Agenda item

Considered – A detailed presentation on the financial management of Adult Social Care cost pressures, provided by the Director for Health and Adult Services (HAS) and supporting officers.

Richard Webb, Director for HAS introduced the presentation and provided an overview of the key cost pressures and the actions being taken to address them, which included:

·          A breakdown of the HAS budget for 2025-26 and expected overspend

·          The increased number of hospital discharges and associated additional cost to the Council

·          The increased use and associated spending on the provision of short-stay beds

·          The comprehensive 3-year plan to reduce the use of short-term beds and average length of stay

·          The increased average cost of care home placements, and the investment in a new e-brokerage system

·          The expansion of Extra Care across the county

·          The increase in resource as a result of the restructure of ASC

·          The above average cost of Home Care across the county as a result of the rural premium paid, which had reduced in 2025 in part due to better prices from providers

·          The ongoing work to improve long waiting times for referrals and assessments

·          An overview of the Pilot in Whitby testing a new model of commissioning home care with an alliance of care providers

·          The expansion of the use of Direct Payments and introduction of individual service funds

·          The introduction of Occupational Therapy Assistants to reduce a backlog in assessments

·          The 140 new supported living units in the pipeline, to reduce the demand for more restrictive and expensive residential care

·          The establishment of a Preparation for Adulthood team to enable more joined up working with Children’s Services

·          The continuing Healthcare Income Plan aimed at ensuring that the NHS pays appropriately

Richard Webb also provided an overview of a proposed 3-year pilot of a new Prevention Plus Model which would build on the success of Living Well and involve working with a number of Community Anchor organisations across the county to deliver local services and activities. 

In response to Members’ questions, officers confirmed:

·          An increase in population was a factor in the rising costs of ASC, as people were living longer

·          The Council had inherited a fairly low public health budget

·          Complaints around hospital discharges were fully assessed for lessons learnt

·          15-16 additional extra care schemes were being developed across the county with funding from Homes for England - Developers were always encouraged to build extra care facilities

·          In response to a finding from the CQC inspection, the workloads of Social Workers were moving to being more specialised.

·          Data on the speed of recovery as a result of early hospital discharge was currently fragmented. 

Members noted the potential future cost pressures and went on to debate the age split used to focus service delivery i.e. 18-74 and 75+, suggesting that it may be appropriate to also have a clear focus on those aged 18-25, given the potentially high number of young people with complex needs transitioning from Children’s Services to Adult Services.

It was also suggested that the Council should use revenue from second homes council tax to fund the building of specialist housing.

The Chair thanked officers for the detailed presentation, and it was

Resolved – That the presentation on the financial management of Adult Social Care cost pressures be noted.