Hampshire County Council
	Executive Member for Adult Social Care		Item 1
	18 January 2008
	Safe and Healthy People Select Committee		Item 4
	18 January 2008
	Revenue Budget 2008/09, 2009/10 and 2010/11
	Report of the County Treasurer and Director of Adult Services

Contact: Jon Pittam, (01962) 847400; [email protected]

Rea Mattocks, (01962) 847200; [email protected]

Erica Meadus, (01962) 846195; [email protected]

1 Summary

1.1 This report sets out the proposed Adult Services revenue budget for 2008/09, a provisional budget for 2009/10 and 2010/11 and recommends a revised budget for 2007/08. This report has been prepared in consultation with the Executive Member and will be reviewed by the Safe and Healthy People Select Committee. It will be reported to the Leader and Cabinet on 8 February 2008 to make final recommendations to County Council on 21 February 2008.

1. 1.2 The budget proposals contained in this report are derived from the departmental service plan which has been developed to support the priorities of the Corporate Strategy.

2.

3. 1.3 Additional funding has been made available by Cabinet as follows: £6.5m for 2008/09, £6.7m for 2009/10 and £7m for 2010/11 allowing an increase of 5.6% in 2008/09 and a further 5.5% in each of the following two years.

4.

5. 1.4 Changes to the grant framework and grant received are explained in section 4.

6.

7. 1.5 Financial recovery for Adult Services has been well documented and this process is due to complete by the end of 2007/08. In addition financial recovery has been undertaken in conjunction with modernising and transforming services to improve outcomes for clients which has been recognised by the Commission for Social Care Inspection (CSCI) with Adult Services receiving a three star rating for performance. Particular note was made that "Financial reporting and management is robust".

8.

9. 1.6 However the service is still faced with significant ongoing pressures. These include unavoidable service pressures (for example demography and levels of care), additional inflation, capital depleters and personalisation. These pressures are covered within the budget proposals. Individualisation, personalisation, self directed support, individual budgets and Putting People First are all terms used in relation to the new agenda for developing a more personlised system to meet the challenges while providing services of choice to people and their carers. This report will refer to this as Putting People First.

10.

11. 1.7 In summary:

2007/08

· The outturn at the end of the financial year is predicted to achieve all financial recovery within the set two years.

· The saving targets set in the original budget should broadly be met.

· The unused money available for winter pressures in 2007/08 (which totals £3.5m) is requested to be carried forward into 2008/09 subject to pressures on it between now and the end of the financial year. The first £2m will be allocated to capital in order to invest in the social care building stock, particularly extra care. The remainder will be transferred to winter pressures in order to bolster this, ideally to the £3m which is considered necessary to manage a demand-led service in the context of the pressures applying in 2008/09.

· A planned underspend of £0.8m be carried forward in order to fund the shortfall in resources required to meet the growth pressures in 2008/09. Resource is already available in future years.

· It is requested to carry forward £0.298m of Emergency Carer's Respite grant into 2008/09 for continuation of a pilot scheme.

2008/09

· Meaningful budgets have been set for the client groups to meet current as well as demographic pressures; the impact of grant settlements have also been taken into account.

· Saving plans will be closely monitored during the financial year and remedial action will be taken where appropriate.

· The budget is constructed at the cash limit and allows for:

Category	£m
Pressures	15.6
Savings	(6.8)
Net Growth	8.8
Met by: 5.6 % Cash Increase	(6.5)
Further savings to be identified *	(2.3)

* made up of £0.8m shortfall in savings for 2008/09 and £1.5m to build the winter pressures money back up to £3m (1.1% of cash limited budget).

1.8 Recommendations

To approve for submission to the Leader and Cabinet:

12. 1. The revised budget for 2007/08 totalling £273m (as set out in appendices 1 and 2).

13. 2 The base budget for 2008/09 totalling £274.8m (as set out in Appendix 3).

14. 3 The proposals for growth totalling £15.6m (as set out in Appendix 4).

15. 4 The proposals for redeployment of resources totalling £6.8m in 2008/09 (as set out in Appendix 4).

16. 5 The proposals for efficiency improvements totalling £7.7m (3.1% of the base budget) in 2008/09 (as set out in Appendix 5).

17. 6 The annual review of income and charges (as set out in Appendix 6).

18. 7 The detailed budget for 2008/09 (as set out in Appendices 7 and 8).

19. 8 The workforce implications of the proposed budget for 2008/09 (as set out in Appendix 9).

20. 9 The provisional budget for 2009/10 of £294.9m and for 2010/11 of £308.1m (as set out in Appendix 10).

10 The unused money available for winter pressures in 2007/08 (which totals £3.5m) is requested to be carried forward into 2008/09 subject to pressures on it between now and the end of the financial year. The first £2m will be allocated to capital in order to invest in the social care building stock, particularly extra care. The remainder will be transferred to winter pressures in order to bolster this, ideally to the £3m which is considered necessary to manage a demand-led service in the context of the pressures applying in 2008/09.

11 A planned underspend of £0.8m be carried forward in order to fund the shortfall in resources required to meet the growth pressures in 2008/09. Resource is already available in future years.

12 The carry forward of £0.298m of Emergency Carer's Respite grant into 2008/09 for continuation of a pilot scheme.

2 Budget strategy

2.1 A provisional budget for 2008/09 and 2009/10 was agreed by the Cabinet in February 2007 alongside the 2007/08 budget. The budget strategy was incorporated in the Medium Term Financial Strategy approved by Cabinet in May. The budget strategy was reviewed by Cabinet in October following the publication of the Comprehensive Spending Review and in December to update inflation assumptions. The strategy is based on the following principles:

· Increases for all services in accordance with the County Council's base budget rules

· Above inflation increases for Adult Services and Children's Services

· Redeployment within each service of cashable efficiency improvements identified in 2008/09 towards new priorities and pressures

· No other provision for any new service developments unless funded by cashable efficiency savings

· Pay inflation of 2.5%

· 2.5% for non-pay inflation

· Income to be maximised by reviewing charges in line with the average inflation on the related gross expenditure.

2.2 The same assumptions have been used to set a provisional budget guideline for 2010/11.

2.3 For this service, the adjusted budget guidelines are:

	£m	% cash increase on year before
2008/09 guideline	280.8	5.6
2009/10 provisional guideline	294.9	5.5
2010/11 provisional guideline	308.1	5.5

2.4 This report sets out the Adult Services Executive Member's responses to the guidelines. The report:

· Reviews the revised budget for 2007/08 ( as set out in Appendices 1 and 2)

· Reviews the 2008/09 base budget which totals £274.8m (as set out in Appendix 3)

· Identifies net growth of £ 6.5m (as set out in Appendix 4)

· Identifies £15.6m of pressures and costs absorbed (as set out in Appendix 4)

· Proposes the redeployment of £6.8m of resources (as set out in Appendix 4)

· Identifies efficiency improvements of £7.7m, being 3.1% of the base budget (as set out in Appendix 5)

· Reviews the charges made by this service (as set out in Appendix 6)

· Proposes a detailed budget for 2008/09 (as set out in Appendices 7 and 8)

· Identifies the workforce implications of the budget proposals (as set out in Appendix 9)

· Proposes a provisional budget for 2009/10 and 2010/11 (as set out in Appendix 10).

3 Revised budget

3.1 The cash limit for the revised budget is £273m. The calculation is shown in Appendix 1.

3.2 A summary comparing the revised budget with the cash limit is set out in Appendix 2. This shows overall that the budget is in line with the cash limit.

