|
If these buttons don't work, try |
SOCIAL SERVICES NORTH WEST
MEETING TO BE HELD ON 14 SEPTEMBER AT BLACKBURN
REPORT OF THE CO-ORDINATOR
KEY SERVICE / FINANCIAL PRESSURES
1. Matter for Consideration
To report on the current financial position of social services authorities in the North West, based on the results of the recent national LGA/ADSS/Treasurers Budget Pressures Questionnaire.
2. Introduction
This report, the latest in a series, is intended to update members and directors across the Region about current Key Service and Financial Pressures in North West authorities. The report is based on the findings - as they apply to the North West - of the Local Government Association / Association of Directors of Social Services / Treasurers survey sent out this summer. Members may wish to use the results to raise again any continuing concerns with both the LGA and Government Ministers.
3. Information
3.1 The issue of financial pressures has of course been identified as one of the major areas of work for SSNW this year. Members will recall the valuable co-operation between Social Services North West and ADSS North West on a joint survey of the above pressures in the year 2000. The subsequent reports to the SSNW Committee were noted by the LGA at our joint meeting and referred to by Rita Stringfellow’s speech to the Social Services Conference. Concerns were also expressed in letters from the Chair to Ministers in relation to this year’s spending round, resulting in detailed replies from two of them.
3.2 We know from the LGA that the financial situation facing many authorities across the country is still a matter for serious concern, and any information that this report can provide about the position in the North West will be of great use in highlighting present difficulties. The most recent report on financial pressures to SSNW in March of this year confirmed the problem of overheating budgets and consequent reductions in services, and the particular concerns around services for children and older people. This picture is confirmed by the current findings. A summary follows of the twenty responses received in time to include in this report. (A supplementary appendix with a detailed breakdown of the responses received is available on request, an abbreviated version is attached to this report).
3.3 Budget Position 2000/01
Across the region, expenditure was expected to be some £21 million in excess of that budgeted for the financial year 2000/01. There were a variety of reasons but the most common was the increases in costs of placements for children -boarded out children or foster care (cited by five responding authorities). Other reasons included: extra funds from health authorities, reviews of elderly people’s homes, payments in respect of young offenders, and staffing variations.
3.4 Ways that budget over spends in 2000/01 have been dealt with
Fifteen social services authorities have received budget supplementation, five have not. Nine said this was on a one off basis, four ‘not one off’ and the others made no comment.
3.5 Other considerations 2000/01 and beyond
Respondents were asked how significant was any one-off government ‘Winter Pressures’ money (Health Authority direct contributions) in reducing delayed discharges etc. A clear message from respondents was that longer term, more certain funding was much to be desired, but generally the funding so far had been significant for nearly all.
- Nine respondents reported that this was very significant, being most helpful in reducing delayed discharges, but even so the value of more permanent funding was highlighted.
- Six respondents said this was quite important but again the need for longer term more guaranteed funding was seen as crucial.
- Four respondents said the effect was marginal but it did help with delayed discharges
Respondents were asked how significant was the availability of nursing /residential or domiciliary care capacity on ability to use funding effectively. Responses included the following:
- Nine respondents said that it was very significant, helping to accommodate extra clients, with supply exceeding demand in some areas. Extra funding would meet the need for more preventative work, along with intensive support where individuals are discharged to their own homes. The limited supply of domiciliary care was cited along with few EMI beds.
- Six respondents said that this factor was quite significant, due to the contracting capacity in the nursing home market and the expansion of increasingly expensive domiciliary care and generally rising costs.
- Four respondents said this was not very significant, whilst stating that pressures continue - with worries about the impact of the minimum wage, recruitment and the variable quality of the workforce
When asked whether for 2001/02 they were able to maintain or increase the level of services put in place over the last two winters to deliver on winter agenda, twelve respondents said no and eight answered yes
In relation to the £100m announced in December 2000 to meet ongoing winter commitments in 2001/02, authorities were asked whether this would cover the recurrent costs of these packages of care for 2001/02. Ten answered yes and ten said no.
