To consider items relating to People Services and make any recommendations to Cabinet.

Kevin McDaniel, Executive Director of People Services, gave a presentation to the Panel on the proposals for People Services within the current draft budget.

Adult Services had a proposed growth bid of £3.816m and targeted savings of £4.899m. This would be achieved through a focus on independent living for all and looking to discharge home first. The service would look at reviewin­g its use of agency and other staffing, while looking at the longer-term impact of working collaboratively with Health.

Housing and Environmental Services were looking at a growth bid of £0.120m and savings of £0.853m. This would be achieved through combining skills across housing, licensing, environmental health and trading standards teams to maintain a full service offer. The service recognised the loss of income on Hackney Carriage Licenses and the increased pressure on housing and temporary accommodation while looking at how to use property in a smarter way across the entire Council portfolio.

Children’s Services had a proposed growth bid of £2.992m and targeted savings of £3.571m. Fundamentally, the service looked to continue good progress on ensuring that children weren’t brought into care when they didn’t need to be. More was needed to replace the case management system (CMS) in order to increase efficiency. In the short term, the scale of the family hubs would be reduced.

The proposals for the Capital Review Board were to continue to support the fully funded scheme using as much as money from developer contributions in the form of Community Infrastructure Levy (CIL) and s106 payments as much as possible and as appropriate. A focus would be kept on capital programmes that were affordable. Within the programme were two significant IT investments in replacing the CMS for both Adult’s and Children’s Service as significant drivers of long-term improvements in the way the borough worked with families and became more efficient over time.

Kevin McDaniel highlighted the key dates for the budget. The consultation portal was open until the 24 January 2023 and was available on the RBWM Together website. After the consultation ended, Cabinet would consider this feedback and propose their final budget on 9 February 2023, which would then go to Full Council for approval on 22 February 2023.

The Vice-Chair asked how schools were faring as concerns had been raised at the Schools Forum meeting on 19 January 2023 about government funding being reduced, and asked if this would impact on the draft budget.

Kevin McDaniel confirmed that the schools’ budget did not impact the budget being discussed currently. There was a separate ringfenced budget for education of £151m in the coming year for RBWM. Schools were rightly concerned that the budget had not increased with the level of pay offer that was under discussion, but there were very few lines that crossed over between the two budgets.

Councillor Knowles asked if the pay rises overall for staff was a generalised 3%.

Kevin McDaniel stated that a flat percentage of the pay pot had been modelled, which is where this figure had come from

Councillor Baskerville asked why there had been a loss of income on Hackney Carriage Licenses.

Tracy Hendren, Head of Housing, Environmental Health, and Trading Standards, confirmed that one of the main factors was that during Covid, many taxi drivers had to find alternative jobs as the taxi service was not running in the way it used to. As things returned to normal, many taxi drivers did not return to the trade.

The Vice-Chair asked if the domiciliary care contract had an impact on the budget.

Lynne Lidster stated that looking at the cost pressures in the current budget, most of these were on residential and nursing placements, which meant that there wasn’t currently pressure on the domiciliary care budget. At the beginning of the year, the department were looking at a £1.1m overspend which hadn’t materialised, which was good news. A good response from providers was evidenced, with there currently being around 12 providers up from an original 7. There was a decreasing number of people placed outside those providers decrease over time, demonstrating that the contract was working well despite pressures in the workforce and communities.

Councillor Carole Da Costa asked if pressures on the budget were being felt from different geographical areas of the borough.

Lynne Lidster stated that there was a fixed rate of £19.40 across the borough which was brought in from 1 August 2022. There was no particular difficulty felt in areas such as Ascot. It was more difficult to find workforce in certain parts of the borough, with Ascot traditionally being one such area, but capacity was being achieved across the borough.

As of 23 January 2023, a provider would be starting to work on the hospital discharge programme on a 370-hour contract which would support people coming out of hospital and aim to get those people mobilised within 5-6 weeks.

Councillor Sharpe stated that this sounded like really good news as the system seemed to be working as it was intended to work. If residents were able to be moved out of the hospital and into a care system, it was good for the borough and good for the NHS.

Councillor Hunt added that this was thanks to the hard work of officers.

Councillor Knowles commented that one ongoing problem was that many residents didn’t have anywhere to go after leaving hospital, and this would require a long-term solution.

Kevin McDaniel added that there was a national agenda around getting people out of hospital so that they could treat those who absolutely needed urgent care. The domiciliary care contract was part of an investment in the RBWM area between the borough and the NHS. This would enable the flow out of hospitals. It was not a case of people being taken directly from hospital to a care home but trying to take people back to their own homes with the support that was needed in order to live their lives independently for as long as possible.

Councillor Carole Da Costa commented that taking people from hospital to recover into a care home was the most disabling thing that the borough could do. The period of support within the home to enable people to get back to their pre-hospital selves would be very important in order to assess longer term needs.

Councillor Tisi stated that the budget item that concerned her the most was the removal of non-statutory Family Hub services, given that this would be an 80% reduction in Family Hub services. Councillor Tisi asked what the long-term impact on families and the demand for statutory services would be if this early help offer was removed.

Lin Ferguson, Director of Children’s Services – AfC, stated that the current proposals would mean a significant reduction in Family Hub services, primarily staffing. This impact would mean that Family Hubs couldn’t deliver the breadth and volume of services currently delivered. Research showed that the earlier that Family Hubs were able to intervene, the more likely this could prevent families needing statutory services and additional support. Early help was a valuable resource which kept the majority of families in this service from needing statutory support.

Councillor Tisi asked how the percentage of children receiving statutory support within RBWM compared to neighbouring authorities.

Lin Ferguson stated that statistically, children in care were measured per 10,000 of the child population. RBWM were statistically lower than the national average and those of local authorities for children in care. Research suggested that if a borough had a robust early help service, it was likely to have fewer children in care, but it was difficult to establish cause and effect.

Councillor Tisi asked about the financial implications for the authority if the number of children in care increased.

Kevin McDaniel stated that if a child came in to the care of the borough, their life chances were significantly reduced compared to others. If the child was in the care of their family, extended family and/or with a local fostering family, this care would cost around £50,000 a year for the council. If the child was placed externally, this cost could easily reach £150,000 a year. The number of children currently in care was very low, and whether this number would increase was difficult to determine.

Councillor Tisi stated that in the framework for Ofsted evaluations of local authorities, a local authority would be likely to be ‘good’ if it included early help. Councillor Tisi asked what the perceived risk to the authority’s ‘good’ rating would be if this part of the criteria could not be fulfilled.

Lin Ferguson stated that if these savings were to be realised, it could have an impact on regulatory outcomes. Although it was hard to say for certain and could not be predicted, it could have the potential of the authority not being able to retain its ‘good’ rating.

Councillor Sharpe commented that it was important to realise that the authority did not want to make cuts to the budget, but it had been put into a position where these cuts were necessary. It was a question of how resources could be used most effectively to deal with the problems which the borough faced, and how the budget could be used in such a way as to prevent these things happening. Research showed that preventative measures were a good way of keeping costs down but more importantly, it was the best way to look after people who were in need of help. Councillor Sharpe asked officers to paint a picture of what the services would look like if these proposed cuts went ahead, in order to understand the real impact on the level of service.

Kevin McDaniel stated that if the draft budget passed in its current form, those in the most critical need would still get the support that was needed. The risk with this budget was those who currently engaged with early help at the earliest stages may not find the support that was needed and may find that their issues escalated to the point where they would be in a worse position before engaging with services.

Councillor Sharpe asked if any work was being undertaken to deliver alternative services that would support the community, such as remotely delivered mental health support.

Kevin McDaniel stated that this was a professional job, with families expecting to be able to get a service which takes money. A lot of work had gone into making family hubs as efficient as possible. This saving was the least worst thing for the borough to do, though it was not being recommended as a good thing to do.

Lin Ferguson added that these cuts would mean relying on other services within the borough in order to support families with this being achieved through signposting.

Councillor Sharpe stated that it was important that all services were as joined up as possible with regards to every family to ensure that services were delivered in the most integrated way.

Lin Ferguson stated that Achieving for Children would continue to scrutinise their own budget to ensure that the money available was going to the right place.

Councillor Del Campo said that with regards to reablement, she supported the idea of helping people stay in their homes for as long as it was appropriate and safe, and emphasised the role of signposting. Councillor Del Campo asked how this would be monitored to ensure that people who were still in their homes were not just surviving but were also thriving.

Kevin McDaniel stated that Councillor Del Campo was right to recognise that signposting was something that the borough could do better at, as the earlier people understood they can help themselves, the better the outcome for residents. With regards to reablement, the service had been improving and developing with reablement occurring for a particular group of adults.

David Birch, Chief Executive of Optalis, added that over the last year, Optalis had been revamping the service to maximise capacity and productivity in order to access as many people who need that service as possible. An external review had been commissioned which indicated a number of areas where capacity could be increased. Some non-reablement services had been stopped to ensure that specialists were dedicated to working in the area they were specialising in. The Home First initiative would help to free up additional capacity as it meant that the assessment phase was being carried out by a multi-disciplinary team rather than just the reablement team. Additionally, a significant recruitment campaign was ongoing to increase the size of the team by 15-20 people over the next year.

