The Adult Social Care and Communities Scrutiny Committee met to discuss the Adult Social Care Quality Commission Improvement Plan, the Making Every Adult Matter Programme, the Quarter 1 Performance Report, an Adult Social Care update, a Public Health update, and the committee's work plan. The committee noted the progress on the Adult Social Care Quality Commission Improvement Plan and supported the proposed actions. They also discussed the importance of addressing the needs of adults facing severe and multiple disadvantages through the Making Every Adult Matter Programme.

Adult Social Care Quality Commission Improvement Plan

Emily White, Director of Quality and Performance Strategy, provided an update on the Adult Social Care Improvement and Transformation Plan, following a Care Quality Commission (CQC) inspection in September 2024 that rated the council's services as Requires Improvement .

The CQC's report, published in January 2025, highlighted areas needing improvement across four themes: how the council works with people, how it supports people, how it keeps people safe, and leadership and governance. Key issues included the use of data and intelligence, evidencing outcomes, delegated functions, waiting lists, safeguarding, and workforce development.

The council is required to report quarterly to the Department of Health and Social Care (DHSC) on its progress, including actions taken, their impact, and any barriers encountered. Failure to improve could lead to government intervention under the Health and Care Act 2022.

The Adult Transformation Programme 2025-2027 is structured around five key areas: Reshaping Care, Pathways to Independence, Prevent, Reduce & Delay, Customer Experience, and Digital Solutions and Innovation. Achievements to date include the completion of the Make The Difference assessment model review, weekly audits of safeguarding cases, and reduced waiting times for occupational therapy and mental health social work assessments.

Risks and issues identified include access to data, waiting list fragmentation, staff capacity, and delays in projects related to carers and advocacy. Priorities for the next three months include strengthening risk documentation, benchmarking safeguarding practices, and improving carer support.

The committee was asked to note the progress, endorse the proposed actions, support ongoing investment in adult social care improvement, and review how the impact and outcomes of the plan are measured.

Making Every Adult Matter (MEAM) Programme

Helen Flitton, Head of Inclusion Health, Public Health and Communities, gave an overview of the Making Every Adult Matter (MEAM) Programme, which aims to improve outcomes for individuals with severe and multiple disadvantages in Gloucestershire. The MEAM approach seeks to create effective, coordinated services for people facing multiple challenges, including homelessness, substance misuse, mental health issues, and involvement with the criminal justice system.

The programme seeks to achieve change at three levels: improving health, safety, wellbeing, and access to services for individuals; promoting greater integration and collaboration across local services; and promoting strong multi-agency partnerships and better use of data within the wider system of services and support.

The vision of MEAM is:

To create a flexible system where barriers are broken down and where services partner with the whole person and every adult is empowered to access the support they need to thrive.

Next steps for the programme include the MEAM coordinator commencing in their role, establishing a Systems Change Community of Practice, and developing a communications plan.

Quarter 1 Performance Report 2025/26

The committee reviewed the Adult Social Care and Communities Performance Report for Quarter 1 2025/26, which provided an update on performance from 1 April to 30 June 2025.

Key highlights from the report included:

• Contact Activity: 91.8% of all Adult Social Care contacts had a decision within one working day, which is within tolerance of the 95.0% target. 29.1% of contacts were signposted or closed, below the 33.0% target.
• Assessment, Brokerage & Review: 76.1% of people had a review of their needs in the last 12 months, exceeding the 75.0% target. The average time people waited for brokerage was 3.0 weeks. Only 31.0% of Financial Assessment and Benefits (FAB) assessments were completed within 40 calendar days.
• Adult Safeguarding: 85.5% of Adult Section 42 enquiries closed with risk reduced or removed, slightly above the 85.0% target. 6.0% of Section 42 Enquiries were open for more than 26 weeks, well below the 20.0% target.
• Quality Assurance: 85.6% of Gloucestershire Adult Social Care Providers were rated Good/Outstanding by the CQC, below the 90.0% target.
• Long Term Care: Permanent admissions to residential/nursing care for those aged 18-64 was 16.5 per 100k population, and for those aged 65+ was 534.8 per 100k population, both better than target.
• Mental Health: 62.4% of AMHP assessments resulted in a Mental Health Act detention/support/admission.
• Learning Disability: 67.7% of Adults with Learning Disabilities were in settled accommodation, below the 79.0% target. 1,054 people with a disability were in employment supported by Forwards, exceeding the 950 target.
• Addressing Public Health Inequalities: 45.0% of Healthy Lifestyle Service customers achieved a significant risk factor improvement, below the 65.0% target. 36.0% of pregnant smokers achieved a 4-week quit, below the 80.0% target.

