The Health and Adult Care Scrutiny Committee met on Monday 14 September 2026 to discuss the Care Quality Commission's (CQC) inspection report on adult social care, improvements to carer support services, and dental service provision across Devon. Key decisions included the approval of an improvement plan for adult social care, a new approach to supporting unpaid carers, and a discussion on the challenges and future of NHS dental services.

Integrated Adult Social Care and CQC Inspection Report and Improvement Plan

The committee reviewed the Care Quality Commission's (CQC) report on adult social care, which rated Devon County Council as Requires Improvement overall, with a score of 62%. While this was acknowledged as disappointing, officers highlighted that the rating was only one point below a Good rating and that significant progress had been made. The report recognised strengths in person-centred practice, partnership working, and leadership, with a positive culture of continuous learning. Areas identified for continued focus included the timeliness of assessments and reviews, financial assessments, safeguarding waiting lists, Deprivation of Liberty Safeguards (DoLS) backlogs, support for unpaid carers, and the sufficiency of local provision in specialist and rural markets. An improvement plan, which will be presented to Cabinet on 14 October, has been developed to address these areas. The committee discussed how it would be updated on progress and involved in future inspection preparations.

Securing Improved Outcomes for Carers

A new approach to supporting unpaid carers in Devon was discussed, which involves bringing carers' assessments and reviews in-house and establishing a Carer Wellbeing Alliance led by the voluntary, community, and social enterprise (VCSE) sector. This change is necessitated by the expiry of the current carers' contract. The new model aims to improve outcomes for carers by strengthening accountability, enhancing quality assurance, and providing more flexible, community-based support. The existing annual funding of approximately £2.6 million will be maintained, with a greater proportion directed towards frontline support. The transition is planned to be operational from 1 October 2026. Concerns were raised about the consultation process with carers and the evidence demonstrating that the new model will improve outcomes. Officers assured the committee that co-production with carers would be central to the redesign of services and that continuity of support would be maintained during the transition. A 100-day update on the implementation progress was requested.

NHS Devon ICB Dental Services Update

The committee received an update on NHS dental services in Devon, highlighting national contract reforms aimed at improving access to urgent and unscheduled care. Locally, Devon holds 167 NHS dental contracts, and providers delivered 84% of the planned activity target for 2025/26, with a 5% increase in urgent dental care activity. Challenges remain in patient access, particularly for vulnerable groups, and workforce recruitment and retention is identified as the most significant barrier. The report noted an atypical in-area student profile for Peninsula Dental School, with fewer local graduates staying in Devon. The committee discussed the need for a map showing the location of dental services, particularly in rural areas, and requested data on children without access to dentists and the barriers preventing engagement with NHS dentistry. There was a strong emphasis on the need for a strategic, coordinated approach to workforce planning across the public sector, not just within dentistry, and a recommendation was made for this to be discussed at a full council meeting. The committee also requested an update on performance against the ICB's joint forward plan commitments.

Let's Talk Neighbourhood Health – Communications and Engagement Programme

John Groom, Place Director for North and East Devon for NHS Devon, introduced the Let's Talk Neighbourhood Health communications and engagement programme. This initiative aims to gather public views on developing joined-up health and care services within local communities, focusing on keeping people healthier for longer, increasing access to care closer to home, and reducing hospital admissions. Residents are encouraged to participate through surveys, local events, and feedback groups. The programme is supported by VCSE organisations and aims to ensure a diverse range of opinions shape the future of health and care services in Devon.

Standing Overview Group: Adults Transformation Programme

The committee received an update on the Living Well in Devon (LWID) programme, which aims to modernise adult social care and deliver financial savings through an invest-to-save approach. The programme has progressed through its diagnostic phase and into implementation, with reported improvements in service delivery and staff morale. The Standing Overview Group, which monitors the programme, requested stronger performance evidence, including validated key performance indicators and financial benefits. The importance of incorporating lived experience into the programme's design and delivery was also emphasised. The group will continue to provide oversight of the programme, focusing on performance, outcomes, financial benefits, governance, and assurance.

Health and Adult Care General Update

This report provided a general update on various matters, including the national Big Conversation on Care reform initiative, which invites public views on the future of adult social care. It also detailed progress on the Living Well in Devon programme, highlighting increased reablement activity and reduced hospital admissions. A quarterly performance report was presented, outlining Integrated Adult Social Care priorities and performance data. The Public Health update included information on the improper disposal of vapes and the ongoing efforts to complete a dental epidemiology survey. Updates were also provided on NHS Devon's chief executive appointment, the new cluster executive team, and the ICB's financial performance.

Quarterly Performance Report Update

This report provided a snapshot of Integrated Adult Social Care priorities for 2025-26, focusing on working with people, providing support, ensuring safety, and leadership. It included data on client demographics, front door contacts, Care Act assessments, reviews, financial assessments, and safeguarding referrals. The report highlighted that while some areas, such as financial assessments, have seen improvements in waiting times, Care Act assessment waiting lists remain higher than desired due to increased demand and capacity constraints. The report also noted that people from other ethnic backgrounds are under-represented among adult social care clients in Devon.

The meeting also included public participation from Linda Hughes and Jo Earlham, who shared their experiences as carers and raised concerns about the impact of council budget decisions on the quality of care.