To consider the proposed Capital and Revenue budgets for the Adult’s Services and Children’s Services Directorates
The Committee considered a report, set out in agenda pages 11 to 62, which set out the revenue and capital bid proposals for both Adult’s and Children’s Services Directorates for the 2022-25 Medium term Financial Plan (MTFP).
Graham Ebers (Deputy Chief Executive (Director of Resources and Assets) attended the meeting to give an overview of the current draft budgetary position. The financial landscape was very difficult to determine, and there would be some changes to the currently presented figures which would be taken back to the Committee as and when changes occurred. Areas of uncertainty included utility costs, construction costs, general inflation, National Insurance contribution increases, Adult Social care costs and NHS funding review, the Local Government Finance Settlement, the new homes bonus, minimum wage increases, and the ongoing impact of Covid-19 (C-19).
Phil Cunnington left the room for this portion of the item.
Charles Margetts (Executive Member for Health, Wellbeing, and Adult Services) and Matt Pope (Director of Adult’s Services) attended the meeting to answer Member queries. The financial consequences of the Government’s Adult Social Care reforms were unknown until the white paper was published early 2022. Savings to be achieved within the service would predominantly come from the demand management programme coming into fruition, whilst much of the forecasted growth was from inflationary costs. Fully utilising the voluntary sector and giving customers the specialist care that they needed were also measures whereby savings and better service provision would be achieved. On the capital programme, the proposed new dementia care home would help more residents get specialist care within the Borough.
During the ensuing discussions, Members raised the following points and queries:
· Would the proposed care home be filled from within the opening year of 2024/25 or would there be an additional cost if it was not filled? Executive Member and Director response – the hope was to fill the care home within the opening year, and many residents would move over from Suffolk Lodge which would help the transitional period.
· What provision was in place for current increases in construction costs in relation to the new dementia care home? Executive Member and Director response – What was proposed was the current budget figure and a range of demand modelling was taking place. It was believed that the figure was correct however this would be adjusted if necessary. There was a detailed business case and there was confidence that this would stand up, and there was a real need for a facility such as this within the Borough.
· Could some additional commentary be provided with regards to the Mosaic system? Executive Member and Director response – Systems had to be kept up to date to the latest standards and specifications. There was scope for some customer requests and evidence provision to be done online in the future. The system would give better data and report management for staff and senior officers. There was no specific bid for this item as it had been re-profiled from the 2021/22 MTFP and was therefore already approved.
· Members commented that they were pleased to see that each bid was being considered against the Public Sector Equality Duty prior to finalisation of the bid.
· Were savings proposals within the Service on track? Director response – Yes, savings proposals were on target and targets were met in the last financial year. Members congratulated officers and the Lead Member for meeting these targets, which showed that their forecasts were robust.
· Was there capacity within the voluntary sector to achieve approximately £2.75m worth of savings for WBC? Executive Member and Director response – The voluntary sector was a key part of these savings proposals, however there were also other key elements in place. The current model spent most of the time and resources on giving people care and treatment later down the line when they were in real need of support, and the new model would aim to intervene earlier in the process, providing a better service and using less overall resources whilst keeping more people in their own homes for longer.
· Relating to bid ASC.2, demand management, had funding been identified as the bid sheet on agenda page 44 indicated that it had not? Director response – Funding had been identified, and the information on page 44 stating otherwise was a misprint.
· Was there a bid for proposing funding for the purposes of purchasing properties and converting them for adults with learning difficulties? Executive Member and Director response – Yes there was, and this would be made clearer within future versions of bid proposals.
· In relation to bid ASC.4 (Review of application of Continued Health Care Claims) on agenda page 34, what uncertainty remained around this bid? Executive Member response – The uncertainty centred on particular individuals with specific care needs, and whether they would be funded by WBC or the Health Service. If these individuals were not funded by the Health Service then WBC was the safety net.
· Was there confidence that savings relating to Optalis could continue to be made without a detriment to the service provided considering the previous savings that had already been achieved? Executive Member and Director response – These savings were deliverable and were smaller than the savings that had been achieved in the past few years comparatively. Some of the proposed savings were related to the renegotiation of overhead costs with the Royal Borough of Windsor and Maidenhead.
· Were the savings related to bid ASC.4 (Review of application of Continued Health Care Claims) on agenda page 34 an indication that WBC had been paying too big a share in the past? Executive Member and Director response – WBC had to be the ‘safety net’ for residents in need, and therefore WBC always had to be proactive to identify other appropriate funding sources.