3.3 The unused money available for winter pressures in 2007/08 (which totals £3.5m) is requested to be carried forward into 2008/09 subject to pressures on it between now and the end of the financial year. The first £2m will be allocated to capital in order to invest in the social care building stock, particularly extra care. The remainder will be transferred to winter pressures in order to bolster this, ideally to the £3m which is considered necessary to manage a demand-led service in the context of the pressures applying in 2008/09.

3.4 A planned underspend of £0.8m is to be carried forward in order to fund the shortfall in resources required to meet the growth pressures in 2008/09. Resource is already available in future years..

3.5 It is requested to carry forward Emergency Carer's Respite Care grant £0.298m to 2008/09 for continuation of a pilot scheme. This grant was announced late in this financial year and in order to maximise value from the grant full implementation will occur next year.

4 Base budget 2008/09

4.1 A base budget for 2008/09 has been prepared which contains 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 £274.8m at outturn prices.

4.2 Appendix 3 shows the make up of the base budget.

4.3 Overall, the base budget includes a net increase in expenditure at constant prices of £1.387m. The main variations are:

· Decrease £1.211m to reflect a transfer of services to Hantsdirect. This is in addition to the £0.866m transfer in 2007/08.

· Planned carry forward of £0.8m from 2007/08 revenue budget.

· Re-allocation of £0.553m from purchasing budgets within Older People and Physical Disabilities to re-instate budgets to reflect the near full operational capacity of the in-house nursing homes ( the 2007/08 base budget included budgets reallocations from in-house units to purchasing budgets due to the phased opening of the nursing homes).

· Allocation of £1m from unallocated funds to support increased pressures on in-house nursing due to the staff to client ratios being higher than originally budgeted, partly as a result of higher client dependency levels than anticipated.

· Technical reallocation of £1.512m to reflect the revised income apportionment between in-house domiciliary care (reduced income targets) and purchased domiciliary care (increased income targets), due to the impact of the homecare modernisation programme and improvements to the income recording system.

· Grant Position

o The latest Local Government Financial settlement has introduced some changes to the existing framework. From April 2008, the majority of revenue grants will be delivered to local authorities through the Department of Health's contribution to the new Area Based Grant (ABG). The ABG replaces the current Local Area Agreement Grant, and is paid on an unringfenced basis.

o The Table below shows the details of grant allocation for Adult Services.

2008/9 GOVERNMENT GRANTS		Variations
	Grants 2007/08 £'000	Existing Grants £'000	New Grants £'000	Grants 2008/09 £'000
Specific Grants
HIV/Aids Support	133	0		133
Drug Action Team	120	(17)		103
Social Care Reform	0		1,537	1,537
Learning Disabilities Campus Programme		240	0	240
	253	223	1,537	2,013
Moved to Revenue Support Grant
Acces&SysCap	10,759	(10,759)		0
Delayed Discharges	1,981	(1,981)		0
	12,740	(12,740)	0	0
Grants Ceased
Pump Priming Grant	93	(93)		0
Preventative Technology	996	(996)		0
	1,089	(1,089)	0	0
Area Based Grants
Existing Grants
Mental Health Grant	2,382	(152)		2,230
Homeworkers	2	0		2
Adult Social Care Workforce (was NTS/HR)	1,693	186		1,879
CSCI Reimbursement	13	(13)		0
Carers Grant	2,653	625		3,278
Preserved Rights	6,025	(269)		5,756
IMCA & IMCAS Mental Capacity Grant	262	171		433
Supporting People Admin	820	(41)		779
	13,850	507	0	14,357
New Redirected from PCT
Learning Disability Development Fund		699		699
	0	699	0	699
Total Area based Grants	13,850	1,206	0	15,056
Total Grants exc Supporting People	27,932	(12,400)	1,537	17,069
Other Specific Grants
Supporting People Care Grant	31,111	(101)		31,010
Total Grants inc Supporting People	59,043	(12,501)	1,537	48,079
Variation between 07/08 & 08/09				(10,964)
Moved to Revenue Support Grant				12,740
Less Learning Disability Development Fund previously received from PCT				(953)
Cash Impact				823

o The implication of the above changes is a net increase of £1.77m in grants received by the service. Details are attached in Appendix 3. However, the current Learning Disability Development Fund contribution from Health of £0.95m will reduce in 2008/09 by £0.25m. As this is now reflected as a grant, but was already being received, the true impact on cash into the service is £0.82m.

o Access Systems and Capacity and Delayed Discharges grants are now included in the Council's Revenue Support Grant allocation. Nevertheless, in Hampshire, these allocations have been fully passed to Adults Services. The Preventative Technology and the Pump Priming grants were only made available for two years, therefore, have now ceased. Withdrawal of this grant means that, the local authorities are expected to absorb the remaining costs, by generating efficiency savings.

o A new grant for Social Care Reform has been introduced for a period of three years, which will be used to promote inclusion in communities. This grant will give Adult Services £1.5m in 2008/9; £3.6m in 2009/10 and £4.5m in 2010/11 and will be used for the Putting People First programme to implement Self Directed Support (SDS). The ultimate aim is to empower the individuals who are in need of support in the definition and purchase of services they need for their well being. Grant conditions are not yet available, but a report will be produced at a later date to identify how the funding will be spent, what the long term commitments are and how this will improve the agenda for individual budgets. It is anticipated that this specific grant will be rolled into either the revenue support grant or an area based grant at the end of the 3 year period.

5 Growth proposals, cost pressures, redeployment proposals and efficiency improvements - 2008/09 - 2010/11

5.1 The financial implications of growth and pressures for the service is estimated to be £15.6m in the next financial year. There are plans in place to redeploy resources with a view to generate savings that will help to absorb £6.8m of this pressure. A further £2.3m of reduction remains to be allocated across services. This is made up of £1.5m in order to balance the winter pressures money and it is requested that this be funded from the carry forward already mentioned if it is not required this year. The remaining £0.8m is required to bridge the shortfall in resources required to meet the 2008/09 growth pressures. This can be funded from the carry forward of the planned underspend of £0.8m. This will ensure the service is provided within allocated funds.

5.2 The carry forward of £0.8m into 2008/09 is a one-off and this shortfall in 2009/10 will be met from the additional funding made available by cabinet.

6 Comments of the Director of Adult Services

6.1 Background and Achievements

6.1.1 In the current year (2007/08) Adult Services is on track to deliver a balanced budget as a result of successful financial recovery from over-commitment of approximately £19m at the beginning of 2006/07. This has been achieved through strong Member and corporate support in conjunction with robust scrutiny and governance processes as well as a strong commitment from staff within the service and joint work with our partners.

6.1.2 In addition the department has made a significant improvement in performance and was recently awarded three stars in the Commission for Social Care Inspection performance assessment. This compares favourably with the 2 stars assessment for the previous year, and is the highest star rating that can be achieved by an adult services department.

6.1.3 Other service achievements include:

· LPSA2 - Enabling 109 individuals with an assessed care need to access mainstream housing. This is in addition to the 100 successfully housed in the first year of the programme, meaning that by half way through the three year programme, 80% of the target had been achieved.

· Nursing homes - successfully delivering the ENHANCE nursing strategy by completing ten state of the art nursing homes, ensuring the availability of 500 high dependency beds.

· Supporting People - Hampshire Supporting People awarded 3 stars by the Audit Commission for running an excellent programme with excellent prospects for improvement. Hampshire is the first county council in the country to receive this recognition.

