Archived decisions

Hampshire County Council

Executive Member - Social Care

Item 2

24 January 2003

(Amended Decision)

Revenue Budget 2003/04

Report of the County Treasurer and the Director of Social Services

    Contact: Gordon Shinn, Head of Finance ext 7526

    1 Summary

    1.1 The following decisions are sought:

    · To approve the base budget for 2003/04 (as set out in Appendix 1)

    · To approve the framework, as set out in the report, to set the Social Services 2003/04 revenue budget within the passported amount, but with the understanding that this depends on the outcome of assumptions which cannot yet be verified. These include the extent to which specific grants can be used under the new freedoms for the County Council to meet local pressures and priorities.

    · To advise the cabinet of the potential impact of 1% or 1.5% reductions below the passported amount (as set out in paragraph 6)

    · To approve the annual review of income and charges (as set out in Appendix 4)

    · To approve that the non-residential care charges be reviewed in July with the possibility of increases from October

    · To approve the revised budget for 2002/03 (as set out in Appendix 7)

    · To request the Cabinet consider setting up a corporate contingency against which the executive member for Social Care can make a claim if the outcome of the uncertainties identified leads to a worsened position such that the pressures and demands cannot be absorbed within specific grants and the adjusted 7.3% passported cash increase in the social services formula funding share.

    · To request officers to report back on the costs of implementing and monitoring the proposed legislation on charging for delayed charges.

    2 Reasons

    2.1 Cabinet have requested:

      · that service budgets be prepared in consultation with executive members within budget guidelines, as set out in the report for consideration by policy review committees

      · that executive members approve service budgets within the budget guidelines for submission to the Leader and Cabinet

      · that executive members identify savings of 1% and a further 0.5%, including efficiency savings and cost increases absorbed by efficiency improvements

      · that executive members identify other savings to offset all other growth proposals

      · that executive members report back on their annual review of charges and maximisation of income.

    3 Other options considered and rejected - not applicable

    4 Conflicts of interest declared by the decision maker or a member or officer consulted - not applicable

    5 Dispensation granted by the Standards Committee - not applicable

    6 Reason(s) for the matter being dealt with if urgent - not applicable

    Approved by: (signature) Date: (date of decision)

    ......................................... .........................................

    Councillor Felicity Hindson

 

Hampshire County Council

 

Executive Member - Social Care

Item

 

24 January 2003

 
 

Revenue Budget 2003/04

 

Report of the County Treasurer and the Director of Social Services

    Contact: Gordon Shinn, Head of Finance, ext 7526

    7 Introduction

    7.1 This report sets out the proposed Social Services revenue budget for 2003/04 and reports on the revised budget for 2002/03. The Social Care Executive Member is recommended to approve for submission to the Cabinet:

    · The base budget for 2003/04 (as set out in Appendix 1)

    · The framework, as set out in the report, to set the Social Services 2003/04 revenue budget within the passported amount, but with the understanding that this depends on the outcome of assumptions which cannot yet be verified. These include the extent to which specific grants can be used under the new freedoms for the County Council to meet local pressures and priorities.

    · Potential impact of 1% or 1.5% reductions below the passported amount (as set out in paragraph 6)

    · The annual review of income and charges (as set out in Appendix 4)

    · Non-residential care charges be reviewed in July with the possibility of increases from October

    · The revised budget for 2002/03 (as set out in Appendix 7)

    · The request for setting up a corporate contingency against which the executive member for Social Care can make a claim if the outcome of the uncertainties identified leads to a worsened position such that the pressures and demands cannot be absorbed within specific grants and the adjusted 7.3% passported cash increase in the social services formula spending share

    7.2 For this service, the provisional budget guideline is £222.1m.

    7.3 This report sets out the Social Care executive member's responses to the guidelines. The report:

      · reviews the base budget which totals £222.1m

      · identifies £327,000 of pressures and costs absorbed

      · identifies additional funding of £6.6m from the passporting of an increase of £13.4m in Social Services

      · sets out the potential use of government grants

      · reviews the charges made by this service.

    7.4 Prior to the Executive Member for Social Care considering the budget, this report is being presented to the Social Care Policy Review Committee to provide the Committee with the opportunity to comment to the Executive member.

    8 Revised budget

    8.1 The last monitoring report to the Executive Member for Social care on 15 November 2002 showed a potential overspend for this year of just over £3m, were no corrective action to be taken. That report identified the increased demand for services across all client groups.

    8.2 Management action continues to bear down on those pressures in order to try and achieve a balanced budget by year end. However, this means that some clients are not receiving services they would have expected or are waiting longer as cash limited sums are targeted on those most in need and on delayed charges. This applies particularly to support at home and to respite care.

    8.3 The Cabinet has agreed to release up to £2m to Social Services in 2002/03 as a one-off addition in order to assist Social Services to meet targets for the reduction of beds blocked in hospital for the rest of 2002/03 and into 2003/04. This will fund direct care costs for those coming out of hospital and will be added to the Social Services cash limit later in the year.

    8.4 Social Services officers are also working closely with Health colleagues in order to develop services to prevent hospital admissions. For example, intermediate care services are being developed in the County Council's own older people's homes. However, it is unlikely that this will have much impact in the current financial year.

    8.5 Whilst this additional funding is extremely welcome, it will not directly impact on the bottom-line position for older people as it is to enable additional care to be purchased; and the main pressure in children and families and adults' services will remain.

    9 Base budget 2003/04

    9.1 A base budget has been prepared which continues the current financial policies of the Council, in order to provide a starting point from which decisions can be made. The base budget for this service is £222.1m.

    9.2 Appendix 1 shows the make up of the base budget.

    9.3 Overall, the base budget includes a net increase in expenditure at constant prices of £6.6m. The main variations are:

      · Loss of income of £1.0m in respect of non-residential charges. The revised policy agreed by the cabinet in September 2002 as a result of the Government's `Fairer Charging' guidelines, means an estimated annual loss of income of £1m (see paragraph 7.3)

      · Increases in Government Grants of £8.9m. These are shown in Appendix 6 and discussed in paragraph 5

      · A reduction of £5.8m in respect of Free Nursing Care (or NHS funded nursing care). Funding has been transferred to the Health Service to meet the cost of health care of all social services clients placed in nursing care

      · Additional increase of £2.3m in respect of the withdrawal of the residential allowance that clients entering independent sector residential care used to be entitled to. In effect this equalises the minimum income from residents in both the County Council's homes and independent sector homes.

