The Adult Care and Public Health Scrutiny Committee met on Friday 27 February 2026 to discuss several key issues affecting local residents. The committee reviewed proposed increases to residential and nursing care rates, debated the future of mental health support services, and considered the extension of the Direct Payment Support Service. The committee proposed that their summary of comments be shared with the executive for their consideration regarding the decommissioning of the Memory Support Service. The committee also proposed that their summary of comments be shared with the executive for their consideration regarding the review of the Mental Health Section 75 Agreement, which was agreed with one abstention. The committee proposed that their comments and strong feelings be shared with the executive regarding the Future of the Mental Health and Wellbeing Community Investment Fund, which was agreed. The committee agreed the planned work for the year, subject to consideration of the highlighted items.

Residential Care and Residential with Nursing Care Usual Costs

The committee considered a report detailing proposed increases to the rates the council pays to providers of residential and residential with nursing care for the financial year 2026-27. Alina Hackney, Head of Commercial Services, and Gemma Hatton, Strategic Finance Lead, presented the report, explaining that the proposed uplift of 5.28% across most categories aims to reflect the national living wage increase and inflation forecasts. The Adult Social Care Fair Pay Grant of £2.2 million for 2026-27 has also been allocated to providers.

Melanie Weatherley MBE, Chair of the Lincolnshire Care Association, spoke on behalf of providers, welcoming the rate increases but expressing ongoing concerns about market stability. She highlighted that the issue is not solely about fees but also about placement levels, the distinction between health and social care needs, and significant workforce challenges.

Councillor Maggie Cullen questioned the steps taken to ensure the three-month extension to the current residential framework would not create risks, such as provider withdrawal or placement disruption. Alina Hackney reassured the committee that providers had been informed of the extension and that only a small number had raised concerns. She added that the annual fee increase would take effect from April 1st regardless of the extension, mitigating financial gaps for providers.

Councillor Mrs Susan Woolley noted that the tables in the report did not specify if rates were per week, month, hour, or day, suggesting this would be helpful for public understanding. She also raised questions about the long-term certainty of the Fair Pay Grant, its inflation linkage, and whether it fully covered pay elements. Martin Samuels, Executive Director of Adult Care and Community Wellbeing, explained that the government has committed to a new fair pay agreement nationally from April 2028, with £500 million allocated to cover local authority elements. He stated this funding is baked into the baseline and guaranteed.

Councillor Christopher John Reeve expressed support for the three-month extension, calling it sensible. He raised concerns about provider feedback indicating significant weekly losses per resident, questioning central government's role in funding such issues. Martin Samuels clarified that while social care is a local authority responsibility, national government provides significant funding, and fee rates are ultimately at local discretion. He also mentioned a hardship process for providers at risk of financial failure.

Councillor Mrs Marianne Jane Overton MBE raised concerns about the £43 weekly loss per resident mentioned in the feedback and a minimum weekly requirement of £1,200 per week for residents. Gemma Hatton explained the rate calculation, which includes salary and non-salary elements, and noted that the council is only obligated to pay for a reasonable standard of care, with any additional costs covered by third-party top-ups.

The committee ultimately proposed that their summary of comments be shared with the executive for their consideration, which was agreed unanimously.

Review of the Mental Health Section 75 National Health Service Act 2006 Agreement

Martin Samuels, Executive Director of Adult Care and Community Wellbeing, presented a report on the review of the Mental Health Section 75 Agreement. This agreement, in place for over 20 years, delegates responsibility for adult social care aspects of care for working-age adults with mental health issues to the Lincolnshire Partnership Foundation Trust (LPFT). Mr Samuels explained that while LPFT has delivered a good service, it has become increasingly difficult for them, as a healthcare organisation, to keep up with developments in adult social care. The service has increasingly become a medical model rather than an integrated health and social care service.

The recommendation is to bring the agreement to a close by mutual agreement on 30 June 2026, with staff transferring to LCC via a TUPE process. This is not intended as a cost-saving measure but to ensure strength-based, person-centred adult social care that maximises independence.

Councillor Wally expressed concern that the equality impact assessment was a tabletop exercise and questioned why a more thorough investigation with affected individuals had not been conducted. Martin Samuels explained that the intention is to transfer the service as is, with staff moving as a single team. He added that direct engagement with individuals drawing on care at this stage was deemed too early and could cause anxiety, but that redesign would be an engaged process.