· Learning Disabilities - Progress in this service area has been significant. Managers have worked extraordinarily hard to address the 2006/07 budget outturn and the identified pressures for 2007/08. The main focus has been a discrete project to reduce high cost placements (placements over £1,000 a week). To date £900,000 has been achieved in savings, much of which will translate into 2008/09 savings.

· A user satisfaction survey undertaken by Adult Services recorded an 83% satisfaction rate.

· Home Care - The modernisation of the In House home care service towards a reablement service is well underway and will be completed in mid 2008/09. This has focussed on delivering outcomes for service users to enable them to live more independently. Home Care modernisation has contributed towards financial recovery through reducing costs of the in house service (a reduction in spend on this service of £4.6m to date, approximately £5.3m in real terms) and reduced the unit cost of long term care. This has also improved the outcome for users.

· Improving our processes - Local Government Employee of Year - Paul Burrows received this award for reducing the number of forms processed from 200 to 10.

6.1.4 The financial picture for 2008/09 and beyond remains challenging. In addition to a tight national three year spending programme, there will also be a new performance regime, and a substantial change programme around Putting People First. The Leader has recently announced the establishment of a Commission to develop a social care model that will Put People First, making care services personal to clients. It will also be a forum to respond to the Government Green Paper Consultation on Social Care Funding. The challenge for Hampshire is delivering the right capacity at the right speed for the change process.

6.1.5 The capacity to continue to make future savings and efficiencies will need a different emphasis, as demand and market pressures mount and the performance framework changes. Demographic pressures will impact not only in terms of volume, but also as a growing more complex level of need. People in all care groups are living longer and therefore need to be supported for longer with more complex care needs.

6.1.6 The department has worked hard to manage inflationary pressures in the market but recognises that there is scope to achieve further efficiencies in particular areas. However, the core rates paid externally for care are under pressure from national issues, such as changes to bank holiday payments, and from the need to improve care standards in the independent sector in line with more complex demand.

6.2 Strategic Direction

6.2.1 The service continues to implement the three year strategic direction agreed by Cabinet last December as well as implementing priorities identified by the Department of Health such as "Putting People First" support for unpaid carers, equalising the position of self-funders with local authority funded clients and responding to the prevalence of dementia in an aging population.

6.2.2 Delivery of the strategy and Department of Health (DH) priorities will require implementation of personalised services (including Putting People First), integration of learning disability services, improved information for self-funders, continuous improvement in the use of Hantsdirect to gain efficiencies in service provision, and continued reshaping and modernisation of services. All of these are part of a significant change programme which will require additional programme management and support.

6.2.3 The change programme is aimed at creating responsive and efficient services for the future that will meet changing demand, changing expectations, the choice agenda and will also achieve financial balance. The budget sets out the resources needed to implement that change and to create the alternatives to current service models.

6.2.4 These priorities are set in the context of already constrained resources, capacity and growing demand. The Secretary of State has announced that the Government will commence a consultation during 2008 on the future funding of adult social care. The Green paper consultation will be a valuable opportunity to review the care system with consideration of demographic and funding pressures and to influence the future of service provision for adult social care. The impact is likely to be in the next Comprehensive Spending Review period and it will be important to ensure the County Council's views are taken into account as part of this process particularly in relation to future funding. It is likely that the emerging response will reflect the Government's vision around personalised services and equalising the position between self and state funded care clients. It seems likely that client contributions will remain a significant source of funding and may increase.

6.3 Putting People First

6.3.1 Traditionally, services have developed to meet the needs of groups of people. Inevitably people have been matched to the services available with some choice, but within a limited framework. As a result less than optimum outcomes for individuals and their families have been achieved.

6.3.2 Putting people first means focusing on the client as an individual with aspirations as well as needs and a circle of family, friends and other resources and support mechanisms around them. It introduces the requirement for greater personal responsibility and for individuals to exploit all their own resources, as well as those available through statutory services to meet their needs in the best way possible. The individual is at the centre of the process of identifying their needs and making choices about who what and when regarding the support and care required to achieve their aspirations.

6.3.3 Its most significant manifestation is the national move towards clients receiving an assessment of their needs expressed in cash terms, which they may choose to take as a direct payment rather than receive a service directly from or commissioned by Adult Services. This will require a significant change programme as it requires changes to the way we engage with clients from first contact through to review.

6.3.4 Putting people first is at the heart of modernising our service to deliver choice and control and meet the new Outcomes Framework on which our performance will be measured. Government has recognised this with a 3 year specific grant allocation.

6.4 2007/08 Revised Budget

6.4.1 The service has worked very hard to complete the two year financial recovery plan whilst modernising the service. The reductions have been achieved through implementing the financial recovery plan as well as making efficiency savings. In addition, budgets were set for client groups to meet demand taking into account eligibility.

6.4.2 The unused money available for winter pressures in 2007/08 (which totals £3.5m) is requested to be carried forward into 2008/09 subject to pressures on it between now and the end of the financial year (such as the impact of the `norovirus'). The first £2m will be allocated to capital in order to invest in the social care building stock, particularly extra care. The remainder will be transferred to winter pressures in order to bolster this, ideally to the £3m which is considered necessary to manage a demand-led service in the context of the pressures applying in 2008/09.

6.4.3 In addition, it is requested that a planned underspend of £0.8m be carried forward to fund the shortfall in resources required to meet the growth pressures in 2008/09.

6.5 2008/09 - 2010/11 Budgets

6.5.1 Managing within available resource will continue to be a major priority for the service as well as maintaining and improving performance. The key priorities for the service will be:

· Remaining within resources - using the available resource to manage the increasing demand in terms of numbers and complexity

· Building partnerships - continuing to work with our partners to achieve best outcome for our users

· Modernising services - continued modernisation of the services to meet the aspirations of both our clients and legislation.

· Maintaining performance - ensuring cultural change within the service and across the community in order to meet the new performance regime

· Improving efficiency - Implementing structural and service changes to improve efficiency.

6.5.2 These priorities are linked with a number of challenges as well as others which face the service and they are set out below. The service has received additional grant monies in 2008/09 of £1.7m although when you account for the changes in funding streams, the benefit to adult services is reduced to £0.82m in cash terms.

6.6 Demographics

6.6.1 This section covers pressures included in the budget for demographics, transition , increasing dependency levels and capital depleters.

Older People Demography

6.6.2 Using the latest population estimates from the Office of National Statistics (ONS), in 2005, there were an estimated 103,133 people aged 75 and over in Hampshire and in 2006 this had increased to 105,978, indicating an increase of 2,845 people or 2.75%. This compares with a national increase of 1.4%. So more clients over the age of 75 will need help in their daily lives. There are currently 8,813 Hampshire clients over 75, or 8.3% of the Hampshire over 75 population, so assuming the same % relationship, a 2,845 increase in population could mean a potential additional 236 Hampshire clients (i.e. 8.3% of 2,845), who will require services from Adult Services.

6.6.3 Furthermore, the number of over 85s is expected to increase by over 5% in the next two years.

6.6.4 Pressures in Older People domiciliary, nursing, residential, day and direct payments due to dependency levels and population changes are £1.3m in 2008/09 with a further £1.8m in both the following two years.

Physical Disabilities Demography

6.6.5 The demographic pressure for physical disability clients was calculated using the assumption that these clients would increase at the same rate as the over 18 population increase in Hampshire - 1.06% between 2007 and 2008. On an average of 1,818 physical disability clients, this gave an increase of 19 clients across all care types, equating to a £0.425m pressure using the average package cost for each relevant care type.