    10 Passported increase in social services

    10.1 The passported Social Services Formula Spending Share (FSS) increase is 7.3%, which amounts to a cash limit increase of about £13.5m. The average increase for the 34 Shire Counties is 8.5%, with Hampshire receiving the 28th highest increase.

    10.2 In addition to this there is a net increase of £6.5m to the 2002/03 SSA baseline figure, made up as follows:-

 

£000

£000

(i) Grants rolled into formula spend:-

   

    Promoting Independence

3,021

 

    Residential Allowance

1,676

 

    Building Care Capacity

5,160

 
   

9,857

(ii) Function transfers

   

    Free Nursing Care

(5,831)

 

    Residential Allowance (new)

2,285

 

    National Care Standards Commission

182

 
   

(3,364)

   

6,493

    10.3 The items in (i) simply replace the 2002/03 grant allocations and, therefore, there should be no `bottom line' impact as a result of these changes.

    10.4 From 1 April 2003 the NHS becomes responsible for the cost of nursing care for all Social Services clients in nursing homes. The funding transfer represents an estimate of these costs. This would appear to be broadly in line with the assumption that the average cost per client will be between £75 and £85 per week.

    10.5 The new residential allowance figure of £2.285m represents the cost in terms of lost income from new clients entering independent sector residential care who, prior to April 2002, would have been eligible for the allowance. In October 2003 the allowance is also due to be withdrawn from clients placed prior to April 2002. A further funding transfer is to be made plus an additional amount to cover administrative costs for re-assessment.

    10.6 The National Care Standards Commission transfer represents the balance of the full year effect of the transfer in 2002/03. This is to cover for the income collected in advance prior to transfer in April 2002.

    10.7 After allowing for corporate inflation assumptions for pay (3.5%) and non-pay (2.5%) and other base budget adjustments, there is approximately £6.6m available from the passported FSS increase to meet new pressures in 2003/04, as follows:

     

    £m

    £m

     

    FSS increase

     

    13.4

     

    Less:

       
     

    Joint Finance taper

    (0.1)

     
     

    Non-residential charges income loss

    (1.0)

     
     

    2003/04 inflation

    (5.6)

     
     

    2002/03 pay full year cost

    (0.1)

     
         

    (6.8)

         

    6.6

    10.8 Details of the provisional financial settlement for Social Services, including some information on specific grants, are set out in the Department of Health's Local Authority Social Services Letter LASSL(2002)11.

    11 Government Grants

    11.1 Current estimated specific grants for 2003/04 are shown in Appendix 6. This identifies an estimated increase of £8.9m compared with 2002/03, after excluding those rolled into formula grant and assuming the same level of grant as 2002/03 (where applicable) for those not yet announced.

    11.2 As explained in paragraph 4.2, three grants have been rolled into formula funding, which means that spend on these services is incorporated into the base budget.

    11.3 Some grant details that were not announced within LASSL (2002) 11 are being released in subsequent weeks. In particular, details of the Preserved Rights Grant are still awaited. It is understood that these will not be known until February.

    11.4 The Government is introducing some new grants, most notably:-

      · Access and Systems Capacity (£3.2m). The purpose of this is to expand the capacity and range of community based social care services for older people and other adults. The intention is that it will help social services meet the new access targets for assessment and provision of services. It is aimed at providing funds to employ more staff to undertake assessments, home care, intermediate care, services from home improvement agencies (HIAs), and community equipment. Sums will be ring fenced within the grant for HIAs and community equipment services.

      · National Training Strategy. This is to support the training of social care staff across the statutory, private and voluntary sectors. It is expected that the majority of this grant will be spent on developing National Vocational Qualifications (NVQs) in social care to meet the National Minimum Standards.

      · Human Resources Development Strategy. This grant is to support social care employers develop the social care workforce, so that:

        · reforms in service provision can be assisted by developments of new types of worker;

        · developments in the social work post-qualifying framework can be taken forward;

        · the effectiveness of human resources management can be raised; and

        · serious problems of recruitment and retention of staff can be tackled

    11.5 There are three new areas of responsibility for which details of funding transfer mechanisms are not clear. These are:

      · Supporting People (contracts)

      · Children's Fund

      · Delayed Discharges

    11.6 The Supporting People initiative is a major new responsibility that comes into effect on 1 April 2003. It brings together various different funding streams for supported housing and sets up a new `single pot' to be managed by local authorities. The expectation is that local authorities will maintain stability in the commissioning arrangements with the independent sector. This funding transfer should, therefore, match the spending required. Based on existing contracts the estimated value that Hampshire Social Services will have to manage in 2003/04 is £46m, for which funding will be transferred. Clearly this is a very significant management challenge: details of how it is being tackled were approved by the Executive Member on 15 November 2002.

    11.7 Hampshire County Council Social Services is the lead agency in a Government initiative to help develop preventive services across various agencies for 5 to 13 year olds. The funding for this comes via the Children's Fund, for which there is a grant of £2.4m per annum for 3 years.

    11.8 The Community Care (Delayed Discharges etc) Bill, when enacted, will introduce payments to acute trusts for delayed hospital discharges deemed to be the responsibility of Social Services. A funding transfer of £100m from the NHS to Social Services has been earmarked. Hampshire Social Services' share would be in the region of £2m if funding were allocated according to FSS. However, the distribution mechanism and criteria are not yet known. Also, it is understood that this sum will be reduced if the necessary legislation is delayed.

    11.9 There are increases and changes to other ongoing grants, including:-

      · Children's services - increase of £1.8m. This includes new elements for Adoption Support and Special Guardianship Support and for Choice Protects.

      · CAMHS (Child and Adolescent Mental Health Services) - increase of £0.5m. The government priority for 2003/04 is to ensure that all CAMHS have child and adolescent mental health workers or other child mental health professionals available to support services for children and young people seen within primary care settings.