· Bid ASC.5 (Care & Support – manage increasing demand in numbers and complexity) was a significant growth bid nearing £6m. Was there any funding available from Central Government to help cover these costs? Executive Member response – These were significant costs, and this was a sector that had been nationally underfunded for a long time and this was the consequence of that underfunding. The Executive Member and the Leader were in conversations with officials relating to an appropriate Adult Social Care funding settlement, and any other involvement would be welcomed. Discussions had been had in the past with the Association of Directors of Adult Social Care (ADAS) and with BOB ICS, and the Deputy Executive Member was very involved in assisting the Executive Member which freed up additional time to discuss funding proposals with local MPs and other bodies.
· Relating to bid ASC.6 (Prevention – Investment in preventative services) on agenda page 36, was this funding being provided to local voluntary groups and if so was it only lasting for two years? Executive Member and Director response – This was additional funding which was going to the voluntary sector over and above previous funding. There was potential to review this funding amount in future years to ascertain whether this would be enough funding. The move to longer term contracts with the voluntary sector would give them more security and tenure. Part of this strategy involved investing in the voluntary sector hub. The current proposal was for two years of additional funding, but there was certainly the will to continue this far beyond that timeframe.
· Would the funding to Wokingham Healthwatch be restored, if not already, to the levels from a few years prior? Executive Member and Director response – The £500k was not all allocated, and the voluntary sector had received a three percent uplift this year. There was a genuine effort to provide more long term assurances for the voluntary sector. Healthwatch Wokingham did a fantastic job, and there was likely a way forwards in terms of meeting their funding needs, as the demand management programme could not be delivered without the help and support of the voluntary sector.
· Relating to bid ASC.9 (transitions – additional assessment capacity) on agenda page 39, would the Service manage without these additional posts in 2024/25? Director response – The extra posts were bid for to enable additional work and to work with younger children as they transitioned into adulthood. At the moment there was confidence that these posts would not be needed past the funding date, however this would be kept under review.
Phil Cunnington re-joined the meeting.
Graham Howe (Executive Member for Children’s Services) and Carol Cammiss (Director of Children’s Services) attended the meeting to answer Member queries. The overall message was that the Service was on a journey of continuity of improvement with over £3m proposed to be invested over three years and proposed savings of £2.8m over the same period. Unpredictability within the Service came from the unknown arrival of one complex case from out-of-Borough which could cost over £100k and was unpredictable. Elements of the Service such as Home to School Transport (HTST) and the Corporate Transport Unit were examples of the Service being streamlined and transformed.
During the ensuing discussions, Members raised the following points and queries:
· Relating to HTST and the expected four percent increase in demand, were the proposed increases in funding over and above the four percent figure relating to something specific, and would there be smaller increases in future as a result of the review into HTST? Executive Member response – There was a two percent increase in demand anticipated for mainstream schools, and a nine percent increase anticipated for Special Educational Needs (SEND) pupils. There were expected savings in future as a result of the ongoing review into HTST delivery and operations.
· How did WBC compare to other Local Authorities with regards to increasing demand on care services? Director response – Looked after children numbers were lower within the Borough than in neighbouring Local Authorities, and WBC had a good set of preventative measures in place. The predicted percentage increase was as a result of modelling which involved line-by-line reviews of each child and tracking to ensure that each placement was the most cost effective and suitable for each child. The increased costs were not related to an expected increase in the number of looked after children, but instead related to the increasing cost of existing placements year-on-year.
· Had lessons been learnt from the issues relating to HTST experienced by a couple of schools at the start of the academic year? Executive Member and Director response – There was a commitment to plan earlier, plan deeper, and communicate better going forwards. Community transport sat outside of Children’s Services, however Children’s Services commissioned these services. In looking to implement a route optimisation system both SEND and mainstream transport methods were assessed. Some of the decisions were made on very good intelligence around how transport could be optimised, however once schools had gotten in touch to voice some concerns the situations were reviewed and one of the decisions was reverted.
· What impact would the potential delay to the construction of the recently approved Winnersh SEND school have on WBC and how many families could be affected? Executive Member and Director response – A more detailed answer in relation to this would be available within the next few weeks, and this issue was being worked on a daily basis.
· What model was used in relation to bid CS.R3 (Transforming Children’s Services) on agenda page 47? Director response – This bid was about looking at the ways in which services were delivered as part of the continuation of transformation for the Service. This was about creating efficiencies, for example via changing providers and commissioning services in different ways. Each of the savings and activities had been worked through and had detail associated with them.