Dependency

6.6.6 A significant element of the total pressures is the increasing dependency levels of clients, in particular large increases in clients with dementia. Purchased residential placement for clients with dementia costs £130 per week more than an average residential placement, which is mainly the result of staff to client ratios. The higher staff to client ratios needed for dementia clients also affects in-house units.

Self-Funders & Capital Depleters

6.6.7 Central Government has also recognised the sustained growth in the number of self-funding clients. This will be a factor it considers when it produces a Green Paper on the funding of Social Care. The impact that it may have on Hampshire is indicated by the fact that around 60% of the total number of older people in residential and nursing care are self-funders.

6.6.8 Over the next two years we will expand the support provided to people who do not meet our eligibility criteria and ensure that everyone (not just those who qualify for our services) gets good advice and help to arrange care.

Learning Disabilities Demography

6.6.9 Advances made in medical care also mean an increase in life span for people with learning disabilities, which is estimated to be increasing by about 1% a year. There are also a growing number of people with learning disabilities living into older age. Some of these people have been cared for by their families and have not presented to adult service previously and now coming within the scope of adult services as their parents become too old and frail to care for them. This means that an average 22 additional people with learning disabilities may require services from Adult Services each year. The average cost (across all types of services) for clients with learning disabilities is around £30,000 a year, however, residential care costs for this client group are on average around £50,000. Pressures of £0.5m have been included for 2008/09 for increased demand on the Learning Disability services and a further £0.3m in the following two years.

Transition

6.6.10 There is a substantial demographic pressure on the services and support for eligible clients moving from Children's Services to Adult Services. This covers the full year effect in 2008/09 from people moving across in 2007/08 and the part year costs of clients moving across in 2008/09. Pressures for Learning Disability are £2.4m in 2008/09 with a further £2.5m in each of the following two years.

Demographic Summary

6.6.11 n summary, £5.699m has been included in the budget for 2008/09 for the key challenges, including demographics, dependency, self-funders and capital depleters with a further £5m in the following two years. The 2008/09 total is broken down as follows:

Older people demographics & dependency £1.300m

Physical Disabilities demographics & dependency £0.425m

Learning Disabilities-transition £2.403m

Learning Disabilities-other £0.514m

Older people capital depleters £0.750m

Other £0.307m

Total £5.699m

6.7 Health Service

6.7.1 In order to maximise outcomes for the people of Hampshire, seamless working between Social Care and Health is essential. It is also required by the Department of Health and will feature heavily in proposed new performance indicators for adult social care. The joint appointment of the Director of Public Health in Hampshire has facilitated a seamless approach at a strategic level and joint funded community development workers and senior practitioners will ensure a similar approach at an operational level.

6.7.2 Complexities of providing a seamless service across both sectors will increase with the proposed introduction of personalised budgets within health as well as social care, however there may be opportunities for efficiencies and better outcomes for users.

6.7.3 Additionally, provision over the next two years has been made in the budget for the set up costs relating to the Learning Disability Integration with Health that will deliver service improvements through the integrated teams, hosted by the Council. Nationally, the NHS will be passing its responsibility for learning disability clients to local authorities. The priority of the service is to encourage people to live at home. We will need to response robustly to the government proposal regarding the transfer of responsibility to ensure that the resource transfer is adequate to meet client needs now and in the future.

6.7.4 There still remains very significant financial risks in our relationship with health. Whilst new national guidance on Continuing Health Care has been issued, it has still left too much room for discretion for PCTs. Adult Services is working with the Association of Directors of Adults Services to gain acceptance of a more detailed and transparent set of guidance.

6.8 Market conditions

6.8.1 In recent years many provider rates have been kept at or below the budgeted 2.5% rate of inflation. Providers are facing increasing external cost pressures including government and EU legislation on minimum wage and holiday entitlement, as well as increasingly higher registration standards. Tight management of cost inflation needs to be balanced with the impact on supply, investment and standards in the sector. Commissioning /inflation pressures are £1.8m in 2008/09.

6.9 Supporting People

6.9.1 Hampshire has the only Excellent rated County Supporting People programme in the country. Nevertheless, there is a pressure of £0.940m in LD operations budgets for 2008/09 due to Supporting People hours being reduced in existing schemes in the disability sector. This arises from the disability strategic review. Supporting People teams are required to undertake these reviews to ensure value for money and to match spend to available resources.

6.9.2 The Supporting People grant allocations have reduced by £0.141m from £31.9m to £31.789m in 2008/09, there are further reductions of £0.062m in 2009/10 and £0.997m in 2010/11. The reduction in 2008/09 is less than was expected but gives the service little room to manoeuvre in how strategic reviews are implemented.

6.10 Modernisation Programme

6.10.1 While some modernisation of services has already been achieved, financial recovery has been the key focus over the past two years, although this has not impacted on performance. Substantial achievements since 2005 have ensured that further modernisation of services can now be built on a more stable financial and performance platform.

6.10.2 The identified pressure of £3.2m in 2008/09 includes implementing the modernisation programme as well as implementing Hants Direct. The programme also includes updates to systems on Supporting People, the Integrated Community Equipment Store (ICES) and Electronic Social Care Records (ESCR) (which is a national requirement to meet our performance indicators).

6.10.3 Savings in the order of £2m are anticipated in 2008/09 from this modernisation programme including £1.3m from modernisation of the in-house home care service.

6.11 Safeguarding clients

6.11.1 Safeguarding adults is an increasingly high priority for the Department. This has been recognised in the budget with the creation of a number of dedicated posts as well as making allowance for the additional work that is increasingly falling to the care management teams around the Protection of Vulnerable Adults with a total investment of £0.470m being included in the budget for 2008/09. Ensuring that safeguarding arrangements are clear and well integrated in the operational processes is a key priority for the department as Hants Direct is phased in.

6.12 Promoting Independence

6.12.1 Pressures included within the budget under promoting independence cover the Wellness Recovery Action Planning team, maintenance of equalities of excluded groups and equipment direct running costs.

6.13 Operational Pressures

6.13.1 There is a total operational pressure of £3.1m. The main pressures relates to the reinstatement of the winter pressures funding to an adequate level in 2008/09 as previously detailed.

6.14 Efficiency Improvements

6.14.1 The CSR07 sets an annual efficiency target for local government overall of 3%, all of which has to be cashable, compared with 1.25% cashable improvements required by Gershon. The County Council will be required to publish a performance indicator demonstrating how it has contributed to the national target. Appendix 5 identifies efficiency improvements totalling £7.7m (3.2%). Of these, £7.3m (3%) represent usable budget savings which are incorporated in the redeployment proposals in Appendix 4.

o Dependency and demographic pressures £0.6m

o Commissioning / inflation £2.0m

o Modernisation programme £2.0m

o Promoting independence £0.7m

o Operational efficiencies £1.4m

o Others £1.0m

6.14.2 The department has demonstrated its ability to realise significant efficiency savings during the two year financial recovery period.

