The Adult Care and Well-Being Overview and Scrutiny Panel met on Monday 13 July 2026 to discuss the Care Quality Commission (CQC) assessment report for Worcestershire County Council's adult social care services, the progress of the Adult Neurodiversity Team, and the 2025/26 draft year-end budget monitoring. The meeting confirmed that Worcestershire's adult social care services received an overall good rating from the CQC, with specific praise for its strengths-based practice, prevention initiatives, safeguarding, partnership working, and leadership. However, areas for improvement were identified, including equality in experience and outcomes, care provision, integration, and continuity. The panel also reviewed the performance and financial position of adult social care services, noting significant overspends in demand-led areas, and discussed the work programme for the upcoming year.

Care Quality Commission (CQC) Assessment Report

The panel received a positive report from the Care Quality Commission (CQC) regarding Worcestershire County Council's adult social care services, which were rated as good overall. Councillor Mel Allcott, Cabinet Member with Responsibility for Adult Social Care, expressed her delight with the outcome, highlighting that 70% of areas assessed received a good rating, with four out of five domains scoring well. Mark Fitton, Strategic Director for Adults & Communities, echoed this sentiment, praising the dedication of the workforce.

Despite the positive overall rating, two areas were identified as requiring improvement: Equality in experience and outcomes and Care provision, integration, and continuity. Councillor Tor Pingree raised concerns about gaps in protected characteristics data, asking for more information on who might be at risk due to this lack of data. Kelly Palmer, Principal Social Worker for Adults, explained that while data on protected characteristics was not fully recorded on the system, it was still considered in assessments and support plans. The council is revising its recording guidance to improve data capture.

Councillor Pingree also inquired about rural access and the balance between transport issues and staff availability. It was noted that this was a broader council issue rather than solely an adult social care concern, and work would continue with colleagues to improve transport access. The issue of carer registration was also discussed, with plans to update needs assessments and increase awareness through public spaces like libraries and GP surgeries.

Councillor Andrew Cross commended the report but noted that some details, such as those concerning deprivation of liberty and backlogs, were not immediately apparent in the presented summary and would have been beneficial to have included. Mark Fitton acknowledged this, explaining that the aim was to provide a concise overview, with the full CQC report available via a link for more detailed information.

Councillor Richard Morris praised the workforce and leadership team, and raised points about developing the Targeted Adult Support Team (TAST) further, particularly its preventative nature, and working more closely with social prescribers. He also highlighted the importance of partnerships with the voluntary sector and the NHS. Mark Fitton confirmed that TAST is part of a wider council transformation programme focusing on the front door approach to public engagement.

Councillor Sue Eacock raised concerns about the poor recording of protected characteristics and its potential impact on carers, asking about urgent actions to mitigate risks. Kerry McCrossan, Assistant Director for Adult Social Care, explained that identifying unpaid carers can be challenging as many do not see themselves in that role. She assured the panel that efforts were being made to raise awareness and improve identification through social workers and the independent carers' service.

Councillor Michele Hulme inquired about the availability of the comprehensive improvement plan. It was stated that a draft plan was nearing completion and was expected to be shared in September. Councillor Anthony Upton sought clarification on the disparity between being rated good at assessing needs but requiring improvement in care provision, integration, and outcomes. It was explained that the requires improvement rating in equality and outcomes was linked to the recording of protected characteristics, and that issues around transitions for people, such as hospital discharges, were also a factor.

Andrew Cross requested information on which actions within the improvement plan could be completed within six months and which would require longer-term system change, as well as key measures for monitoring progress. It was confirmed that the focus would initially be on areas rated as requires improvement, such as EDI and integration. Work is already underway on various service development initiatives, and the improvement plan will consolidate these efforts.

Sue Eacock revisited the issue of missing protected characteristic data, questioning if AI was being implemented and if it would increase costs. It was clarified that the planned improvements would not incur additional costs and that making data recording mandatory was not feasible due to the need to act quickly in crisis situations. The council aims to improve data capture through better reporting and working with partners.

Councillor Jo Monk asked why the equality data was missing and if AI would help. She also questioned whether the existing improvement programme would be maintained or if significant changes were planned. Councillor Mel Allcott stated that the improvement plan was being developed and that the council was in a holding pattern regarding future strategy, pending a decision on local government reorganisation.

Councillor Nick Price congratulated all involved on the good CQC rating and asked about the timeline for delivering improvements and how success would be measured. He also inquired if quality criticisms had affected commissioning decisions and what action the new Cabinet Member for Adult Social Care would take. Councillor Mel Allcott reiterated that the improvement plan was being developed and that the council was awaiting decisions on local government reorganisation before finalising its strategy.

Adult Neurodiversity Team

Francesca Darby, Head of Service for Continuing Healthcare, Learning Disabilities, and the Adult Neurodiversity Team (ANT), presented an update on the ANT. She highlighted that demand for the service is increasing and becoming more complex, with active caseloads rising by 13% between April and August 2025. The team supports individuals with complex needs, including those experiencing housing instability, mental health issues, and crisis presentations. The focus is on prevention, early intervention, and reducing escalation.

Case studies were presented to illustrate the team's impact, including preventing long-term dependency and supporting individuals towards independence. Councillor Dave Edmonds inquired about the triggers and timescales for service reviews, and it was explained that the review of the ANT was driven by a need to address capacity issues and feeds into the wider CQC improvement plan.

Councillor Sue Eacock asked about the investment in new posts and the guarantee of continued funding for support workers from public health. It was confirmed that additional qualified social work and social care worker posts had been agreed to meet demand, but information on the continuation of public health funding for support workers was still pending.