· The recent CQC and OFSTED progress assessment deemed that five of six significant weaknesses had been addressed sufficiently. Given savings proposals, was the Service still on track to address the last weakness? Director response – This visit, and the six target areas, were in relation to SEND. There was a good program in place within the sixth area but not yet deemed as sufficient. All of the SEND service, as well as the whole of Children’s Services, were truly making good progress and were in the process of making changes to become more effective whilst containing costs.
· In relation to bid CS.R5 (Growth in children in care and care leavers (placements)) on agenda page 49, how many places were to be available provisionally? Director response – The Service was planning to develop a number of care leaver accommodation units to allow care leavers to stay local. Approximately six or seven places would be provided.
· In relation to CS.R9 (Delay in capitalisation of system contract) on agenda page 53, was this previously on a one-year rolling contract? Director response – Yes, this was on a rolling one-year contract and as such this could not be added to the capital programme. This would now be changed to a two-year contract, which allowed the cost to be capitalised.
· In relation to bid CS.R2 (Placements Review – Strategy Review and Edge of Care Demand Management) on agenda page 46, how would those children staying at home be educated? Director response – These children would be accessing mainstream education, and if they were looked after children then they would get additional support from the virtual school. Just because a child might remain at home did not necessarily mean that Children’s Services would not be working with them, it would just mean that they would not have looked after status, whilst they might be subject to a child protection plan or they could be a child in need.
· What assurances were there that lessons had been learnt in relation to the issue with HTST at two schools at the beginning of the academic year? Director response – Lessons had been learnt across the organisation and there were now robust processes in place to ensure that this would not happen again.
· In relation to bid CS.R5 (Growth in children in care and care leaves (placements)) on agenda page 49, could some commentary be given as to the analysis undertaken? Director response – Line-by-line analysis was carried out for each child in care, and a child would only be moved from a placement if that was the best decision for their wellbeing and not based on any financial implications. These costs were based on the increases in cost of current provision and not additional children being placed into care.
· How much was being spent on children in care? Director response – Slightly under £10m was spent annually on children in care, with placements being the biggest cost whereby one week in a secure placement could cost £7k per week.
· Members commented that the overall reduction in agency workers had been good to see. The Director commented that WBC had seen a reduction in agency workers within Children’s Services from 36% to 15%.
· How long were the assessment times for CAHMS referrals? Director response – This depended on the pathway, with assessments for ASD still taking too long at approximately thirty weeks, however support was available for children whilst on the waiting list via the CCG. Other referrals took around six to eight weeks which was a big improvement on previous times.
· When was the next OFSTED inspection likely to take place? Director response – This was unlikely to take place until after 2022, as if the June 2021 meeting was graded then a ‘Good’ or ‘Outstanding’ rating would have been awarded. The Service knew the areas where further work was needed, and strategies were in place to facilitate this.
· Which secondary schools were proposed to receive funding for additional places, and was this mainly focussed on 6th forms? Executive Member and Director response – The secondary school strategy was being finalised, and the Service had to make sure that no school was disproportionally disadvantaged. All secondary schools within the Borough were now at least rated ‘Good’, and an additional 6th form was not required until 2024/25. Dialogue was underway with all school head teachers in a productive an collaborative way
· It was noted that a survey was being undertaken to ensure that schools were in a good condition, which was a statutory requirement. If an academy had a major issue, WBC would have a responsibility to ensure that those children were supported. Minor issues were the responsibility of each academy to address and pay for.
· Were more parents choosing to choose The Forest School as a higher preference? Director response – The early indication was that The Forest was proving to be more popular, and the Head was engaged with the Local Authority to help support the future of the school.
· Were conversations ongoing with the DfE regarding grant funding for 2023/24 and why grants appeared to be decreasing in value? Executive Member and Director response – The missing figures may come to light within the Local Government Finance Settlement in December. Grants were determined via a funding formula and were based on perceived need.
· The Executive Member, Director, and all staff within the service were thanked for all of their hard work in retaining staff and keeping social workers with the same children.
1) Charles Margetts, Graham Howe, Matt Pope, and Carol Cammiss be thanked for attending the meeting;
2) Changes to bids be taken back to the Committee when future financial lockdown versions had been internally agreed;
3) Directorates consider the Committee’s comments when finalising proposals within their Service areas.