The Adult Care Services Cabinet Panel convened to discuss key strategies and performance metrics, focusing on enhancing services for older adults, individuals with dementia, and those with physical disabilities. The panel endorsed a proposed five-year care homes commissioning strategy for older people to be sent to the cabinet, and also supported the delivery plan for the dementia strategy, including the introduction of a Dementia Friendly Accreditation Scheme in Hertfordshire. Additionally, the panel reviewed and commented on the physical disability strategy and the adult care services performance monitor.

Care Homes Commissioning Strategy for Older People

The panel endorsed a proposed five-year care homes commissioning strategy for older people to be sent to the cabinet. The strategy addresses several key challenges, including:

• The increasing number of older people with complex needs, such as dementia and frailty.
• Economic and workforce pressures affecting the care market.
• The need to improve outcomes and experiences for older people with dementia.
• Gaps in support for people with non-cognitive symptoms of dementia.
• The need for the council to reduce spending and improve efficiency.

The strategy focuses on four main areas:

1. Commissioning better outcomes for older people with dementia and frailty.
2. Supporting provider partnerships and sustainability.
3. Strategic care estate delivery.
4. Working with integrated care system partners to better support people in care homes.

Councillor Tony Kingsbury raised concerns about achieving the forecast of 800-bed shortfall in Hertfordshire for nursing care by 2032. It was noted that the initial aim is to deliver 300 market beds through areas two and three of the strategy. It was also noted that the council is considering options beyond directly building and leasing care homes, such as public-private partnerships.

Councillor Rachel Carter asked about how the council commissions care homes and how that works with the care market. It was explained that independent providers can establish new care homes if they acquire [Care Quality Commission (CQC)]¹ registration. The council maintains awareness of new care homes and works with providers to offer care to county council-funded individuals.

Councillor Paul Seeby raised a point about men being more likely to be in nursing care because of behaviour. It was explained that while most care home residents are female, there are certain parts of care pathways with larger numbers of men, possibly connected to how the needs of men with advanced dementias are perceived.

Councillor Liz Leadham inquired about provision for people with early-onset dementia. It was acknowledged that current provision in Hertfordshire is insufficient, and some people have had to move out of the area to receive residential nursing care.

Councillor Calvin Horner touched on the economics of care, emphasising the need for affordable places due to increasing needs. It was explained that the council aims to deliver care economically to provide the right quality at the necessary volumes.

Dementia Strategy Delivery Report

The panel showed their support for the dementia strategy delivery plan, including the introduction of a Dementia Friendly Accreditation Scheme in Hertfordshire. The Hertfordshire Dementia Strategy 2023-2028 aims to enhance the county's approach to dementia care, focusing on prevention, timely diagnosis, and support for all affected by dementia.

Alison Spaulding from the Hertfordshire Mental Health and Disabilities and Neurodiversity Health and Care Partnership (MHLDN) presented the dementia strategy delivery report. She noted that diagnosis rates in Hertfordshire are increasing, and the strategy is built around the principles of early identification, treatment, and support. The strategy includes four main work streams: commissioning, community response, health, and young-onset dementia.

Councillor Nigel Bell highlighted the importance of long-term preventative care models and addressing issues of diversity within the county.

Councillor Rachel Carter suggested involving taxi services and shops in the accreditation scheme and inquired about linking with citizens advice for benefits information.

Councillor Tony Kingsbury asked about the key differences between the new Hertfordshire accreditation scheme and the previous national one, and about the success of community support aspects. It was explained that the Hertfordshire scheme is less administratively heavy and more accessible to smaller organisations.

Councillor Paul Seeby expressed support for ensuring safety and addressing scams, and inquired about integrating dementia work with age-friendly initiatives.

Councillor Calvin Horner asked about the role of parish and town councils in promoting the accreditation scheme and improving early diagnosis for young-onset dementia and people with learning disabilities.

Physical Disability Strategy

The panel noted and commented on the contents of the Strategy for Physically Disabled Adults 2025-2030. Laura Gordon, Head of Community Commissioning for Disabled Adults, introduced the strategy, which is Hertfordshire County Council's first adult physical disability strategy. The strategy covers the period 2025 to 2030 and is co-produced with the physical disabilities co-production board. It sets seven system-wide objectives to address physical, social, and environmental barriers that physically disabled people face.

Councillor Liz Needham asked how the number of people in Hertfordshire that are considered disabled is measured. It was explained that the data is based on census responses, where people self-identify as physically disabled.

Councillor Rachel Carter inquired about sharing the strategy with district councils and other relevant bodies. It was agreed that sharing the strategy with district and borough councils would be beneficial, especially in the context of local government reorganisation.

Councillor Tony Kingsbury noted the importance of addressing the needs of people living in rural areas, particularly in terms of public transport, community buildings, and digital contact activities.

Adult Care Services Performance Monitor

The panel reviewed the Adult Care Services Performance Monitor for Quarter 1 of 2025/26. Alex Ogle, Performance and Improvement Manager, presented the report, which included key performance indicators and results from the Adult Social Care Survey 2024-25.

Councillor Tony Kingsbury raised concerns about waiting list numbers and times, which were the highest they had been during the reported period. It was explained that there are interventions in place to support adults and carers while they wait, and the council is actively working to manage the waiting lists.

Councillor Tony Kingsbury also noted the decrease in social interaction among people, despite the easing of Covid-19 restrictions. It was suggested that transport issues in rural areas may be a contributing factor.

Councillor Nigel Bell highlighted that referrals are still 18% above pre-pandemic levels and that assessment wait times are below 28 days.

Councillor Paul Seeby asked how the percentage of new requests coming from the community compares with previous years. It was explained that there has been a slight increase in requests from the community, possibly due to preventative work and efforts to avoid hospital admissions.

Councillor Rachel Carter inquired about how the council works with the community to address loneliness. It was explained that the council supports grassroots organisations and encourages individuals to connect with their families and local opportunities.