Report of the Executive Director of Adult Social Services attached

The report of the Executive Director for Adult Social Services explained how the budget proposals for the Directorate had been developed.

The gross 2023/24 budget was £285.023m and the net budget of £219.666m. Income of £65.357m which included client fees £30.416m, Better Care Fund Grant £17.791m, contributions from NHS partners of £10.267m and other income of £6.883m which included grants and use of reserves.

Growth and pressures of £26.372m were estimated and included in the Medium Term Financial Plan (MTFP) for 2024-26, as part of the 2023/24 budget approvals process, alongside an additional £5.936m of base assumptions for 2026/27. Together the current MTFP included £32.308m of funding of which £6.074m related to the transfer of grant funding in accordance with the statutory conditions, the Market Sustainability and Improvement Fund (MSIF) original allocation (£3.105m) and the Adult Discharge fund (£2.969m), with the balance of £26.234m Council funding for demographics and towards the care fee uplift, including use of the proposed Adult Social Care precept.

Further pressures identified included:-

·            A £9m pressure into 2024/25 arising from the 2023/24 financial forecast position (as at August 2023), which was fully mitigated through a combination of additional resources and specific service initiatives detailed (and now presented in this report in the savings section below);

·            Additional demographics in 2024/25 of £3.735m including £2m for transition of children to adult support, with increases of £1.064m in 2025/26 and £0.764m in 2026/27 to set the demographics budget to £4m in each year;

·            Additional funding towards the cost of care uplifts of £3.500m in 2024/25;

·            Mainstreaming the cost of new care models £1.300m from 2026/27; and

·            An expected £1.779m reduction in the 2024/25 MSIF workforce grant from £4.055m to £2.276m

The above represented an additional £8.584m, bringing the total investment 2024-27 to £40.892m

In addition, the full year cost into 2024/25 of clients in long term care as at November was assessed at £20.812m above the existing budget. And it had been deemed prudent to provide £1.5m for further growth in homecare to the end of the financial year.

Key budget movements were summarised as follows:-

The recurrent underlying position for 2024/25 had become significantly more challenging over the last five months and whilst the budget challenges outlined were significant, due to cost effective management of demand, Manchester’s social care financial pressures were less than many comparable authorities

Overall there were £27.107m of additional budget pressures.   Substantial work had been completed to mitigate these pressures, with a plan of £19.8m savings put in place, which left a residual additional budget requirement of £6.807m and this had been included in the proposed update to the medium term financial plan.   Of the £19.8m savings proposed, £13.4m would be achieved through additional funding and reallocated budgets which was secure and £6.4m of service actions which would be added to the approved savings programme but which included a level of risk.  The Directorate had also committed to the delivery of an additional workforce savings target from reducing a number of long term vacant posts in the establishment by £0.255m for 2024/25.

It was also reported that there was heightened work underway across Commissioning, Contracts and Market Development in response to the fragility of the current care market.  A MLCO Commissioning Plan had been developed which would act as a key communication tool with providers, partners, wider stakeholders, citizens and the commissioning workforce. This Plan would set out the key principles of how commissioning was intended to be more ‘responsive’ to the frontline staff as part of the Better Outcomes Better Lives transformation programme, and for staff to highlight where there were perceived gaps in provision.

Whilst there was additional investment proposed for the Adult Social Care budgets there remained  considerable pressure and the fragility of the social care market, the increased demands for mental health services in particular remain key risks.

It was noted that the budget report had also been considered at a recent meeting of the Health Scrutiny Committee and the committee had endorsed the proposals in the report (Minute HSC/24/08).

Decision

The Executive approve the Directorate budget proposals as set out in the report.