David Birch stated that Councillor Del Campo’s point about finding people who were struggling was well made. The challenge was how to identify people who were struggling but not wanting to bother anybody. Discussions were ongoing with health colleagues and community groups in order to identify these people in a non-intrusive way to provide them with the support they need.

Councillor Del Campo stated that when care home resident savings fell below a certain threshold, the borough stepped in and paid an appropriate amount for their care. Councillor Del Campo asked for clarity on the base budget figure and what percentage of this figure had come about through a deprivation of assets scenario.

Kevin McDaniel responded that there were many care home beds within the borough that people chose to put themselves into and paid for, rather than being put into the state-funded places. There was a significant price differential in the beds that were paid for, with these differences sometimes being as much as a £1000 per week.

In the cases where somebody had run out of money to pay for their care, the borough would step in to make sure that they had care, but it would still be the good quality care at the same amount of money that was paid for those who didn’t have the wherewithal to pay for their own care. This saving covered individuals who may have been in care for a short term and had run out of money, in which a sensible conversation would be needed. If a third party, normally the family, were not able to pay, then the borough’s policy was to ask people to move when it was safe to do so.

Lynne Lidster stated that the borough used to see under 10 people per year who would run out of money. However, this position had changed quite dramatically with this number almost doubling and more and more people running out of money. Lynne Lidster stated that this may have been a result of the pandemic, which resulted in people going into care homes far earlier than they normally would have. It was hoped that these high numbers would start to come down, but the number of people running out of money was significant.

In these cases, the first thing would be to negotiate with the provider where the person is currently residing. Every step would be taken to keep people where they were, but in instances where the provider was unwilling to negotiate, the family were unable or unwilling to top-up costs, and it was safe to do so, the individual would be moved to a different location which was more affordable for the authority. In these instances, a personal budget would be set which could meet the individual’s needs, which would enable the person to choose where they would go.

Councillor Del Campo asked about if deprivation of assets was a particular issue for the borough and if so, what the scale of the issue might be.

Lynne Lidster stated that that she didn’t have an idea on the possible scale but added that it was very hard to prove that someone had either been deprived or had deprived themselves of their assets. Reasonable assumptions and investigations were made to try and detect any self-deprivation, but it did occur. In instances where a third party had deprived somebody of their assets, this was a safeguarding issue which would be dealt with and potentially referred to the police. It was more difficult to see if people were depriving themselves of their own assets.

Councillor Del Campo stated that she was concerned about the cuts to Meals on Wheels, and asked officers to describe the value that this service provided.

Lynne Lidster stated that some of the people who received Meals on Wheels were reluctant to have formal care. The company used were specially trained to work with people, look at what was in people’s homes, complete risk assessments and so forth. Meals on Wheels was a means of keeping an eye on somebody who was reluctant to enter the formal care system, and may result in that individual being more likely to eventually accept support. It was a valuable service, especially for those people who were at risk and were vulnerable.

Councillor Del Campo asked if Meals on Wheels could potentially help people who might otherwise fall through the gaps.

Lynne Lidster stated that the other side of the coin was that people would only ever pay their assessed charges. For instance, if an individual had an assessed charge of £50 per week and received services of £200 per week, they would still only pay the initial assessment of £50.

Kevin McDaniel confirmed that for the final budget he was proposing that this saving be made in a different way, with an increase in the meal price but still making the service available.

Councillor Del Campo asked the Chair if she could propose a recommendation to Cabinet now, or if this was better suited to the end of the debate.

The Chair confirmed that it would be better to propose any motions at the end of the debate.

Councillor Carole Da Costa stated that she came from a medical background, and every service would look to intervene as early as possible to make longer term savings and better outcomes for individuals. She stated that she couldn’t support a budget that would look at removing those early help interventions, particularly when looking at CAMHS waiting lists of almost two years. One of the justifications for family hubs was that support could be put into place while people were waiting to see some kind of counselling. Councillor Carole Da Costa added that to take away the early intervention would be doing a disservice to the Council and its young people.

Councillor Carole Da Costa suggested looking again at this savings line and trying to reserve as much of the non-statutory Family Hub service as possible, as well as looking at ways to recruit and retain good quality staff so as to decrease reliance on agency services.