    11.10 The County Council's `Excellent' CPA rating, together with the Social Services Department's `Two Stars', provides a range of freedoms from 2003/04 with the use of grants, as follows:-

      · Ring fencing removed

      · 25% of grant money can be carried over into the following year

      · No audit

      · Inspection holiday for 3 years (except child protection services)

    11.11 Details are still emerging as to exactly how these freedoms can be implemented. However, current guidance says that these freedoms are reviewed in accordance with changes in the authority's CPA rating and the Social Services Department's star rating. For example, if the Department becomes three star in November 2003, then the greater freedoms such as 100% grant carry over will apply from 2004/05. However, if the Department becomes one star then grants will become ring fenced again.

    11.12 In 2003/04 the Department should be considering investment in those areas where performance needs to be maintained or improved. There will be expectations that the Department is aiming to achieve key government objectives for which grants are intended to be used even though there is no need to account for spend in those areas. However, the pressures in areas to which the government attaches high priority (in particular delayed discharges) are such that some flexibility in the use of grants is appropriate. Accordingly, this paper is constructed on the basis that all non-ring-fenced grants can be accumulated into a single pot to be offset against the overall pressures on the budget.

    11.13 In total it is estimated that there will be an extra £15.5m to meet additional pressures in 2003/04 as follows:

       

    £m

    Net increase in passported FSS increase (see paragraph 4.7)

     

    6.6

    Estimated Increase in specific grants (excluding impact of Preserved Rights, Children's Fund, Supporting People and including £2.0m for Delayed Discharges)

     

    8.9

       
       

    15.5

    12 Savings and redeployment proposals

    12.1 Cabinet requires the executive member for Social Care to report back on the implications of 1% and 1.5% reductions in cash limits.

    12.2 Given the substantial increase in the budget but the even more substantial new and continuing pressures, the only sensible way to make savings in 2003/04 is to ration supply. This boils down to how strongly to resist new demands in which judgement must be applied as there is a danger of unsatisfactory care outcomes, legal challenges, additional costs eventually being incurred or, for blocking beds, fines. The management actions which can achieve savings (such as bringing clients back from more expensive placements to cheaper ones) are existing parts of the actions planned to keep within the budget. Any closure of facilities could not be expected to generate significant savings in 2003/04 given the need to consult, plan, pay transitional costs and arrange re-provision as appropriate.

    13 Review of charges

    13.1 The service's 2003/04 revenue budget includes income of £46.5m from fees and charges. Details of the material headings are included in Appendix 4.

    13.2 There are some mandatory and national charges which the County Council is not able to vary. Some charges, most notably those for residential accommodation for adults and older people, require financial assessments based on nationally determined guidelines.

    13.3 The Government has imposed new `Fairer Charging' guidelines for clients receiving non-residential services. Some aspects of these guidelines had to be introduced by 1 October 2002, with the rest by 1 April 2003. On 23 September 2002 the Cabinet agreed a revised policy, effective from 1 October 2002 that also included a rationalisation of charging from 1 January 2003 and a recognition that charges would not be increased from 1 April. This has resulted in a substantial increase in the number of clients receiving free services and an estimated loss of income of about £1m per annum. Most of this (£0.7m) is being dealt with within the 2002/03 budget by one off action, which still leaves a £1m pressure on 2003/04. It is proposed that a decision be made in July as to whether any increases in charges (which would help to deal with this) should be made with effect from October 2003 or should wait until 2004.

    13.4 Discretionary charges are reviewed annually except when they are subject to agreements which cover longer periods when the review takes place at the end of the period of the agreement. Examples of those reviewed annually are the provision of meals for adults and older people and parental contributions for children in care.

    14 New Government requirements

    14.1 As in previous years, there has been a steady flow of new Government requirements of Social Services in 2002/03. One Act of Parliament, the Adoption & Children Act 2002, received Royal Assent (on 7 November 2002). This Act supersedes the 1976 Adoption Act and modernises the legal framework for domestic and inter-country adoption. It will be implemented over the course of the current year and next, with full implementation planned for 2004. The budget proposals in section 9 include an allocation for improvements to adoption work.

    14.2 The Children Act (Miscellaneous amendments)(England) Regulations 2002 were published. Their intention is to promote the health of looked-after children, ensuring that a health assessment (including both physical and mental health) is undertaken as soon as practicable after a child comes into care, a written report and a health plan is prepared for each child and a health review is carried out every 6 months for children between 2 and 5 years old and annually for the over fives. New fostering services regulations also came into force on 1 April 2002.

    14.3 The Government announced:

      · new codes of practice for social care workers and employers;

      · a National suicide prevention strategy;

      · the creation of a practice learning taskforce to assist with the reform of social work education and training;

      · new education, training and qualification requirements for social care services for people with learning disabilities;

      · an action plan on young runaways.

    14.4 New national minimum standards, covering fostering services, children's advocacy services and children's homes also came into force. The latter covers: planning for care; quality of care; complaints and child protection; care and control; environment (room size, etc); staffing; management and administration.

    14.5 New guidance, aimed at driving up the quality of services, was issued on a range of topics including:

      · drug services for homeless people;

      · developing services for carers and families of people with mental illness;

      · discharge from hospital;

      · autistic spectrum disorders (co-ordinating provision with education);

      · care management for older people with serious mental health problems;

      · care leaving strategies;

      · complex child abuse investigations;

      · `Fair access to care services' - eligibility criteria for adult social care;

      · an information strategy for older people;

      · `Fairer charging' policies for home care and other non-residential social services;

      · the single assessment process for older people;

      · person-centred planning (Valuing People implementation);

      · stroke services.

    14.6 The Government also issued consultation documents, foreshadowing changes to come, on a range of subjects, including:

      · promoting inter-agency working in the family justice system;

      · modernising mental health services for people who are deaf;

      · policy and practice guidance changes to the Community care (Direct Payments) Act 1996.

    14.7 All of these new expectations carry potential resource implications for Social Services which will imply difficult prioritisation decisions, given the pressures on the budget described elsewhere in this report.

    15 Overall position

    15.1 In common with most Social Services departments across the country, funding pressures are severe. The Association of Directors of Social Services (ADSS) and the Local Government Association (LGA) are carrying out a survey of all Social Services authorities in January 2003 to ascertain the overall picture. However, in assessing the exact extent of the pressures this year, it is clear that these are greater than in previous years and carry even more uncertainties:

      · the level of some grants is unknown

      · the exact nature of the un-ring-fencing regime for 2003/04 is not yet certain and this could also have a large impact. It has been assumed at this stage in the two largest areas of recent transfer of responsibility (preserved rights and supporting people), which between them account for in excess of £50m, that the amounts transferred will be sufficient to meet the Council's responsibilities but no more.