Councillor Overton asked what would be done differently and if acute mental health support would still go to LPFT. Martin Samuels confirmed that healthcare aspects would remain with LPFT, but LCC's social work expertise would be applied to ensure individuals are not disempowered by over-provision of care. He cited an instance where a person placed in residential care could have lived in the community with a different, less costly care package.

Councillor Bean asked about measurable improvements expected in the first 12 months and assurances that the change would improve outcomes rather than just transfer existing pressures. Martin Samuels anticipated a smaller number of individuals in residential care and reduced hours in community settings, leading to improved quality of life and financial savings through more appropriate placement decisions.

Councillor Rowe asked if the TUPE'd staff would be working in the intended areas. Martin Samuels confirmed they would be operational staff and that LCC would connect them to other social work teams, offering career advantages.

The committee proposed that their summary of comments be shared with the executive, which was agreed with one abstention.

Decommissioning of the Memory Support Service

Martin Samuels presented a report on the proposed decommissioning of the Memory Support Service, which provides information, advice, and guidance for people diagnosed with dementia and other cognitive conditions. He stressed that this was not a reflection on the quality of the service provided by LPFT, but a budgetary decision. He explained that nearly all referrals come from LPFT to itself, and that other commissioned services, such as the Carers' Service and Wellbeing Service, are capable of picking up this demand, thus avoiding duplication.

James Bean sought clarification, stating that the service was being decommissioned due to duplication and that the service was provided elsewhere. Richard Stephen Litchfield asked for elaboration on the duplication and any risks of reduced support or gaps. Martin Samuels reiterated that other services are capable of providing the necessary information, advice, and guidance, and while a dementia-specific service might be more reassuring, the council could not afford the duplication.

Councillor Overton questioned how people currently access the service and how they would access the new service, asking if the new service would be upgraded. Martin Samuels explained that LPFT staff would simply refer people to other information, advice, and guidance services, and the experience for the individual should remain the same. He acknowledged that it was not a dementia-specific service but expressed confidence in the quality of existing services.

Councillor Woolley questioned the assumption that other services were better and expressed nervousness about the impact assessment being a tabletop exercise given the number of people using the service. She also queried the cost of the service and whether the decommissioning was primarily about saving money. Martin Samuels stated the Memory Support Service costs approximately £300,000 per year and clarified that information and advice is a statutory service, but a dementia-specific one is not. He assured the committee that the review had been rigorous.

Councillor Reeve supported the proposal, finding it reassuring that the service was considered duplicative. Councillor Rowe asked about beefing up existing support to handle the incoming work and what percentage of savings would be used for this. Martin Samuels clarified that the other services are LCC-commissioned, not directly delivered, and the increase in workload is expected to be small.

Councillor Woolley questioned why the council assumed other services were better and expressed concern about access and the tabletop nature of the impact assessment. Martin Samuels reiterated that the services were equivalent and that the decision was based on identified duplication and the current financial context. He also confirmed that a commissioning strategy for dementia would be developed.

The committee ultimately proposed that their summary of comments be shared with the executive, which was agreed with one abstention.

Review of the Mental Health and Wellbeing Community Investment Fund

Martin Samuels presented the report on the future of the Mental Health and Wellbeing Community Investment Fund (MHWCIF), which has been run in partnership with Shine Lincolnshire since April 2023. The fund provides small grants to third-sector organisations for preventative mental health and wellbeing programmes. The fund is primarily financed by the NHS Integrated Care Board (ICB), with a smaller contribution from LCC.

Mr Samuels explained that the ICB had informed the council that they would no longer be able to contribute their £1 million annual funding from April 2026 due to cost pressures. This withdrawal of funding makes it impractical to continue the current arrangement. The proposal is to allow the existing contract with Shine Lincolnshire to expire at the end of March 2026.

LCC's £375,000 contribution is part of the Better Care Fund and must be spent on appropriate initiatives. Discussions are ongoing with the ICB about potential future funding, but nothing is certain.

Councillor Cullen asked for examples of alternative sources of support and how communication and signposting would work. Martin Samuels explained that mitigation would largely involve working with Shine to help them manage the loss of income, and to be clear with voluntary sector organisations about the fund's end.

