Agenda item

Report ACH22-030

The Committee considered a report providing a summary of the changes embedded within the Adult Social Care Reform White Paper – ‘People at the Heart of Care’, and an update on the work undertaken by the Council to prepare and implement the changes.

The Programme Manager – Adult Social Care Reforms advised Members that in September 2021, in the Build Better plan, the government announced £5.4bn of investment in the adult social care system in England over 3 years to transform the sector – £3.6bn was allocated for the charging reform (including paying a Fair Cost of Care) and £1.7bn for the systems reforms. The government was committed to the introduction of charging reforms by October 2023 including a new £86k cap on personal care costs; changes to the means test thresholds, further bringing into effect section 18(3) and a move towards paying a fairer rate of care. A decision was also requested to drawdown the grants totalling £908k to support the work detailed in the report.

A Co-opted Member commended the decision made to charge higher earners for care. In response to questions, the Director of Adult Social Care advised that the budget for Adult Social Care was determined as part of the Council’s annual budget setting process. It was noted that the changes were part of the national agenda, allowing those who funded their own care to purchase it at the same price as pad by the Council. The movement of money from one budget to another would be subject to political decision – the Council was doing all it could to mitigate the risk, whether care was paid for privately or by the Local Authority,

A Member noted that the Association of Directors of Adult Social Services in England (ADASS), had stated that a sustainable care home market sat at circa 85%. As Mental Health and Physical Disabilities homes were at 98%, it was questioned whether there was a risk of reaching maximum capacity. The Director of Adult Social Care advised that Bromley was well placed in terms of the number of care homes and a large private market. It was not a struggle to find places, however they may not be at a price the Council could afford. In terms of the Mental Health homes market, Bromley’s perspective was mirrored on a national level, but alternative methods of support could be considered for those with mental health needs. It was noted that the borough had an older population and therefore had more capacity which could be drawn upon. In response to further questions, the Director of Adult Social Care advised that if another local authority placed someone in a residential care home, they would retain financial responsibility for the duration of the placement. However if a resident moved into a care home on their own accord, they would become the responsibility of the Council in which it was located if they reached the point of requiring funding. It was noted that a house was currently a chargeable asset, but only if there were no dependents living there – however guidance going forward was still awaited.

A Member noted paragraph 9.3 of the report, which stated that ‘with regard to the potential cost implication of the reforms themselves, initial modelling suggests this could be in the region of £6m in 2023/24, rising to £22m in 2026/27’, and queried why there was such a big jump. The Director of Adult Social Care advised that this was as a result of the government introducing the cap on the cost of care. October 2023 would see the start of this process – working towards the cap of £86k would see this figure increase year on year, as more people fell into Council funding.

In response to questions, the Director of Adult Social Care informed Members that some boroughs had taken part in a trailblazer, but Bromley had chosen not to participate due to the financial risk involved. It was noted that the Programme Manager – Adult Social Care Reforms had formed good links with some of the trailblazer boroughs, as well as the Department of Health and Social Care (DHSC), and was able to obtain information via these routes. The DHSC was using Bromley as a test case, due to the large number of care homes, and would connect them with other boroughs that were in a similar position. In relation to stresses on the wages of care workers, the Director of Adult Social Care advised that last year, COVID-19 grants had been received to assist care homes with their response to the pandemic – additional funding had been allocated to those evidencing that the payment would be passed on to staff. As outlined in the report, care homes had been asked to provide a breakdown of all costs, to show their expenditure and how it was built up, and a detailed analysis of the returns was underway. It was highlighted that, going forward, significant issues related to workforces across the sector were anticipated. The Portfolio Holder for Adult Care and Health noted that the Local Authority had good relationships with providers in the borough – returns providing the requested information had been received, and would help inform the decisions made.

A Member highlighted that the document was a White Paper, and may well change. The Director of Adult Social Care noted that a new Secretary of State for Health and Social Care had also recently been appointed – the Directorate would be required to be “fleet of foot” to adapt to any changes.

The Chairman noted that, going forward, regular updates on adult social care reforms would be provided to the Committee.

RESOLVED that the Executive be recommended to agree the drawdown of the grants totalling £908k as detailed in paragraphs 9.1 and 9.2 from central contingency to support the work detailed in the report.