      · full details ( including timing) of the introduction of fines for blocking hospital beds are not yet known. If this regime is deferred, this may in turn impact on the amount of grant received.

      · the number of places which will need to be provided in order to prevent blockage of hospital beds is hard to forecast. It depends crucially on the patient turnround in hospitals, which is a factor which is beyond the County Council's influence, let alone control.

      · the market for purchasing care in all sectors remains highly volatile, and the need to purchase more beds (at least in the interim until the planned capital investment adds to in-house nursing care capacity) will add to pressure on supply and potentially on price. In 2002/03 the Social Services Department agreed to pay substantial increases in fees to independent sector home providers for clients entering residential care - about 5% for very dependent elderly clients and over 14% for elderly nursing care clients. These brought increases over the last four years to 16% and 32% respectively, summarised as follows:

 

Very Dependent

Nursing

 

Annual

Cumulative

Annual

Cumulative

1999

4.1%

4.1%

4.3%

4.3%

2000

2.3%

6.4%

2.8%

7.1%

2001

4.0%

10.7%

7.5%

15.2%

2002

5.0%

16.2%

14.2%

31.6%

      · provision is being made within the funds available to make further above inflation increases from April 2003. However, it is unlikely that the anticipated demands from providers will be met in full. Whilst the pressures faced by the independent sector are recognised, a balance needs to be struck taking into account what Social Services can afford.

      · there are similar pressures on domiciliary care (which operates through a contract-by-contract competitive tendering process and is therefore driven almost entirely by the market) and other placements on learning disabilities, physical disability and children's services. Price increases were typically above 5% for these in 2002/03 and similar levels of increase are possible in 2003/04.

      · The National Care Standards Commission proposes to introduce demanding new staffing requirements with major cost implications. That could impact on both in-house and external sectors. It is assumed for the purpose of setting this budget any such changes can be covered through a combination of phasing in, absorbing and offsetting the impact.

    15.2 Given all these issues, it is possible to give only a broad provisional view of how the budget might look. This suggests that, assuming that there is no overspend in 2002/03 to be carried forward, the following is feasible. After adjustments for corporate inflation assumptions, including extra national insurance and pension contributions (details in Appendix 1) there remains £6.6m available of effective growth to meet pressures (see paragraph 4.6). In addition, it is estimated at this stage that £8.9m of grant can be used flexibly although this includes an estimated £2m in respect of delayed discharges grant. This provides £15.5m which it is proposed could be deployed as follows:

     

    £m

    £m

    % of 2003/04 base budget

    Older People

         

    Purchase of extra capacity (including equipment)

    2.3

       

    Price increases above corporate inflation assumptions for domiciliary, residential and nursing care

    7.0

       

    Revenue costs of intermediate care developments

    0.5

       

    Sub total

     

    9.8

    11.8

           

    Children & Families

         

    Adoption & family support

    0.6

       

    Price increase above corporate inflation assumptions

    0.3

       

    Ongoing children's placement pressures that cannot be managed down

    2.4

       

    Sub total

     

    3.3

    6.9

           

    Adults

         

    Transitional age cases

    1.0

       

    Price increases above corporate inflation assumptions for domiciliary, residential and nursing care

    0.7

       

    Equipment testing requirement

    0.2

       

    Sub-total

     

    1.9

    2.7

    Other

         

    Training, health and safety, essential Information Technology and information management, and communications

     

    0.5

     

    Total

     

    15.5

     

    7.0

    15.3 In order to reach this position, it is necessary both to take some risks with unknown factors and not to progress some items which are judged of a very high priority. It is difficult to quantify these impacts, but they could amount to £10m in the worst case. It is unlikely that all will occur together, and there should be some offsetting ability to manage down demand. The main risk areas are:

      · Extra capacity may be needed to purchase enough older persons care to avoid bed blocking

      · There may be additional market pressures to increase both nursing care and older persons' residential prices,

      · It may be difficult to restrict older persons domiciliary demand to current levels

      · Increases may be needed to adults and older persons home staffing

      · Delayed discharge grant (£2m) may not be available

      This assumes that there will be full freedom in the use of ring fenced grants. Even the most favourable allocations from those grants which are not yet finalised would not be enough to cover the potential scale of these issues.

    15.4 High priority actions which are not feasible given the budget position include additional children's capacity to recognise the full extent of ongoing budget pressures this year (more effective management action will have to be taken next year), further transitional age pressures to be absorbed, help for older carers with learning disability clients, mental health pressures, and advertising costs.

    15.5 There are also pressures to fund Swift, the new Social Services IT system. It is being assumed that this can be handled through a capital route over the next three years, but this will require further consideration at a later date.

    15.6 Given the extent of both pressures and uncertainties, it is proposed at this stage that the Social Services budget be set at the passported amount on the basis set out above, but that the Cabinet be asked to examine the potential for setting aside a contingency sum on which the Executive member for Social Services could call at a later stage should the pressures set out above be shown to have developed towards the worst case scenario.

    16 Performance Implications

    16.1 The Social Services Department's performance position, in the context of the Department of Health's Performance Assessment Framework and Performance Classification, is well-known. A report on this subject was considered by the Executive Member, Social Care, on 20 December 2002 and there is a report elsewhere on the agenda of the current meeting of the Social Care Policy Review Committee. The two-star classification is a satisfactory one and has helped the County Council overall to the `excellent' rating recently achieved in the Comprehensive Performance Assessment (CPA).

    16.2 This general position, however, does conceal some weaknesses, notably in such areas as the provision of intensive home care. The current two-star rating is based upon the Social Services Inspectorate's assessment that the Department is serving some adults well, with promising prospects, and most children well, also with promising prospects. This is the minimum requirement for such a rating. An SSI assessment that concluded that only some children were served well, for example, or that future prospects for services for either adults or children were uncertain, would mean a reduction in the star rating. Such an assessment would impact upon the CPA and, potentially, on the County Council's Public Service Agreement.

    16.3 To improve from a two-star to a three-star position would require the SSI to judge that the Department was serving most adults well, with excellent prospects, and all children well, also with excellent prospects. This would be unlikely without considerable additional investment in services.

    16.4 The £15.5m increase in budget provision, referred to in section 9, should ensure that two star performance is maintained. However, the proposals set out in that section acknowledge that due to severe inflationary pressures £8m of the increase would be needed simply to ensure that current levels of service are continued. The allocation of a further £2.4m to meet continuing pressures of placements for looked-after children adds to this. Only £2.3m would be available to increase care capacity. Such an increase would be unlikely in itself to result in a three-star rating, but the overall budget increase should improve the chances of management actions taking forward service improvements within available resources rather than concentrating primarily on budget management. That is in line with the Government's stated intention that the introduction of flexibilities in the use of grants was intended to give authorities incentives to improve services.

    17 Other expenditure

    17.1 The budget includes some items which are not counted against the cash limit. This includes budgets for central departments support services, except where they have been given to departments to buy services, and repair and maintenance of buildings. It also includes costs of member support within the Social Services budget which are rechargeable to Policy and Resources for Corporate and democratic core services.

    18 Staffing statistics

    18.1 The average number of staff in the base budget for 2002/03 is 3,384. The department's workforce plan shows that these are 3,220 full-time equivalent posts, with proposals for 233 extra staff. The proposals for growth (section 9) include proposals that may require new staff, although exact numbers are unclear at this stage.

    19 Recommendations

      It is recommended that the Executive Member recommends to the Cabinet that:

    · The base budget for 2003/04, as set out in Appendix 1, be approved

    · The framework, as set out in the report, to set the Social Services 2003/04 revenue budget within the passported amount be approved, but with the understanding that this depends on the outcome of assumptions which cannot yet be verified. These include the extent to which specific grants can be used under the new freedoms for the County Council to meet local pressures and priorities.

    · The potential impact of 1% and 1.5% reductions below the passported amount, as set out in the report, be noted

    · The annual review of income and charges, as set out in Appendix 4, be approved

    · Non-residential care charges be reviewed in July with the possibility of increases from October

    · The revised budget for 2002/03, as set out in Appendix 7, be approved

    · The Cabinet consider setting up a corporate contingency against which the executive member for Social Care can make a claim if the outcome of the uncertainties identified leads to a worsened position such that the pressures and demands cannot be absorbed within specific grants and the adjusted 7.3% passported cash increase in the social services formula funding share

    · To request officers to report back on the costs of implementing and monitoring the proposed legislation on charging for delayed discharges.

    Section 100 D - Local Government Act 1972 - background papers

    The following documents disclose facts or matters on which this report, or an important part of it, is based and has been relied upon to a material extent in the preparation of this report.

    NB the list excludes:

    1. Published works.

    2. Documents which disclose exempt or confidential information as defined in the Act.

      TITLE FILE

      None

    Appendix 1

    Social Services

    Revenue Budget 2003/04

    Construction of Base Budget 2003/04 - Summary of Cash Limited Expenditure

    The following table shows the progression from the original budget for 2002/03 which was prepared at outturn prices 2002/03.

   

£'000

£'000

Original budget 2002/03 at outturn prices

 

206,034

 

Transfers to/from other Services:

   
 

PU Charges (IT)

274

 
 

HPSN Charges (IT)

125

 
 

Inflation (IT Charges)

44

 
     

443

       

206,477

Variation in inflation to November 2002 as detailed in Annex 2

 

-

Full year cost of pay awards in 2002/03

878

 

-

Inflation on business rates

11

 

-

Excess cost of inflation over the inflation allowance 2,500

2,500

 
       

3,389

   

209,866

     

Other variations (see Annex 3)

   
       

Function Changes

   
 

Free Nursing Care

(5,831)

 
 

Residential Allowance - New

2,285

 
 

National Care Standards Commission

182

 
       

Variations in Government grants

8,884

 
       

Virements between Services

   
 

Personnel and Training

(15)

 
 

Health and Safety Training from Personnel and Training 26

 
 

Transfer of Blue Badges to CT

(124)

 
 

PSA Pump Priming Grant

108

 
       

Allowable Base Budget Adjustments

   
 

Joint Finance Taper

117

 
 

Revenue Effects of Capital Schemes

6

 
 

Non Residential Charging Review

1,000

 
       
     

6,638

       

Base Budget at November 2002 prices

 

216,504

       

Allocation for future inflation

 

5,628

     

Base Budget 2003/04 at outturn prices

 

222,132

    Annex 1 to Appendix 1

    Social Services

    Calculation of Base Budget 2003/04

    Parameters used in the compilation

1

Definitions

1.1

The first stage in the construction of the budget for 2002/03 is the preparation of a base budget. The rules used this year are similar to those applied in 2002/03, which are summarised below.

       

1.2

The 2003/04 base budget is defined as the current year's budget adjusted for:

allocations made for inflation in 2002/03 including the full year effect of the provision made for pay awards in 2002/03

exclusion of expenditure included in the 2002/03 budget which was financed by the carry forward of planned underspendings from 2001/02, the one-off use of reserves or balances, or which was approved on a non-recurring basis

the revenue effect of past capital programmes, subject to its inclusion in the approved capital programme

changes in income volumes which are not the result of policy decisions

correction of arithmetical errors in the current year's budget

The following specific items:

   

Education

Variations arising directly from changes in the number of pupils in schools, pupils eligible for free meals and numbers of days in the school year

       
   

Environment

Routine highway and street lighting maintenance arising from variations in road length

     

Variations in waste disposal volumes

       

    Annex 2 to Appendix 1

    Social Services

    Calculation of Base Budget 2003/04

    Significant costs of inflation

1.

Variation between the actual cost of inflation in 2002/03 and the provision for inflation included in the 2002/03 budget

       

£'000

£'000

           
 

Additional cost of inflation

 

3,828

 

Less

   
 

-

full year effect of pay awards during 2002/03

(878)

 
 

-

subsequent allocations made from the central contingency for inflation:

     

business rates

(11)

 
     

Excess cost of inflation over the inflation outturn and November 2002.

(2,500)

 
       

(3,389)

 

=

Shortfall in inflation provision

 

439

           

2.

Significant costs of inflation between 2002/03 outturn prices and November 2002 prices.

2.1

Pay awards

   
 

Provision was originally made in 2002/03 for pay awards of 4% to teachers and 3% for other pay.

 

£2,406,000

       
 

A subsequent allocation has been made for full year effect of pay awards

 

£878,000

       
 

The additional cost in 2003/04 of the pay awards agreed in 2002/03 is:

 

£23,000

       
 

The pay awards agreed are:

   
     
 

Negotiating body

Effective

Date

%

Included in

Outturn

%

Additional

To Nov 2001

%

 

Hampshire Management Grades

1 April 2002

5.0

3.0

2.0

           
 

Local Government Services Staff

1 April 2002

3.0

3.0

0.0

   

1 Oct 2002

1.0

0.0

1.0

           
 

Teachers

1 April 2002

4.0

4.0

0.0

           

2.2

Non pay inflation

   
 

Provision was originally made in 2002/03 for a net amount of

 

£1,861,000

       
 

This was for price increases of 2.5% (£3,643,000) and income of 2.5% (-£1,782,000)

   
       
 

A subsequent allocation has been made for business rates

 

£11,000

 

A subsequent allocation has been made for increases in Social Care prices

£2,500,000

       
 

Additional cost of price increases other than pay and net of income

 

£416,000

       
       
 

The most significant non-pay rates are as follows

   
       

Outturn 2002/03 to November 2002

Cost in 2003/04

       

%

£'000

 

Staff car allowances

(1.2)

(42)

       
 

Domiciliary Purchasing

7.1

1,163

       
 

Older Person Nursing purchasing

6.3

1,656

       
           

3

Allocation for future inflation

 

£'000

           
 

Provision for pay awards of 3.5% in 2003/04

 

2,731

       
 

Provision for pay award to teachers of 3.5% in 2003/04

 

8

       
 

Provision for non-pay inflation at 2.50%

 

4,564

       
 

Adj. For expenditure financed by specific grants at outturn

 

(730)

       
 

LGPS Pension Contributions

 

370

       
 

National Insurance

 

492

       
 

Allowance for increased income

 

(1,807)

       
 

Total allocation for future inflation

 

5,628

           

    Annex 3 to Appendix 1

    Social Services

    Calculation of Base Budget 2003/04

    Significant variations

    Major variations between the repriced budget 2002/03 and the base budget for 2003/04 at November 2002 outturn prices contributing to the increase/decrease of £6,199.00 (3.0%) are set out below:

 

Variations against the repriced

 

2002/03 budget

 

£'000

£'000

%

       

Transfer of responsibility for paying for Nursing Care

 

(5,831.0)

(2.8)

       

The transfer of this responsibility to the NHS from 1 April 2003 has

     

resulted in a reduction in the base budget, as follows:

     
       

Older People

(5,268.9)

   

Adults under 65 years with Physical or Sensory Impairment

(314.3)

   

Adults under 65 years with Learning Disabilities

(186.6)

   

Adults under 65 years with Mental Health Needs

(61.2)

   
       
       
       

Balances for later allocation

 

(1,777.0)

(0.9)

       

Unallocated balances have decreased by £2.3m, from £16.8m to £14.5m

   

Original unallocated balances of £16.8m included contingency and

     

grant-related expenditure.

     

New grants of £3.7m have not yet been allocated. There has been an

     

increase of £1.0m in respect of the impact of the Non Residential

     

charges review. £9.0m has been allocated to client groups in

     

respect of the Preserved Rights, Promoting Independence and Carers Grants.

   

Allocations of contingencies and grants are as follows:

 

8,757.0

4.2

       

Children's Services

74.1

   
       

Older People

2,382.2

   

Adults under 65 years with Physical or Sensory Impairment

1,378.4

   

Adults under 65 years with Learning Disabilities

4,736.2

   

Adults under 65 years with Mental Health Needs

300.2

   

Other Adult Services

142.6

   

Assessment & Care Management

31.1

   

Management & Support

(287.8)

   
       

Increased / New Grant Funding

 

3,194.0

1.5

       

New and increased grant funding has been included in the 2003/04 base

     

budget. A full analysis is shown at Appendix 6. New grants that have

     

been allocated to client groups are as follows:

     
       

Children and Families

2,214.0

   

Older People

1,009.0

   

Mental Health

1.0

   

Management & Support (Invest to Save)

(30.0)

   
       

Function change - withdrawal of Residential Allowance

 

2,285.0

1.1

for new independent sector clients

     
       

Shortfall in inflation provision

 

(439.0)

(0.2)

       

Joint Finance Taper

 

117.0

0.1

       

This addition reflects the further financial responsibilities under the 'pick-up'

     

arrangements with the Primary Care Trusts for those schemes already

     

in operation within Hampshire

     
       

Management & Support

 

(107.0)

(0.1)

       

Allocations to other services for Personnel and Training, Health and Safety

     

and the transfer of the Blue Badges scheme to County Treasurers have

     

resulted in a reduction for 2003/2004

     

    Annex 4 to Appendix 1

Social Services

Base Budget 2002/03

Analysis of variations

 

(1)

Adjusted Original Budget 2002/03

(2)

Variation in inflation to November 2002 prices

(3)

Other variations

(4)

Inflation allocation to 2003/04 outturn

(5)

2003/04 base budget

Cash limited expenditure

£'000

£'000

%

£'000

£'000

%

£'000

Service Strategy and Regulation

366

5

1.37

26

0

0.00

397

Balances for later allocation

16,770

(531)

3.17

(1,777)

5,628

0.00

20,090

               

Children and Families

             

Commissioning and Social Work 15,400

210

1.36

3,751

0

0.0

19,361

Children Looked After

15,856

324

2.04

623

0

0.0

16,803

Family Support Services

6,516

68

1.04

(3,166)

0

0.0

3,418

Youth Justice

2,957

61

2.06

(45)

0

0.0

2,973

Other Children's and Families Services 4,394

17

0.39

1,187

0

0.0

5,598

 

45,123

680

1.51

2,350

0

0.0

48,153

Older People (Aged 65 or Over) including Older Mentally Ill

     
               

Assessment and Care Management

15,222

190

1.25

(400)

0

0.0

15,012

Net Cost of services

66,485

2,193

3.30

(585)

0

0.0

68,093

 

81,707

2,383

2.92

(985)

0

0.0

83,105

Adults under 65 years with Physical or Sensory Impairment

     
               

Assessment and Care Management

5,118

67

1.31

1,807

0

0.0

6,992

Net cost of services

12,674

219

1.73

903

0

0.0

13,796

 

