The Health & Social Services Scrutiny Committee met on Monday 03 February 2025 to review the council's financial position and future budget strategy. The committee received updates on the 2024/25 revenue and capital budget monitoring, the 2025/26 to 2027/28 revenue budget strategy consultation, and the 2024/25 performance monitoring report. They also reviewed the 2025/26 business plans for Children and Families, Adult Social Care Services, and Integrated Services, as well as the Annual Youth Justice Plan for 2024/25.

Revenue & Capital Budget Monitoring Report 2024/25

The committee reviewed the revenue and capital budget monitoring report for Health & Social Services, which provided an update on the budgetary position as of 31 October 2024. It was noted that the Health & Social Services department was forecasting an overspend of £7,011,000 on its revenue budget. For capital schemes, there was a forecasted variance of £0k against a net budget of £728k for social care projects, and a variance of -£14k against the Children Services projects net budget of £136k.

During the discussion, several points were raised:

• Regarding the 'Older People Residential Care Homes' division, a question was asked about why progress in managing variances was not being made in the same manner as other areas. The Head of Adult Social Care explained that while demand and complexity in mental health cases had increased significantly, there would be a future focus on mental health services, which would be covered in more detail in a later session.
• Clarification was sought on the 'Learn Dis - Other variances' section of Appendix B. The Head of Financial Services explained that this represented an aggregation of small variances within the overall budget.
• An overspend of £321,000 on Unaccompanied Asylum Seeker Children (UASC) was discussed. The Head of Children and Families reported that while she could not confirm if the Home Office would cover these additional costs, national work was underway to address the shortfall. She explained that the current model ensured no children allocated into the Council's care were placed into commissioned placements, as this was now managed in-house within Home Office funding. The issue stemmed from early referrals when the Council lacked the necessary infrastructure and had to rely on expensive commissioned placements. Incremental achievements were being made to relocate these young individuals into more affordable, needs-met placements. Assurance was given that future costs would reduce due to a continued reduction in commissioned services and successful in-house care provision.
• Regarding the £400,000 saving proposal for Commissioning & Social Work (UASC) within Appendix A(i), a question was asked about the progress in bringing support for UASC and Young People (YP) within Home Office funding to release core budget for the social work team. The Head of Children and Families explained that the Home Office fee was a set rate, which aided budget management and planning. The transition from commissioned to in-house placements would enable savings. Neighbouring authorities still used commissioned placements, making Carmarthenshire's transition towards quality, affordable provision commendable.

The committee unanimously resolved to receive the Revenue & Capital Budget Monitoring Report 2024/25.

Revenue Budget Strategy Consultation 2025/26 to 2027/28

The committee reviewed the council's Revenue Budget Strategy for 2025/26 to 2027/28, which outlined the projected revenue budget for 2025/2026 and indicative figures for the subsequent two years. This report was based on officer projections and took into account the provisional settlement from the Welsh Government on 11 December 2024.

Key points from the discussion included:

• The provisional settlement represented a 4.1% increase for Carmarthenshire, equating to £25.1 million after 'transfers-in'. Despite this being higher than the council's planning figure, a substantial funding shortfall remained due to significant cost pressures, particularly the increase in Employers' National Insurance rates.
• Most Welsh Government Service Specific Grants would remain at the same cash value as previous years, negatively impacting outputs due to rising inflation and pay awards. Welsh Government funding was falling short of the actual service costs, meaning the gap would be funded by Carmarthenshire taxpayers. The Local Authority Education Grants (LAEG) saw an increase of approximately 6%, but this was only sufficient to cover pay award costs, not increased outputs.
• The committee's attention was drawn to Section 3.5 of the budget strategy, which detailed the critical situation regarding schools' delegated budgets. An overspend of £10 million was forecast, with potential to destabilise the authority's wider finances. It was proposed that this reduction would not be applied, and instead, the shortfall would be met through an increased council tax, estimated at 3.5% to prevent the situation from worsening while urgent action was taken to align expenditure with resources. The council was proposing a total council tax increase of 9.75% for 2025/26.
• The report detailed the updated financial outlook, incorporating the provisional settlement and recent validation changes. The total budget reductions required for 2025/26 were £8.6 million, with an estimated £29 million over the three-year period.
• Regarding Appendix A(i) – CHC Placements, it was noted that the Health Board had reduced its funding for placements by 50% over the last four years. The Head of Integrated Services reported progress in challenging packages deemed CHC by the Health Board to ensure correct assessments and care levels. Jointly funded cases had resulted in positive outcomes for the Council, and future advocacy for individuals from the outset was crucial to avoid disputes.
• In response to a query about national-level work on legislation and guidance, the Director of Community Services explained that working groups with the Health Board were in place, but progress was slow. The demographic shift towards an older population and the complexity of individual cases meant a more flexible model of care was needed, focusing on the right care and placement rather than just cost.
• The Director of Community Services clarified that NHS funding for CHC was not under pressure, unlike other areas. The Head of Adult Social Care added that individuals detained under certain sections of the Mental Health Act were entitled to funding from both the Local Authority and the Health Board.
• Concerning the Non-Residential Care Charges in Appendix C, the £100 weekly cap set by the Welsh Government, unchanged for six years, had resulted in a significant loss of income. The Director of Community Services stated that the lost income over the period equated to approximately £3.5 million, with only £159,000 in additional targeted funding this year. The Cabinet Member for Resources noted that raising the cap would be a political decision, and aligning with England's uncapped system could generate millions of pounds.

