The Commission considered a report setting out an overview of the reset Adult Social Care (ASC) transformation programme, including the approach being taken to ASC In-house services.
The Interim Director: Adult Social Care Transformation outlined the report. In response to the public forum statement submitted by the GMB, the following points were clarified:
* Changes to any of the projects within the transformation programme would need to be taken forward through the Council’s decision-making processes.
* There was no proposal to transfer the intermediate/rehab centre in east Bristol to Sirona.
* As indicated in the report, the South Bristol rehab service was closed in July and the management of change process for the affected staff was now close to completion. Important lessons had been learned in relation to working with health partners and the impact on staff during the process, and these would be applied to future work.
Summary of main points raised:
1. Cllr Weston queried whether the identified saving of £800k in relation to workstream 9 (pricing control) was realistic given the rate of inflation currently. In response, officers acknowledged that this and some other identified savings were challenging in light of national economic factors. There was ongoing liaison and dialogue with providers over cost pressures, recognising also that a key rationale for the transformation programme was to address the fact that Bristol was a relatively high-cost outlier nationally.
2. In response to questions about Bristol Community Meals, it was noted that the ambition was to grow the service so that it became self-sustaining and able to generate a profit. In light of the cost of living crisis and related pressures, it was suggested that as part of developing further the business case for Bristol Community Meals, careful consideration be given to phasing any future price increases to customers that may become necessary.
3. In response to a question from the Chair, it was confirmed that Discharge to Assess and Home First were key programmes for the Council and health partners; the focus was to ensure a ‘whole system’ approach which maximised the flow of patients from hospital into appropriate care, either at home, into intermediate care, or residential care where this was necessary. The Chair commented that the effectiveness of this approach might be an area for the Commission or member leads to examine in greater detail at a future point.
4. In response to a question from Cllr Hance, it was noted that inflation costs were factored into the care placement budget each year; regular discussions were held through a provider forum to ensure information around cost pressures (e.g. energy costs) was shared; an appropriate balance was sought through the programme between recognising the need to address the Council’s position as a high cost outlier and the need to sustain/work with the market.
5. In response to a question from Cllr Stone, it was confirmed that increasing the use of direct payments was an area that was being considered through the modelling, including the issues around pay rates for personal support assistants. It was important to try to ensure positive outcomes for individuals through direct payments.
6. In response to a question from the Chair in relation to the deliverability of the 2022/23 MTFP savings in Adult Social Care as set out in Appendix 2, the Executive Director: People advised that there were particular challenges in delivering savings related to the care market, given the national economic situation. However, the overall position in terms of the delivery of savings within the Adult Social Care budget had improved in comparison to previous years, as referenced in the regular budget monitoring reports to Cabinet.
The Commission RESOLVED:
To note the report and the above information.