The Health & Social Services Scrutiny Committee meeting on Thursday, 16th October 2025, focused on the financial performance of the Health and Social Services directorate and the progress of the Children and Families Services Transformation Programme. Key decisions included noting the significant projected overspend for the Health and Social Services revenue budget in 2025/26 and reviewing the ongoing delivery of the Children and Families Services Transformation Programme.

Revenue & Capital Budget Monitoring Report 2025/26

The committee received an update on the revenue and capital budget monitoring for the Health and Social Services directorate as of 30th June 2025. The report indicated a projected £3,557,000 overspend on revenue budgets. This overspend is attributed to various factors across different service areas.

Within Adult Services, the Older People division is forecasting a £913,000 overspend. This is largely due to increased costs in Older People - Residential Care Homes (£368,000) and Older People - Private Home Care (£753,000), despite efforts to reduce residential care numbers and provide more community-based care. The report notes that while homecare packages are increasing, which is seen as a positive shift towards person-centred care, the complexity of commissioned care packages is also rising. Direct Payments are also overspending by £193,000 due to increased demand, viewed positively as it indicates greater client control over their care.

Physical Disabilities services are forecasting a £14,000 underspend, primarily due to reduced provision of community support and group homes.

Learning Disabilities services are projecting an overspend of £317,000. This is influenced by increased demand and complexity in packages for those with mental health issues and children transitioning from Children's Services. High-cost independent providers and packages are still being commissioned, and the current budget allocation does not fully reflect this demand.

Mental Health services are forecasting an overspend of £833,000. This is driven by increased residential care costs (£372,000 for Older People - Residential Care Homes and £297,000 for Group Homes/Supported Living) and pressures relating to the Out of Hours service and a forecasted increase in demand for Direct Payments and Community Support (£164,000).

The Support division is forecasting an underspend of £62,000.

Children's Services are projecting a significant overspend of £1,569,000. This is largely due to increased demand for assistance to clients and their families, increased staffing costs, and higher costs associated with providing fostering placements for children looked after, particularly those with complex needs and Special Guardianship Orders. Commissioned placements also show a substantial overspend due to several ongoing highly complex placements. Conversely, there are underspends in Fostering Support Team and Residential Settings, mainly due to staff vacancies and reduced occupancy.

On the Capital Budgets, Social Care projects show a forecasted variance of -£582,000 against a net budget of £1,294,000. This is primarily due to a slip to 2026/27 for the Care Home Schemes (£582,000). Children's Services projects show a nil variance against a net budget of £1,022,000.

The Savings Monitoring Report for 2025/26 indicated a £1,165,000 variance from the delivery target as of 30th June 2025. Operational savings are £965,000 off target, and policy savings are £200,000 off target. Notably, £200,000 of policy savings within Education, Children & Family Services are off target, with none forecast to be delivered. The report detailed specific savings proposals that were off target, including those related to Children & Family Services and Social Care within Communities.

Revenue Budget Outturn Report 2024/25

The committee also reviewed the Revenue Budget Outturn Report for 2024/25. The Health and Social Services Scrutiny Committee services reported a £6,375,000 overspend at year-end. This is a significant increase from the February 2025 forecast of £1,265,000 for Older People, £93,000 for Physical Disabilities, £633,000 for Learning Disabilities, £723,000 for Mental Health, and a £57,000 underspend for Support. The Children's Services overspend was £4,240,000.

The report detailed main variances, with Older People services showing an overspend of £1,265,000, attributed to increased residential care home costs and private home care costs, despite efforts to reduce residential numbers. Direct Payments also saw an increased demand, leading to an overspend of £288,000. Physical Disabilities services had an underspend of £93,000, attributed to vacant posts and additional income. Learning Disabilities services had an overspend of £633,000, with progress in right-sizing packages taking longer than anticipated and increased demand and complexity. Mental Health services had an overspend of £723,000, due to increased residential care costs and demand for direct payments and community support. The Support division had an underspend of £57,000.

Children's Services had a substantial overspend of £4,240,000, primarily due to increased demand for assistance to clients and families, higher staffing costs, and increased costs for fostering placements, particularly for children with complex needs. Commissioned placements also contributed to the overspend due to ongoing complex placements.

The Savings Monitoring Report for 2024/25 indicated that £2,193,000 of managerial savings against a target of £2,443,000 were delivered, with no policy savings put forward for the year. However, there was a £250,000 variance from the delivery target.

Children and Families Services Transformation Programme

An update was provided on the Children and Families Services Transformation Programme. Key achievements since June 2025 included:

• Children's Homes: Cabinet Member's Award for Team Achievement for residential teams, positive inspection report for Llys Caradog short breaks home, recruitment of casual staff reducing agency use, decision on the location for a new build children's home, and progress in implementing the model of care. Areas of focus include progressing capital grant funding for new builds, reviewing Ross Avenue building certification, testing business continuity plans, and implementing the Children's Home Proposal.
• Fostering: A new Foster Carer Payments Framework was presented to Cabinet, Fostering Panel membership was reviewed and increased, the first cohort of foster families completed revised 'Skills to Foster' training, and a revised process for annual reviews was implemented. Areas of focus include implementing the new Family Placements and Permanence Service structure, launching a 'Foster in Llanelli' recruitment campaign, and reviewing policies.
• Support for Disabled Children and Young People: A draft Fair Access to Services Policy for Disabled Children was approved at CMT, and a new Complex Needs and Transition Senior Manager was recruited. The report detailed the expansion of provision for disabled children and young people, including clubs in Llanelli and Carmarthen, nursery partnerships, holiday trips, Actif Sensport sessions, and a Saturday club. Areas of focus include scheduling the Fair Allocation to Resources Policy for pre-cabinet, developing an IT system for new allocation arrangements, and piloting the new allocation approach.
• Neurodivergence (ND) Pathway: An ND Delivery Group was established, focusing on identifying support needs, workforce development (including mandatory ND core training), and becoming an ND aware employer. An assistant psychologist is piloting the Portsmouth Profile tool and developing a resources hub.
• Performance, Systems and Data: Reports are being built in the new Eclipse system, with 112 reports built to date. The Process and Practice group is operational, overseeing report development and data gathering. An Early Help data system has been set up to collate 'distance travelled' data. Areas of focus include completing the Care and Support WG census, tracking grant allocation for the Social Care Reporting system, working with the TiC Team on robotic processing, developing performance dashboards, and moving foster carer payments to Eclipse.
• Early Help and Assessment: The Early Help systems review is complete, and the Early Help Hub is operational with data gathering mechanisms. A successful 12-month pilot of the 14-18 Multi Agency team supported 110 young people, resulting in an estimated cost avoidance of over £100,000 within six months. Areas of focus include reviewing data on contacts and referrals, implementing recommendations from a systems thinking review, and considering the learning from the 14-18 pilot.
• Family Support: Re-structuring of management oversight is complete, funding has been secured for the Families Together team, the Family Time Team is at full capacity, and Child Support workers have been recruited. Supported lodgings have 25 placements across 14 providers. Areas of focus include recruiting and training the 'Families Together' team, increasing supported lodgings placements, and recruiting casual staff for crisis support.
• Unaccompanied Asylum-Seeking Children and Young People (UASC): The service is supporting 63 UASC, with a lower number of new transfers impacting Home Office income. Key achievements include reducing the overspend against the Home Office Budget and developing in-house accommodation options. Areas of focus include addressing gaps in ESOL provision, securing local housing for young people aged 18+, developing a standardised offer for all Children Looked After, and increasing in-county accommodation placements.
• Workforce and Business Enablers: Agency Social Worker numbers have been further reduced, migration from CareFirst to Eclipse is embedded, Magic Notes is being rolled out, and key practice guides are being developed. A Team Manager development programme has been completed. Areas of focus include completing training matrix development, developing practice standards, reducing cases held by managers, removing remaining agency Social Workers, appointing a policy officer, and continuing staff well-being focus.

The report also included performance data comparing Carmarthenshire to other Welsh authorities on metrics such as contacts leading to child protection enquiries, support needs assessments, children looked after, child protection cases, absences, and school attendance.

Carmarthenshire County Council's Draft Annual Report for 2024/25

The committee reviewed the draft Annual Report for 2024/25, which aims to meet the requirements of the Well-being of Future Generations (Wales) Act 2015 and the Local Government and Elections Act (Wales) 2021. The report is structured around the Council's four well-being objectives: Start Well, Live & Age Well, Prosperous Communities, and Our Council.

The report highlighted progress in various areas, including:

• Start Well: Efforts to reduce child poverty, maintain nutritious free school meals, and increase physical activity engagement. Challenges remain with rising demand and complexity in Children and Families Services, but significant investment and a transformation programme are underway. Progress in ALN reforms and school infrastructure development was noted, though school attendance remains a concern.
• Live & Age Well: Initiatives to tackle poverty, improve housing affordability and energy efficiency, and reduce hospital admissions through early intervention and prevention. A focus on expanding supported living options to reduce reliance on residential care was highlighted.
• Prosperous Communities: Significant economic recovery and growth through external funding, support for businesses, town centre regeneration, and employability programmes. Progress in decarbonisation and biodiversity was noted, with a 37% reduction in targeted carbon emissions. The Welsh language promotion strategy is a key focus due to a decline in speakers. Highways and Transport services received the lowest satisfaction levels in the residents' survey, indicating areas for improvement.
• Our Council: Modernisation efforts include cost savings from fleet reviews and debt recovery, embedding hybrid working, and technological investments in automation and robotics. The Council was recognised as 'Employer of the Year' for its Welsh language support. Cybersecurity remains a central focus.

The report also detailed the Council's core business enablers, including Legal, Planning, Procurement, Internal Audit, Democratic Services, Risk Management, Electoral Services, and Civil Registration.

Explanation for Non-Submission of Scrutiny Reports

The committee received explanations for the non-submission of three scrutiny reports:

• Early Help Strategy: Delayed due to the transition to the Eclipse system and prioritisation of report development. The revised submission date is 29th April 2026.
• Living Well in Carmarthenshire (Prevention Strategy): Further analysis is needed to ensure robustness before final adoption. The revised submission date is 27th November 2025.
• Regional Safeguarding Annual Report & Communities Annual Safeguarding Report: These reports were not submitted due to officer absence and the timing of the reporting year, respectively. Revised submission dates are 19th March 2026 and 8th June 2026.

Forthcoming Items

The committee noted the forthcoming items for the next meeting on 27th November 2025, which include Budget Monitoring (April-August), the Youth Justice Plan, and a Domiciliary Care Update. The committee also reviewed its Forward Work Plan for 2025/26 and the Cabinet's Forward Work Plan for information.

The minutes of the previous meeting held on 30th April 2025 were unanimously approved and signed as a correct record.