Councillor Knowles stated that he was involved as a trustee of two alms houses and had a vested interest, referring to savings lines AHH01S and AHH021S. During the pandemic, he was involved in supporting older residents through this period. Councillor Knowles knew how passionate most people were about independence and staying in the own homes, so the drive towards increased reablement was something that should be supported.

Councillor Knowles stated that the shared lives scheme in budget line AHH03S was quite brilliant, and asked if there had been any trials of this in the UK as it was often the norm for older people to remain with their families in other countries such as Germany. Councillor Knowles also asked how this would be managed, as it was a complex method that may pose safeguarding risks.

Lynne Lidster said that shared lives in the UK was primarily for people with learning disabilities, so was tried and trusted. The scheme was regulated through the Care Quality Commission (CQC) and would involve the borough partnering with another local authority to deliver this scheme. The scheme was originally launched in the borough around 7/8 years ago but wasn’t successful, so the aim was to try again.

In terms of the personal care aspects, it would be the same as individuals living in their own home. The scheme was not registered for personal care so if the individual needed personal care, an agency registered to deliver this kind of care would come in to provide it. With regards to safeguarding, checks were carried out on the family and the individuals living in the home in the same way that Children’s Services would do for foster carers.

Councillor Knowles asked if the level of safeguarding was the same as that required in care homes.

Lynne Lidster confirmed that this was the case.

Councillor Knowles stated that he knew many senior friends who were recipients of Meals on Wheels, and a reduction in this service would mean a reduction in mobility and support. Councillor Knowles’s main worry was that he was concerned about an overall reduction in a level of staffing and what this would mean if gaps were needed to be filled by agency staff. Councillor Knowles stated that the People Service was very important as this related to people’s lives, and if there was any slack in the original grant, it should be directed into these services as a priority.

Kevin McDaniel stated that he agreed with Councillor Knowles’s statement but would reflect on other services of the Council which were equally as important. Many services were also becoming leaner in terms of staffing, but this was the nature of the budget.

Councillor Sharpe asked for clarification that the recommendations proposed in the draft budget would result in the savings stated in the papers. If these recommendations went through, Councillor Sharpe asked about the number of people who would be made redundant and if there was the option for redeployment off these affected staff.

Kevin McDaniel explained that at this stage of the budget proposals, none of the processes that would be necessary had begun. In all areas, the borough had looked to minimise the number of redundancies of permanent employees of the council or its partner companies. Within the borough, there was a very clear set of policies around reskilling and reasonable alternatives that wherever this option was possible it would be carried out. However, within People Services, there was a significant amount of training and development that would be required to move an individual from a non-specialist professional position to some of the more specialised roles.

The Vice-Chair asked for clarification on the need for, and cost of, a new CMS.

Kevin McDaniel explained that at present, a shared system (PARIS) was used by both Adults and Children’s Services which provided the electronic record keeping of all interactions, particularly the statutory interactions with adults and children. This CMS enabled these services to ensure that they were effectively able to provide the right services and demonstrate the progress over time. In many cases, this CMS provided statutory data returns to the government and demonstrate through external reviewers that services provided were good quality.

The CMS was last purchased around 12 years go, and the borough was one of three councils left using the system, and the supplier had stated that they would no longer be updating and developing the software. Therefore, two new CMS would be required with one for Adult’s and one for Children’s. The cost indicated was how much it would take to complete a migration of the computer system so would be a one-off cost, however the borough did pay a couple of hundred thousand pounds a year to run these tools and systems.

The Vice-Chair asked if the cost of providing care for unaccompanied asylum-seeking children would decrease next year.

Lin Ferguson stated that the National Transfer Scheme (NTS) had become mandatory at the beginning of 2022. During 2022, the NTS increased the quota of the number of unaccompanied asylum-seeking young people from 0.07% to 0.1% [of the 0-18 age population]. For a small borough, this meant taking on significantly more young people. Information indicated that not all south-east authorities were at the same quota. A decision had been made that at the current time, unless the borough had the capacity to safely support and care for any additional young people, they would not be taking any further young people through the NTS. Therefore, it was expected that these costs would go down. The young people received through the scheme were offered support and care in the same way as any other young person would, and it was important to highlight that these young people arrived with very significant needs due to trauma and required additional support.

Lin Ferguson explained that there were currently two hotels in the borough for asylum seekers, and if any young asylum seekers presented themselves outside the NTS, the borough had a responsibility to support these people and the borough would do so as it would with any other young person.

Kevin McDaniel added that one of the issues was that these young people arrived with no additional resources over and above the base budget for any council. Councils were provided with around £1000 per week to cover the cost of accommodation for these young people, but this did not provide support for the cost of their care. The borough had continually spoken with the Home Office, who had responsibility for this group, to explain that if the resources provided were increased then the number of young people that the borough took on could be increased.

Kevin McDaniel noted that as of 1 February 2023, the Home Officer were paying a one-off £15,000 per young person who was taken in as an incentive, in addition to this £1000 per week that was also provided. The borough was at capacity so would not be taking any more young people, but it may serve as an incentive to boroughs which did have the capacity but lacked the resources.

The Vice-Chair asked why the figure indicated in budget line AHH19S, review policies for access to care, was so high.

Kevin McDaniel explained that the first few lines in Table 4 added up to well over £3m. This was some of the people who had gone into care earlier than they needed to, and this was the figure that would need to be spent if this continued. The policy review was a saving the borough hoped to achieve by placing people into the right locations.

The Vice-Chair asked for an explanation on budget line CHI01S.

Kevin McDaniel and Andrew Vallance, Head of Finance, confirmed that this would be responded to outside of the meeting.

ACTION: Written response to the Vice-Chair’s question to be provided.

Councillor Tisi asked if the borough were aware of the strains and stresses that were being put on agencies and the voluntary sector, and whether anything could be done to help.

Kevin McDaniel stated that, anecdotally, he had heard that in the voluntary sector, for the right bid there was quite a lot of money out there, with quite a lot of benefactors willing to support families and young people in particular. Work on the borough’s side in order to improve signposting and join organisations up could be improved.

Councillor Tisi explained that she had submitted questions ahead of the original Corporate Overview & Scrutiny Panel’s session on the budget, to which she had received detailed replies. Councillor Tisi stated that she would be happy to send the answers to her written responses to panel members.

ACTION: Councillor Tisi to send Panel members answers to her written questions.

Councillor Tisi proposed a motion that Cabinet uses £500,000 funding from the additional budget settlement to remove the amount of savings required of the non-statutory Family Hub services (savings ref. CHI20S) and create a new growth bid of £20k for the Family Hubs to ameliorate increasing demand on the service. This motion was seconded by Councillor Carole Da Costa.

The result was 6 votes in favour and 3 abstentions, therefore the motion passed.

Councillor Baskerville stated that he was glad to see that the borough recognised that by maintaining lower levels of council tax, it was missing out on additional revenue.

Andrew Vallance explained that it was the Council’s policy to cut council tax for several years in the early 2010s. If it had taken the full increase every year that was allowed under that scheme, there would be an extra £30m in the budget.

Councillor Story asked if the £500,000 figure for unaccompanied Asylum Seeker Children was part of the total £1m figure that was given for the total cost of all asylum seekers, and if the other £500,000 was for adults.

Kevin McDaniel stated that much of the expense came to Children’s Services, but AfC had responded during the year with increased efficiencies to the structure. The total cost was £1m, but some of this was a cost that would have been necessary. Most of the costs associated with asylum seekers related to hotel costs.

Councillor Story asked for clarification on the process for the budget moving forward.

Andrew Vallance explained that the administration would put forward a revised budget, which was currently being prepared and would be published on 1February 2023 as part of the Cabinet agenda. This budget would incorporate what the administration wished to do with the extra £3.6m worth of funding. The results of the consultation, which ended on 24 January 2023, would also be considered at Cabinet alongside any recommendations from all three Overview & Scrutiny Panels.

Cabinet would then vote to recommend a final budget to Full Council in February, at which the budget would be debated by all political groups and any amendments to the budget could be proposed.

Councillor Del Campo emphasised the importance of Meals on Wheels in terms of safeguarding and supporting residents.

Councillor Del Campo proposed a motion to strike savings line item AHH22S from the budget. Councillor Tisi seconded this motion.

The result was 8 votes for and 1 abstention, so the motion carried.

Councillor Knowles proposed that a risk assessment was kept on the impact of reduction of staff on services.

Kevin McDaniel confirmed that the Council ran both a corporate and directorate level risk register, with financial and staffing stability both being included on those registers.

The Vice-Chair proposed a motion that Cabinet approved the draft budget.

Kevin McDaniel clarified that the draft budget had already been approved by Cabinet on 1 December 2022.

Councillor Sharpe stated that it was appropriate for discussion to finish as two motions had been proposed and passed.

Councillor Del Campo asked if it was just a matter of Cabinet taking the minutes of this meeting into account when considering any recommendations to the budget.

Becky Oates, Democratic Services Officer, confirmed that it was just a matter of Cabinet taking the minutes into account.

The Chair thanked all for their contributions.