17,792

286

1.61

2,710

0

0.0

20,788

Adults under 65 years with Learning Disabilities

       
               

Assessment and Care Management

5,872

77

1.31

(1,175)

0

0.0

4,774

Net cost of services

26,502

769

2.90

4,667

0

0.0

31,938

 

32,374

846

2.61

3,492

0

0.0

36,712

Adults under 65 years with Mental Health Needs

       
               

Assessment and Care Management

4,981

71

1.43

(32)

0

0.0

5,020

Net cost of services

4,679

73

1.56

245

0

0.0

4,997

 

9,660

144

1.49

213

0

0.0

10,017

Other Adult Services

       
               

Assessment and Care Management

377

5

1.33

(97)

0

0.0

285

Net cost of services

1,137

6

0.53

226

0

0.0

1,369

 

1,514

11

0.73

129

0

0.0

1,654

               

Supported Employment

712

4

0.56

41

0

0.0

757

               

Asylum Seekers

459

0

0.00

0

0

0.0

459

               

Total base budget

206,477

3,828

1.85

6,199

5,628

0.0

222,132

               
 

(1)

Adjusted Original Budget 2002/03

(2)

Variation in inflation to November 2002 prices

(3)

Other variations

(4)

Inflation allocation to 2003/04 outturn

(5)

2003/04 base budget

 

£'000

£'000

%

£'000

£'000

%

£'000

Expenditure outside of cash limit (not yet available)

             
               

Support Services and Repair and Maintenance of Buildings

0

0

0.0

 
               

Less: Charges to Corporate and Democratic Core

0

 

0

0

0.0

 
               

Capital Charges

 

0

 

0

0

0.0

 
               

Total net expenditure before grant

206,477

3,828

1.85

6,199

5,628

0.0

222,132

               

Specific Government Grants (see Appendix 6)

(39,053)

0

0.0

974

0

0.0

(38,079)

               
               

Total net expenditure

167,424

3,828

2.29

7,173

5,682

0.0

184,053

    Appendix 2

    Social Services

    Revenue Budget 2003/04

    Proposals for efficiency improvements and for savings

 

2003/04

2004/05

Staffing (FTEs)

2003/04

2004/05

     

£'000

£'000

   
           

1

Cost increase absorbed

       
 

Net cost of salary increments

327

327

   
   

327

327

   

    Appendix 3

    Social Services

    Revenue Budget 2003/04

    Proposals for new growth and redeployment of resources

 

2003/04

2004/05

Staffing (FTEs)

2003/04

2004/05

     

£'000

£'000

   
           
 

Increase in passported FSS - to be used to meet unavoidable pressures as set out in section 9 of the report

6,559

6,559

   
             
             
 

Total increase allowed in the budget guidelines

6,559

6,559

   

Appendix 4

    Social Services

    Revenue Budget 2003/04

    Review of income

   

Current charge

Total income

(Budget 2002/03)

Date of last review

Proposed new Amount

Charge Effective Date

Is charge set to recover full cost?

Yes/No

Is charge subject to an assessment scale determined locally?

Yes/No

Additional income from increased or new charge

   

£

£'000

 

£

     

£'000

1

Mandatory/National Charges

               
                   
 

Residential Care for Older People

343.00

4185

April 02

357.00

April 03

Yes

No

178

 

Residential Care for the Elderly Mentally infirm

392.00

830

April 02

399.00

April 03

Yes

No

59

 

Residential Care for people with Physical or Sensory Disability

770.00

134

April 02

789.00

April 03

Yes

No

8

 

Residential Care for Adults with a Learning Disability

693.00

564

April 02

710.00

April 03

Yes

No

44

 

Orchard Close - Standard Week

588.00

98

April 02

603.00

April 03

Yes

No

1

                   

2

Discretionary charges

               
                   
 

Residential Accommodation for Children

               
 

Community homes for Children

1330.00

0

April 02

1820.00

April 03

Yes

No

0

 

Secure Unit (Swanwick Lodge)

3304.00

1590

April 02

3451.00

April 03

Yes

No

38

 

Homes for Children with a Disability

1057.00

159

April 02

2135.00

April 03

Yes

No

0

 

Residential Accommodation for Adults

               
 

Orchard Close - Client Contribution

108.00

51

April 02

112.00

April 03

No

No

Included above

                   
 

Day Care Establishments

               
 

Day Services for Older People

135.00

34

April 02

140.00

April 03

Yes

No

0

 

Day Services for People with Mental Health Needs

195.00

6

April 02

200.00

April 03

Yes

No

229

 

Day Services for People with Physical or Sensory Disabilities

               
   

including transport

265.00

239

April 02

270.00

April 03

Yes

No

3

   

excluding transport

215.00

 

April 02

220.00

April 03

Yes

No

 
                   
 

Day Services for Adults with a learning Disability

               
   

including transport

155.00

169

April 02

160.00

April 03

Yes

No

19

   

excluding transport

125.00

 

April 02

130.00

April 03

Yes

No

 
                   
                   
 

Full Cost Annual Charges

               
 

Day Services for Adults with a Learning Disabilities

               
   

including transport

4360.00

included

April 02

4470.00

April 03

Yes

No

Included above

   

excluding transport

3450.00

above

April 02

3540.00

April 03

Yes

No

Included above

                     
 

Banded Charges for Day Services for People with a Learning Disability

           
   

including transport

4020.00

included

April 02

4120.00

April 03

Yes

No

Included above

   

excluding transport

3130.00

above

April 02

3210.00

April 03

Yes

No

Included above

 

Plus banded charge for each hour per week

518.00

 

April 02

534.00

April 03

Yes

No

Included above

                   
 

Non Residential Charges

10.00

5566

April 02

No Change

Jan 03

No

Yes

See NOTE

 

Other Charges

               
                   
 

Meals for Adults:-

               
 

Day Services for People with a Physical Disability, Learning Disability, Mental Health Needs or Older People, Meals on Wheels and Luncheon Clubs per meal

2.40

630

April 02

2.50

April 03

No

No

37

                   
 

Hostels for People with a Physical Disability:- Transport charge per week

6.90

 

April 02

7.10

April 03

No

No

Included above

                   
 

Parental Contributions Weekly Charge

16.60

20

April 02

16.90

April 03

No

No

4

                   
 

