Agenda item

Questions and Issues raised by the People and Health Scrutiny Committee 

Response 

Adult Social Care

1.    Recruitment was a risk factor. What are we doing to retain staff? Are there any apprenticeships? 

This was a big challenge for the care sector.  We have put in place centralised recruitment process to recruit staff. 

We were supporting staff with their wellbeing – for example training for good mental health, conflict resolution, and resilience. 

We do support Apprenticeships – we were encouraging staff into the social care system.

2.    Were the hospital discharge pressures pandemic related – was the high level of demand a spike, or a longer-term issue? 

In our assessment, the high level of demand was a combination of pandemic related and underlying demand.  Covid had stopped people accessing early intervention. This would continue for some time. This was a five-year legacy, and it was why we are working on a 10-year plan. 

3.    Should there be more funding coming from the NHS? 

We have received more monies into the council this year and we have been investing these monies into the Home First programme. We were trying to address the immediate demand and we were working together as a system which was key to delivering programmes. 

4.    We do not have enough carers - have we taken into account the wider responsibility of people/employees who have a caring role in the community?  

We are working on a 10-year plan so that we can try and predict the demand and have a strategy to manage that demand. If we work more on early intervention this should support carers who were employees and also people in the community.

5.    In your pressures list you have £11.5m for increased care market costs. Was that enough? 

We have used the corporate calculation and we felt that this funding was sufficient. There were some things that were outside of our control, but we think the budget is sufficient.

6.    The service has done a good job and done the best job we can. The demographics of the county have an impact on the services that are provided. Have we done enough to promote on what services were available after people become discharged from hospital.

We were expanding the reablement service which sits within Care Dorset. We have introduced reablement beds this year which was a new service where we were helping people to regain the health and independence to go home. The beds were based in a care home environment with support to help people move back home.

7.    Reablement service – will that be a 9-5 5 days a week. It was difficult to get equipment at the right time when it was needed for discharge from hospital. Will this be improved?

We were working with community reablement staff to try and improve this service. 

8.    With Adults there was a lot coming forward within the 10-year plan. Are we looking at our assets to see if we can repurpose them for the future?

We are always looking at our assets.

9.    Working together - ¾ of council taxpayers’ funding was spent on Children’s and Adults budgets when only 5% of the population accessed this service. Perhaps interventions with Housing would be better spent?  Priority was keeping families together so are we doing enough in public transport and housing as targeted intervention?  

There were attempts to get people to move into better housing which was work we do with housing associations.  

10. If the 10-year plan was not impacting on the 2023/24 budget what were the timescales for the 10-year plan? 

The 10-year plan would impact on the 2023/24 budget, but we will bring regular updates to Cabinet. The 10-year plan would come through the People & Health Overview Committee. 

Housing

1.    Does the council have plans to set up a housing revenue account? 

We do not have the scale to do this. Councils with a larger housing stock would be in a better position to do this. Homes Dorset would give opportunities for the housing team.  

2.    What are we doing to get more housing? 

We get more from Housing Associations and more from Health. We need to ensure that we have enough support from providers. 

3.    A budget this small was very good value for money. Could we manage a deal with providers when they were looking at disposing their stock? 

We do speak to registered providers constantly and do have options to purchase their stock.  

4.    Homes Dorset could be a small player and needed some disruption – a dynamic council providing more social housing so that other providers can become more efficient. 

Noted. 

5.    What could we as councillors do to help you provide more accommodation? 

We need more funding to be more agile as and when we want to be. A report would be coming to cabinet in February to discuss the capital plans. 

6.    We need to make a clear and concise strategy around housing as otherwise we would be in the same place next year.  

Government’s changes to planning policy would change viability for planning which would help local authorities. Our aspiration was to make sure we have enough housing for our residents. 

Public Health

1.    What would a 1% uplift in the Public Health Grant be used for?

It would be likely to be put into existing services, however the Joint Public Health Board would make the decision.

Children’s Services  

1.    Concern that the funding on the National Transfer Scheme for unaccompanied minors was not enough and that additional funding had to be found locally for something that was a national policy. 

This was an issue impacting the whole country and not just specifically for Dorset. In order to ensure that the unaccompanied minors have the right level of care we have needed to meet the additional cost which was a risk to our budget.

2.    Concern about that there aren’t enough foster carers to meet demand, and that the budget may not be sufficient. 

We regularly have campaigns to increase the number of foster carers. The budget has been reviewed and remodelled and it is felt that the budget is sufficient for this work in 2023/24.  

3.    How will the budget risks be mitigated? 

The Children’s Services management team would carefully manage their budgets, but where these cannot be contained within the service alone, then the service was able to draw on the central contingency budget.  

For 2023/24 the contingency budget has been set at £8.2M.  

Finally, the council has reserves to manage the most significant financial risks. 

4.    Observation of no cuts – well done.

5.    Huge thanks and comments around partnership working.

6.    Pressure of £700k for Children who are Disabled Service – Intensive Support Packages. Could we be in a position where we do not spend, or overspend, this money due to a lack of carers? 

There was a challenge in the number of carers and overnight short breaks available. Developing in-house accommodation and adopting the harbour approach for supporting children with disabilities. Working with adult social care to get a fairer price for in-home care.

7.    Was there any income from Coombe House anticipated? 

Any additional income for additional places from other local authorities would come through the Dorset Centre of Excellence company rather than into the Dorset Council’s budget.

8.    Can you explain the £3.7M additional funding social care grant? 

This money was funded through the service area and was in addition to the increase in fees and charges income that was expected.