Minutes:
The Committee considered a report of the Director of Adults
and Communities, the purpose of which was to advise on the current demand
pressures being faced by the Adults and Communities Department and the impact
of this demand on the 2021/22 forecast departmental budget outturn. A copy of
the report marked ‘Agenda Item 10’, is filed with these minutes.
Arising from discussion the following the points arose:
(i)
Regarding the table at paragraph 28 of the
report which showed the difference in spend between Leicestershire and
comparator authorities on overall expenditure on adult social care and on the
amount of spent on older adults, a member commented that Leicestershire had
spent considerably less than the other authorities listed on long term care for
older adults in 2019/20. In response the Director confirmed that local
authority’s expenditure levels largely depended on the level of funding they
received. Therefore, this did not mean that the Council was not meeting the
care requirements of those with eligible needs, rather that other areas of the
country receiving greater levels of funding were in a better position to
provide higher levels of funding. Leicestershire had been the lowest spending
authority out of 151 councils for that particular area of care for the year
2019/20, but other authorities such as Nottinghamshire and Derbyshire County
Councils had received significantly more funding per head of population thus
providing them with the ability to spend more. For the year 2020/21,
Leicestershire’s position had improved somewhat to 143 out of 151 despite the
Council remaining the lowest funded council in England. The funding allocations
were determined by a complex formula set up by the National Government which took into account a range of factors such as deprivation and
income. Representations previously made by the Council to the National
Government had raised the need for fairer funding for Leicestershire.
(ii)
A member commented that there could be a
difference between providing care in line with statutory responsibility and
meeting people’s care needs entirely. It was questioned whether Adult Social
Care in Leicestershire should be a higher priority area to receive additional
funding. In response it was confirmed that in order for the Department to
continue to meet the needs of its service users, a significant amount of growth
would be required going into the next financial year.
(iii)
With regard to the Department’s performance in
recent years, the Director explained that in 2015 the Department had the
highest growth requirement outlined in the Council’s Medium Term Financial
Strategy of any other Department, but by refocusing its strategies on providing
the right outcomes for the right people it had successfully managed the budget
each year between 2015 and 2019, significantly reduced its additional growth
requirements and even declared an underspend indicating that people’s needs had
been met with the budget available at that time. It was confirmed that meeting
people’s needs would always be the highest priority, but this needed to be done
in the right way to help people live as independently as possible and delay the
need for long term care.
(iv)
In response to a question as to whether the
Council’s strategic aims to support people to live at home for longer affected
the statistics shown in the aforementioned table at paragraph 28 of the report,
officers undertook to provide an East Midlands comparison of people aged 65+
supported either in the community or in a permanent placement in the next
report to the Committee on departmental performance.
(v)
In regard to the UK-wide 1.25 per cent Health
and Social Care Levy which was due to be introduced from April 2022 to bring
forward an additional £12 billion per year for health and social care over the
next three years, it was expected that for at least the next two years the
majority of the funding would be directed towards the NHS to tackle the backlogs
of cases for elective services that had accumulated during the Covid-19
pandemic. It was therefore unlikely that any additional funding from the levy
would be received from the National Government for social care until 2023/24
onwards once its plans for reform came into effect.
(vi)
The most significant factor that had contributed
to the increased demand in social care services in February 2021 referenced in
paragraph 8 of the report had been the influx of patients to the Leicester
Royal Infirmary who at that time were receiving a record number of patients of
around 900 per day into its accident and emergency department. As health and
care services worked in an integrated way there had been a knock on effect to
local social care services and other services who were also responding to the
additional numbers of patients by ensuring the appropriate care packages were
put in place for a timely and efficient discharge. Due to the national
restrictions that were put in place to stop the spread of Covid
and allow hospitals to focus on managing Covid
related demand, there had been a delay to the normal winter pressures relating
to other illnesses such as the flu that were usually experienced during the
months of December and January. The impact of the pandemic requiring hospitals
to postpone or cancel elective treatments was also significant and having an
ongoing effect on hospitals being able to meet the continuously high level of
demand.
(vii)
In response to a question the Director confirmed
that having fewer self-funding residents being admitted into care homes would
have a significant impact on the Council’s budget going forward. Members noted
that in terms of the care home placements that the Council funded there were
two types of additional payments that the Council could be required to pay. One
was a supplementary needs allowance for when a person’s additional needs
required them to have a level of care above the standard fee. The second was a
local authority assisted funding allocation which came into play when the fee
for a care home placement was higher than the fee the Council would ordinarily
pay. Since the Covid-19 pandemic the percentage of services users requiring the
Council to make an additional payment had doubled from 20% to 40%. This was
because care providers had increased their fees for placements to make up for
the additional costs they had experienced throughout the pandemic. For example,
to meet new requirements brought in by the National Government around workforce
and Personal Protective Equipment. Another factor was that care homes were
experiencing a higher level of bed vacancies than ever before due to the
effects of Covid-19.
(viii)
The Committee noted the update and offered its
thanks to the staff in the Department for their continued efforts to keep
services running and meet service user’s needs despite the significant
financial restraints and ongoing challenges being faced.
RESOLVED:
(a)
That the update regarding the current demand
pressures on the Adults and Communities Department’s Forecast Budget for
2021/22 be noted.
(b) That the Director be requested to include an East Midlands comparison of people aged 65+ supported either in the community or in a permanent placement in the next performance report to the Committee.
Supporting documents: