot.

The Director of Adult Social Care replied that the commissioning market had changed following the Covid pandemic and that there were now a range of small and large providers that were more person centred. She added that the pilot had worked really well for the time that it has been in place.

Councillor Ruth Malloy asked how many placements were available for the Occupational Therapy apprenticeships, how long would the course be and would it be aimed at post A-Level students.

The Assistant Director – Operations replied that they were about to advertise for three placements and that this would be done in partnership with the University of the West of England. She said that they would in the first instance be offered to any existing Occupational Therapy Assistants who were looking to progress their career.

She added that it would be a three year course and would combine a mixture of learning on sites and studying at the university.

Councillor Joanna Wright said that she was pleased to hear that following the budget discussion at the January Panel that talks with the third sector were ongoing and stated that this should have happened a lot earlier.

The Director of Adult Social Care replied that a strategic review of the commissioned services had always been planned to take place during 2024 and that the budget proposals had been made because of the low Local Government Settlement that had been received. She said that the Council did not want to be in this position, but had to take steps to mitigate the situation that it is in.

Kate Morton, CEO, Bath Mind addressed the Panel and said that they had no knowledge of any proposed cuts until around 15^th December 2023 and had therefore been hit quite hard by the proposed funding arrangements.

Becky Brooks, Director, 3SG addressed the Panel and said in terms of future work that any potential new contracts should be in place by September 2024 and that the third sector need to be involved in these ongoing discussions.

Councillor Joanna Wright asked for confirmation that nobody would be removed from their individually commissioned beds.

The Director of Adult Social Care replied that any change in provision would follow on from an individual having had a Care Act Assessment.

The Assistant Director – Operations added that nobody would be forced to move from their existing provision and a decision would not be taken purely in relation to costs.

Councillor Wright commented that she was concerned over the rising costs associated with temporary accommodation and said that money should not be spent on using hotels as a solution.

Councillor Alison Born replied that this issue was not directly within her remit, but was aware that new facilities for this were due to be opening soon within B&NES.

The Chair suggested that the Panel received an update on their previous homelessness report at a future meeting.

She thanked the Cabinet Member on behalf of the Panel for her update.