Agenda item

John Everson, Director of Adult Social Care and Shakeel Yasin, Assistant Director of Finance provided the Committee with a presentation on the Adult Social Care budget overview for 2024/25 and summarised key points to the Committee.

The following main points were noted in the discussion:

• It was noted that the gross expenditure budget for 2024/25 was £163m. This was the amount the Adult Social Care have spent on various services including home care, residential care and staffing.
• The Gross income budget was £106m. This was the amount expected to receive from various income streams including client contributions and money from the NHS.
• The Committee noted that the net budget was £57m. This was funded from the Remediation Support Grant from the government and the Council Tax re-raise.
• Adult Social Care Funding for 2024/25 was £163m. The majority of the funding came from various income streams which included Central Government Grants, Client contributions, NHS income, Revenue Support Grant and Council Tax.
• In terms of Adult Social Care Gross Expenditure for 2024/25, around 73.4% was spent on placements which provided front line provision of care for vulnerable residents in Islington.  The next highest expenditure was around 9.5% being spent on staffing for Adult Social Care.
• In relation to placement expenditure, it was noted that large amount was spent on residential care and homecare for people with learning disabilities and for people that required memory & cognition and physical support. The Council placed a lot of importance for individuals to receive care at home as this promoted independence and also increased the chances of enabling them to get better. The Committee noted that in total around £120 million was spent on placement in Adult Social Care.
• In relation to budget forecast, pressures & risks for quarter 2, it was highlighted that the pressure from Care UK was caused by the fact the beds were unavailable for several years resulting in the need to place service users in spot provision at an additional cost to the council which was around £2.4 million. Once the beds became available at the end of 2023/24, the process to reoccupy started with some criteria having to be met. There were limits on the number of service users that should be placed each week, to support safe & effective transfers and also had to ensure a match in the level of need of the individual to the specific support available in the placement bed. It was also added that once the homes are filled this pressure will not carry into 2025/26.
• Some of the potential future financial risks included additional demand due to NHS, Community pressures, increase in the acuity of need to exiting clients exceeding budgeted allocation, NHS funding changes, Children transitioning to Adult Social Care, delays in the opening of Adults Social Accommodation and Savings Slippage. The plans and mitigations for these potential risks & pressures were outlined on page 21 of the report pack.
• In terms of Adult Social Care savings, it was noted that for 2024/25, there was a saving of £6.65 million to deliver and Adult Social Care were on target to deliver all their savings.
• In response to a question on more funding being available for Adult Social Care it was advised that historically Islington Council had been able to provide a high level of support for their residents and had been in line with statutory duties in reducing delay and prevented the need of care and support. It was advised that the Council would need to continue to work with partners from the NHS at an earlier stage to stop the deterioration and escalation of need, which in effect would help to reduce costs and ensure the Council is getting the best possible value for money for the care purchased. It was also noted that austerity had caused pressures within the service where provider markets were at risk.
• Officers confirmed that for quarter 2, the total overspend was £739,000 and had indicated that this would come down for quarter 3, hoping to have balanced budget by the end of the financial year.
• The Committee queried about the impact of austerity and if this had any effect on the number of day centres. In response, it was noted that for Islington there was a recent opening for a new day centre in New Park and the Council was committed to providing day centres in order to support those with some of the most complex needs within the day service settings.
• In response to a question on supported living and sheltered accommodation, it was advised that supported accommodation was provided and sheltered accommodation was slightly different in terms of what it provided. Supported accommodation primarily supported people’s care needs and sheltered accommodation was more of a provision for homelessness and temporary accommodation.
• Some of the ways in reducing costs within the service was to focus on preventing, reducing and delaying the need for care and being able to provide short term interventions to get people to be more independent. It was also added that the contracts and brokerage team had worked hard to ensure that the Council was paying the right amount of money and ensuring good value for the care purchased by making important negotiations.
• The Committee sought assurance on whether the service would continue to conduct assessments face to face with service users. In response, it was advised that assessments were completed in person and contact was also maintained even after individuals receiving the care and support they needed.

RESOLVED:

That the report to be noted.