Agenda item

Councillor Dan Levy, Cabinet Member for Finance, Property and Transformation, Councillor Tim Bearder, Cabinet Member for Adults, Karen Fuller, Director of Adult Social Services, Victoria Baran, Deputy Director of Adult Social Care, and Ian Bottomley, Deputy Director of Commissioning, and Kathy Wilcox, Head of Corporate Finance have been invited to consider the Business Management and Monitoring Report with a specific focus on Adult Social Care.

The Committee is asked to consider the report and raise any questions, and to AGREE any recommendations it wishes to make to Cabinet arising therefrom.

Councillor Dan Levy, Cabinet Member for Finance, Property and Transformation, Councillor Tim Bearder, Cabinet Member for Adults, Lorna Baxter, Deputy Chief Executive and S.151 Officer, Karen Fuller, Director of Adult Social Services, Victoria Baran, Deputy Director of Adult Social Care, Stephen Rowles, Strategic Finance Business Partner, Isabel Rockingham, Head of Joint Commissioning HC Age Well, and Kathy Wilcox, Head of Corporate Finance attended to present the Business Management and Monitoring Report, focusing on Adult Social Care.

Councillor Bearder said the item was brought forward due to the Adult Social Care forecast overspend, which had been around £8m earlier in the year but had reduced to around £4m following mitigation work. Pressures reflected the demand-led nature of the service, including more complex presentations and hospital discharge costs. He also highlighted additional costs from the collapse of NRS (the council’s equipment provider). Work continued to stabilise the position by year end.

Officers explained that the business management and monitoring report had summarised the council’s finance, performance and risk position, and that separate capital monitoring and outturn reports had updated progress on the capital programme. The extract before the committee had focused on Adult Services and had formed part of a series of service-focused updates. The figures reflected the position previously considered by Cabinet in March and were based on the January monitoring position, with a revised and improved outturn position due to be reported to Cabinet in June. Officers highlighted key adult-services-related capital schemes, including the residential accommodation programme, an update on the supported homes investment, and the passthrough of Disabled Facilities Grant funding to district councils. It was noted that the January forecast had taken a prudent approach and that mitigating actions had been taken to prevent recurring pressures in 2026/27, including through application of monies from the Better Care Fund and the agreed budget. The Director of Adult Social Care said the service had maintained close financial oversight through regular management reviews, reported continued success in discharge-to-assess and ‘home first’ arrangements with higher numbers of people supported to return home, and noted increased complexity and intensity of need. She also reported progress on reducing unsecured debt, including proactive work on deprivation of assets and recovery action through the courts.

In response to the introduction and on the basis of the report, committee members raised a number of queries.

More information was sought on the high number of discharges. Officers said the increased discharge numbers reflected a shift towards supporting more people to return home, rather than moving into care homes, with additional home-care capacity provided in the early days after discharge. They reported that this had followed joint work with commissioners and providers to strengthen the discharge-to-assess pathways, enabling higher throughput (with seasonal variation). The overall number of people delayed in hospital had broadly stabilised, but the number of days of delay had reduced as the discharge process had accelerated.

Members asked why a £3.5m cost pressure was evident so early on the year and why it had not been included within the Council’s budget.

Officers explained that the figure had been based on the January position and had been subject to change through in-year reconciliations, including changes in individuals’ circumstances and the impact of backdated continuing healthcare payments from the Integrated Care Board. The budget process timetable had meant the increase had not been fully evident when the budget had been set, and that the service had expected some one-off 2025/26 costs to fall away in 2026/27. The issue was expected to be managed through in-year budget realignment within Adult Social Care, and that a small number of high-cost cases (including transitions) could materially affect the position.

Councillor Shiri left the meeting at this point.

Members sought more information on the trajectory of numbers of individuals in care. Officers said the number of people in residential care had continued to reduce, but at a slower rate than previously, reflecting increasing complexity and intensity of need. They noted that around 54% of care home residents were self-funders and that recent increases in placements had been driven largely by the self-funding market, including individuals who had placed themselves without council involvement. They said the council had continued to support eligible people to move from care homes into extra care housing or supported living where appropriate, and that work had been underway with Age UK Oxfordshire and the care association to improve information and choices for self-funders. They also highlighted the opening of a new extra care housing scheme in Faringdon as part of the longer-term strategy, and said that residential and nursing care had remained focused on people with the highest levels of dependency whose needs could not be met through extra care housing or care at home.

Discussion was held over the degree to which adult social care could be influenced at a local level or whether the primary determinants lay with demographics and central government. 

In response to a question about the implications of Local Government Reorganisation (LGR) and learning from neighbouring areas, Cllr Bearder said the eventual model remained a ministerial decision, but noted concerns arising from LGR proposals elsewhere. He cited Essex, where a single adult social care function had been proposed to be split into five, and said the authority had pursued judicial review. He said such fragmentation risked duplicating senior capacity (including multiple Directors of Adult Social Services and deputy posts), splitting contracts and commissioning arrangements, and undermining established integrated pathways. He added that Oxfordshire’s current approach relied on close working with acute hospitals and a single discharge pathway and pooled budget arrangements, which could become more complex if responsibilities were divided across multiple new authorities.

Members discussed the challenges of recruitment, the desirability of being able to recruit locally during a time of increased youth unemployment.

Councillor Mallon left the meeting at this point.

The Committee made no recommendations to Cabinet.