The Adults and Health Select Committee met on Thursday 1 October 2026 to discuss performance assurance, safeguarding, and the impact of local government reorganisation. Key discussions included a request for the Directorate to report performance separately for East and West Surrey to identify emerging issues promptly, and to report on recruitment activity and its budgetary impact when resource capacity is a factor affecting performance.

Performance Assurance and Monitoring

The committee reviewed the Q1 2026/27 Performance Assurance Report, which highlighted that most indicators were rated green, but one, the percentage of Adult Social Care Stage 1 complaints responded to within the council's internal target of 20 working days, was rated red. While statutory timescales were met, the committee sought assurance that the causes of the missed internal target were understood and addressed. Clare Edgar, Executive Director for Adults Wellbeing and Health Partnerships, explained that high demand, partly due to the increased length of complaints generated by AI tools, was a significant factor. She also noted the impact of local government reorganisation (LGR) on staff capacity.

Several other indicators were rated amber, including the percentage of residential and nursing care placements sourced within acceptable timescales, the percentage of completed safeguarding concerns progressing to a Section 42 enquiry, the percentage of people assessed or reviewed within the last 12 months, the percentage of Section 42 enquiries where an identified risk was reduced or removed, and the percentage of people receiving support from Communities Targeted Support services who reduce their use of crisis or statutory services.

Councillor Angela Goodwin expressed concerns about the reliance on AI for complaint handling, suggesting a return to more basic, user-friendly online forms. Councillor Sinead Mooney, Cabinet Member for Adult Social Care and Deputy Leader, highlighted that LGR was a significant factor in increased resident queries, as people sought to resolve issues before the new authorities went live. Ernest Mallett MBE raised concerns about a vulnerable individual not receiving adequate care visits and significant payment arrears, prompting an offer of support from Paul Richards, Director of Living and Ageing Well.

The committee also discussed the amber rating for the percentage of people assessed or reviewed within the last 12 months. While the overall volume of assessments and reviews had increased, the percentage within the 12-month timeframe had declined. Councillor Goodwin requested figures rather than just percentages to provide a clearer understanding of the scale of the issue. The Executive Director for Adults Wellbeing and Health Partnerships provided data showing a significant increase in the number of reviews conducted, despite the percentage not yet meeting the target.

Assessing Needs and Safeguarding

The committee received an update on improvements made following the Care Quality Commission (CQC) inspection of Adult Social Care in November 2024, which rated the service as 'Good' overall but highlighted areas for improvement in assessing needs and safeguarding.

Significant changes have been implemented in safeguarding, including the disbanding of previous MASH arrangements and the creation of Connect to Community teams. Revised safeguarding processes aim to provide greater clarity and accountability, with new e-learning resources shared with partners. Dedicated training for managers has been provided to strengthen understanding of safeguarding responsibilities.

Councillor Robert Evans OBE raised concerns about the timeliness of completing safeguarding procedures and the ongoing monitoring of staff skills. Sharon Turner, Assistant Director for Safeguarding and Quality, explained the development of new safeguarding policies and procedures, a new safeguarding training programme, and a revised audit process. She also detailed the robust recruitment and retention activities within the Adults Wellbeing and Health Partnership, noting a relatively stable workforce despite LGR.

The committee also discussed the Deprivation of Liberty Safeguards (DoLS) and the impact of the Agni ruling. Paul Richards, Director of Living and Ageing Well, explained that the ruling suggested some DoLS applications were overly burdensome for low-level restrictions. While the number of applications was expected to drop, the complexity of cases was anticipated to increase. The council has established a task and finish group and a board to ensure compliance, with a focus on triaging high-risk cases.

Carers' Support

A significant portion of the meeting was dedicated to discussing support for unpaid carers. Councillor Angela Goodwin, an unpaid carer herself, shared her experience of feeling judged during assessments and highlighted the need for more personal, conversational approaches rather than solely relying on surveys. Councillor Carla Morson emphasised the vital role of unpaid carers and noted that the Integrated Care Board (ICB) does not make financial contributions to them, with Surrey County Council being the primary support agency. Catherine Newman from Healthwatch Surrey highlighted the Giving Care as a Voice service, which feeds directly into the council's carers team.

The Carers' Wellbeing Break scheme was discussed, with evidence suggesting it is improving carers' experiences and wellbeing, and reaching a broader range of carers, including those in more deprived areas, male carers, younger adult carers, and those from minority ethnic communities. However, a lower uptake among carers over 85 was identified as an area for further focus. Councillor Goodwin also raised concerns about the communication of assessment outcomes and the need for more meaningful conversations.

Recommendations and Future Work Programme

The committee noted the services improvements and challenges within the Performance Assurance Report and the steps taken to strengthen corporate performance assurance arrangements. The committee requested that the Adults, Wellbeing and Health Partnership Directorate begin reporting performance separately for East and West Surrey as soon as practicable to enable any emerging issues to be identified and addressed promptly. It was also recommended that where resource capacity is identified as a factor affecting performance, the Directorate reports on recruitment activity and any resulting impact on the budget. The committee requested that the Adults, Wellbeing and Health Partnership Directorate continuously report on progress in responding to learning from the CQC assessment, with appropriate governance and performance monitoring. The committee also requested to be informed of progress on the East and West reporting. A joint presentation from Adult Social Care, the Police, and Surrey and Borders Partnership NHS Foundation Trust on innovative work supporting vulnerable offenders was requested. Reporting on the implementation of the objectives of The Mental Health Act 2005 for facilities in Surrey was requested. It was recommended that Surrey and Borders Partnership NHS Foundation Trust, in partnership with CNWL, develop a clear plan to transition to health-based places of safety, replacing the prison system, and provide annual updates. It was also recommended that the Trust produce statistics for Surrey on the use of prisons as a place of safety, despite the lack of national data.

The forward work programme included future discussions on the new Front Door Approach, East Surrey Hospital's safety and leadership, a whole system approach to gambling-related harms, and the Surrey Independent Living Schemes. A tentative item was also added to review the Surrey Safeguarding Adults Board Annual Report.