Agenda item

1.    The item was introduced by Mark Scrivener, Head of Risk and Delivery Assurance, who presented the strategic risks related to both the ASC and Public Health Directorate, in addition to the risks featuring on the Corporate Risk Register. The report also covered the management process for review of key risks.

2.    In response to questions and comments from Members on the Adult Social Care and Health Directorate, discussion covered the following:

a)    Ms Gillivan advised that uplift decisions had been applied during the year where appropriate and emphasised that the Council’s responsibility under the Care Act was to maintain the overall sustainability of the social care market rather than individual providers. She explained that the Council commissioned approximately one third of the market, with the majority funded by self?funders. The commissioning team continued to work closely with providers and representative bodies, including the Kent Integrated Care Alliance (KICA) and the National Care Association. Regular provider forums had also been established, and work was ongoing to support workforce development and market capacity across the county. Ms Gillivan also highlighted that alternative models of care were being considered to enable patients to be able to live in their own homes.

b)    Mrs Hammond emphasised that over four years, the Council had increased residential care prices by around 87%, significantly above inflation, and that research showed Kent paying higher fees per head than statistical neighbours and some other counties for similar providers. She outlined that while some providers offered good quality at affordable prices, for others the Council was paying substantially more than comparable authorities. She stated that the Council did not believe the market was close to collapse, though risk remained high, and reported examples of providers recently reducing their charges to retain Council business.

c)    Mr Scrivener explained that the report had been finalised ahead of the listed review date as part of the approval process, which meant it fell between internal review cycles.

d)    Mr Scrivener explained that risk ratings were set by risk owners and were under ongoing review. Recent discussions at the Directorate Management Team included whether ratings should be adjusted in light of new information, including the outcome of current recommissioning.

e)    Miss Morton stated that allowing care homes to set charges without constraint would not be affordable for the Council.

3.    In response to questions and comments from Members on the Public Health Directorate, discussion covered the following:

a)    Dr Ghosh agreed that the Marmot Programme and wider Public Health work had the potential to implement positive change but emphasised that improvements took time and depended on contributing from the NHS, District and Borough Councils, voluntary sector and residents.

b)    Dr Ghosh acknowledged the importance of wider determinants such as food security, climate change, biodiversity loss and related health impacts. He agreed to consider how these areas might be reflected within the Public Health risk register, stating that responsibilities were shared with partner organisations, including the Environment Agency. Mr Scrivener advised that he would raise the point with the Growth, Environment and Transport (GET) Directorate to consider how such risks were captured.

4.    RESOLVED that the Adult Social Care and Public Health Cabinet Committee considered the risks presented for both the Adult Social Care and Health and Public Health directorates.