Councillor Gandy cabinet member for adults, health and wellbeing introduced the report.

 

The Cabinet Member for Adult Social Care outlined the findings of the Care Quality Commission (CQC) assessment, which reviewed services against four themes: working with people, providing support, ensuring safety and leadership. While the assessment visit took place in September, the report was not published until nine months later, by which time a number of improvements had already been implemented. It was noted that the findings contained no significant surprises and identified areas for improvement including support for unpaid carers, assessment waiting lists, occupational therapy capacity and reablement services.

 

Following publication of the report, information was shared with staff, Members, partners and voluntary sector organisations through a programme of briefings and webinars. The Cabinet Member acknowledged concerns about the impact of the report on staff morale but praised the workforce for responding positively and using the findings as motivation to drive further improvement.

 

Work on the Improvement Plan began immediately following the assessment visit and has continued through regular performance and transformation meetings involving department leads and the Cabinet Member. Progress was reported, although it was recognised that further improvement is required. The challenges of managing fluctuating demand in Adult Social Care were highlighted, together with the importance of prevention and early intervention.

 

The Cabinet Member confirmed that the recommendations made by the joint meeting of the Scrutiny Management Board and Health Scrutiny Committee had been accepted and were aligned with the existing improvement plan. The plan includes strengthened delivery, impact and assurance measures to monitor progress and ensure sustainable improvement.

 

It was emphasised that, while financial sustainability remains important, the council's priority would continue to be protecting and supporting the county’s most vulnerable residents, and that budget considerations would not be placed ahead of meeting care needs.

 

The Leader thanked the Cabinet Member and officers for their work in responding to the CQC findings and welcomed the acceptance of all recommendations made by the Scrutiny Committee. It was noted that significant improvement activity was already underway and that the recommendations supported and strengthened the existing improvement programme.

 

Comments from cabinet members:

 

Members welcomed the positive findings relating to safeguarding within the CQC assessment, noting that the report recognised the strength of Herefordshire’s safeguarding arrangements. Drawing on experience from wider regional safeguarding work, the member highlighted the importance of maintaining a strong focus on safeguarding and ensuring robust protections remain in place.

 

The member emphasised that Adult Social Care services support a wide range of residents, not solely older people, and that many younger adults have significant care and support needs.

 

Members were reminded of the importance of recognising the diverse needs of all service users when considering Adult Social Care provision and improvement activity.

 

A member commended the Cabinet Member and Director for their leadership and hard work in driving improvements within Adult Social Care. While supporting the principle that care should not be compromised by financial considerations, it was noted that effective service delivery is not solely dependent on increased spending. Drawing parallels with the improvements achieved in Children's Services, the member highlighted the importance of understanding how services are delivered and ensuring they are provided in a compassionate and efficient manner. It was expressed that the improvement plan should support both positive outcomes for residents and the achievement of the council's financial objectives in the coming year.

 

A member noted that Adult Social Care manages one of the council’s largest budgets and emphasised the importance of ensuring services remain financially sustainable. While recognising the commitment to providing high-quality care, it was highlighted that the service should continue to seek opportunities to improve outcomes while managing costs effectively. Drawing comparisons with the improvements achieved in Children’s Services, the member expressed the view that service quality and financial performance should be improved in tandem, with careful budget management remaining an important consideration.

 

The Cabinet Member acknowledged the importance of monitoring both expenditure and income within Adult Social Care, while reiterating that the council’s overriding priority must remain supporting those residents with the greatest care needs. It was noted that the service is pursuing a programme of transformation, including changes to access arrangements, commissioning and contracting processes, to improve efficiency and deliver savings without adversely affecting service users.

 

Members heard that significant efforts are being made to manage demand and expenditure effectively, including measures aimed at reducing cost pressures through service transformation. However, it was emphasised that financial considerations would not be prioritised over the care and support required by vulnerable residents, and that any financial planning assumptions would continue to reflect the council’s commitment to meeting those needs.

 

The Leader noted that a wide range of initiatives and new technologies were being introduced to support residents to live independently for longer, emphasising the importance of balancing innovation and prevention with careful financial management.

 

The Cabinet Member for Adult Social Care advised that work was underway to promote assistive technology within community hospitals and with health partners, including Wye Valley NHS Trust. This aimed to demonstrate how technology and support services could help residents maintain their independence, avoid or delay admission to residential care, and improve outcomes for individuals while reducing demand on care services.

