Agenda item

To present the report of External Audit.

The report of External Audit with regard to regional pooled funds in relation to care home places for older people was presented for the Committee’s consideration. The report in the form of two letters, the one to the Chief Executive of Anglesey County Council and the other to the Director General for Health and Social Services raised value for money issues in respect of the current North wales pooled funding arrangements in relation to care home places for older people.

Mr Jeremy Evans, Audit Wales reported that Audit Wales recently completed two reviews looking at residential and nursing care in North Wales, specifically in Conwy County Borough Council and Denbighshire County Council. Whilst the reviews looked primarily at local arrangements they also raised some specific concerns about the North Wales regional pooled fund in relation to care home places for older people which is a partnership between all six North Wales councils and Betsi Cadwaladr University Health Board. The review concluded that the current arrangement whereby the funding from the relevant organisations is initially deposited into a pooled fund administered by Denbighshire County Council and returned to each contributor 24 hours later although it meets the minimum compliance with Welsh Government standards, does not offer value for money, nor any of the intended  benefits of a pooled fund. Whilst Audit Wales has not tested the arrangements in other regions it understands that they are of a similar nature. The information and proposals for improving the pooled fund arrangement have been shared with Anglesey Council as a partner in the fund.  Welsh Government has been apprised of these concerns and has been asked to provide assurance with regard to the actions it intends to take to better support the delivery of pooled funding in Wales.

The Director of Function (Resources)/Section 151 Officer advised that the Social Services and Well-being Act 2014 requires local authorities to enter into a pooled funding agreement for care home accommodation for older people. Given the value of the North Wales regional pooled fund (around £100m), entering into such an arrangement needs to be carefully considered, the risks assessed and procedures agreed beforehand. In the absence of prior consultation with the councils, and a lack of clarity regarding the objectives of the pooled fund in relation to care home accommodation services for older people, the six local authorities and BCUHB discussed their obligations in terms of meeting the minimum technical requirements under the Act and, based on a model implemented by the Cardiff region, came to the arrangement described in  the Audit Letter whereby contributions are deposited into a pooled fund  and returned on the same day.  Whilst the Authority is meeting its legal requirements, as part of ongoing discussions pressure is being brought to bear on Welsh Government by the local authorities through BCUHB to review the Act and to clarify what the pooled fund is expected to achieve. There are risks to the Council in contributing to the pooled fund and being involved in joint procurement with the BCUHB and the five other North Wales local authorities without formal processes around the use of the pooled funds having been established and agreed.

The Interim Director of Social Services said that there are merits to some pooled funding arrangements with the Authority having recently approved entering into a pooled fund pilot with the Betsi Cadwaladr University Health Board for the supported living budget for adults with learning disabilities resident in Anglesey but that the effectiveness of such arrangements can be affected by size. The Director of Function (Resources)/Section 151 Officer further advised that the Learning Disability pooled fund pilot project is based is an agreement between two partners meaning it is more manageable. Pooled funds work best when they are on a smaller scale because they are easier to control and produce better more clearly defined outcomes.

The Leader of the Council and Portfolio Member for Social Services in drawing attention to the scale of the North Wales regional pooled fund highlighted that there is a collective annual cost to the councils to administer the arrangement which might be more productively spent elsewhere in Social Services. Providing contributions to the North Wales pooled fund without assurance about the benefits to the service and end users is a risk. Whilst the Authority is undertaking the minimum in order to comply with the requirements of the Act it has in the meantime identified an area in relation to Learning Disability Services where a pooled budget with BCUHB is likely to be of benefit to the service and its users.

The Committee noted the position with regard to the North Wales Pooled Fund in relation to care home places for older peoples as set out in the Audit Letters and, reflecting on the comments provided by the Officers and Portfolio Member and the reservations expressed with regard to practical and governance aspects of the North Wales Pooled Fund, it confirmed that it was satisfied with the stance taken by the Authority and was happy to support it.

It was resolved to note the Audit Letters and their content and to support the stance taken by the Authority with regard to the North Wales Pooled Fund in relation to care home places for older people.

NO PROPOSAL FOR ADDITIONAL ACTION WAS MADE