Councillor Anthony Upton asked about the interface with transitions from children's services, specifically regarding a young autistic adult who refuses to interact with the system. It was suggested that an offline conversation could help plan the best approach for engagement. Councillor Tor Pingree raised questions about future demand, the support provided to 15 autistic adults to live independently, and how preventative costs are being tracked. It was acknowledged that demand is expected to increase nationally, and work is underway to plan for future staffing needs. The 15 individuals mentioned were a snapshot of those who had achieved good outcomes, and the council would be using new software to track preventative costs.

Councillor Andrew Cross welcomed the renaming of the service to neurodivergent and requested a dedicated financial analysis of the ANT cohort. It was confirmed that the service was established in 2023 and is not new, but is evolving. The team is working on integrating with mental health and housing services for a joint preventative response to crisis situations.

Councillor Richard Morris expressed concern about the increasing demand for older adult diagnoses of autism and the need for national lobbying. It was explained that while the council would apply Care Act eligibility criteria, preventative work and advice would be offered. The team would see an increase in assessments and potential care provision for those with more complex needs impacting their well-being.

Councillor Jo Monk asked if the preventative model could be replicated in other areas. It was noted that while prevention is a key focus, there isn't a specific area being targeted for replication beyond the existing work. An update on the adult social care strategy and prevention strategy was anticipated for a future meeting. Councillor Nick Price asked about the strategic vision for building on this work over the next 12-24 months and priorities for prevention. Councillor Mel Allcott stated that prevention is a key priority across the directorate, but financial pressures make it more difficult.

Performance and 2025/26 Draft Year-End Budget Monitoring

Katie Stallard presented the performance and budget monitoring report. She highlighted a mixed but stable performance, with strong outcomes from reablement services but ongoing pressures in demand, admissions, and workforce capacity.

Admissions to permanent care for 18-64 year olds were rated as red, with a rate of 19.4 per 100,000 against a target of 13.4. This position reflects ongoing system pressure and delays in legal and contractual processes. Councillor Tor Pingree questioned the effectiveness of measures to keep people out of care, noting that the target had been consistently missed. It was explained that the target was self-imposed and that national trends show increasing demand for this age group. The council is exploring new approaches and hopes to see a downward trend in admissions.

Admissions to permanent care for 65+ were rated as green at 643.1 per 100,000 against a target of 645.9, but an upward trend was noted as a concern. Councillor Dave Edmonds requested more emphasis on forward-looking plans and mitigation strategies. Mark Fitton, Strategic Director for Adults & Communities, confirmed that plans are being developed for 2026/27, including anticipating the impact of a Supreme Court judgment on deprivation of liberty safeguards.

Outcomes of short-term services (reablement) were rated as green at 85.97% against a target of 84%, indicating strong performance. However, data for People at home following rehabilitation (aged 65+) was unavailable due to issues accessing hospital episode statistics. Annual care package reviews were rated as red at 80.9% against a target of 95%. It was explained that the 95% target is a statutory requirement, and while performance is improving and regionally strong, it is challenging to meet due to high demand and workforce pressures. Councillor Andrew Cross inquired about the rationale behind the high target, and it was explained that it reflects the statutory requirement for annual reviews under the Care Act 2014.

Richard Stocks presented the draft year-end budget monitoring for 2025/26. The council achieved a break-even position overall but used £15.5 million of reserves and £33.6 million of exceptional financial support. Overspends were noted in adult social care (£17.6 million) and children's social care, driven by increased demand and placement costs. Savings targets of £12.5 million were met.

The high-needs block had an overspend of £82.6 million, resulting in a cumulative deficit of £180.8 million. A SEND plan has been submitted, which, if successful, could reduce this deficit significantly. Revenue debt stands at £40.4 million, with the majority relating to adult social care. Reserves decreased from £93.7 million to £75.8 million, with £22 million deemed usable risk reserves.

The capital programme for 2025/26 was £122.9 million, £27 million less than budgeted. Adult social care's £17.6 million overspend was primarily within client-led areas, including residential and nursing care for older people, and supported living for learning disabilities. Increased one-to-one hours and the cost of care for individuals with increasing needs were identified as key drivers.

Councillor Andrew Cross asked about the anticipated shortfall for the next financial period. It was stated that nearly £25 million has been put into the social care budget for 2026/27 to account for recurrent pressures, growth in numbers, and price increases. Councillor Tor Pingree requested a comparison of average unit costs with UK averages, noting that while Worcestershire achieves good value on some packages, it still struggles to meet overall costs. It was confirmed that comparative data is being compiled but comes with a health warning due to variations in service specifications and demographics.

Councillor Jo Monk questioned the reliance on reserves and government support and how financial decisions would protect service quality. Councillor Mel Allcott stated that work is ongoing to reduce reliance on government support and expressed confidence in maintaining quality through transformation and hard work. Councillor Nick Price inquired about lobbying efforts regarding the funding settlement, which was described as nowhere near enough. It was confirmed that lobbying is ongoing but feels deaf ears are being turned.

Work Programme

The panel discussed and agreed on additions to the work programme. Michelle Hulme requested that assurance on the monitoring of the delivery of commissioned services be added, alongside commissioning processes. Andrew Cross proposed a six-month review of the CQC improvement plan delivery and a value for money review of the Adult Neurodiversity Team after its pilot concludes. The panel also noted the impending decision on Local Government Reorganisation (LGR) as a matter to monitor.