Councillor Overton expressed strong unhappiness with the proposal, highlighting the good work of Shine and the lifeline the fund provides to residents. She questioned why LCC couldn't continue its contribution and argued that allowing the fund to fail was damaging. She urged for more effort to ensure its continuation, even on a smaller scale.

Councillor Wally echoed concerns about cost-cutting exercises and questioned whether these choices were made by officers or dictated from above. He expressed belief in prevention being better than cure and warned that individuals supported now might end up in more expensive services later.

Martin Samuels reiterated that the ICB had turned off the tap for their funding, making it impossible to continue the current arrangement. He confirmed that LCC's £375,000 contribution is within the Better Care Fund and needs to be spent appropriately. He stated that they are actively looking for alternatives but could not commit to finding something or when it might be in place. He acknowledged the gap that would inevitably occur but stressed that this was a consequence of the ICB's funding withdrawal.

Councillor Rowe and Councillor Overton questioned if the public health reserve or windfall funds could be used. Martin Samuels stated that the £375,000 is in the Better Care Fund and must be spent within that remit. He also mentioned a meeting with the NHS on Monday where this service would be on the agenda.

The committee ultimately proposed that their comments and strong feelings be shared with the executive, which was agreed.

Direct Payment Support Service Extension

Carl Miller, Senior Strategic Commercial and Procurement Manager, presented the report on the Direct Payment Support Service (DPSS) contract extension. The existing contract with Penderels Trust Limited is due to end on 30 June 2026. The proposal is to extend the contract for 12 months to 30 June 2027, at a maximum total contract value of £648,140 (incl. VAT).

Mr Miller explained that the extension is necessary to align the future DPSS service with the outcomes of the Direct Payments Improvement Programme, which aims to deliver operational and strategic improvements. He noted that demand for fully managed accounts, the most intensive support type, has grown significantly, exceeding initial forecasts and driving staffing pressures. Despite these pressures, the provider is performing strongly and exceeding KPIs.

Councillor Cullen asked what measures would be put in place to better understand and reduce unnecessary demand for fully managed accounts. Carl Miller explained that this work is ongoing through the Direct Payments Improvement Programme, which has already resulted in a reduction in referrals for fully managed accounts as a proportion of total referrals.

Councillor Iverton questioned if there was an incentive for the person referring to allocate fully managed accounts and if the increase in demand was linked to population demographics. Carl Miller clarified that referrals come from adult social care practitioners, not the service provider, and that while demography plays a role, it's not the sole factor. He added that benchmarking with other authorities would help understand demand.

Councillor Reeve asked for a nutshell explanation of why the new contract wasn't ready and why another 12 months were needed. Carl Miller explained that the Direct Payments Improvement Programme is complex and has not yet fully concluded, preventing the scoping of the future service. He expressed confidence that the next 12 months would provide sufficient time.

Councillor Overton questioned if direct payments offered more money than not having them and if people effectively received more. Carl Miller clarified that there is no direct correlation between the type of account support and the personal budget, and the differential lies in the intensity of support needed.

Councillor Woolley questioned why there hadn't been more competition for the DPSS and if other organisations were out there. Carl Miller stated that the service was open to competitive tender in 2021, with other interested organisations, but it is a specialist service with a limited national market. He assured that a competitive tendering process would occur for the recommissioning.

The committee ultimately proposed that their summary of comments be shared with the executive councillor, which was agreed unanimously.

Adult Care and Public Health Scrutiny Committee Work Programme

Hannah Colclough, Scrutiny Officer, presented the committee's work programme. For the next meeting on 25 March, the committee will scrutinise the advocacy services extension and the housing-related support contract extension. Other planned scrutiny reports include early action and support activity, the adult social care three-year business plan, the co-production strategy, quarter three performance reporting, and support for the care market. An invitation will be sent to members of the Children's and Culture Scrutiny Committee to attend the March meeting, particularly for the advocacy services extension as it includes children's services.

Councillor Overton hoped for hard talk with the ICB regarding the Mental Health and Wellbeing Community Investment Fund and asked for the matter to be brought back to the committee to report on progress. Hannah Colclough confirmed this was possible.

Councillor Woolley inquired about the specific ICB involved in the funding withdrawal and requested a paper on the wider implications of funding withdrawal from other areas within health and social care from the Lincolnshire ICB. Hannah Colclough agreed this would be beneficial.

The committee agreed the planned work for the year, subject to consideration of the highlighted items.