Update to Q2 Revenue Budget Monitoring Report – Adult Social Care & Winter Pressures

Background

In the last few weeks there has been an increased focus on how the Council, along with partners in Health, responds to a number of challenging factors that threaten to impact adult social care during the winter. Given the urgency of some of these pressures an action plan has been brought together.

This report addendum sets out some of that action plan that is to be progressed over the coming weeks and months and have resource implications. All of the actions are funded from existing budget provision and do not cause any changes to the projected revenue budget forecast but they will clearly consume funding that would otherwise be available and the timescales are such that it was not possible to include this information within the earlier published Q2 revenue budget monitoring report.

Current Social Care Pressures

HAS are currently experiencing unprecedented demand and supply pressures across North Yorkshire. This is a national phenomenon but the following provides some of the North Yorkshire specific challenges:-

Care Providers

• 5 homes closed in the last 20 months

• 106 beds closing currently (3% of the market)

• Home care providers handing back packages on a regular basis

• 1500 hours/week home care in-sourced by NYCC and CYC in the Summer when a Selby provider failed

The Table below shows the contrast in just a year on home care packages:-

In-house Staff and Recruitment

• Fierce labour market competition since July 2021

• Vacancies in NYCC teams ranging from 11 – 26%

• Job applications down 70%

• National estimate: 2% contraction in the available workforce in last 3 months

• Recruitment campaign live at www.makecarematter.co.uk

• Reablement staff being diverted to provision of direct care

In addition, the hospital discharge programme remains in place until March 2022 and levels of discharge remain at similar levels to last year (but with less supply of staff and other providers) – see below:

Proposed Actions

A range of actions have been proposed that seek to bolster the care market and internal capacity within the Council. The actions have been broken down into recurring pressures and one-off pressures as set out in the Table below. It is proposed that the recurring pressures are funded from the £5.1m budget provision that was created for “market shaping” in HAS – this use is perhaps different from what was previously envisaged but it does need to impact the care market. The one-off pressures are temporary and can be accommodated within ringfenced grant funding which has already been received from government. It is important to note that these actions must cease at the point when the grant has been fully depleted or this will cause extra financial pressure on the Council’s core revenue budget.

	£000	£000
Recurring Budget Pressure
Front-line social care - Assessment	550
C&S equalisation of pay bands	251
Resource worker car offer	600
Quality Pathway	790
		2,191
One-off Pressures
Recruitment Activity	263
CRC	148
Frontline staffing	878
Auxiliary Workforce	690
Provider Support staffing	1,199
Support to unpaid carers	250
Front-line social care - Reviews	592
		4,020
		6,211

In addition, discussions are ongoing with Health colleagues about further potential interventions to support care staff retention and recruitment. This may result in further actions and funding from Health.

Recommendation

The Executive is requested to note the proposed actions to help address winter pressures in adult social care as set out above.