6.15 Risks

6.15.1 The budget contains some risks for which no allowances have been made:

o A new approach to managing the increasing growth of Independent Living Fund (ILF) applications will be introduced with effect from April 2008. For all new applications from this date and all requests for increases based on change in care need, revised thresholds will be applied. The move in threshold is significant, from £200 per week, to £320 per week. This will, in effect, mean that less cases will be eligible for ILF funding. This currently stands as an unquantifiable risk. This is an example of movement in financial responsibility from Government to Local Authorities.

o Quality in the Independent Sector - The past few months have seen a significant increase in quality concerns about independent sector provision, both in the care home and domiciliary care sector. The position in Hampshire has also been replicated in the 2 Cities and therefore seems be part of a consistent pattern. As from 1 April 08, the Department's commissioning performance will be partially judged on the extent to which we purchase from "poor" rated homes by CSCI. This potentially will place greater onus on the service to act as "quasi" regulators. Indeed, the latter has increasingly been the case for some time now. Managing quality and performance of providers could therefore become much more of an issue in the future, and may require additional resources to meet care governance requirements.

o The new national guidance on Continuing Health Care has left too much room for discretion for PCT's which may put pressure on our budget.

o For Learning Disabilities we will need to respond robustly to any Government proposal regarding the transfer of responsibility and funding to local government from health to ensure the resource transferred is adequate to meet client needs now and in the future.

o Pay and Benefits - The full impact of this is yet to be quantified and may adversely affect resources.

o The Department of Health has signposted their intent that the service should provide more support to self funders. The extent of these responsibilities and the financial implications have not yet been specified.

6.16 Performance

6.16.1 The service received a 3 star rating which was very encouraging and work is ongoing to try and ensure that performance is maintained in 2007/08.As part of the performance assessment CSCI identified 77 areas of strength and 13 areas for improvement. The service is implementing an improvement plan which covers the 13 areas for improvement and this is monitored on a regular basis.

6.17 Conclusions

6.17.1 These Director's comments have noted the achievements and drawn attention to the challenges, whilst acknowledging the support the service has received from the corporate centre (including the additional funding in the next three financial years). The next three years will be challenging with modernisation within limited resources meaning that capacity will be critical to achieve the desired outcomes. On the positive side, financial recovery should have been achieved by the end of the current year but budget monitoring will continue to be key in ensuring that financial stability remains constant. However the business continues to need to be managed, taking into account the risks of a high volume, heavily regulated and complex business.

6.17.2 To assist in this, the unused money available for winter pressures in 2007/08 (which totals £3.5m) is requested to be carried forward into 2008/09 subject to pressures on it between now and the end of the financial year. The first £2m will be allocated to capital in order to invest in the social care building stock, particularly extra care. The remainder will be transferred to winter pressures in order to bolster this, ideally to the £3m which is considered necessary to manage a demand-led service in the context of the pressures applying in 2008/09.

7 Review of charges

7.1 The service's 2008/09 revenue budget includes income of £79.9m from fees and charges (excluding government grants). Approximately £34.1m is received from Health and other local authorities. Approximately £45.8m relates to fees and charges. £10.1m relates to fees and charges set by Adult Services. Details of the material headings are included in Appendix 6.

7.2 There are some mandatory and national charges which the County Council is not able to vary. Charging for residential care has been governed by CRAG (Charging for Residential Accommodation Guide) since 1992, which provided a high level of consistency between local authorities. Charging for non-residential care on the other hand, whilst still subject to national guidance, has been much more variable. Many of these charges require a financial assessment to be undertaken and the charges detailed in Appendix 6 relate to the provision of County Council services but the exact charge may be dependant on this assessment process. Clients placed in independent sector accommodation are subject to the same financial assessment process.

7.3 Discretionary charges are revised 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. The Enhance nursing care project, the refurbishment of in house residential homes and the Adult Services modernisation programme mean that an in depth review of charges needs to be undertaken to ensure current assumptions are still valid. Until this review is undertaken charges have been increased by the standard inflationary rate. Examples of those charges reviewed annually are provision of meals for adults and older people.

8 Other expenditure

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

9 Legal implications

9.1 The modernisation programme will require legal implications to be considered particularly where they impact on the provision of services to clients and how the appropriate consultation should be undertaken. This will be included as part of the business planning process so that appropriate advice is sought.

10 HR implications

10.1 The workforce implications of the proposed budget for 2008/09 are set out in Appendix 9. The 2008/09 base budget supports a planned workforce of 3,297 full time equivalent (FTE) staff. This compares with the original estimate for 2007/08 of 3,315 which is an decrease of 18.

10.2 The net effect of proposals for growth, savings and redeployment of resources (Appendix 4) on staffing levels are as follows:

2008/09	(39) FTEs
2009/10	(5) FTEs
2010/11	(2) FTEs

11 Provisional budget for 2009/10 and 2010/11

11.1 The provisional budget at outturn prices for 2009/10 and 2010/11 for this service is set out in Appendix 10 and summarised below:

2009/10	£294.9m
2010/11	£308.1m

11.2 The main variations from the 2008/09 proposed budget are inflation of £6.0m for 2009/10 and £6.3m for 2010/11, additional resources from redeployment of £6.7m in 2009/10 and £7.0m in 2010/11. There is also an increase in specific grant of £2.3m for 2009/10.

12 Impact assessment

12.1 The proposals in this report are derived from the departmental service plan(s) and are in accordance with the budget strategy and the County Council's financial management policy. An impact assessment of the departmental service plan and the financial management policy has been carried out and the proposals in this report are not considered to be discriminatory.

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:

Published works.

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

TITLE FILE

Departmental Service Plan

Financial Management Policy Impact Assessment - http://www3.hants.gov.uk/impactassessments/cx-puimpact-tres.htm

Links(s) to Corporate Strategy
	Yes	No
Hampshire safer and more secure for all	_	_
Maximising well-being	_	_
Enhancing our quality of place	_	_

Supplement to Report Writing Guide (9/06)

13	Links to Corporate Strategy
13.1	Chief Officers are committed to demonstrating clearly to the Hampshire community how the decisions made by the County Council and the Executive support what the County Council is seeking to achieve through its Corporate Strategy and Corporate Priorities. The protocol to follow for reflecting these in reports to the Council and the Executive can be found at: http://hantsnet2000.hants.gov.uk/TC/chiefexecs/democraticprotocols/corpstrat-guidance-cmt.html
13.2	Appendices 1 and 2 of this guide contain the required format for decision reports to the Executive and for Executive decision sheets respectively. These are for use at all times by Executive report authors when Executive decisions are required.
13.3	When Policy Review Committees are reporting on the outcome of reviews their reports must make clear the link between the review carried out and the Corporate Strategy. Further advice may be required in the light of experience of the PRC's new operating arrangements.
13.4	This requirement does not apply to reports to the Regulatory Committee, the Standards Committee, the Governance Committee, the Pension Fund Panel and the Panels which exercise quasi-judicial functions, eg the Pension Appeals Panel, the School Transport Appeals Panel.
13.5	Reports should also take into account the implications of other corporate strategies, in particular those concerning sustainability, e-government and risk management.

Appendices Colour

Appendix		yellow
1	Revised budget 2007/08 - calculation of the cash limit	yellow
2	Revised budget 2007/08 - comparison with cash limit	yellow
3	Base budget 2008/09 - summary of cash limit	pink
3 - Annex 1	Base budget 2008/09 - definition of base budget	pink
3 - Annex 2	Base budget 2008/09 - significant costs of inflation	pink
3 - Annex 3	Base budget 2008/09 - significant variations from 2007/08 repriced budget	pink
4	Proposals for growth, savings and redeployments 2008/09, 2009/10 and 2010/11	yellow
5	Efficiency statement	yellow
6	Review of income 2008/09	yellow
7	Revenue budget 2008/09 - analysis of variations	Blue
8	Revenue Budget 2008/09 - budget book detail	Green
9	Workforce levels and costs 2007/08 - 2009/10	Blue
10	Provisional budget 2009/10 and 2010/11	Pink
10 - Annex 1	Provisional budget 2009/10 and 2010/11 - analysis of variations	blue

Appendix 1

Adult Services

Revised budget 2007/08

Calculation of the cash limit for the revised budget 2007/08

The following table shows the progression from the original budget for 2007/08 to the cash limit for the revised budget 2007/08. Both are at estimated outturn prices 2007/08.

