Agenda item

Report CS18139

The Board considered an update on the performance of the Improved Better Care Fund including both expenditure and activity up to the end of March 2018.

The Improved Better Care Fund was an additional funding element added to the Better Care Fund for 2017/18 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 pressure 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.  The Improved Better Care Fund 2017/18 had been utilised to deliver a range of schemes relating to the transformation of social care, investment in adult social care, supporting Joint Strategic Needs Assessment priorities, housing initiatives and researching older peoples’ housing needs, support for Integrated Care Networks, Discharge to Assess procedures in Extra Care Housing, safeguarding in relation to mental health need, recruiting a Direct Payments Lead Officer and work to develop and support the adult care market.  As agreement on the final schemes was reached late in the financial year, there had been a delay in implementing the projects which had resulted in an underspend of £3.172M for 2017/18, which would be carried forward into 2018/19. 

The Chairman reminded Members that the Health and Wellbeing Board had a statutory responsibility to be consulted on the use of the Better Care Fund and was required to agree any spending proposals.  The Board also had a role in scrutinising proposals in relation to the use of the Improved Better Care Fund.

In considering the delivery of Improved Better Care Fund schemes, a Board Member highlighted the ongoing challenge in recruiting and retaining Adult Social Care staff.  The Deputy Chief Executive confirmed that a number of measures were in place to support the recruitment and retention of high quality Adult Social Care staff such as the ‘Caseload Promise’.  A highly successful ‘Assessed and Supported Year in Employment’ recruitment event had been held on 14^th May 2018, attracting 141 newly qualified Adult Services Social Workers from which it was hoped to recruit 10-15 high quality Social Workers.  This would be further supported by the establishment of a Placements Coordinator role to engage with London South East Colleges and develop the Assessed and Supported Year in Employment programme in Bromley.

A Board Member was pleased to note investment of the Improved Better Care Fund grant in relation to safeguarding work with the South London and Maudsley NHS Foundation Trust, but underlined the need for any changes made as a result of the work to be sustainable beyond the three year grant period.  Another Board Member was concerned that the Local Authority was not working sufficiently closely with the third sector in expanding the use of Direct Payments, and the Deputy Chief Executive would follow this up with relevant Officers following the meeting.

Members generally discussed the Care Homes Investment Options Appraisal which would explore the business case for the Local Authority investing in the building of a care home to improve access to affordable care home placements within Bromley.  The Deputy Chief Executive confirmed that the appraisal would consider a full range of models to deliver affordable care home placements in a highly competitive market that often favoured self-funded care home residents.  The Government’s green paper on care and support for older people was due to be published in Summer 2018 and was expected to provide further clarity on the future model for adult social care funding.  A Board Member noted the potential to link with a developer in delivering additional care home places in the Borough, provided that adequate nomination rights could be secured.  Another Member suggested that the Local Authority consider funding two care homes to support older people to remain within their own communities.  In response to a question from the Member around the investment of the Improved Better Care Fund as a contingency to raise the sustainability and performance of existing care, the Deputy Chief Executive explained that the scheme benefitted the Local Authority by maintaining a stable and good quality care market across the Borough.  The Chairman requested that the brief for the Care Homes Investment Options Appraisal be provided to Board Members following the meeting.

RESOLVED that the performance and progress of Improved Better Care Fund schemes and the latest financial position be noted.