The Adult Social Care and Public Health Cabinet Committee met on Wednesday, 11 March 2026, to discuss a range of critical issues affecting the provision of care and support services across Kent. Key decisions were made regarding the future of all-age homecare services, with a significant contract to be re-procured. The committee also reviewed performance dashboards for both adult social care and public health services, alongside a comprehensive risk management report.

All-Age Homecare Services Re-procurement

A major decision was made to approve the commissioning of a new Open Framework for an All-Age Homecare Service, which will encompass homecare for adults, care and support within prisons, and community support services for disabled children. This new framework, compliant with the Procurement Act 2023, will span eight years, with opportunities for new providers to join at intervals. The existing contracts for these services are set to expire in March and June 2027, necessitating this re-procurement to ensure continued high-quality support, improved outcomes for residents, and better value for money. The estimated annual value of the new contract is approximately £89.7 million, with a projected lifetime value of £807 million over eight years. This initiative aims to increase the number of contracted providers, ensuring sufficient capacity across Kent, promoting a diverse and resilient local care market, and enhancing cost control through clearer pricing and strengthened contract management. The decision was endorsed by the Cabinet Member for Adult Social Care and Public Health, Diane Morton, with delegated authority given to the Corporate Director, Adult Social Care and Health, to finalise the contract and manage its implementation.

Adult Social Care Performance Dashboard

The committee received an update on the performance of adult social care services for Quarter 3 of the 2025/2026 financial year. Overall, performance showed a reduction in contacts and repeat contacts, with timeliness of assessments improving. However, applications for Deprivation of Liberty Safeguards (DoLS) continued to exceed completions, and safeguarding concerns remained high. A significant concern highlighted was that the percentage of people supported in residential settings with a 'Good' or 'Outstanding' Care Quality Commission (CQC) rating had moved from Amber to Red, falling below the 75% target. This was attributed to recent CQC inspections resulting in an increased proportion of homes being rated as 'Inadequate' or awaiting inspection outcomes. The report noted that while repeat contacts had reached their lowest level in two years and reablement outcomes were meeting targets, demand-related pressures persisted, particularly concerning DoLS applications and safeguarding enquiries.

Public Health Performance Dashboard

The Public Health commissioned services performance for Quarter 3 (October to December 2025) was also presented. Of the 14 Key Performance Indicators (KPIs), five were rated Green (met or exceeded target), and six were Amber (below target but above the floor standard). Four KPIs were not available at the time of reporting, primarily relating to substance misuse and smoking cessation services, though trends for these were reported as positive. The committee was informed of proposed changes to KPIs for 2026/2027, aimed at focusing attention on priority areas and driving continuous improvement from providers. Notably, the Health Visiting Service had excelled compared to other local authorities in the South East region, performing strongly in the delivery rates for mandated health and wellbeing reviews.

Risk Management Reports

Two risk management reports were presented, one for Adult Social Care and one for Public Health.

Adult Social Care Risks: The Adult Social Care and Health Directorate leads on three corporate risks: the sustainability of the social care market, the risk of failing to deliver effective Adult Social Care Services in line with statutory and regulatory requirements, and the ASCH Recommissioning Programme. The sustainability of the social care market remains a 'High' risk due to sustained structural pressures, including financial and workforce challenges, leading to rising care costs and difficulties in securing adequate provider supply at affordable prices. Mitigating actions include the re-tendering of framework contracts with more robust guide prices and ongoing market monitoring. The risk of failing to deliver effective services is also rated 'High' due to growing demand, workforce challenges, and financial pressures, with mitigations focusing on workforce development, governance, and safeguarding. The ASCH Recommissioning Programme is also a 'High' risk due to the complexity and concurrent delivery of multiple large contracts, with mitigations including enhanced governance and a staggered procurement approach. Within the Directorate's own risk register, the risk of failing to deliver within budget is 'High', with strategies focusing on demand and cost management. Other significant risks include Deprivation of Liberty Safeguards (DoLS), safeguarding adults at risk, adult social care debt, the adult social care workforce, and information asset management.

Public Health Risks: There are currently no Public Health-led risks on the Corporate Risk Register. However, the Public Health Risk Register identifies eight risks, with two rated as 'High': Health Inequalities and the increased prevalence of mental health conditions. Health inequalities are a significant concern, with analysis showing much worse health outcomes in the most deprived areas of Kent, leading to rising health and social care costs. Mitigating actions include targeted community work and a focus on population health management. The risk of increased mental health conditions, exacerbated by the cost of living crisis and post-pandemic effects, is also rated 'High', with consequences including increased pressure on services and potential rises in suicide rates. Mitigations include the development of a gambling strategy and closer working with partners to embed services within the integrated care strategy. Other identified risks include those related to CBRNE incidents and emergency response, cost pressures on the public health budget, provider selection regimes, difficulties in recruiting and retaining public health nursing staff, and the management of the public health ring-fenced grant.

Neighbourhood Health

A report on Neighbourhood Health was presented, outlining a pilot programme at Folkestone Heights and the redevelopment of the Health and Wellbeing Board. The initiative aims to keep people out of hospital by re-arranging services and focusing on prevention. The model being used in Kent is based on priority groups developed by John Hopkins, with a focus on those requiring the most care. Challenges were noted regarding the potential difficulty in shifting resources from hospitals to community settings, particularly given the NHS's current focus on reducing waiting times. The committee discussed the opportunities for Kent County Council in improving population health and managing financial challenges through this approach.

Work Programme

The committee noted the work programme for 2025/2026, which includes standing items such as verbal updates, performance dashboards, and risk management reports, as well as specific items like the 'Someone's Listening Campaign' and updates on the CQC Improvement Plan. A request was made to include a financial report on the first quarter in a private session for the July meeting.