Care Home Providers Forum 7 April 2011 Salford - Revenue Budget 2011/12

Contents Overview of Local Authority Funding Formula Grant Settlement – Headlines Impact upon Salford Scale of the Efficiency Challenge

Budget Cycle – Planning to Settlement Continuous monitoring of demand, expenditure and resources available. City Council formal business planning and budget cycle –Timescale is October 10 – March 11 –Headlines on funding announced in Spending Review October 20 th –Detailed Local Government Settlement – first week December –Consultation and clarification on funding resources available between Local Authorities and Central Government – December / January –Budget Options evaluated by early February –Budget set end of February through Council

Summary LA Funding Salford Council Funding Specific grants e.g. Social Care Reform Grant, Area Based Grant, Dedicated Schools Grant, Income from fees and charges e.g. Client contributions, Housing rents Formula Grant -Revenue Support Grant -- Redistributed business rates Services Council Tax Government controlled Council controlled

Formula Grant Settlement - Headlines 2-year formula grant settlement Formula grant reduction – 2011/12 9.9% like-for-like /13 8.2% Introduction of concept of “Revenue Spending Power” = Council Tax + Formula Grant + Specified Specific Grants LA’s “Revenue Spending Power” will be no more than a 8.8% reduction for both 2011/12 and 2012/13 Transitional grant introduced to protect losses over 8.8%

Impact upon Salford 2011/12 (1) “Revenue Spending Power” reduces by : 2011/128.87% 2012/133.95% But : Salford received £203k transitional grant – contributing to our total budget requirement of £228.5m ie 0.1% of total budget

2011/12 Available Resources vs. Spending Requirement Total Available Resources £228.5m Spending Requirement £268.4m Funding Gap £39.9m

The scale of the efficiency challenge

The Scale of the Efficiency Challenge Cabinet has examined in detail all possibilities in identifying the way forward Looked to build upon the strong Think Efficiency platform in looking for innovative efficiency options Sought to safeguard critical front line services to vulnerable residents of the City Facing this scale of challenge, it has not been possible to avoid service reductions in all cases

Salford City Council – Savings 2011/12 Key themes of our approach 1.Workforce reform 2.Income generation 3.Budget adjustments 4.Collaboration 5.Property 6.Service / policy redesign 7.Service reduction

Impact on Community, Health and Social Care Savings proposals have been developed across all areas of the Directorate and across all the key themes. Changes to funding streams are complex and include: –Specific Grants transferring into Formula Grant –Area Based Grant – either lost or transferred into Formula Grant –Funding transferring from the NHS to the Local Authority –Learning Difficulties Transfer – Introduction of Specific Grant (not ringfenced)

Impact on Community, Health and Social Care Adult Social Care savings - £3.383m over 27 service areas During the budget process no savings proposed around care fees for Residential and Nursing Care Home services. Context that approx £100m spend on Adult Social Care and within that £28m on Residential and Nursing care. Council budget plans for 2011/12 has protected current fee levels

Questions ?

Care Home Providers Forum 7 April 2011 Market Development - Feedback

Market development Key Development Areas identified at the last Care Home provider forum Personalisation Working with the NHS Innovation / Diversification / Efficiency

1. Personalisation To improve the life chance of Salford citizens and to promote the independence of individuals and communities in Salford” Services will encourage individuals to reduce their dependency on public services, through encouraging people to take control and exercise choice over how they lead their lives. The Directorate’s relationship with its citizens will increasingly be influenced by a move towards enabling people as opposed to simply providing services and support.

Definition of Personalisation in Salford “Personalisation is about making services fit around the individual; enabling people to make decisions, maximising their life chances and giving them choice and control in the way care and support is delivered”

The Vision for Salford “To create the best possible quality of life for the people of Salford” by: Improving our services Leading the Local Strategic Partnership Working with Partners in Salford Providing Strategic Direction for all organisations, to work together to get the best possible outcomes for people

Some Key Challenges User/Carer/Citizen Involvement Marketing/Communication Co-production –User Lead Oranisations (ULO’s) Development of Social Capital and Empowered Communities Development of Universal Services/Markets/Choice Prevention – to realise/measure benefits Effective reablement linked to efficiency realisation

Personalisation - Salford Care Training Partnership Resources Web: Jane Wright Principal Organisational Development and Training Officer,

2. Working with the NHS Understanding of Salford’s approach to working with the NHS in Salford Prevention of Admission to hospital, supporting discharge from hospital, step up step down arrangements Joint session - Jennifer McGovern Assistant Director Joint Commissioning and Care Home provider representatives

Working with the NHS Salford has a well developed range of Intermediate Care Services Step up / step down facilities within Salford care homes, rapid response, intermediate home care focussing on re-enablement Conclusion – services are already in place, continuously monitor demand and effectiveness, re- evaluate as part of ongoing development of commissioning strategy – medium to long term

3. Innovation / Diversification / Efficiency Understanding of options and scope for innovation, diversification and efficiency for care homes. Joint session - Keith Darragh Assistant Director (Resources), procurement, Care Home provider representatives

Innovation / Diversification / Efficiency RECOGNISE THE STARTING PLACE Primary business – supporting long term care needs Business models based on “residents” occupancy levels CQC Regulation – CQC standards for running a care home (environmental, staffing, recruitment, training, care processes and recording

Innovation / Diversification / Efficiency OPPORTUNITIES Strengths – locality base, trained workforce, experts at care Business model development to become a Community Asset

What does the business model become Long term care Short term / sessional care Community accessing services within the home Staff outreach to the community Diversification of services in the home

Community Asset Business benefits –wider and more intense utilisation of assets –Increased income –Increase in marketable services Social Care benefits –Services closer to where people live –“Expert” base for care and support –Flexible support where services fit around individuals

Community Asset Building Blocks –Commissioners building more diversification into commissioning strategies –Providers developing business models and range of services –Marketing of services and information to Users and Carers Professional staff (Social Work / NHS partners) Local Communities / Neighbourhoods –CQC understanding and support of developments

Community Asset Next steps –Developing “community asset” model with commissioners and providers – Jennifer McGovern –Jointly developing strategy for provision of information about range of services (User / Professional / Communities) - Keith Darragh –CQC understanding and support of developments – Jennifer McGovern / Keith Darragh

Care Home Providers Forum 7 th April 2011 Next Steps

Care Home Providers Forum Looking to the future and our meetings together over the next 12 months What more do you want us to do together ?

Care Home Providers Forum Quality Assurance Efficiencies / Funding Joint Support to Self Funders Funding for Long Term Care - Dilnot

Care Home Providers Forum Personalisation – Innovation / Diversification Local services / Neighbourhoods Further development of specifications and contracts Proposal on frequency – Joint / Sector meetings Care Homes (2), Home Care (2), Joint (2)