		£'000	£'000
Original budget 2007/08 at outturn prices			267,271
Transfers to/from other services
	European Policy Officer to Policy & Resources	(6)
	Transfer to Children's Services	(116)
	Transfer from Children's Services	625
			503
=	Adjusted original budget		267,774
Inflation
Provision added since the original budget for
-	business rates		10
Other variations
-	Carry forward from 2006/07 winter pressures	2,000
-	Corporate Travel Co-ordinator	(6)
-	Salary sacrifice - Busy Bees childcare vouchers	(11)
-	Carry forward of 2006/2007 Grants	3,508
-	Additional Aids Support Grant 2007/2008	25
-	Invest to Save Budget Round 9 (LAA Flagship)	120
-	Additional Carers Grant 2007/2008	358
-	Planned Carry forward to 2008/09 Revenue	(820)
			5,174
=	Cash limit for the revised budget 2007/08		272,958

Appendix 2

Adult Services

Revised budget 2007/08

Summary comparing the revised budget with the cash limit

	Cash Limit	Revised	Variation
	£'000	£'000	£'000	%
Cash Limited Expenditure
Service Strategy and Regulation	496	496	-	-
Unallocated	3,500	3,500	-	-
Older Persons	135,918	135,918	-	-
Adults with Physical or Sensory Impairment	24,937	24,937	-	-
Adults under 65 Years with Learning Disabilities	58,821	58,821	-	-
Adults under 65 Years with Mental Health	13,328	13,328	-	-
Other Adult Services	1,590	1,590	-	-
Supported Employment	482	482	-	-
Supporting People	33,546	33,546	-	-
Non-distributed Costs	340	340	-	-
Total	272,958	272,958	-	-

Appendix 3

Adult Services

Revenue budget 2008/09

Calculation of the base budget 2008/09 - summary of cash limited expenditure

The following table shows the progression from the original budget for 2007/08 which was prepared at outturn prices 2007/08 to the base budget 2008/09 at outturn prices 2008/09.

		£'000	£'000	£'000
Original budget 2007/08 at outturn prices				267,271
Transfers to/from other services
	European Policy Officer to Policy & Resources		(6)
	Transfer to Children's Services		(116)
	Transfer from Children's Services		625	503
=	Adjusted original budget			267,774
Increases for inflation to November 2007 prices (see annex 2)
-	Inflation allocated during 2007/08 from the central
	inflation contingency - Business Rates		10
-	Excess cost of inflation over inflation allowance		(249)	(239)
Original budget at November 2007 prices				267,535
Other variations (see annex 3)
-	Reduction to offset excess inflation		249
-	Revenue impact of capital programme		45
-	Corporate travel co-ordinator		(27)
-	Office accommodation - technical adjustment		(256)
-	Second Home Council Tax Adjustment		(9)
-	Hantsdirect		(1,211)
-	Planned Carry forward from 2007/08 Revenue		820
	Variations in expenditure funded by government grants
-	Mental Health Grant	(152)
-	Invest to save	240
-	Adult Social Care Workforce (was NTS/HR)	186
-	CSCI Reimbursement	(13)
-	Carers Grant	625
-	Supporting People Admin	(42)
-	Supporting People Care Grant	(100)
-	Preserved Rights	(269)
-	Preventative Technology	(996)
-	IMCA & IMCAS Mental Capacity Grant	171
-	Pump Priming Grant	(93)
-	Drug Action Team	(17)
-	Social Care Reform	1,537
-	Learning Disability Development Fund	699	1,776
Other variations (see annex 3) sub total				1,387
Allocation for future inflation				5,833
=	Base budget 2008/09 at outturn prices			274,755

Annex 1 to Appendix 3

Adult Services

Calculation of base budget 2008/09

Parameters used in the compilation

1	Definitions
1.1	The first stage in the construction of the budget for 2008/09 is the preparation of a base budget. The rules used this year are similar to those applied in 2007/08, which are summarised below.
1.2	The 2008/09 base budget is defined as the current year's budget adjusted for: · allocations made for inflation in 2007/08 including the full year effect of the provision made for outstanding pay awards from 2006/07 · exclusion of expenditure included in the 2007/08 budget which was financed by the carry forward of planned underspendings from 2006/07, 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 unless a specific Cabinet decision to the contrary · the full year effect of council-approved policies included in the 2007/08 original budget, which have been introduced part-way through the year · 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:
		Adults		Increased cost of joint finance schemes with health due to operation of the taper

Annex 2 to Appendix 3

Adult Services

Calculation of base budget 2008/09

Significant costs of inflation

1.	Variation between the actual cost of inflation in 2007/08 (as at November 2007) and the provision for inflation included in the 2007/08 budget
						£'000	£'000
	Additional cost of inflation					(239)
	Less:
	-	Allocation from contingency for business rates				(10)
	=	Shortfall in the provision					(249)
2.	Significant costs of inflation between budgeted 2007/08 outturn prices and November 2007 prices
2.1	Pay awards
	Provision was originally made in 2007/08 for pay awards of 2.25% for teachers and other employee groups:						£1,840,000
	The additional cost in 2008/09 of the pay awards agreed in 2007/08 has been met in full and is:						£216,000
	The pay awards agreed were:
	Negotiating body: Effective date:						%
	Local Government Services Staff Hampshire Management Grades				1 April 2007 1 April 2007		2.475 2.475

2.2	Non pay inflation
	Provision was originally made in 2007/08 for a net amount of £2,699,000
	This was for general price increases of 2.5% (£2,948,000) offset by increased income (£249,000) to match inflation in gross expenditure
3.	Allocation for future inflation					£'000
	Provision for all pay awards of 2.5% in 2008/09					2,406
	Increase in local government employers' pension contributions					237
	Provision for non-pay inflation at 2.5%					3,367
	Reduction for increased income					(177)
	Total allocation for future inflation					5,833

Annex 3 to Appendix 3

Adult Services

Calculation of base budget 2008/09

Significant variations

Major variations between the repriced budget 2007/08 and the base budget for 2008/09 at November 2007 prices contributing to the increase of £1,387,000 (0.5 %) are set out below:

							Variation against the
							repriced 2007/08
							budget
							£'000	%
	Transfer re Hantsdirect						(1,211)	(0.5)
	Transfer from 2007/08 revenue						820	-
	Variations in Government Grants ( Itemised in Appendix 3 )						1,776	3.0
	Excess inflation						249	0.1
	Revenue impact of capital programme						45	-
	Corporate travel co-ordinator						(27)	-
	Office accommodation-technical adjustment						(256)	(0.1)
	Second Homes Council Tax adjustment						(9)	-
*	Older People nursing care in-house						553	4.0
*	Older People residential care purchased						(250)	(0.8)
*	Older People nursing care purchased						(303)	(0.9)
*	Winter Pressures/Unallocated funding						(1,000)	-(36.1)
*	Older People nursing care in-house						1,000	7.2
*	Older People home care in-house						1,413	14.6
*	Older People home care purchased						(1,413)	(4.3)
*	Adults < 65 with Physical or sensory impairment - homecare in-house						99	6.1
*	Adults < 65 with Physical or sensory impairment - homecare purchased						(99)	(3.0)
*	see para 4.3

Appendix 4

Adult Services

Proposals for growth, savings and redeployments 2008/09 to 2010/11

Proposals are shown at outturn prices for the relevant year.

