Adult social care strategy 2026 to 2028

In this section we have outlined our strategic commitment to transform Adult Social Care services over the next two years. Implementation of the changes will be managed on the basis on annual service improvement priorities, drawn from these strategic commitments, in line with the council’s medium-term financial plan.

Annual priorities will be determined through rigorous analyses of service and financial performance data and will be subject to discussions within the co-production groups, with the aim of continuously improving outcomes for people and value for money.   

Co-production and personalisation

Co-production is when professionals and interested members of the public work together to co-design and develop solutions and make decisions.

We put people at the heart of adult social care in Lincolnshire. This means listening to what matters to each person and making sure the support available to them reflect their unique needs, strengths, and wishes. We work together with people who draw on care, unpaid carers, and local communities from the very beginning, so everyone has a say in how their support is planned and delivered.

Embedding a culture of co-production, where our teams work in genuine partnership with individuals, unpaid carers, and communities, is essential to making personalisation a reality. Key principles that guide all adult care practitioners in Lincolnshire, in every conversation and every interaction we have with people, include:

• making sure the person is at the centre of everything we do. The conversations that staff have with people are interventions in themselves
• always focusing on building on people’s strengths and what they want to achieve to live a good life - a strength–based approach
• always ensuring people are supported to have as much choice and control over their support as possible
• giving good information, advice and access to support, so people can benefit fully from self-directed care and support
• ensuring a personalised approach supports the person to make the best use of the support available and working to create new opportunities, where there are unmet needs

In Lincolnshire, we have developed co-production as a way of working that involves people who draw on care and support, unpaid carers, and the wider communities as equal partners with the Council, and which engages people at the earliest stages of service design, development, and evaluation. People with lived experience are often best placed to advise on what support and services will make a positive difference to their lives.

The Better Lives Lincolnshire Strategy has been co-produced and in July 2024 launched ‘Our Shared Agreement’, which explains what the best wellbeing, care and health for Lincolnshire looks like. It describes a new relationship and the roles providers of health, care, and the local population play in this.

Our shared agreement for co-production: the five foundations

• are open to change and acknowledge that it will take time
• have patience, and learn by doing
• have and give permission to do things differently

• offer a safe and non-judgemental environment for you to be open and honest, and to be ourselves
• embrace and value differences and implement this in a person-centred way
• make no decisions about you without you

• walk alongside you instead of leading you by asking people, carers and all involved in the care, what the goals are and how we will achieve them together
• see the well-being of staff as equally important

• recognise the importance of active listening and having time to make choices
• do what we say we will do in an environment of openness and honesty
• offer information, knowledge and skills

• are honest about what is and isn't available
• recognise our own strengths and opportunities
• recognise support starts with the individual, family and community
• actively support communities to best manage their health and wellbeing

These foundations promote a culture and environment in which co-production can thrive. All ICS partners, including the council, are committed to this agreement.

To ensure the co-production group represents the authentic voice of a cross-section of the communities connected to adult social care, we refresh the group of people who contribute by regular invitations to different cohorts of people, and we work in small groups to facilitate discussion. Safeguarding people is of paramount importance in all co-production work. All staff working with people who draw on care and support, and with their carers, are subject to Disclosure and Barring Service (DBS) screening by the employing organisations.

Strategic goals

• develop and support co-production groups to facilitate the development of a wide set of underpinning plans and ongoing service developments, as part of an annual forward work plan
• ensuring everyone can make informed decisions about their care and put individuals at the heart of all decisions
• provide clear information and guidance to help people direct their own care, and tailor care plans to reflect each person's unique talents, preferences, and needs
• make support planning more creative and flexible, focusing on what people want to achieve
• enable people to explore their own social networks to draw on informal support that can work together with statutory support, so that care remains personalised, responsive to changing circumstances and effective
• involve people who draw on support and carers in decision-making processes, ensure all interactions and care plans uphold these values, and support individuals in progressing towards their personal goals and aspirations

Prevention, early action and support (EAAS)

The term ‘prevention’ can have different meanings, depending on the issue being considered and the population cohort being addressed. In health and social care terms, prevention efforts are organised in three main categories: primary, secondary and tertiary.

Definition of primary, secondary and tertiary prevention

• primary prevention: generally healthy population - preventing people from getting sick by managing risk factors
• secondary prevention: at-risk population - early identification and treatment of conditions by identifying and screening at-risk people
• tertiary prevention: people with a health condition - supporting people with conditions to live a good life through rehabilitation and preventing complications

People who draw on care and support have access to all three types of prevention support, as they may require support in several areas. We acknowledge that some people who draw on care and support feel the term ‘prevention’ can have negative connotations.  In the context of this strategy and in the lives of people who experience health and social care services, the Co-production Group offer an alternative term, “Early Action And Support (EAAS)”, which shifts attention away from “preventing problems and costs” (which is a service-centred concept), to one that focuses attention on a positive, compassionate and proactive approach to promoting and enabling people to lead independent lives by addressing the barriers.

Social Care professionals are focused on enhancing EAAS services to enable people to live healthy and independent lives, and in so doing, we aim to slow the growing demand for adult social and health care. Existing initiatives, including the Wellbeing Service, and carer support, are being further developed to ensure efficiency and effectiveness, while maintaining financial sustainability. Empowering our population to lead healthier lives is crucial for enhancing wellbeing and creating a sustainable health and care system.

