Following agreement on Oxfordshire County Council’s budget on Valentine’s Day, we look at the implications for Adult Social Care. Last December, the Government announced changes to how much it will permit Councils, which deliver Adult Social Care, to raise in council tax. The result of this decision is that there is no extra permanent money overall, but there is temporary finance released, which can be spent on one-off measures. The Council reports that £1.957m more money is available this year as a result of better than expected business rate collections conducted by Oxfordshire’s five district councils, council tax collection fund surpluses and a higher than expected share of a national grant.
In addition to existing budgets, there are two funding streams across England for Adult Social Care:
- the Adult Social Care ring-fenced element of the 2% Council Tax precept, which first came into effect in 2016/17 and raised an additional £5.883m (estimates for 2017-18 are not available yet);
- a new one-off Adult Social Care grant of £2.3m for 2017/18 (which is Oxfordshire’s share of a national grant funding stream).
The total benefit of these two funding streams for Oxfordshire for the period 2017-20 (three financial years) is reported by the Council to be £20.2m.
The Council intends to spend a total of £6.586m of the new funding on meeting demographic pressures; that is the growing demand of more people needing care and those people living longer with more complex conditions. The Council believes it will be able to directly meet £3.353m of new funding pressures that have been identified in Adult Social Care from these funding streams. Money previously set aside to cope with demographic demands in adults will be released to meet demographic pressures in children’s social care, an area which has not had major new funding previously.
A balance of £10.3m from 2017-2020 will be available to fund expenditure related to pressures including increases in the National Living Wage with ‘the Council obliged to assist private and voluntary care sector organisations with their costs in this area’. This was one area the Government had in mind when setting the Adult Social Care 2% precept. However, whilst NLW in County is a small pressure at present, social care providers face many other additional costs such as general inflation and being on the receiving end of suppliers passing on their NLW costs – it’s likely that wage inflation in Oxfordshire will mean that NLW may never become a major issue, as the cost of living forces wages up to compete with retail and other sectors for limited labour in the County. And a potential six years’ of back pay to cover sleep-in cover, as referenced by David Mowat MP, in the recent sitting of the Adult Social Care Select Committee Inquiry (see Q414) may collapse part of the sector nationally.
In spending the temporary finance raised the Council proposes to:
- Spend £0.875m more than originally intended in making the changes to daytime support services approved by Cabinet in January. Of this money £0.650m is temporary spend on transitional/ grant funding for the voluntary sector, while £0.225m is permanent funding.
- Allocate £1.01m toward growing , developing and building resilience in the external care workforce helping the private and voluntary sector with issues such as recruiting, retaining, training, and supporting this workforce. The high cost of living means that care organisations face difficulties in these areas. This funding would increase the numbers and the skill base of local care workers and help providers to recruit and retain for the longer term.
- Spend £1.485m on transforming delivery in Adult Social Care. The Council plans to increase internal staff capacity (social workers, occupational therapists, and care managers) to ensure delivery of home care packages (a key issue for people needing hospital discharge).
- The Council also plans to train and develop their staff to improve their commercial negotiation skills – sub-text, drive contract prices downwards? – and proposes to invest in improvements to systems to enable it to better track and monitor care demands in order to understand and use available capacity. Online commissioning through dynamic purchasing is already happening for care homes and is planned for domiciliary care.
The Council also aims to increase its ability to design and evaluate Adult Social Care services with significant input from people in Oxfordshire, including service users.
So, whilst the news yesterday of the Council proclaiming itself as being on a solid footing (in contrast to national headlines about local government looking at technical insolvency), is welcome, there are still massive pressures on the social care sector. Budget setting yesterday relied on temporary funding that provide temporary arrangements for the near future only.
Success in delivering good quality care relies on a steady supply of quality labour, retaining the good business brains of providers and harnessing the goodwill present in those who deliver care 24/7. All of these are under threat. We’ve avoided a Valentine’s Day massacre of services, but neither is it a bed of roses. Social care in Oxfordshire has gained a short-term fix of sorts (though the devil is always in the detail), but it also requires a long-term solution.
We remain a long way from an assurance about long-term care for the most vulnerable people in our County.
[More information about the Council budget is available from the Council’s press release yesterday.]