Hire of Rooms - per hour

20.50

1

April 02

21.00

April 03

Yes

No

0

                   
 

Hampshire Foster Care Placement Management Charge - per week 201.00

0

April 02

210.00

April 03

Yes

No

0

                   
 

Foster Care assessments

1849.00

0

April 02

1895.00

April 03

Yes

No

0

                   
 

Broken down over the following elements:-

               
                   
   

Initial Enquiry

124.00

0

April 02

127.00

April 03

Yes

No

0

   

Preliminary Checks/Contracts

132.00

0

April 02

135.00

April 03

Yes

No

0

   

Preparation Groups

185.00

0

April 02

190.00

April 03

Yes

No

0

   

Individual Assessment

1334.00

0

April 02

1367.00

April 03

Yes

No

0

   

Standard Visit

74.00

0

April 02

76.00

April 03

Yes

No

0

                   
 

Total Additional Income

             

620

    Appendix 5

    Social Services

    Revenue Budget

    Reconciliation of the original 2002/03 budget on the following pages with the 2002/03 budget in the budget book.

   

£'000

£'000

     

Total net expenditure on page B77 of the budget book

 

178,781

Less:

   

- Support services and repairs and maintenance of buildings

(5,800)

 

- Unapportionable overheads

465

 

- Capital Charges

(6,465)

 
   

(11,800)

Add:

   
     

Transfer between Committees:

   

- PU charges (IT)

274

 

- HSPN charges (IT)

125

 

- Inflation (IT)

44

 
     
   

443

     

Total net expenditure for 2002/03 original budget

 

167,424

    Appendix 6

    Social Services

    Revenue Budget 2003/04

    Government Specific Grants (at outturn prices)

 

Original

Original

Increase /

 

2002/03

2003/04

(Decrease)

 

£m

£m

£m

Former Grants rolled into formula funding

     

Promoting Independence

3.021

3.021

 

Building Care Capacity

5.160

5.160

 

Residential Allowance

1.676

3.961

2.285

 

9.857

12.142

2.285

Grants

     

Carers

1.667

1.857

0.190

Children's services

6.414

8.176

1.762

Preserved Rights

13.468

13.468

 

Performance Fund

0.937

1.946

1.009

Deferred Payments

0.798

1.043

0.245

Mental Health

2.361

2.362

0.001

CAMHS

0.241

0.693

0.452

Training Support (TSP)

0.531

0.531

 

AIDS Support

0.115

0.115

 

Asylum Seekers

0.450

0.450

 

Blind Homeworkers

0.003

0.003

 

Youth Justice Board

1.351

1.351

 

Supporting People (Administration)

0.630

0.630

 

Invest to Save

0.030

0.000

(0.030)

Teenage Pregnancy

0.135

0.135

 

Young Persons Substance Misuse

0.064

0.064

 

Access and Systems Capacity

 

3.255

3.255

Delayed Discharges

   

2.0000

 

2.000

National Training Strategy

   

N/A

   

Human Resources Development

   

N/A

   

TOTAL GRANTS

29.195

38.079

8.884

    *Figures in italics still to be announced.

    In addition to the above grants there will be funding transfers in respect of the Children's fund (£2.4m) and Supporting People (estimated £46m)

    Appendix 7

    Social Services

    Revised Budget 2002/03

    Calculation of the Cash Limit for the Revised Budget 2002/03

    The following table shows the progression from the original budget for 2002/03 to the cash limit for the revised budget 2002/03. Both are at estimated outturn prices 2002/03.

     

£'000

£'000

Original budget 2002/03

 

206,034

         

Transfers to/from other services

   

- PU charges (IT)

274

 

- HSPN charges (IT)

125

 

- Inflation (IT charges)

44

 
   

443

=

Adjusted original budget 2002/03

 

206,477

         

Inflation

   
         

Provision added since the original budget for

   

- Additional allocation for pay in 2002/03

530

 

- Increase in Social Care Prices

2,500

 
       

3,030

       

209,507

Other variations

   

Carry forward of 2001/02 underspending

148

 
     

Variations in Government grants

1,004

 
     

Virements between Services

   

- Personnel & Training

(15)

 

- Blue Badges (to CT)

(124)

 
   

1,013

     
     

Base Budget

 

210, 520

    Annex 1 to Appendix 7

    Social Services

    Revised Budget 2002/03

    Summary comparing the Revised Budget with the Cash Limit

 

Cash Limit

Revised Budget

Variation

 

Cash limited expenditure

£'000

£'000

£'000

%

         

Service Strategy and Regulation

291

397

106

36.43

Balances for later allocation

18,457

7,014

(11,443)

(62.00)

         

Children and Families

       

Commissioning and Social Work

16,187

20,102

3,915

24.19

Children Looked After

16,055

16,835

780

4.86

Family Support Services

6,517

3,177

(3,340)

(51.25)

Youth Justice

3,051

3,019

(32)

(1.05)

Other Children's and Families Services

4,528

3,176

(1,352)

(29.86)

Total

46,338

46,309

(29)

(53.1)

         

Older People (Aged 65 or Over) including Older Mentally Ill

 

Assessment and Care Management

15,937

15,559

(378)

(2.37)

Net cost of services

65,448

69,600

4,152

6.34

Total

81,385

85,159

3,774

4.0

         

Adults under 65 years with Physical or Sensory Impairment

   

Assessment and Care Management

5,350

7,381

2,031

37.96

Net cost of services

12,923

13,919

996

7.71

Total

18,273

21,300

3,027

45.7

         

Adults under 65 years with Learning Disabilities

   

Assessment and Care Management

6,143

5,016

(1,127)

(18.35)

Net cost of services

27,053

31,691

4,638

17.14

Total

33,196

36,707

3,511

(1.2)

         

Adults under 65 years with Mental Health Needs

   

Assessment and Care Management

5,107

5,065

(42)

(0.82)

Net cost of services

4,676

5,084

408

8.73

Total

9,783

10,149

366

7.9

         

Other Adult Services

       

Assessment and Care Management

481

930

449

93.35

Net cost of services

1,154

1,157

3

0.26

Total

1,635

2,087

452

93.6

         

Supported Employment

712

939

227

31.88

         

Asylum Seekers

450

459

9

2.00

         

Overall Total

210,520

210,520

0

0.00