Agenda item
IMPROVED BETTER CARE FUND
Minutes:
Report CS18065
The Committee considered an update on the Improved Better Care Fund (IBCF) summarising the national conditions for the use of the Improved Better Care Fund and making recommendations for the proposed use of the grant.
The Improved Better Care Fund was a time-limited grant provided to local authorities for investment in adult social care services including meeting current and future adult social care needs, ensuring that the local social care provider market was supported and reducing pressures on the NHS such as through timely discharge from hospital. In the Spring Budget 2017 the London Borough of Bromley was awarded an IBCF Grant of £4.2M in 2017/18, with additional grant funding of £3.4M and £1.7M to be provided in 2018/19 and 2019/20 respectively. A condition of the Improved Better Care Fund allowed this grant to be spent in advance of final NHS England approval of the Bromley Better Care Fund Plan following agreement of any spending plans by health and wellbeing partners. It was proposed that the Council’s Executive agree that the IBCF grant for 2017/18 be utilised to stabilise and reduce pressures on the health and social care market, as well as provide opportunities for ‘invest to save’ projects across adult social care in the short to medium term.
The Interim Director of Programmes advised Members that the proposed investment of £100k to commission a specialist to carry out research into the housing and care needs of older people in Bromley to inform future commissioning and service strategies would partly be used to fund detailed research work into the housing needs of all Bromley residents, including a potential project to encourage existing tenants to release social housing where it was no longer required.
In considering the report the Chairman raised a concern that any recurring spending plans were based on the assumption that the Improved Better Care Fund would continue to be available and that contingency planning would be needed if this was not the case. A Member also noted the proposed use of the Improved Better Care Fund for workforce development and queried whether this was too distant from the service user. The Interim Director of Programmes confirmed that there was a need to add workforce capacity to adult social care in the short term to review the social care pathway and enable a more efficient and seamless service to be delivered into the future.
In general discussion, Members were concerned at the proposed investment of £250k in the Care Homes Investment Options Appraisal. The Interim Director of Programmes reported that the Local Authority was facing increasing difficulty in securing local nursing home placements due to competition from self-funders and other local authorities. To address this it was proposed to explore the potential for the Local Authority to purchase but not manage a care home with full nomination rights on the placements by instructing the Local Authority’s property surveyors to undertake a two-phased options appraisal on the purchase of suitable accommodation. This would comprise an initial high level options appraisal of available sites, which was not expected to be costly, followed by a full feasibility study on any preferred options which would identify capital investment opportunities for the Local Authority and be funded from within the agreed full-cost envelope of £250k. In considering this proposal, a Member emphasised the need for the Local Authority to review the level at which it funded care home placements as it was not financially viable for many care homes to accept Local Authority-funded service users. The Member also highlighted the unacceptable backlog in assessment for additional social care packages, and the Deputy Chief Executive noted that the proposed investment in workforce capacity in this area would allow the existing backlog to be cleared and processes to be reviewed across the four assessing organisations to ensure the assessment and property adaptation procedure was efficient and sustainable.
With regard to the proposal to invest £40k in a Direct Payments Lead Officer, the Director: Adult Social Care advised Members that there had been a low take-up of Direct Payments in Bromley due to the difficulties service users faced in managing their own care packages and a lack of choice within the local care market. The Direct Payments Lead Officer would drive forward the whole system response for Direct Payments which was expected to increase the uptake of Direct Payments by service users, enabling them greater choice and independent in managing their care as well as supporting the development of the local care market.
A Member was concerned at a proposal to invest £200k in a market development and support initiative. The Deputy Chief Executive outlined the aim of the proposed investment which was to improve the sustainability and performance of Bromley care homes, assist in staff training and provide emergency care funding for those providers in danger of failing financially, and that this would drive a general improvement in care home provision across Bromley as well as enabling the Local Authority to meet its obligations in terms of safeguarding vulnerable service users. It was also important for the Local Authority to understand the local care market in terms of existing provision and current and future levels of need to ensure high quality social care was in place for Bromley residents.
The Vice-Chairman underlined the need to recruit and retain high quality adult social workers.
RESOLVED that the Council’s Executive be recommended to:
1) Note the value of this IBCF grant in paragraph 3.3 and the conditions relating to the IBCF grant as identified in paragraph 3.2 of Report CS18065;
2) Approve the principles of the areas identified for investment in adult social care as set out in section 4 of Report CS18065;
3) Grant delegated authority to the Deputy Chief Executive and Executive Director for Education, Care and Health Services and the Portfolio Holder for Care Services (including Public Health) to draw down the value of the IBCF Grant for 2017/18 (£4.184m) and to determine detailed expenditure plans for the IBCF Grant proposals within the framework described within this report;
4) Subject to the agreement above, the recurring costs of £1.7m in 2018/19 and £1.6m in 2019/20 identified in paragraph 8.2 of Report CS18065 be agreed; and,
5) Request that a regular progress report on the impact of the investment of the Improved Better Care Fund be provided to Members.
Supporting documents: