The Chair noted that this would be Stephen Beet and Emma Crowther’s last scrutiny meeting before they departed the authority next month. The Chair thanked both for their contributions to the Panel’s work, and wished them well for the future.

 

Stephen Beet (Head of ASC Retained Functions) and Ian Lightley (Livewell Southwest) delivered the Quarterly Performance report for Adult Social Care and discussed:

 

a)     Since the last update in February, the service had been working through the Transformation Board on an improvement plan focused on:

                          i.    Reducing waiting times for Care Act assessments and annual reviews;

                         ii.    Practice development;

                        iii.    Occupational therapy (OT) performance.

 

b)    Improvements had been seen in waiting times for assessments and reviews, and there had been an increase in the number of people receiving direct payments;

 

c)     The service had undergone a CQC inspection in June 2025, following an information return submitted in January. The inspection had been a positive experience, with the CQC engaging with a wide range of staff, providers, partners and councillors. The final report was expected in one to two months;

 

d)    Performance data demonstrated that:

                          i.    The number of people waiting over 500 days for assessments had significantly reduced, with the longest waits now under 300 days;

                        ii.     The overall number of people waiting for Care Act assessments had dropped considerably;

                       iii.     Improvements had been achieved through quality improvement work rather than additional resources, with successful test-of-change pilots in the South and East localities now rolled out city-wide;

 

e)     The service had developed a trajectory model to forecast when waiting times would reach acceptable levels, with October 2025 identified as the target. Although recent data had shown a slight reversal, the service remained on track;

 

f)      Analysis of assessment outcomes had shown that a high proportion of individuals did not require a funded care package, highlighting missed opportunities for early intervention and signposting. Work was underway with the Wellbeing Hub network to improve front-door triage and reduce unnecessary assessments;

 

g)     The “Waiting Well” policy had been implemented, including proactive contact with individuals on waiting lists via text messages and follow-up checks;

 

h)    Review performance had improved, with 57.9% of people receiving a review within 12 months of their care package, approaching the regional benchmark of 60.7%. No individuals had waited more than two years for a review;

 

i)      Occupational Therapy (OT) performance remained challenging, with a slight improvement in the number of people waiting. Improvement work was ongoing including:

                          i.    Demand and capacity modelling had been completed using national benchmarking tools;

                         ii.    The service was exploring whether some assessments could be avoided or replaced with quicker support offers;

                       iii.    A trajectory model for OT improvement was in development.

 

j)      A partnership with Plymouth Community Homes had enabled trusted assessors to carry out simple adaptations and remove over 100 cases from the waiting list.

 

In response to questions, the Panel discussed:

 

k)     Whether similar partnership arrangements existed with other housing providers such as LiveWest, Sanctuary and Sovereign. It was confirmed that broader partnership arrangements existed through the Plymouth Alliance;

 

l)      Livewell Southwest was not holding any OT vacancies. To address demand and capacity challenges, lower-risk cases were prioritised for alternative support options;

 

m)   While waiting list numbers had dropped, average wait times had increased. This was due to the data being captured retrospectively, which skewed the averages temporarily as long-wait cases were closed. It was anticipated that future reports would show a reduction in average wait times;

 

n)    The Committee discussed the impact of the national spending review and whether funding would reach Plymouth. Officers confirmed that modelling was underway with external advisors, and a consultation response was being prepared ahead of the 15 August deadline;

 

o)    The Committee queried the number of individuals receiving care outside the Plymouth area. Officers explained that:

                         i.         Out-of-area placements were often due to individual choice or specialist needs;

                       ii.         Plymouth remained the responsible authority for funding such placements;

                      iii.         Data had been provided to the CQC and could be shared with the Committee in future.

 

p)    The Committee asked for data on the proportion of Care Act assessments resulting in funded care packages. Officers reported that:

                         i.         Approximately 20% of assessments resulted in a care package, though this figure included hospital discharges;

                       ii.         A more accurate figure for community-based assessments was being prepared;

                      iii.         For individuals with mental health as their primary support reason, only 10% required a care package or direct payment.

 

q)    A pilot was being introduced to support individuals with mental health needs through talking therapies and emotional skills development, aiming to reduce reliance on formal care packages;

 

r)     The Committee discussed concerns regarding domiciliary care providers. Emma Crowther (Service Director for Integrated Commissioning) explained that:

                        i.         Concerns were typically related to leadership, workforce stability, or specific incidents;

                       ii.         A “Provider of Concern” process was in place, with fortnightly meetings between commissioning and safeguarding teams;

                      iii.         Quarterly meetings were held with the CQC and Ofsted to triangulate intelligence;

                      iv.         The Council aimed to support providers collaboratively but would use contractual levers where necessary.

 

Helen Slater (Lead Accountancy Manager) delivered the quarterly finance report for Adult Social Care at Month 2 of the 2025/26 financial year and discussed:

 

a)     While early in the financial year, a nil variance was currently being reported on the Adult Social Care budget;

 

b)    The Adult Social Care budget was the largest revenue budget in the Council, totalling £113 million;

 

c)     The service had been monitoring its highest-risk areas, particularly care package expenditure. Risks had been identified in the domiciliary care budget, driven by increased volumes and client numbers. Residential care budgets were also under pressure, but this was attributed to the complexity of need rather than client numbers;

 

d)    Income budgets, which had been a source of pressure in the previous year, had been rebased during budget preparation. It was anticipated that these would not present significant issues in the current year and might help offset expenditure pressures;

 

e)     The Adult Social Care savings target for 2025/26 was £2.7 million. Of this, £1.175 million had already been achieved, with plans in place to deliver the remainder during the year;

 

f)      The Committee was informed that the Budget Containment Group had been established, as in previous years, to monitor and manage financial risks. The group was working with colleagues in Livewell to identify priority areas for detailed review, including:

                        i.         Domiciliary care;

                       ii.         Residential care;

                      iii.         Health funding for client packages;

                      iv.         Budget impacts of working-age adults versus older adults.

 

g)     A more detailed financial report would be presented at Month 3, in line with quarterly budget monitoring.

 

In response to questions, the Panel discussed:

 

h)    The Chair welcomed the positive start to the financial year and praised the service’s approach to balancing budget pressures with the need to ensure individuals received appropriate care.

 

The panel agreed to note the reports.