Asked for comments about any specific elements within children’s services which have led to budget overspend, twelve respondents emphasised the pressures on the budget due to the rising costs and or demand for placements especially for foster care and children with disabilities. Leaving care costs and problems with recruitment and retention of staff also mentioned. Six respondents made no comment. Twelve responding authorities said that the residual cost of young unaccompanied asylum seekers, net of grant, was nil or negligible.
3.6 Budget Position 2001/02
Authorities reported a percentage increase in their social services budget ranging from -0.16% to 8.7% averaging 3.2.%. Twelve respondents cited increased costs relating to children’s services, especially external placements and foster care. Adult services – primarily for older people - were also an important financial pressure factor for nine. Four respondents made no comment here.
3.7 Budget Prospects 2001/2002
Asked whether there was a gap between the cost of meeting all expected demand which falls within existing eligibility criteria in 2001/02 and the budget available, seventeen respondents said that there was a gap, ranging from 0.63% to 7.35 % and averaging 2.36%. Three answered no. To address this, most respondents are attempting to cut expenditure in adult provision, for instance reviewing domiciliary care (cited by four respondents) and Best Value reviews, mentioned by four. Three responding authorities are looking to reduce expenditure on home care by transferring provision to the external sector, two others by tightening criteria. A number are looking at efficiency savings. Limiting the size and expense of care packages was mentioned, and putting more emphasis on rehabilitation and intermediate care to restrict demand for residential and nursing care. One respondent is aiming for lower cost provision in child care and looking at placement strategy.
Authorities were asked whether they had changed, or proposed to change, the eligibility criteria. Nine respondents said no, though one of these said that there would be a stricter application of existing criteria. Ten respondents answered yes. The respondents that said yes were mostly reviewing with a view to tightening criteria for adult/ older people’s services though two were also doing this with regard to children’s services as well.
Respondents were asked for any particular points in relation to Children’s, older peoples, learning disability, other adult or management and support service strategy.
- Ten respondents here stressed growing pressure on budgets due to children’s services, with rising costs due to increased fees, increasing complexity of need, foster care and more school leavers with learning disabilities. One respondent said that the cost of individual agency placements is rising at an alarming rate!
- Ten cited adult services pressures including rising fees or potentially rising low fees. Concern also expressed about how free nursing care may impact on the SSA position.
- Learning disability budgetary pressures were highlighted by seven respondents including the cost of intensive home care and supported packages, increasingly complex cases, the transition from childhood to adulthood, ageing carers and the demands created by the recent White Paper.
- Management and support strategy issues were cited by three respondents, highlighting the increasing demands re performance management and regulation and infrastructure inadequacies.
Invited to comment about resources for implementing the Supporting People changes, most respondents were still looking at this matter; a number felt it too early to comment. Concern was expressed by two respondents about the loss of Housing Benefit income for in house clients. One authority has already appointed a Supporting People Officer.
Asked for their view of the budget position in 2001/02 compared to 2000/01, eleven responding authorities said that in their view the budget position had worsened (one being much worse). The position was no different for six and two said that the budget position was better. Seven respondents reported growing demand and increasing pressures, especially in the adult sector; only two specifically highlighted children’s services in this respect. One authority reported a successful reduction in both child placement costs and adult residential. Six respondents had no comments to make here. One respondent claimed a better outlook due to supplementation of the 2001/02 budget with extra resources. Five anticipate an overspend.
In terms of managing the financial implications in 2002/03, ten respondents are awaiting guidance or clarification; three specifically expressed concern about reduced income related to revised charging rates. Of the main issues dominating forward planning for 2002/03, external placements generally loom large (fifteen specifically mention children , eleven elderly). Home / domiciliary care was cited by four respondents, along with general concern about the increasingly complex and costly care packages required. Other issues mentioned include: leaving care, retention of foster carers and their fees, Care Standards impact, loss of winter pressures grant and mental health and learning disabilities external placements.
