Councillor Aspinall (Cabinet Member for Health and Adult Social Care)introduced the item and highlighted the following key points: 

a)    There was a clear focus on continuous improvement with efforts directed at addressing challenges relating to wait times for assessments, reviews, service accessibility and sustainability of the workforce; 

b)    The improvement work built upon the Council’s self-assessment and findings from the Local Government Association’s (LGA) Adult Social Care Peer Review in January 2025, which identifiedboth strengths and areas for development; 

c)    Plymouth underwent a Care Quality Commission (CQC) inspectionand the experience was described as positive, with inspectors engaging with a wide range of stakeholders including staff, partners, service users and carers. Formal feedback was expected within two to three months which would further inform the Council’s improvement journey; 
 

d)    Expressed thanks to all staff across Plymouth City Council, Livewell Southwest, and care and support providers for their dedication and professionalism, particularly during the peer review and CQC inspection processes. 

Stephen Beet (Head of Adult Social Care and Retained Functions) added: 
 

e)    The improvement plan was progressing well and outlined the priority areas with targets, time scales for delivery and trajectories, monitoring of progress and management of risk. 

Andy Williams (Lead for Adult Social Care, Livewell Southwest) and Ian Lightly (Senior Manager at Livewell Southwest) added: 

f)     There had been a focus on reducing the wait times and the longest wait time for Care Assessments reduced from 500+ days to 300+ days;

                      i.        A sustainable waiting list position would be reached by 30 October 2025, with full compliance expected by 31 January 2026; 

g)    The Care Act guidance recommended reviews every 12 months,  as a minimum, and performance against this had improved by 22%, with 58.5% of individuals getting reviews within the 12 months;

                      i.        The regional benchmark was 60.7% and Plymouth was aiming to meet this by 01 November 2025;

                     ii.        A central dedicated team has been established to manage reviews; 
 

h)    Occupational Therapy (OT) OT demand was identified as a key issue in the self-assessment, peer review, and CQC inspection;

                      i.        Demand exceeded current resource capacity, prompting a review of the wider front door offer;

                     ii.        Improvements in performance data visibility have been made using System One, with reporting now available;

                    iii.        A rounded plan to address OT performance was expected by end of September 2025; 
  

i)     Waiting Well Policy  had been developed to ensure individuals on waiting lists remained safe;

                      i.        All individuals were risk assessed and prioritised accordingly;

                     ii.        Team managers maintained proactive contact with those waiting;

                    iii.        An automatic text reminder system had been implemented; 

                    iv.        Individuals were informed of how to escalate their needs if circumstances change;

                     v.        Crisis response options were available through Livewell;
  

j)     During the last 18 months, a practice improvement model had been developed which collated information to understand Adult Social Care (ASC) practice within Livewell and key elements included:

                      i.        Monthly practice-based audits focusing on referral and triage, assessments, reviews, mental capacity, and safeguarding;

                     ii.        Targets of 85% of audits rated good or outstanding by end of 2025, and 90% by 2026;

                    iii.        Completion of Phase One, including: Development of a practice framework, Identification of training opportunities and review and implementation of quality assurance processes; 

                    iv.        Phase Two was underway and included: Tracking and sharing of assessments with individuals and representatives, workforce engagement and rollout of the practice framework, and an equality, diversity and inclusion (EDI) impact review assessing training and outcomes; 
 

k)    The programme took a comprehensive view of practice, reviewing assessments, funding applications, complaints, and customer feedback, enabling the identification of trends and areas for improvement.  

In response to questions, with support from Gary Walbridge (Strategic Director for Adults, Health and Communities), the following was discussed: 

l)     The team welcomed the suggestion to bring a presentation back to a future meeting of Cabinet to demonstrate their positive work at Meadow View, but with an emphasis on the importance of focusing not only on the building but on the transformational impact of the services being delivered; 
 

m)  Livewell did not hold any significant OT vacancies, and the volume OT cases had not fluctuated, but did exceed capacity and backlog clearance exercises had been invested in, in the past, which could be considered again; 
 

n)    A broader conversation was proposed around preventative approaches, workforce modelling, and future funding needs for OT; 
 

o)    Phase Two of the improvement plan included work on reablement, community engagement, and workforce modelling, which would inform future investment strategies; 
 

p)    The Leader stressed the urgency of identifying resource requirements and funding opportunities, particularly in light of anticipated changes to government funding. 
 

Cabinet agreed to: 

1.    To support and monitor the Adult Social Care Improvement Plan through Cabinet and the Health and Adult Social Care Scrutiny Panel. 

At the conclusion of this item, The Leader expressed his gratitude to Emma Crowther (Service Director, Strategic Co-operative Commissioning) and Stephen Beet (Head of Adult Social Care and Retained Functions) for their hard work as they were both leaving Plymouth City Council (PCC).