 

Group Leaders were invited to offer their views:

 

The Green Group Leader outlined the views of their group and raised that:

It was noted that both the Adults and Wellbeing Scrutiny Committee and the Scrutiny Management Board had been afforded the opportunity to review and examine the Adult Social Care Improvement Plan. The importance of considering and responding to scrutiny recommendations was highlighted, recognising the role of scrutiny in supporting service improvement and accountability.

 

It was also noted that the council would need to monitor the development of national adult social care reforms and consider any implications these may have for future service delivery and improvement planning.

 

It was highlighted the challenges faced by individuals and families in navigating transitions between NHS services, local authority provision and private care providers, noting the complexity and associated costs for both individuals and public services. It was recognised that the Adult Social Care Improvement Plan helps focus attention on the role of partner organisations and public health in supporting effective service delivery, and its implementation was welcomed.

 

The representative for Independents for Herefordshire outlined the views of their group and raised that:

 

Councillor Crockett spoke for Independents for Herefordshire and as Chair for Health and Wellbeing Scrutiny Committee.

 

It was suggested that future versions of the Adult Social Care Improvement Plan could be enhanced through the inclusion of RAG ratings to provide a clearer view of progress against each improvement action. It was also suggested that actions could be presented in chronological order to improve readability and make progress easier to track.

 

The positive first-quarter Adult Social Care budget position was noted, and thanks were expressed to the Corporate Director for Community Wellbeing for providing an update to the Scrutiny Committee. Members acknowledged that the improvement plan is a live document which will continue to evolve, with feedback and recommendations from scrutiny being incorporated as the programme develops, in a similar manner to the Children’s Services Improvement Plan.

 

The Liberal Democrat Group Leader outlined the views of their group and raised that:

 

The overall structure of the Adult Social Care Improvement Plan was welcomed, considering it clearer and more accessible than similar plans produced in previous years. However, concern was expressed about the significant and growing financial pressures facing Adult Social Care, with particular reference to the rising cost of specialist placements and care packages.

 

It was noted that increasing demand and limited provider availability can lead to very high costs for complex care provision, creating substantial financial risks for local authorities. It was highlighted the need for continued attention to these pressures and suggested that wider changes to the care system and market may be required to support long-term sustainability.

 

The True Independents Leader outlined the views of their group and argued that:

Did not attend for this item. 

 

In response to the comments made:

 

The Cabinet Member welcomed the positive recognition received for safeguarding and partnership working within the CQC assessment, noting that these were significant achievements for the service.

 

In responding to the debate, the Cabinet Member thanked members for their contributions and confirmed that all recommendations from the Scrutiny Management Board would be considered and incorporated into ongoing improvement work. It was acknowledged that revisions to the presentation of the improvement plan, including the ordering of actions and the potential use of RAG ratings, would be explored.

 

The Cabinet Member provided assurance that efforts to improve financial performance remained a priority, with work continuing to reduce expenditure, achieve savings targets and bring the service closer to budget, while maintaining a focus on delivering effective support for residents who need care and assistance.

 

A member highlighted the importance of ensuring that partner organisations engage fully and meaningfully in consultations and reviews, noting that the council may have a leadership role in coordinating and encouraging effective partnership involvement.

 

Reference was made to the forthcoming Casey Review, and it was suggested that the council and its partners should seek opportunities to engage proactively with the process, particularly given the accelerated timetable. Members noted that strong partnership working has been a longstanding feature of the county’s approach and could provide a positive foundation for future engagement and improvement activity.

 

Members noted the opportunity for the council to engage proactively with the forthcoming Casey Review and emphasised the importance of ensuring that partners contribute meaningfully to the process. It was suggested that the council write to Baroness Casey to highlight Herefordshire’s experience, including both the challenges faced and the successes achieved through partnership working across the county.

 

In closing the debate, the Leader reflected on the council’s demonstrated ability to deliver significant service improvement, drawing parallels with the progress made in Children’s Services. It was noted that, while the challenges facing Adult Social Care differ in scale, there is a clear commitment from both officers and Members to deliver the necessary improvements. Particular recognition was given to the Cabinet Member for Adult Social Care for her leadership and commitment to improving services and safeguarding vulnerable residents.

The Leader of the Council concluded the discussions. Councillor Gandy proposed the recommendations,  the Leader seconded the recommendation. The Leader directed that the decision to be put before Cabinet is:

 

That:

a)    Cabinet notes the outcome of the Herefordshire CQC Assessment;

 

b)    Cabinet approves Herefordshire’s CQC Assurance improvement plan 2026-2027; 

 

c)    Cabinet authorises the Corporate Director Community Wellbeing to lead this improvement plan on behalf of the Council and to take all operational decisions, as set out within this report and appendices.

 

The recommendations were unanimously approved.