The Adult Care and Public Health Scrutiny Committee met on Wednesday 29 July 2026 to discuss the Care Quality Commission's (CQC) assurance process for adult social care, the council's performance framework for the upcoming year, and the allocation of public health grant funding for substance use services. The committee also reviewed the council's work programme for the coming year.

Adult Social Care - CQC Assurance and EM ADASS Peer Review

The committee received an update on the Care Quality Commission's (CQC) assessment of Lincolnshire's adult social care services and an East Midlands Association of Directors of Adult Social Services (EM ADASS) peer review of safeguarding. Martin Samuels, Executive Director for Adult Care and Community Wellbeing, informed the committee that the final CQC report was expected imminently and would be shared with members. He noted that Lincolnshire had participated in a pilot CQC assessment in 2023, the findings of which were not comparable to subsequent assessments. The EM ADASS peer review, conducted in June 2026, identified strengths in the council's safeguarding approach, including a committed workforce and supportive leadership. However, it also highlighted areas for improvement, such as complexity in referral routes and inconsistent understanding of thresholds across teams and partners. These identified areas for improvement are already being addressed through the council's existing Adults Improvement Programme.

Scrutiny Committee Performance Framework 2026/27

The committee considered the proposed performance indicators (PIs) for the 2026/27 Scrutiny Committee Performance Framework for Adult Care and Public Health. Martin Samuels presented the framework, which aims to provide a focused and manageable set of indicators for scrutiny. Key performance indicators discussed included:

• PI 60: Permanent admissions to residential and nursing care homes aged 65+: This indicator did not meet its target, with 1,046 admissions against a target of 950. This was attributed to an aging population, increasing complexity of need, and a rise in self-funded admissions. The council is proposing a switch to a rate per 100,000 population for easier comparison with other authorities.
• PI 65: Percentage of adults receiving long-term support who have been reviewed: This indicator also fell short of its target, with 68.6% reviewed against a target of 85%. This is a deliberate policy shift to prioritise timely assessments for new and higher-risk cases, as existing service users are seen daily by carers who can flag changes in need.
• PI 111: People supported to successfully quit smoking: This indicator did not meet its target, with 2,222 quits against a target of 2,691. The target was set by the Department of Health and Social Care (DHSC) and was considered unachievable. Local targets have since been adjusted to reflect new national targets and available resources.
• PI 158: For adults discharged from hospital, the percentage who remain at home 91 days after discharge: This indicator exceeded its target, with 90.4% remaining at home against a target of 85%. This demonstrates the effectiveness of discharge planning and support.

Councillor Karen Elizabeth Lee raised concerns about the removal of weight management as a performance indicator, arguing for its reintroduction due to its impact on public health. The committee agreed to consider this further.

Service Level Performance Reporting against the Performance Framework 2025-26 Quarter 4

The committee reviewed the service level performance for Adult Care and Public Health as at Quarter 4 of the 2025-26 financial year. Overall performance was mixed, with most indicators meeting or exceeding targets, particularly in areas of prevention, independence, and safeguarding. However, residential admissions remained higher than targeted, and annual reviews were below target.

Key highlights included:

• Adult Care and Specialist Adult Services:
  • Exceeded target: PI 158 (adults remaining at home 91 days after hospital discharge) at 90.4%.
  • Achieved target: PI 63 (adults receiving direct payments), PI 124 (completed reablement episodes with no or lower support), PI 28 (safeguarding cases supported by an advocate), PI 116 (safeguarding enquiries with desired outcomes achieved), and PI 163 (people asked about desired outcomes during safeguarding enquiries).
  • Did not meet target: PI 60 (permanent admissions to residential and nursing care homes aged 65+) and PI 65 (people in receipt of long-term support who have been reviewed).
  • Contextual measure: PI 204 (people waiting for care and support) remained stable.
• Public Health and Community Wellbeing:
  • Exceeded target: PI 31 (alcohol users leaving specialist treatment successfully) with 372, PI 59 (carers supported) with 1,000 per 100,000 population, and PI 121 (carers receiving a review of their needs) at 98.8%.
  • Achieved target: PI 33 (NHS health check uptake) at 56%, PI 112 (people maintaining accommodation via Housing Related Support Service) at 98%, and PI 181 (people accessing Wellbeing Service achieving improved outcomes) at 99%.
  • Did not meet target: PI 111 (people supported to successfully quit smoking) at 2,222 against a target of 2,691, with a reported quit rate of 62%. Efforts are underway to improve this through new clinics and increased subcontractor provision.

Councillor Kelham Cooke raised concerns about the increasing use of nicotine pouches and suggested this be reviewed by the council in the future.

Public Health Substance Use Grant Funding

The committee considered proposals for the allocation of the £10.395 million protected public health grant for substance use services for 2026/27, supplemented by £214,000 from the Probation Service. Lucy Gavens, Public Health Consultant, explained that the funding would be used to vary existing contracts with the Lincolnshire Recovery Partnership (£3.24 million) and the Housing Related Support Service (£385,979). This funding will enhance treatment capacity, strengthen support for young people, expand outreach, support employment through Individual Placement and Support, and provide enhanced support for rough sleepers. Councillor Mrs Susan Woolley raised concerns about ensuring equitable access to services across the county, particularly for transient populations. It was confirmed that the service prioritises Lincolnshire residents and works with individuals to return them to their home areas for treatment where appropriate.

Adult Care and Public Health Scrutiny Committee Work Programme

The committee reviewed its work programme for the upcoming year. Kiara Chatziioannou, Health Scrutiny Officer, presented the programme, noting that it is a living document subject to ongoing review. The committee discussed adding the issue of nicotine pouches to the work programme, which was agreed to be considered for inclusion in a future report on smoking cessation. The committee also agreed to add the issue of the smoking pouches to the tobacco smoking and smoking cessation report scheduled for December.

The committee approved the planned work programme for 2026 and beyond, subject to the consideration of items highlighted during the meeting.