The report also included updates on corporate strategic risks, including adult social care provider failure, failure to protect vulnerable adults, and the risk of legal action due to failures in completing Deprivation of Liberty assessments.

Adult Social Care Update

Sarah Scott, Executive Director for Adult Social Care, Wellbeing and Communities, provided an overview of key information relating to the delivery of Adult Social Care in Gloucestershire. The update included a written response to a question about housing responsibilities in relation to older people, detailing the roles of district, city, and borough councils in local housing delivery and planning control, and the county council's responsibilities for strategic services that influence housing for older people.

The update also detailed the Adult Social Care Co-production charter, which is being enhanced to reinforce Gloucestershire County Council's commitment to co-production.

Public Health Update

Siobhan Farmer, Director of Public Health, provided an update on several key areas, including changes to the national vaccination programme, physical activity in an ageing society, the Pharmaceutical Needs Assessment (PNA), a domestic abuse training pathway pilot, Positive Relationships Gloucestershire (PRG), children and young people's healthy weight, and oral health.

Key points included:

• Changes to National Vaccination Programme: NHS England announced changes to the national vaccination programme, including a new routine appointment for children aged 18 months for the second dose of the Measles Mumps and Rubella (MMR) vaccine, and the stopping of the Hib/Meningococcal C vaccine at 1 year of age.
• Health Select Committee Inquiry: Physical Activity in an Ageing Society: The Council and the Integrated Care Board (ICB) collaborated with Active Gloucestershire to develop a joint response to the inquiry, showcasing local examples of good practice to support active ageing and reduce health inequalities.
• Pharmaceutical Needs Assessment (PNA): The Gloucestershire Pharmaceutical Needs Assessment (PNA) 2025-28 is due to be published by 1st October 2025. The draft 2025 PNA was agreed by the steering group and members of the Health and Wellbeing Board prior to a 60-day formal consultation with both stakeholders and the public.
• Domestic Abuse (DA) Training Pathway Pilot: A one-year Domestic Abuse Training Pathway pilot will provide free access to domestic abuse training modules for all frontline professionals.
• Positive Relationships Gloucestershire (PRG): The council's Positive Relationships Gloucestershire (PRG) service is due to be recommissioned ahead of the current contract ending 30 June 2026.
• Children and Young People's Healthy Weight: Findings from the 2023/24 National Child Measurement Programme (NCMP) show that the obesity rate among Reception children in Gloucestershire is not significantly different to the England average, while the rate of obesity among Year 6 children continues to be significantly lower than the England average.
• Oral Health: The commissioning responsibility for oral health has transferred from NHS Gloucestershire ICB to Public Health.

Work Plan

The committee noted the historic committee work plan for the period 2022-25 and a range of proposals suggested by the former committee as potential items for the committee to consider adding to the committee work plan for the committee year 2025-26.

Items proposed by the new committee as possible items to include on the committee work plan (for discussion at the 9 September 2025 meeting) included:

• Carbon emissions
• Trading Standards (possible joint item with Fire Scrutiny in 2026)
• Gloucestershire Care Provider Market
• Drug and Alcohol Abuse
• Making Every Adult Matter Programme
• The work of GARAS in providing support to refugees and asylum seekers in Gloucestershire, including protecting people/women from domestic violence living in these communities
• Support for Older People with Autism

Items suggested by the former committee as possible items of interest for the new committee to consider included:

• Adult Transformation Programme (transformation of Adult Social Care)
• Vaping national changes and local work
• Work to support adults of working age, (including adults with learning disabilities, autism, and physical disabilities)
• Occupational Therapy Services
• Technology Enabled Care (to include a possible site visit)
• GCC Safeguarding Function Briefing
• Gloucestershire Community Safety Partnership Presentation (CFO to invite Chair of the CSP, Deputy Police and Crime Commissioner Nick Evans to present the item)
• Sexual Health Services and Funding – 4 Nov 2025 meeting

Items suggested at the Corporate Scrutiny Committee meeting (Oct 2024)

• Strategic Risk Update (to include in the Director of ASC Update Report) on the monitoring of data relating to council interventions with adult social care providers (individual care provider risk).
• Strategic Risk Update (to include in the Director of ASC Update Report) re ASC risks associated with Nursing/Residential Care and the impact on delays in Domiciliary Care admissions.

Items proposed for consideration at the Adult Social Care and Communities Scrutiny Committee meeting on 9 Sept 2025 include:

• Adults CQC Improvement Plan Update
• Making Every Adult Matter Programme

Items proposed for consideration at the Adult Social Care and Communities Scrutiny Committee meeting on 4 Nov 2025 include:

• Gloucestershire Safeguarding Adults Board (GSAB) Annual Report 2024-25
• Sexual Health Services