Agenda item

Revenue and Capital Outturn Report:  Budget Monitoring

The budgetary outcome position for 2018/2019 was presented and the relevant parts within the committee’s remit were discussed. Members challenged the 989k underspend in the Adults Select portfolio as follows:

Challenge:

Members requested explanation of the 989k underspend and were advised these related to:

•           Adult Services (£181k overspend) – resulting from a significant drop off in community meals income, together with £155k staffing pressures, a £120k net pressure caused by limited capacity in the external domiciliary care provider market, compensated for by vacancies and management savings of £97k.

•           Community Care (£1.073m underspend) – savings within Mental Health Care team budget and Frailty pooled budget (collective £1.4m) compensate for an inherent pressure to adult disability care provider costs and client needs (£323k overspend).

•           Commissioning (£104k underspend) – predominantly the effect of reviewing service contracts, and a staffing saving, compensating for Drybridge Gardens income shortfall caused by a tenancy vacancy.

•           Resources (£7k overspend) – net effect of increased transport costs.

Members challenged officers on the following:

•           The Number of agency staff in domiciliary care ~ they were advised that agency workers are employed for times when there sickness or maternity cover required, not as part of the longer term operating structure and that certain projects such as the Integrated Care Fund project may require agency staff for short term projects.

•           The reduction in take up of Community Meals and the fact that if there is a lower take up, there are fewer people who will be benefiting from the social interaction that would take place and whether that poses a concern for the department. Members were advised that the Success of reablement has meant that some people are more independent and together with the luncheon clubs at Mardy Park and the marketing of Wiltshire farm foods (where the costs are comparable) has led to a reduction in take up of the service. The committee heard that the Community Meals Team undertook a review in which they asked if people would like the driver to spend some time with people when delivering the meal, to have a chat and that the team is now working on how this can be factored into the timetable to make the experience more of a social interaction in which relationships can be developed.

•           Members challenged officers as to whether they can confirm that nobody is being disadvantaged by the cost increase. Members asked whether service users have been asked why they are not taking up meals and whether a socio- economic assessment has been undertaken to ensure that people are not suffering due to financial reasons.  Members were advised that as far as we know, people are not being disadvantaged and that when asked, if finance has been identified as a problem, options are considered to help them. 

•           Members expressed that the social interaction aspect is crucial and that if people decide not to have meals, they may not realise the impact on their loneliness and isolation.   There were questions relating to whether consideration is given to the size of the meals and the amount of time given to the visit. Officers confirmed that a trial has been completed which found that not everyone wants their meal at a certain time, which was something they hadn’t anticipated. People can order smaller meals and make choices. The aim would be that visits would be at least 15 mins if the person was happy with the contact and that this is being explored further. 

•           Members asked finance officers whether they feel the budget monitoring process is robust enough to identify underspends and overspends. The officer advised that a move to monthly budget monitoring as opposed to quarterly because of the fluctuations in the budgets will assist significantly in terms of timelier monitoring. 

•           Members queried whether the underspends that have occurred through using internal reablement staff as opposed to external domiciliary care is something that should be encouraged.  The committee was advised that reablement staff have had provide additional support because there hasn’t been the availability in the private sector and that this has had an impact on the teams’ ability to support other people.  Members heard that whilst this has provided a short term saving, this would not be achieved over the long term and would not be a desirable position to be in. A shortfall of 250 hours in the Usk area has had a huge impact on people living in Usk. I rural areas, we have had to give an external provider ‘guaranteed hours’ in order to provide them with reassurance in order for them to recruit and lease cars for their staff. Members heard that specifying guaranteed hours has proven very successful in terms of providing service stability.

Outcome:

•           The Committee would like oversight of the Monmouthshire Meals report, together with detail on whether pricing has been identified an issue for the lower take up in meals. Members are looking for reassurance that people are not being disadvantaged on price, so information such as the previous take up figures compared to currently and the reasons identified through the audit/survey of service users.  Members supported the new proposals in relation to visits and increased social interaction.

•           The Committee approved the move to monthly budget monitoring which will assist in monitoring variances in underspends and overspends. 

•           The Committee would like oversight of the Monmouthshire Meals report, together with detail on whether pricing has been identified an issue for the lower take up in meals. Members are looking for reassurance that people are not being disadvantaged on price, so information such as the previous take up figures compared to currently and the reasons identified through the audit/survey of service users.  Members supported the new proposals in relation to visits and increased social interaction.

•           Members requested that a full report on the fragility of domiciliary care market be brought back to the committee.