The committee resolved to receive the Revenue Budget Strategy Consultation 2025/26 – 2027/28, receive the proposals for efficiency savings in Appendix A(i), and endorse the Charging Digest in Appendix C.

Performance Monitoring Report - Quarter 2 2024/25

The committee reviewed the 2024/25 Quarter 2 Performance Report, which detailed progress against the Corporate Strategy and Well-being Objectives.

Key points from the discussion included:

• Regarding the 'Off target' measure concerning the total number of days children remained on the Child Protection Register, the Head of Children and Families clarified that this was more of a factual statement than a target, and the team worked tirelessly in this area. The Director of Community Services noted that current performance management symbols were not ideal for complex data and that future reporting would use statistical methodology to show trends and variations.
• The successful work of the Flying Start and Cwm Gwendraeth Early Years Integration Team was praised, and a question was raised about extending this to the Ammanford area. The Head of Children and Families and the Director of Communities expressed high regard for this work and invited the committee to visit the team to see their work firsthand.

The committee unanimously resolved to receive the Performance Monitoring Report – Quarter 2 2024/25.

Business Plans 2025/26

The committee reviewed the 2025/26 Business Plans for Children and Families, Adult Social Care Services, and Integrated Services.

Regarding the Children and Families Divisional Delivery Plan 2025-26:

• Clarity was sought on the colour scheme used in the Integrated Services Divisional Delivery Plan's structure chart, which the Head of Integrated Services agreed to update.
• The table of costs within the Integrated Services Divisional Delivery Plan was commended as useful and important information, with thanks extended for efforts in achieving a balanced budget despite challenges.
• Regarding the objective to further modernise and develop as a resilient and efficient Council, the Head of Integrated Services explained that CGI had been appointed as the Health Board's digital partner, with initial work commencing in safeguarding. A 360-degree digital interface across various daily systems was recognised as necessary for future efficiency, centralising information for 24/7 access to a complete individual profile.

The committee unanimously resolved to receive the Business Plans 2025/26.

Annual Youth Justice Plan 2024/25

The committee received the Annual Youth Justice Plan for 2024/25. The plan, developed with partners and aligned with YJB guidance, reviewed the previous year's performance and outlined plans for the upcoming year. It was noted that the Youth Justice Team had achieved an 'outstanding' rating in an HM Inspectorate of Probation inspection in November 2023.

Key discussion points included:

• Concerns were raised about the future funding of youth justice and mental health services, particularly with the Shared Prosperity Fund ending. It was suggested that Central Government, Welsh Government, and Hywel Dda Health Board should consider long-term funding solutions.
• Regarding the Standards for Children in the Justice System – At Court Action Plan, a suggestion was made to include 'Hot Spots for Policing' to aid resource prioritisation and workload sharing. The Principal Manager - Youth Support Service confirmed an established relationship with the Office of the Police and Crime Commissioner (OP&CC), which had funded various elements of the work, and that a business plan for future years was being developed.
• The inclusion of national comparison data for Children Looked After (CLA) figures on page 12 of the report was requested for added context.

The committee unanimously resolved to receive the Annual Youth Justice Plan 2024/25.

Explanation for Non-Submission of Scrutiny Report

The committee received an explanation for the non-submission of the 'Progress Update Against the Cabinet Visions & Actions' scrutiny report. The explanation stated that the progress was incorporated into the performance report submitted twice yearly to the committee, and therefore, the separate report was no longer required. The committee resolved to note the explanation.

Forthcoming Items

The committee noted the list of forthcoming items scheduled for the next meeting on 20 March 2025. These included Budget Monitoring 2024/25 (April-February), Q3 Performance Management Report, Early Help Strategy Update, Mid & West Wales Safeguarding Report 2023-24, Communities Safeguarding Annual Report, Corporate Safeguarding Annual Report, and the Living Well in Carmarthenshire (Prevention Strategy) report.

Scrutiny Actions Update

The committee considered an update report detailing progress on actions, requests, and referrals from previous meetings. The committee unanimously resolved to receive the report.

To Sign as a Correct Record the Minutes of the Meeting Held on the 28th November, 2024

The committee unanimously resolved to sign the minutes of the meeting held on 28 November 2024 as a correct record.