Twelve respondents estimated that some over spend is likely in 2002/03. Another two respondents are considering reducing services or increasing waiting lists as over spend is not an option, others find it difficult to estimate at this stage. Five respondents stressed continued difficulties in funding services for older people long term, due to non recurrent funding and anticipated major problems with supporting existing service users.
4. Conclusion:
4.1 In 2000/01 there is evidence of a substantial overspend in the Region amongst the twenty responding authorities of over £21 million or more than £1 million per authority on average. An average over spend of 1.5%.4.2 The increase in the Region’s budget (for the year 2001/02) is overall reported as of 3. 2% (compared with 2000/01) (one authority reported a decrease: another zero change) this appears to be not much more than the rate of inflation compared to the previous financial year.
4.3 The one-off ‘Winter Pressures’ money or Health Authority direct contributions, have helped significantly in improving delayed discharges. There was a clear message that longer term more certain funding was much to be preferred. Extra funding would for instance facilitate more preventative work and extra intensive support for individuals discharged to their own homes.
4.4 Twelve respondents highlighted the serious ongoing pressures on the budget due to the rising costs and demand for external placements and foster care for children, many with increasingly complex needs.4.5 Adult services were a source of significant budgetary pressure according to eight respondents, especially residential care (where costs and the length of stay are rising) and domiciliary care (which is becoming costlier and dealing with people with more complex needs). Most authorities are looking to reduce costs, and engaging in reviews such as Best Value; using more external provision and limiting the size of care packages were also cited. Ten authorities are likely to tighten eligibility criteria. It is worth noting that at the time of putting the results of the survey together, several member authorities have come under renewed pressure regarding placements for older people.
4.6 Seven authorities also highlighted concerns around learning disability services particularly the growing cost of intensive home care and supported packages, the increasing complexity of cases and the transition from childhood to adulthood.
4.7 Most respondents – twelve - thought that the budget position for 2001/02 was worse than the previous year, especially because of increased pressures from the adult sector. Twelve respondents think that an overspend is likely in 2002/03 due to the cost of external placements in both the children’s and adult sectors, along with the loss of Winter Pressures money and the rising cost of domiciliary care .
5. Recommendation
5.1. Members are asked to note the report
5.2. Members are asked to consider what further action they wish to take to deal with the findings of the above report.
APPENDIX
LGA/ADSS/TREASURERS BUDGET SURVEY 2001
MAIN FINDINGS FROM 20 NORTH WEST AUTHORITIES
1. Budget Position 2000/01
Social Services Budget net 2000/01
Ranged from £22,386 to £209,100, a total Regional budget of £1,278,455,600 and an average of £63,922,780 per Social Services Authority in the Region
Predicted out turn 2000/01
From £23,411,000 to £211,700,000, an average of £64,897,165 per authority in the Region.
Reasons for the difference in the Social Services Budget (net) 2000/1 and the predicted out turn where at variance.
There were a variety of reasons but the most common was due to increases in costs of placements for children -boarded out children or foster care (cited by four responding authorities).Other reasons included: extra funds from health authorities, reviews of elderly people’s homes, Youth Offending Agency payments and staffing variations.
Actual out turn 2000/01
Likely to be around £64.34 million on average per authority amongst the twenty respondents, compared to a predicted out turn of £66.56 million.
The reasons for any differences between predicted out turns and actual out turns ,including specific service reasons. The main reported causes were :
- Four respondents reported non service related cost factors, namely reducing cost of support services (2 respondents) and reducing maintenance / repair.
- The increase costs for children’s services featured (4 respondents).
- Extra money from health authorities (2 respondents) and money from the Further Education Funding Council.
