Agenda item

Consider update by Chief Officer Health and Social Care and Joint Manager Learning Disability Service.

1.1         With reference to paragraph 3 of the Minute of the Meeting held on 14 March 2022, Mr Chris Myers, Chief Officer Scottish Borders Health and Social Care Partnership, provided a verbal update on the Learning Disabilities Service Financial Management Recommendation progress.  Mr Myers advised that progress on the final Internal Audit report recommendations relating to Learning Disabilities Service (LDS) work had been ongoing, further work was required on local assurances, and that Julie Hayward Consultancy was invited to give further views on progress which had been completed.  Mr Myers advised that significant work had taken place since the March 2022 meeting of Audit and Scrutiny Committee, however, despite positive progress, expenditure was not in balance with available budget and work was ongoing to reduce spend.  Further work was underway to complete outstanding actions, some of which did not sit with the Service but were being progressed.  Progress was being monitored at monthly control meetings taking place at directorate level and at business unit level.  The trajectory of expenditure was being monitored so that it was reduced while maintaining service for people with learning disabilities.  Mr Myers advised that the Learning Disabilities Service was on a journey where there was a much better control of the service and progression was being made on actions.  Mr Simon Burt, Joint Manager Learning Disabilities Service, advised that there were two approaches taken to tackle the problem which incorporated ensuring that not too much was being paid for elements of the services comparable to other local authorities, and making sure that the appropriate volume of support for service users was being paid for, to allow people to be as independent as they could.  Staff were engaged to contribute to solutions so that changes were not entirely management-led.  Processes were in place to support Social Workers to take information to support panels where requests were heard to put support in place to allow people to be independent.

1.2         Mr Burt and Mr Myers responded to questions from Members.  Regarding duplication in transition planning, Mr Burt advised that a transitions project led by a funded project officer had reported a couple of years ago that there were a number of legal requirements for various support plans, while an individual could require a single support plan that may contain different elements.  This had not been achieved.  However when an adult support plan was prepared as far in advance before an individual turned 18 years-old, a multidisciplinary approach was taken for transition to adulthood services and duplication was avoided as far as possible.  Ms Stacey advised that timings of the Internal Audit recommendation completion were reviewed with ongoing discussions with Mr Myers and Mr Burt, and that monthly meetings took place with the Section 95 Officer (the Acting Chief Financial Officer) to gain insights of the financial pressures on LDS.  Mr Burt advised that the number of those with very complex needs transitioning to adulthood was low although increasing and the solutions they required could be very expensive.  Work was ongoing looking at how the Health and Social Care Partnership assessed what needed to be commissioned to support people with complex needs so that plans would be in place for when individuals reach adulthood.  A report concerning a project based in Tweedbank for supporting people with complex needs in the Borders would be presented to Scottish Borders Council in the near future.

1.3         Mr Burt advised that, regarding planning for who required support for complex needs, the service knew of children requiring support for transitions at 14 years-old.  However it sometimes would not be clear what support they would need until they approached 18 years-old, which would necessitate meetings to track the needs of an individual.  Regarding financial pressures, Mr Burt advised that there was a cost pressure of approximately £625,000 if all £490,000 targeted savings in the financial plan were made.  The whole saving was unlikely to be met within the financial year, however there was confidence a significant amount of savings could be made.  Savings had been made through the review of day services and further savings may be made from reviewing care packages.  The LDS aimed to review everyone’s care within two years, however reviews had been limited due to there not being a fully staffed service in place.  On average 67% of people were being reviewed within two years.  With regards to service delivery contracts from third-party providers, Mr Burt advised that the Scottish Government had a framework where rates were set and the LDS generally paid below the Scotland Excel framework rate.  Furthermore, providers used by the Service were rated highly by the Care Inspectorate.  Before the Covid-19 pandemic, there would be an LDS manager assigned to a contracted provider that would assess day-to-day problems and hold regular meetings with providers to assess contracts.  That work had stopped during the pandemic but was due to restart again so that contract performance could be assessed.  The Acting Chief Financial Officer advised that the financial risk from the Learning Disabilities Service on the Council was lower than it had been due to significant Scottish Government funding to support IJB services.

1.4         The Chair suggested that the LDS Financial Recommendation remained on the action tracker and an update come to the Audit Committee in six months’ time and requested that the Julie Hayward Consultancy reports be circulated to committee members.

DECISION

(a)       AGREED:

(i)        to circulate the update report on Learning Disabilities Service to members of the Audit Committee;

(ii)       to keep the LDS Financial Recommendation action on the Audit Business Action Tracker.

(b)       NOTED the verbal update.