The Health and Adult Services Scrutiny Committee met to discuss a new prevention strategy for Lancashire, a redesign of adult social care provider services, and the committee's work programme. The committee agreed that proposed changes to orthodontic services should be reviewed by the full committee. They also requested a report back after winter to review the impact of winter planning.

Adult Social Care Provider Services Redesign

The committee discussed the proposed redesign of adult social care provider services, following a cabinet decision taken on 9 October 2025. The proposals include an accelerated reprovision of some older people's services, specifically five residential care homes and five-day services.

The cabinet considered three options:

• Option 1: A redesign of provider services over 12 to 18 months to gain a comprehensive understanding of the service landscape and identify efficiencies. This option was not chosen as it risked failing to address immediate safety concerns and might worsen service quality.
• Option 2: (The preferred option) A redesign of provider services while accelerating the reprovision of five residential and five-day care services to address safety risks and enhance service delivery.
• Option 3: Do nothing. This was considered unsustainable due to asset quality and the risk of deteriorating service quality.

The report presented to the committee outlined the investment required, utilisation rates, and Care Quality Commission (CQC) ratings for the care homes and day services under review.

The report stated that capital requirements were determined using a combination of condition surveys and suitability assessments. The surveys were carried out in 2021 and are non-intrusive, visual inspections that assess essential repairs, maintenance, health and safety, and any other obvious building issues. New surveys are being undertaken to reflect the most up-to-date position before any decisions are made.

The council intends to engage with those impacted through a public consultation, market engagement, and ongoing communication.

Concerns raised

Several councillors raised concerns about the proposals.

Councillor Tettler said:

If you've got a beautifully designed care home with excellent staff, but it's only got 10% occupied, what is that?

Councillor Clifford apologised for the release of data, but said that they wanted to ensure that the councillors had access to as much information to inform themselves about what was happening. They also noted that this was the first time condition reports had ever been released in this council.

Councillor Snape raised concerns about transparency, stating that they had visited Grove House and been told that new admissions were still being taken, but later found out that an instruction had been given not to take new admissions other than for two weeks' respite care¹. They also questioned a discrepancy in the investment required for Grove House, with the committee report stating £857,000 while a previous condition survey quoted £267,000. Councillor Whip asked how many care home places have to be removed to get the right numbers in care homes, and why it wasn't an option in the document for service users to remain in the homes. They also asked why there was little weight given to quality in the current consultation, and how great and imperative cutting costs is in this process, given the administration's aim of cutting £50 million from adult social care.

Councillor Dalton said that they would take the concerns raised seriously and would come back to the cabinet for a decision. They encouraged councillors to express how they feel about the proposals and to provide stories about what the staff did, as this would affect how the cabinet look at it.

Property Issues

Simon Lawrence, Director of Growth and Regeneration, noted that the County Council Cabinet agreed a property strategy at its meeting last month, and that it was agreed that they would release copies of the condition surveys that were undertaken for all the properties in relation to this study, which were undertaken in 2020 and 2021. He stated that it is their view that the homes meet current compliance standards and are therefore safe.

Helen Mills, Director of Operations, summarised care home quality and regulatory expectations, noting that older care homes are not automatically non-compliant, but new or varied registrations are unlikely to be approved without en-suite bathrooms, accessible layout, and strong infection-control design.

Developing a Prevention Strategy for Lancashire

The committee discussed a report outlining the development of a unified prevention strategy for Lancashire County Council. The strategy aims to establish a single, coordinated approach across council services to achieve better outcomes and manage demand more effectively, especially across social care services.

Dr Sakthi Karunanithi, Director of Public Health, explained that prevention includes any action taken to reduce the burden of illness, premature death, or disability. He said that this could include creating better conditions for health, improving healthy choices and behaviours, and providing services to identify issues early and help people prevent escalation.

Dr Karunanithi stated:

health is made in our homes and our neighbourhoods more than it's one of the fundamental principles that we seek to achieve in this piece of work.

The strategy will focus on understanding neighbourhoods and how different communities live in them, bearing in mind the wider public sector in which this work is being undertaken. The plan is to make services more accessible and intervene early enough so that people can be helped to prevent further escalation.

The council is planning a phased approach to the strategy, with the first phase focused on immediate decisions and feeding into the 2026/27 budget setting. The second phase will build on the first by shaping the future strategy for prevention and early intervention, and the third phase will support the transition to whatever new structures emerge from Local Government Reorganisation² and establish a single, integrated prevention and early intervention strategy across the whole system. Councillor Jewell asked whether the strategy would be shaped around existing funding or whether it could be shaped around what interventions make sense and then look at how that can self-fund.

Dr Karunanithi responded that the ambition for preventing unnecessary suffering will look at what can be prevented and isn't going to be constrained in terms of the ambition for preventing issues. He added that the action will need to be mobilised across society, including members of the community, the county council, and public sector organisations.

Councillor Hindle asked Dr Karunanithi to expand on how the health of people who live in Ribble Valley is very good compared to other districts, but it also has lots of rural isolation and suicide.

Dr Karunanithi said that the thinking at this stage is how to not try and do things all the time for people or instead of people just taking care of themselves. He added that a lot of that rests on truly listening to work and working with people and with all the answers and we have the solutions.

Report of the Health Scrutiny Steering Group

The committee received the report of the Health Scrutiny Steering Group from 14 October 2025. The report included updates on:

• Orthodontic Secondary Care
• Winter Planning
• Speech and Language in Early Years

The committee agreed that the item on the changes to Orthodontic Secondary Care should be presented to the Health Scrutiny Committee.

John Williams, Director of Operations, Sue Lott, Head of Service Urgent Care, Barbara McKeown, Head of Strategy for Urgent & Emergency Care, Simon Raffaelli, Senior System Coordination Centre Manager, and Matt Cooper, NWAS Area Director Cumbria and Lancashire, presented the Winter Plan for Adult Social Care and NHS services for 2025/26.

The committee agreed that a winter planning item be brought back to the group after the winter period to review actions and impact.

Stephen Morton, Consultant in Public Health, provided an update on the development and implementation of Easy Access Speech and Language Therapy (SALT) Walk-In Clinics across Lancashire.

The committee noted the progress made and supported the alignment with wider early years and Special Educational Needs and Disability (SEND) strategies.

Health and Adult Services Scrutiny Committee and Steering Group Work Programmes 2025/26

The committee reviewed and confirmed the work programmes for the 2025/26 municipal year. They also determined the key lines of enquiry for items due to be presented at the next meeting of the Health Scrutiny Steering Group on 25 November 2025 and considered the key lines of enquiry set out for items due to be presented at the next meeting of the Committee on 10 December.