The Health and Adult Social Care Scrutiny Committee of Waltham Forest Council is scheduled to consider updates on home care and reablement services, as well as the progress of an improvement plan following a Care Quality Commission (CQC) inspection. The committee will also review the overall scrutiny report.

Home Care and Reablement Update

The committee is scheduled to receive an update on the current home-based support, also known as domiciliary care or home care, and reablement services in Waltham Forest. The report outlines the existing model, the reasons for change, and proposals for future commissioning arrangements. Home-based support is described as a crucial element of Adult Social Care, aiming to help adults with care and support needs live independently at home, maximise their wellbeing, and remain connected to their communities. Reablement is highlighted as central to this approach, assisting individuals in regaining or maintaining independence and reducing reliance on longer-term care. The report notes increasing demand for these services, alongside workforce and capacity challenges within the care market. Adult Social Care has been working with stakeholders to develop a new integrated, outcomes-focused commissioning model designed to improve resident outcomes, promote independence, manage demand, and strengthen system flow across health and care services. The committee is asked to note the current model, its challenges and opportunities, and to provide feedback on the proposed new commissioning model.

The report details the current home care model, which operates through a five-lot geographical framework with eight active providers, with contracts due to expire on 31st July 2027. Challenges identified include capacity constraints leading to reliance on spot purchasing, delays in sourcing care, and variable ability to support complex needs. The reablement service currently operates on a hybrid model, with assessment and care planning by Waltham Forest Council and NELFT, and care delivery by commissioned providers. While outcomes are generally positive, the model is largely focused on hospital discharge pathways and is not consistently used as a preventative intervention within the community. The report proposes establishing a new Home Care and Reablement Framework from 1st August 2027, with a maximum term of four years. This new framework aims to strengthen integration between health and social care, support neighbourhood-based delivery, improve resident outcomes and independence, and reduce demand for long-term care. The proposed structure includes three locality-based home care lots, one supplementary home care lot, one borough-wide reablement lot, and one supplementary reablement lot. The report states that the proposed framework is intended to improve independence, reduce demand for long-term care, increase access to reablement, improve system flow, deliver greater consistency and value for money, and develop a sustainable and resilient provider market.

Adult Social Care CQC Improvement Plan Update

The committee is scheduled to receive an update on the Adult Social Care (ASC) CQC Improvement Plan. Following a Care Quality Commission (CQC) inspection in 2025, which resulted in an overall rating of 'Good' for Waltham Forest Council's Adult Social Care services, an action plan was developed to address areas identified for improvement. This plan, which has been finalised after further engagement with stakeholders, sets out activity underway or planned against each of the CQC themes and quality statements. These themes include how local authorities work with people, how they provide support, how they ensure safety within the local system, and leadership. The plan also includes targeted work to strengthen safeguarding, assessment of need, provision of care and support, safe pathways, systems, and transitions. The finalised plan is supported by a set of metrics to evidence progress and demonstrate the impact of improvement activities. The committee is asked to note the engagement undertaken with stakeholders, review progress made against the action plan, and provide feedback on the approach, delivery, and proposed measures of success. A further progress update is scheduled for the end of Quarter 4 2026/27.

The report details that the CQC inspection assessed Adult Social Care against four themes: how local authorities work with people; how they provide support; how they ensure safety within the local system; and leadership. The inspection involved engagement with staff, residents, providers, partners, and voluntary and community organisations. The finalised action plan is aligned with Mission Waltham Forest and incorporated into the ASC Transformation Programme. Improvement activity is focused on areas highlighted by the CQC, including the timeliness of assessments and reviews, strengths-based practice and support for carers, care provision and market development, safeguarding and transition pathways, and data, performance management, and workforce development. The plan is supported by a suite of measures, combining national Adult Social Care Outcomes Framework (ASCOF) measures, operational performance indicators, quality assurance findings, market oversight reporting, and feedback from residents and carers.

The Scrutiny Report

The committee is scheduled to review The Scrutiny Report, which includes the Forward Plan and Action Tracker. This item invites members to review suggested items for the 2026/27 Forward Plan and make additional suggestions. The Forward Plan outlines the committee's work programme, factoring in statutory reports, major decisions, themed reviews, and policy areas of interest. The report also covers the Action Tracker, which captures actions required of officers from previous scrutiny meetings and provides updates on their progress. The committee is invited to review and approve the Action Tracker and any accompanying responses. The report notes that the Scrutiny team is currently operating under capacity, which may limit the ability to undertake intensive thematic reviews in the immediate term, with a focus remaining on scheduled committee items. The committee has suggested looking into the transition of services previously provided by Age UK to the new all-age befriending service, ensuring resident experience is included as part of this review. A one-year performance update on this is suggested for late 2026/early 2027.