Agreed proposals will be incorporated into future year's base budgets and so on-going costs are shown in the first year only. One-off costs are shown in the first year and subtracted from the following year.

				Staffing (FTEs)
	2008/09	2009/10	2010/11	2008/09	2009/10	2010/11
	£'000	£'000	£'000
Growth proposals and unavoidable service pressures:
Dependency & Demographic Pressures	5,699	5,126	5,049	-	-	-
Commissioning /inflation	1,780	100	100	-	-	-
Modernisation Programme	3,155	-170	416	17		-1
Safeguarding clients	470	0	0	16	-	-
Supporting People	940	0	0	-	-	-
Promoting Independence	442	0	-85	3	-	-1
Other Operational Pressures	3,090	2,320	0	15	-	-
Sub-total	15,576	7,376	5,480	51	-	-2
Unallocated balance - to meet un-identified growth & pressures in future years	-2,320	580	3,332	-	-	-
Total increase	13,256	7,956	8,812	51	-	-2
Redeployment and savings proposals
Dependency & Demographics efficiencies	-665	-75	-75	-	-	-
Commissioning/inflation efficiencies	-2,032	0	0	-	-	-
Modernisation Programme efficiencies	-2,011	-805	-1,397	-86	-5-	-
Promoting independence efficiencies	-660	-310	-190	-	-	-
Other Operational efficiencies	-931	-66	-150	-4	-	-
Efficiencies subtotal	-6,299	-1,256	-1,812	-90	-5	-
*Scope for increased income	-400	0	0	-	-	-
Scope to Reduce Services	-57	0	0	-	-	-
Total redeployment proposals	-6,756	-1,256	-1,812	-90	-5	-
Net Total	6,500	6,700	7,000	-39	-5	-2
Guideline Addition	6,500	6,700	7,000
Final Net Total	0	0	0	-39	-5	-2
Additional saving for Pay & Benefits	-500	-	-	-	-	-

*£0.1m cashable as per Appendix 5 relates to improved FAB referrals

£0.3m relates to non cashable efficiencies following the introduction of a single rate RNCC (registered nursing care contribution) Appendix 5

Adult Services

Cashable efficiency improvements 2007/08 to 2010/11

	2007/08	2008/09	2009/10	2010/11
	£'000	£'000	£'000	£'000
a) Cashable efficiency improvements producing a budget saving and meeting the Government's definition of efficiency:
Dependency & Demographic pressures	-	665	75	75
Commissioning/inflation	2,595	2,032	-	-
Modernisation programme	1,416	2,011	805	1,397
Promoting independence	218	660	310	190
Operational efficiencies	959	1,431	66	150
Scope for increased income	385	100	-	-
Scope to reduce services	85	57	-	-
Total	5,658	6,956	1,256	1,812
b) Cashable efficiency improvements producing a budget saving but not meeting the Government's definition of efficiency:
Scope for increased income	-	300	-	-
Total	-	300	-	-
c) Cashable efficiency improvements not producing a budget saving:
Supporting people	737	-	-	-
Other operational pressures	575	475	-	-
Total	1,312	475	-	-
Total cashable efficiency improvements	6,970	7,731	1,256	1,812
% of base budget	2.9	3.1	0.5	0.7

Notes

Cashable efficiency improvements occur when:

- inputs (money, people, assets etc) are reduced but outputs remain unchanged

- the price of inputs (procurement, labour costs etc) are reduced but outputs remain unchanged.

a) Cashable efficiency improvements producing budget savings and meeting the Government's definition of efficiency include general procurement savings against the budget provision of a 2.5% increase in prices.

b) Cashable efficiency improvements producing budget savings but not meeting the Government's definition of efficiency include introducing new charges for services and fortuitous savings.

b) Cashable efficiency improvements not producing budget savings arise because the efficiency is avoiding unbudgeted cost e.g. staff reductions made to absorb increments, procurement efficiencies where costs are still exceeding 2.5%, capital receipts or developer contributions applied to avoid unplanned additional borrowing.

Adult Services Appendix 6

Revenue Budget 2008/09

Review of Income

Weekly Charge	Current charge	Total income (Budget 2007/08)	Date of last review	Planned date for next 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
Mandatory/National Charges	£	£'000			£
Nursing Care for Older People	446.00	6,717	April 07	April 08	455.00	April 08	Yes	No
Residential Care for Older People	403.00	4,759	April 07	April 08	413.00	April 08	Yes	No
Residential Care for Elderly Mentally Infirm	446.00	747	April 07	April 08	455.00	April 08	Yes	No
Residential Care for people with Physical or Sensory Disability	891.00	185	April 07	April 08	917.00	April 08	Yes	No
Residential Care for Adults with a Learning Disability	798.00	481	April 07	April 08	819.00	April 08	Yes	No
Orchard Close - Standard Week	676.00	95	April 07	April 08	693.00	April 08	Yes	No
Discretionary Charges
Residential Accommodation for Adults
Orchard Close - Client Contribution	122.00	73	April 07	April 08	126.00	April 08	No	No
Day Care Establishments
Day Services for Older People	159.00	223	April 07	April 08	165.00	April 08	Yes	No
Day Services for People with Physical or Sensory Disabilities
Including transport	303.00	204	April 07	April 08	310.00	April 08	Yes	No
Excluding transport	252.00	As above	April 07	April 08	255.00	April 08	Yes	No
Day Services for Adults with a Learning Disabilities
Including transport	185.00	2,619	April 07	April 08	190.00	April 08	Yes	No
Excluding transport	154.00	As above	April 07	April 08	160.00	April 08	Yes	No
	Current charge	Total income (Budget 2007/08)	Date of last review	Planned date for next 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
Full Cost Annual Charges
Day Services for Adults with Learning Disabilities
Including transport	5,022.00	As	April 07	April 08	5,160.00	April 08	Yes	No
Excluding transport	3,974.00	above	April 07	April 08	4,080.00	April 08	Yes	No
Banded Charges - Day Services for Adults with Learning Disabilities
Including transport	4,627.00	As	April 07	April 08	4,750.00	April 08	Yes	No
Excluding transport	3,605.00	above	April 07	April 08	3,700.00	April 08	Yes	No
Plus banded charge for each hour per week	626.00		April 07	April 08	665.00	April 08	Yes	No
Non Residential Charges (per hour)	13.68	7,474	April 07	April 08	14.05	April 08	No	Yes
Charge to External Organisations (per hour)	24.24	n/a	April 07	April 08	25.00	April 08	Yes	No
Other Charges
Meals for Adults:-
Day Services for Older People & Adults, Meals on Wheels and Luncheon Clubs per meal	2.90		April 07	April 08	3.00	April 08	No	No
Hostels for People with a Physical Disability:-
Transport charge per week	8.00		April 07	April 08	8.25	07Apr 08	No	No
Hire of Rooms - per hour	25.00		April 07	April 08	25.50		Yes	No