- Vacancies were also a factor (one example each of either additional savings or extra spent due to high turnover and recruitment
Actual over / under spend 2000/01
Regional over spend of £21,380,338 averaging £1,069,016.9 per responding authority. Per cent age over spend ranged from 0 to 6.96 % and averaged 1.5%.
2. Ways that budget over spends in 2000/01 have been dealt with
Budget supplementation received:
Fifteen social services authorities have received supplementation, five have not. Of the ones answering yes six said the amount was additional to that stated in the January survey, four the same as. Nine said this was on a one off basis, four not one off and the others made no comment.
Is under spending likely to be sustained?
Five respondents say no the rest reply not applicable
3. Other considerations 2000/01 and beyond
How significant was the one off government ‘Winter Pressures’ money of Health Authority direct contributions (if any) in improving delayed discharges?
A clear message from respondents that longer term more certain funding was much to be desired, generally the funding so far had been significant for nearly all.
- Nine respondents reported that this was very significant, being most helpful clearing delayed discharges, but even so the value of more permanent funding was highlighted.
- Six respondents said this was quite important but again the need for longer term more guaranteed funding crucial.
- Four respondents said the effect was marginal but it did help with delayed discharges
How significant was the availability of nursing /residential or domiciliary care capacity on ability to use funding effectively( including further comments).
- Nine respondents said that it was very significant helping to accommodate extra clients, with supply exceeding demand in some areas. Extra funding would meet the need for more preventative work along with intensive support where individuals are discharged to their own homes. The limited supply of domiciliary care was cited along with few EMI beds.
- Six respondents said that this factor was quite significant due to the contracting capacity in the nursing home market and the expansion of increasingly expensive domiciliary care and generally rising costs.
- Four respondents said this was not very significant whilst stating that pressures continue with worries about the impact of the minimum wage, recruitment and the variable quality of the workforce
How much of the 2000/01 overspend attributed to delivering on the winter agenda?
Fourteen respondents quoted figures ranging from 0% to 95% (the average being 21.6%), six respondents provided no figures,
For 2001/02 are you able to maintain or increase the level of services put in place over the last two winters to deliver on winter agenda?
Twelve respondents said no and eight answered yes
Does your share of the £100m announced in December 2000 to meet ongoing winter commitments in 20001/02 cover the recurrent costs of these packages of care for 2001/02?
Ten answered yes and ten said no, for the latter the expected short fall of on average:
Any further comments about specific elements within Children’s services which have led to budget overspend
Twelve respondents emphasised the pressures on the budget due to the rising costs and or demand for placements especially for foster care and children with disabilities. Leaving care costs and problems with recruitment and retention of staff also mentioned. Six respondents made no comment
How significant is the asylum seekers grant in affecting the outcome for 2000/01
Thirteen respondents said that the grant size was as expected, three that it was larger and only one that it was smaller. Twelve responding authorities said that the residual cost of asylum seekers net of grant was nil or negligible
4. Budget Position 2001/02
Social Services Budget
Total for the twenty responding authorities in the North West Region £1,308,611,200 an average of £65,430,560 per authority
Increase in Budget
Percentage increase ranging from -0.16% to 8.7% averaging 3.2% compared to 2000/01
Describe any particular increase for Children’s Older peoples learning disabilities and other services
Eleven respondents cited increased costs relating to children’s services, especially external placements and foster care. Adult services – primarily for older people - were also an important financial pressure factor for eight. Four respondents made no comment here.
If the LGA/ADSS survey in January has had an impact on your councils budget decision re 200/01 02 please explain
Twelve respondents said that the above survey had no impact. Six said yes, in two cases said that projections had been made that there would be a significant increase in clients or other potential major pressures. Two others said that the survey had helped members understand the need for more money
5. Budget Prospects 2001/2002
Is there a gap between the cost of meeting all expected demand which falls between existing eligibility criteria in 2001/02 and the budget available?
