Agenda Item No
The Vale of Glamorgan Council
Scrutiny Committee (Corporate Resources): 16th October 2012
Report of the Director of Social Services
Budget Programme Update - Residential Care Services for Older People
Purpose of the Report
1. To update Scrutiny Committee regarding the budget position in residential care services for older people.
1. That Scrutiny Committee notes the content of this report.
Reasons for the Recommendations
1. To ensure effective scrutiny of key developments in the delivery of these frontline services.
2. On 28th February 2011, Cabinet approved the revenue and capital budget for 2011/2012. In order to remain within the allocated budget for Social Services, the Directorate was required to achieve savings of £1.6m during that year and so a range of measures was identified within an overall budget programme. The plan included restructuring the staffing establishments within the residential care homes for older people directly provided by the Council or made available under the 25-year contract with Hafod Care (as the staff group in the homes is employed by the Council). The identified saving was £45,000 per home through deletion of the deputy manager posts (i.e. a total of £180,000).
3. At the same time, the Directorate undertook a review of the staffing levels in each of these homes - Cartref Porthceri, Southway, Ty Dewi Sant and Ty Dyfan. The key principles adopted in undertaking the review have been to:
ensure that the service is fit for purpose and meets the changing needs of older people;
ensure that there is clear role allocation among the staff in the home;
ensure that residential services are managed on a more business like footing;
ensure the service continues to meet Care and Social Services Inspectorate Wales (CSSIW) requirements;
meet the ongoing service demands within the Directorate; and
achieve significant budget savings.
4. Residential care provision is regulated by CSSIW. Their role is to register each home and to ensure that the service provided is in accordance with regulations and meets national minimum standards. The inspections may be announced or unannounced. One of the standards deals with the staffing and management of the home. Ultimately, if the service is not meeting the minimum standards and appropriate action is not taken, CSSIW has the power to deregister a home.
5. The Council has directly provided residential care for many years. It is evident that residents are generally much older now and that they have an increased level of need, especially as more of them are living with dementia-related illnesses. This does have an impact on the staffing levels required within the home to meet national minimum standards.
6. Given the increasing amount of care required by residents, it was found that staffing levels were not sufficient on all occasions to maintain a safe level of care. As a result, on an incremental basis staffing levels have been increased or the number of residents has been reduced, leaving unused beds in the homes. Implementing Job Evaluation has also affected staffing costs, although this has been funded corporately. There is a consequential impact on the costs of the service.
Relevant Issues and Options
7. Because of increasing legislative and monitoring requirements and related changes in working practices, managers, deputy managers and senior care officers are dealing with more administrative tasks. This has reduced the time available to undertake other management functions. Examples of these administrative tasks include :
answering the phone;
processing time sheets, as staff are paid on a four weekly basis;
ordering, and sometimes collecting, supplies for the home;
processing invoices for goods and services; and
creating and maintaining records.
8. The initial review concluded, therefore, that eliminating e the deputy manager roles can be done only in the context of a wider review of staffing structures within the homes. Ty Dyfan and Ty Dewi Sant are managed through a contract with Hafod Community Care. When this contract was agreed in 1991, the staffing structures were agreed and these differ from those operating in the other homes managed by the Council. Hafod have agreed that these arrangements can be changed, if necessary. Proposals for change will be the subject of consultation with staff and recognised trade unions in the next three months.
Resource Implications (Financial and Employment)
9. To take into account the planned saving through restructuring staffing levels in the homes, the revenue budget for residential care services has been reduced by £180,000 per year. These savings were not achieved in 2011/2012. Work has been done to reduce costs elsewhere in the budgets but this has not been at the level required to balance these budgets.
10. The draft proposals for change do include implications for a small number of staff across the four homes and these will be dealt with in accordance with the appropriate HR policies and procedures.
Legal Implications (to Include Human Rights Implications)
11. The powers and duties of the Social Services Department to provide residential accommodation are dealt with primarily in part 3 of the National Assistance Act (“NAA 1948”) and, in particular, in section 21. In addition, there are provisions relating to accommodation services in other legislation including the NAA 1948 section 29(iv), the Mental Health Act 1993 section 117, the Local Government Act LGA 2000 and the Children Act 1989.
12. Relevant regulations include ‘The Care Homes (Wales) Regulations 2002’ and subsequent amendments. These state that “the registered provider shall carry on the care home in such a manner as is likely to ensure that the care home will be financially viable for the purpose of achieving the aims and objectives set out in the statement of purpose.”
Crime and Disorder Implications
13. There are no crime and disorder implications as a direct result of this report.
Equal Opportunities Implications (to include Welsh Language issues)
14. In developing proposals in respect of residential care homes for older people, the overall objective is to ensure that sufficient places are available to meet need at a cost that the Council and self-funders can afford.
Sustainability and Climate Change Implications
15. Part of the overall purpose of any changes to residential services for older people is to ensure that current and future demand can be met and delivered in settings which are fit for purpose, sustainable and financially viable.
16. The development of proposals for change in respect of residential services will support the following corporate objectives:
to make the Vale a safe, healthy and enjoyable place in which individuals can live their lives to the full; and
to manage the Council's workforce, money and assets efficiently and effectively in order to maximise its ability to achieve its service aims.
Policy Framework and Budget
17. This is a matter for executive decision.
Consultation (including Ward Member Consultation)
18. The proposed changes to the staffing levels within residential care services will be the subject of consultation with staff concerned and the recognised trade unions.
Relevant Scrutiny Committee
19. Corporate Resources
Carys Lord, Head of Business Management and Innovation
Operational Manager, Legal Services
Group Accountant, Finance
Philip Evans, Director of Social Services