Appendix 7

Adult Services

Revenue budget 2008/09

Analysis of variations

	Adjusted	Variation in		Other	Inflation		Growth &	Revenue
	original	inflation to		base budget	allocation		Redeploy-	budget
	budget 2007/08	November 2007 prices		variations	to 2008/09 outturn		ment proposals	2008/09
	£'000	£'000	%	£'000	£'000	%	£'000	£'000
Cash limited expenditure
Service Strategy and Regulation	443		0.0	77	14	3.2	66	600
Unallocated	2,766		0.0	(281)	53	1.9	(786)	1,752
Unapportionable Overheads	340	4	1.2	(6)	9	2.6	(5)	342
Older Persons	132,469	(161)	(0.1)	2,969	3,331	2.5	(642)	137,966
Adults under 65 with Physical or Sensory Impairment	25,092	(22)	(0.1)	(455)	636	2.5	3,363	28,614
Adults under 65 Years with Learning Disabilities	59,360	(51)	(0.1)	(537)	1,397	2.4	3,725	63,894
Adults under 65 Years with Mental Health	12,807	(9)	(0.1)	196	344	2.7	258	13,596
Other Adult Services	1,582		0.0	29	37	2.3	13	1,661
Supported Employment	957		0.0	(436)	12	1.3	8	541
Supporting People	31,958		0.0	(169)	0	0.0	0	31,789
Net Cash limited expenditure	267,774	(239)	(0.1)	1,387	5,833	2.2	6,000	280,755
Expenditure outside cash limit :
Capital Charges	2,245			(114)				2,131
FRS17 pension adjustment	745			760				1,505
Specific Government Grants
Homeworkers	2							2
National Training Strategy	1,157			186				1,343
Human Resources Grant	536							536
AIDS Support	133							133
Access and System Capacity	10,759			(10,759)				0
Delayed Discharges	1,981			(1,981)				0
Mental Health	2,382			(152)				2,230
Supporting People	31,931			(142)				31,789
Preserved Rights	6,025			(269)				5,756
Preventative Grant	996			(996)				0
Carers	2,653			625				3,278
Drugs and Alcohol	120			(17)				103
Local Area Agreement	0							0
Pump Priming	93			(93)				0
Mental Capacity Grant	262			171				433
Social Care Reform	0			1,537				1,537
Learning Disabilities Development Fund	0			699				699
CSCI Reimbursement	13			(13)				0
Invest to Save Budget	0			240				240
Sub-total Specific Grants	59,043			(10,964)			0	48,079
Total Net Expenditure	211,721	(239)		12,997	5,833	2.8	6,000	236,312

Appendix 8

Adult Services

Revenue Budget 2008/09

Reconciliation of the original 2007/08 budget on the following pages with the 2007/08 budget in the published budget book.

	£'000
Net expenditure on page B3 of the published budget book	226,584
Adjustments for items not included in the budget book :
Adjustments made to the original budget figures :
European Policy Officer to Policy & Resources	(6)
Transfer to Children's Services	(116)
Transfer from Children's Services	625
Capital charges	(5,457)
Total net expenditure for 2007/08 original budget shown overleaf on page	221,630

Appendix 9

Adult Services

Workforce levels and costs

		2007/08		2008/09
		£'000		£'000
Analysis of workforce cost in base budget :
Salaries of permanent staff (including employee's national insurance and pension contributions)		81,825		84,581
Temporary/fixed term/casual staff		581		686
Agency Staff		3,053		3,129
Additional Hours		2,278		2,335
Total workforce costs		87,737		90,731
Average FTE staff actually in post		3,067		3,297
Staffing changes in growth , savings & redeployment proposals :
Variation in staff (FTEs)				-39
Variation in budget (£000)				-1,073
Workforce implications of budget proposals :
FTE posts available				3,258
Workforce budget available (£000)				89,658

Appendix 10

Adult Services

Provisional budget 2009/10 and 2010/11

The following table shows the progression from the 2008/09 proposed budget at outturn prices to the provisional budget for 2009/10 and 2010/11 at outturn prices.

		£'000
Proposed budget 2008/09 at outturn prices		280,755
-	Base budget variations
	Corporate travel strategy	7
-	Exclusion of non-recurring 2008/09 expenditure	(820)
-	Removal of second homes council tax adjustment	(11)
-	Specific grants	2,321
Growth and redeployment proposals
	Redistribution from other services	6,700
Allocation for inflation		5,983
Provisional budget 2009/10 at outturn prices		294,935
-	Base budget variations
	Corporate travel strategy	20
	Specific grants	(175)
Growth and redeployment proposals
	Redistribution from other services	7,000
Allocation for inflation		6,305
Provisional budget 2010/11 at outturn prices		308,085

Adult Services Annex 1 to Appendix 10

Provisional budget 2009/10 and 2010/11

Analysis of variations

	Proposed	Base	Growth	Inflation allocation		Provisional	Base	Growth	Inflation allocation		Provisional
	budget	Budget	and	to 2009/10		Budget	Budget	and	to 2010/11		Budget
	2008/09	Variations	redeployment	outturn		2009/10	Variations	redeployment	outturn		2010/11
	£'000	£'000	£'000	£'000	%	£'000	£'000	£'000	£'000	%	£'000
Cash limited expenditure
Service Strategy and Regulation	600			14	2.3	614			15	2.4	629
Unallocated	1,752		6,700	54	0.6	8,506		7,000	57	0.4	15,563
Unapportionable Overheads	342			9	2.6	351			9	2.6	360
Older Persons	137,966			3,418	2.5	141,384			3,602	2.5	144,986
Adults under 65 with Physical or Sensory Impairment	28,614			652	2.3	29,266			687	2.3	29,953
Adults under 65 Years with Learning Disabilities	63,894			1,433	2.2	65,327			1,510	2.3	66,837
Adults under 65 Years with Mental Health	13,596			353	2.6	13,949			372	2.7	14,321
Other Adult Services	1,661	1,497		38	1.2	3,196	(155)		40	1.3	3,081
Supported Employment	541			12	2.2	553			13	2.4	566
Supporting People	31,789			0	0.0	31,789			0	0.0	31,789
Total net expenditure	280,755	1,497	6,700	5,983	2.1	294,935	(155)	7,000	6,305	2.1	308,085
Expenditure outside cash limit
Capital Charges	2,131					2,131					2,131
FRS17 Pension Adjustment	1,505					1,505					1,505
Specific Government Grants
Homeworkers	2					2					2
Invest to Save Budget	240					240	(240)				0
Social Care Workforce	1,879	87				1,966	88				2,054
AIDS Support	133					133					133
Access and System Capacity	0					0					0
Delayed Discharges	0					0					0
Mental Health	2,230	111				2,341	110				2,451
Supporting People	31,789	(61)				31,728	(997)				30,731
Preserved Rights	5,756	(262)				5,494	(239)				5,255
Preventative Grant	0					0					0
Carers	3,278	250				3,528	253				3,781
Drug Action Team	103					103					103
Pump Priming Grant	0					0					0
Mental Capacity Grant	433	116				549	(19)				530
CSCI Grant	0					0					0
Social Care Reform	1,537	2,081				3,618	872				4,490
Learning Disability Development Fund	699	(1)				698	(3)				695
Sub-total Specific Grants	48,079	2,321	0	0	0.0	50,400	(175)	0	0	0.0	50,225
Total Net Expenditure	236,312	-824	6,700	5,983		248,171	20	7,000	6,305		261,496