Agenda item

To consider a joint report of the Cabinet Member for Health & Adult Social Care.

The report outlines our strategic approach in responding to the review of the medium-term financial plan. This report should be read in conjunction with the MTFP update report (both parts A and B) presented to Cabinet meeting on 19 September 2023.

The appendix to the report outlines the budget proposals being considered by the Cabinet to address financial and demand challenges, enable longer term transformation, and ensure the delivery of shared strategic partnership ambitions.

The Scrutiny Committee is recommended to comment on the report and the proposals presented within that are relevant to the Committee’s remit.

Officer Contact: Gill Lawton on 0161 474 3686 or email: gill.lawton@stockport.gov.uk

The Cabinet Member for Health & Adult Social Care submitted a report (copies of which had been circulated) outlining the strategic approach in responding to the review of the medium-term financial plan. The report should be read in conjunction with the MTFP update report (both parts A and B) presented to Cabinet meeting on 19 September 2023.

The appendix to the report outlined the budget proposals being considered by the Cabinet to address financial and demand challenges, enable longer term transformation, and ensure the delivery of shared strategic partnership ambitions.

The Cabinet Member for Health & Adult Social Care (Councillor Keith Holloway) attended the meeting to respond to questions from the Scrutiny Committee.

The following comments were made/issues raised:-

·         It was queried whether there was an explanation to the statement that Stockport had the third highest number of residential placements in Greater Manchester.

·         In response, it was commented that one factor related to the higher proportion of older people than most boroughs within Greater Manchester and there was further work through the early intervention agenda to support people to be more independent at home.

·         In response to a question regarding the anticipated impact of the removal of two support work posts within Adult Social Care Specialist Services, it was stated that the posts had been vacant for some time and felt that the removal of the posts would not have a significant impact on the delivery of services.

·         Additional information was requested in relation to the proposal around managing the External Care Markets.

·         In response, it was commented that following the fair cost of care exercise around market sustainability there was ongoing work to maintain the relationship with the external provider market by understanding the external pressures around staffing and higher costs of delivering care, and the savings would be achieved through the removal of the inefficiencies within the management of fees including by paying gross and removing the third party top up.

·         Clarification was requested in relation to how the relevant savings would be achieved by paying gross as opposed to net.

·         In response, it was stated that there was a duty to financially assess individuals alongside a national criteria and the previous practice was for the council and individual to pay their respective proportions directly to the care home, however best practice was to pay the upfront costs to the care home and for the council to retrieve the costs from the individual. It was noted that this resulted in a number of advantages for providers including a greater cashflow and stability and financial savings for the council through the removal of the debt recovery element of the provider costs and subsequent reduced fee uplift.

·         It was queried whether the proposal would impact on the council’s debt recovery costs.

·         In response, it was stated that a programme of transformation work was underway to ensure that the workflows around debt management and recovery was appropriate which included staffing and system solutions.

·         Members commented on the benefits of the Community Led Support Model and queried the support available to carers.

·         In response, it was stated that Signpost for Carers provided carers groups, support and counselling and the commission from the council had been extended to enable the organisation to support more carers assessments and develop a Carers Partnership Board and Carers Strategy which would be brough to Committee for consideration. 

·         Information was requested in relation to Technology Enabled Care and how this would result in a financial saving.

·         In response, it was commented that some parts of an individuals care could be managed in a different way and supported by the use of technology. It was noted that there was technology with the capability to oversee and monitor someone’s health, welfare, falls and medication and trials around the use technology to complete welfare checks virtually were being piloted. However, it was appreciated that Technology Enabled Care was not suitable or viable for a number of individuals and would only be used following an assessment.

·         It was queried whether Adult Social Services could consider adopting shared back office functionality with other boroughs to deliver a financial saving.

·         It was noted that council’s had been managing cuts since 2010 and queried how further savings would be delivered and managed in the future.

·         It was noted that the lack of future visibility with regard to funding models in social care impacted on the council’s ability to develop plans for the longer term.

·         Members welcomed the creative approach and proposals around the maximisation of the Government public health grant.

·         A discussion took place in relation to demand management and how the council were able to predict demand in Adult Social Care.

·         Members requested assurances that residents would not be disproportionately affected by the saving proposals and that individuals would continue to receive the care packages they required.

·         In response, it was commented that the proposals would not be finalised until sufficient consultation with the affected groups had taken place and the service was confident that the final proposals would be fair. It was noted that the Care Act required the service to identify eligible need in accordance with a national criteria and there were no proposed changes in respect of this eligibility. 

·         Information was requested in relation to the current figures of a similar saving proposal from the previous financial year to understand the practical savings against the predicted savings.

RESOLVED – That the report be noted.