The Adults and Health Policy and Scrutiny Committee met on Tuesday 7th July 2026 to discuss the council's work programme for the upcoming year and receive an update on the homecare mobilisation programme. The committee also heard from the Cabinet Member for Adults and Health on various departmental priorities and ongoing initiatives.

Work Programme 2026-2027

The committee reviewed its proposed work programme for the 2026-2027 municipal year. Members suggested bringing forward several key areas for future discussion, including the support provided to residents with dementia, the impact of the Casey report, contractual arrangements with homecare providers, the cost of living crisis and its effect on residents requiring continued support and care for mental health concerns. The committee also considered items suggested by the service for inclusion in the work programme, such as the support offered to carers and social care pathways for hospital discharge.

Update from the Cabinet Member for Adults and Health

Councillor Lorraine Dean, Cabinet Member for Adults and Health, provided an update on the portfolio's priorities and recent developments. Discussions covered a range of topics, including:

• Support for Adults with Disabilities and Learning Disabilities: The committee discussed efforts to improve the lives of adults with disabilities and learning disabilities, including the development of day services at Lisson Grove and plans for interim provision.
• Elderly Residents: The meeting addressed accommodation needs for elderly residents, residential care, aids and adaptations, direct payments, and the opening of Taylor House, a new development providing specialist accommodation.
• Vulnerable Residents and Transition Services: The committee examined the transition services for young people with disabilities moving from children's services to adult provisions, including plans to review protocols between services to enhance communication and collaboration with the NHS and partners.
• Mental Health Provision: Significant discussion focused on mental health services, including planned additional beds in North Pimlico, the development of step-down and permanent crisis beds, and addressing delays in service provision. The committee also discussed funding received from the NHS, the requirements for secure units, staff specialisms, training, quality assurance, and the potential for substance testing of residents and facility staff. The committee requested a future update on the decision regarding the provision of additional mental health beds in Westminster.
• Office for Health Improvement and Disparities (OHID): The committee received an update on the OHID audit, the funding of discretionary payments, and the overall performance of the public health grant, with a focus on ensuring its effective utilisation for public health purposes.
• Wheelchair Services: The meeting addressed how the council plans to improve accessibility and maintenance of wheelchair services, working with the NHS to enhance the overall provision.
• Wellbeing Hub: The committee discussed pathways available for individuals who experience difficulties accessing the Wellbeing Hub.

The committee also requested site visits to Carlton Dene and mental health accommodation providers for interested members. Officers were tasked with working with mental health accommodation providers to explore the administration of substance testing for facility staff.

Homecare Mobilisation Update

The committee received an update on the council's Homecare Mobilisation programme. Discussions with Councillor Dean, the Bi-Borough Director of Adult Social Care, the Bi-Borough Director of Integrated Commissioning, and the Head of Care Markets covered several key areas:

• Workforce: The committee explored working conditions for care staff, efforts to keep staff local, the provision of guaranteed hours, increasing hours for staff on zero-hour contracts, payment for travel time, staff stability, and the flexibility of working arrangements. The prioritisation of contracted hours in future planning, staff retention, and the operation of spot providers were also discussed.
• Financial Considerations: The meeting addressed the schedule for full mobilisation, monitoring the efficiency of the programme timeline, the differing costs per hour for homecare and placements, and the expense of training and development for care staff.
• Staff Development: The committee examined the consistency of training across all care providers, how quality assurance is being achieved, who funds staff training and development, and the training offered by agencies.
• Contracts: The operational aspects of billing between residents, the council, and providers were discussed, along with the role of the financial assessment team. The reconciliation of planned staff working hours with actual delivery, how care providers keep the council informed, acceptance targets, overall performance, contractual arrangements for carers working for multiple agencies, and how provider workforces are contracted and monitored to meet local needs were also debated.
• Continuity Planning: The committee discussed how continuity is managed in commissioning, issues such as power outages and cyber-attacks affecting providers, their potential impact on care and support plans, and how system information is shared between the council and other partners.
• Complexity by Exception Pathway: The discussion included the support provided for challenging behaviour, one-to-one support for specific needs, and the increasing demand for complex and extra care services to improve residents' quality of life within the community.

The committee requested information on the number of residents whose care packages are fully funded by the council, the number who pay privately, and the number who are means-tested with partial council subsidy. They also requested to be provided with staff retention results since changes to carer travel arrangements were implemented and contracts were bedded in, along with relevant feedback from staff surveys.