Agenda item

Mr Martyn Storey, the Council’s Head of Strategy Finance – Adult Social Care, advised that this Committee was receiving the Month 10 report, whereas the timing of the Cabinet meeting had meant that the other Select Committees had received reports on Month 9. 

Concern was expressed that a £6.5m overspend had been discovered early in the financial year and Member questioned whether the next financial year would start with more accurate figures.  Mr Storey advised that officers were confident that the growth figures for the new year included demand and inflation and that 2025/26 had been rebased into 2026/27 to avoid these issues recurring.  After 31 March 2026, officers would undertake a refresh in the commitments for adult social care placements which would then provide a clearer picture and a profile for the year.  Mr Matt Davis, the Council’s Director of Strategic and Operational Finance, noted that £18m of growth had been included for adult social care and that the cost pressures in this area were known.  There would be pressures in 2026/27 in relation to fuel costs and Special Educational Needs transport but these should be covered by the provisions that had been put in place. 

It was noted that the budget position was showing as £0.8m worse that it had been at Month 7 (which had been the last budget monitoring report received by the Committee).  There were two reasons for this increase in spend: care home costs; and home to school transport.

Ms Sandra Taylor, the Council’s Corporate Director of Adult Social Care and Health, advised that when individuals approached the Council to ask for support, an assessment was undertaken of their eligible needs which was then followed by a financial assessment (capacity assessments might also have to go to court).  If the individual had savings of more than £23½k, they needed to pay for their own care.  Most people had assets of more than this amount and would often go into a care home sooner than the Council would choose (when responsible for making the decision, the Council would usually put support in place to help residents to stay at home) and would pay for this care themselves.  It was noted that the cost of a care home could range from £1,300 to £1,500 per week.  The Council provided residents leaving hospital with a “Paying for Social Care” booklet that covered issues that would need to be considered – Ms Taylor would forward a copy of this booklet to the Democratic, Civic and Ceremonial Manager for circulation to the Committee. 

There had been a small number of residents (4-6) identified that had been funding their own care home costs in homes that cost a lot more that the Council would pay.  These residents had previously been unknown to the Council and had reduced their savings to a level that meant they now met the threshold for support from the Council.  Sometimes it could take these residents a little while to work out what they needed to do to get support from the Council and for arrangements to be made to move the resident into a less expensive home that would usually be used by the local authority.  Once the arrangements had been sorted out, the funding had to backdated to the date that they became eligible and fees paid for the time that they had remained in the more expensive care home.  It had been unusual to have this many residents in this situation at the same time. 

Concern was expressed that the Council having to pick up the cost of a more expensive care home placements appeared to be a loophole that could have a significant impact in the authority’s resources.  Ms Taylor advised that this was a national issue and, although it had been talked about as part of the fairer funding arrangements five years ago, this had not progressed any further.  The authority’s money needed to be spent wisely and fairly and, although the residents’ best interests were always taken into account, finance was also a consideration. 

The Council had been charging home to school transport costs for children with an Education and Health Care Plan (EHCP) to the Dedicated Schools Grant (DSG).  Ms Taylor advised that personal transport budgets funded by the DSG had been available to those with an EHCP to ensure attendance at school.  However, the Department of Education had advised that this should not be done unless the child or young person had home to school transport identified within their EHCP.  Individual cases were being reviewed as some of this money would need to be returned to the DSG where transport had not been specified in the EHCPs.  Members queried how many more cases still needed to be reviewed and the financial risk that this posed.  Ms Taylor stated that her service area provided the transport but did not undertake the EHCPs so she would find out and pass this information on to the Democratic, Civic and Ceremonial Manager for circulation to the Committee. 

It was noted that the next budget monitoring report to Cabinet in the new municipal year would not be until July 2026 which meant that it would not be presented to the Committee until September 2026 (a six month gap).  Given that this would a huge timelapse, Mr Davis advised that officers would see what they could do to provide Members of the Committee with an update before then.

Ms Taylor advised that there were a significant number of contacts with adult social care but that the triage and early intervention that had been put in place had been effective in diverting residents and reducing the number of conversions.  There had also been a shift from direct care to direct payments.  This work needed to be built upon to help residents to help themselves, with initiatives such as AskSARA which enabled residents to undertake an online self-assessment to identify the equipment that they might need to help make everyday tasks easier.  It was recognised that technology enhanced and enabled but would not replace, unless this had been specifically requested.

As greater use of technology had been part of the savings strategy, Members were keen to see the cost benefits as this was not explicitly visible – where had money been saved and how had this worked.  It was agreed that a single meeting review on tech enabled care be held at the Health and Social Care Select Committee meeting on 21 July 2026.

Members queried what had happened to almost £4m in table 3 that was either in the red or had been written off.  Ms Taylor advised that there had been an ongoing dispute with the North West London (NWL) Integrated Care Board (ICB) about their allocation of funding (other NWL boroughs had been experiencing the same issue) – although there should be a 50/50 split of costs after discharge, the Council paid 67% and the ICB paid 33%. 

The Council had also been in the process of renegotiating the social care contracts when the increase in employers’ National Insurance contributions had been announced.  Effort continued to ensure that the Council received best value but this £2m had been written out as a difficult situation.  The purchase of the care home had not been completed until August 2025 and registration had only been completed the previous week so this had also been behind the curve in terms of providing savings. 

RESOLVED:  That:

1. Ms Sandra Taylor forward a copy of the Paying for Social Care booklet to the Democratic, Civic and Ceremonial Manager for circulation to the Committee;
2. Ms Sandra Taylor provide the Democratic, Civic and Ceremonial Manager with information about the number of EHCPs that still needed to be assessed to determine whether or not they were eligible for DSG payments and the financial risk that this posed for circulation to the Committee;
3. Mr Matt Davis provide Members of the Committee with an update on budget monitoring before its meeting in September 2026;
4. a single meeting review on tech enabled care be held at the Committee’s meeting on 21 July 2026; and
5. the 2025/26 Month 10 budget monitoring position be noted.