Seventeen said that there was a gap ranging from 0.63% to 7.35 % and averaging 2.71% Three answered no.
If yes what steps taken to address this:
Most respondents are attempting to cut expenditure in adult provision for instance reviewing domiciliary care (cited by four respondents) and Best value reviews, mentioned by four. Two responding authority are looking to reduce expenditure on home care by transferring provision to the external sector, two others by tightening criteria. A number are looking at efficiency savings . Limiting the size and expense of care packages was mentioned and putting more emphasis on rehabilitation and intermediate care to restrict demand for residential and nursing care. One respondent is aiming for lower cost provision in child care and looking at placement strategy.
Have you changed or do you propose to change the eligibility criteria
Nine respondents said no, though one of these said that there would be a stricter application of existing criteria. Ten respondents answered yes.
Explain if yes
The respondents that said yes were mostly reviewing with a view to tightening criteria for adult/ older people’s services though two were also doing this with regard to children’s services as well.
Are there particular points you wish to make in relation to Children’s, older peoples learning disability ,other adult or management and support service strategy?
- Ten respondents here stressed growing pressure on budgets due to children’s services, with rising costs due to increased fees, increasing complexity of need, foster care and more school leavers with learning disabilities.
- Ten cited adult services pressures including rising fees or potentially rising low fees. Concern also expressed about how free nursing care may impact on the SSA position.
- Learning disability budgetary pressures were highlighted by seven respondents including the cost of intensive home care and supported packages, increasingly complex cases, the transition from child hood to adult, ageing carers and the demands created by the recent White Paper.
- Management and support strategy issues cited by three respondents highlighting the increasing demands re performance management and regulation and infrastructure inadequacies.
Average actual fee rates being paid in 2001/02
Nursing Home weekly fees range from £224 to £ 369.66 averaging £336.40 per week
Independent sector residential fee rates :
Range from £226.50 to £346.68 averaging £261.78 per week
Are Annual fees rates different from published minimum?
Eleven respondents said that these above were not different. Those that were different cited a variety of factors including increasing nursing fees in two cases and placements for people with complex needs.
Comments about resources for supporting people
Mostly respondents are still looking at this matter, a number felt it too early to comment. Concern was expressed by two respondents about the loss of Housing Benefit income for in house clients. One authority has already appointed a Supporting People Officer
View of budget position 2001/2 compared to 2000/1
Eleven responding authorities said that in their view the budget position had worsened (one being much worse). The position was no different for six and two said that the budget position was better.
If better or worse explain
Seven respondents reported growing demand and increasing pressures, especially in the adult sector , only two specifically highlighted children’s services in this respect. One authority reported a successful reduction in both child placement costs and adult residential. Six respondents had no comments to make here. One respondent claimed a better outlook due to supplementation of the 2001/02 budget with extra resources, the other due to substantial extra funding from the Council.
Proposals to manage the financial implications in 2002/3
Ten respondents are awaiting guidance or clarification, three specifically expressed concern about reduced income related to revised charging rates.
What is the best projection to date of a possible budget overspend / under spend in 2001/02
At least four anticipate an over spend.
How are you planning ahead for 2002/3 and beyond Main issues:
External placements generally loom large here ( sixteen specifically mention children , twelve the elderly). Home / domiciliary care cited by four respondents along with general concern about the increasingly complex costly care packages required. Other issues mentioned include -leaving care, retention of foster carers and their fees, Care Standards Impact, loss of Winter pressures grant and Mental Health and Learning disabilities external placements.
What is your best estimate of the likely budget position in 2002/03
Twelve estimate that some over spend is likely. Another two respondents are considering reducing services or increasing waiting lists as over spend is not an option, others find it difficult to estimate at this stage.
Any other comments
Four respondent stressed continued difficulties in older people long term due to non recurrent funding and anticipated major problems with supporting existing service users. Nine respondents had no other comments
|
Clicking on these links will help you to use SSNWeb, |