We are working to strengthen all areas of prevention, by adapting public health initiatives and applying them to people with complex needs. We aim to offer reablement support to adults of all age groups in the community and not just for people being discharged from hospitals.

Strategic goals

• expand targeted interventions to delay or reduce the need for statutory care, while maximising the use of technology and self-help tools
• strengthen preventative services to improve health outcomes, reduce care costs, and enhance service efficiency
• integrate services more effectively to ensure co-ordinated, cost-effective, and impactful delivery of support

Direct payments (DP)

We have a long history of promoting the use of direct payments, as they provide the maximum level of choice and control. Direct payments are intended to give greater choice in care and support, enabling people to live independently in their own homes and providing greater flexibility regarding how their service is provided and by whom, although there are some restrictions on how direct payments can be used. We must ensure this is advancing greater levels of personalisation of care.

To achieve this, we will:

• monitor progress and produce a report which highlights progress and areas for development
• collaborate with people with lived experience of using a direct payment to understand their experiences
• develop our intelligence on what types of support direct payments are being used for, how effectively they are being used and how they are being used to maximise personalisation of social care and support
• offer support to practitioners to be creative and maximise their potential to innovate
• recognise and celebrate creative practice in use of direct payments

Alongside the legislative requirements, local evidence, and available best practice guidance, we use the ‘Think Local Act Personal’ Framework to guide the development of Direct Payments delivery.

Strategic goals

• reduce the time taken to access direct payments
• increase transparency and efficiency in budget management
• increase positive experiences for people using direct payment
• increase the examples of positive, real-life experiences
• refine services based on people’s insights and experiences

Digital technologies

Rapid developments in digital technologies are transforming the world and all our lives, however the benefits are not spread uniformly across the population. Many people who draw on social care support experience barriers to accessing life enhancing technologies. We know digital exclusion can reduce people’s quality of life and increase living costs for those least able to afford it, with people who are digitally excluded being estimated as £500 worse off per year (Left Out: How to tackle digital exclusion and reduce the poverty premium).

We have championed the take up of digital technologies through establishing a digital strategy, which can be found on our SharePoint. We are using data to understand where people are most at risk of digital exclusion. The Lincolnshire Digital Health toolkit helps commissioners and planners of health and care services to understand the risk of digital exclusion across the county, as well as the reasons for it (Lincolnshire Digital Health Toolkit - Lincolnshire Health Intelligence Hub). We promote and support access to digital and technology solutions through the following approaches:

Digital-by-design

We recognise that digital influences how we work. We will utilise digital approaches and adapt our services to enable customers to interact with us in a modern and efficient manner.

Digital working

We are flexible and dynamic in the way that we work; individually, amongst ourselves and with partners - our time is focused on activities that add the most value to our residents.

Digital capabilities

We have the core innovation, technical and delivery capabilities required to realise our digital ambitions, and our employees have the digital skills they need to thrive in the modern workplace.

Data-driven digital

We use data intelligently, analytically, and safely to drive how we deliver services and improve customer experience.

We focus on what digital technologies mean to people who draw on social care support and the care workforce.  Our aim is to use digital support to improve the experience of both groups of people. Central to this is the ability to access and use digital and technology solutions effectively.

People who draw on social care and support

We will:

• use digital solutions to empower people to maintain their own independence, manage their care and support needs, and interact with the council and care services in a way that is convenient and effective for them
• offer self-serve, self-management and digital solutions as a choice, allowing people who want and are able, to access services digitally. Technology will help maximise people’s independence

Our workforce

We will use digital to support the care workforce to always deliver high quality care, as part of a network of professionals who can:

• communicate easily with each other 
• have access to people's records and care plans at the right time
• be supported by the best decision support and monitoring tools
• undertake administrative tasks such as record keeping, more efficiently

NHS England’s Digitising Social Care Records programme was designed to jump start investment and interest in care providers taking up digital solutions to manage their care business. In Lincolnshire, the programme led by the council ensured 153 providers benefitted from £800,000 in grants: Digitising social care fund - Digitising Social Care - NHS Transformation Directorate.  

Strategic goals:

• develop a greater understanding of the digitally excluded
• provide advice and support on where people can access their own solutions
• introduce and promote self-service tools that help people get to what they need.  This will include self-service, technology and social care solutions
• develop and expand Technology enabled prevention and care (TEPaC) solutions available for people with care and support needs
• work will now continue with our care providers to make the best use of their digital assets, which include:
  • work with Lincolnshire Care Association (LinCA) on provider Digital Health checks
  • increase the use of digital care records sharing between statutory organisations and care providers
  • evaluate efficiencies created by using digitised systems
  • explore how digital solutions can help us move towards a more proactive care model

Partnership working

Lincolnshire has a long history of joint working between the council, the NHS, and wider partners. We have worked hard to build the relationships needed to support the people of Lincolnshire.

We will continue to:

• deliver the priorities in the JHWS and the strategic enablers in the ICP Strategy 
• work with partners to jointly plan a neighbourhood health and wellbeing service for local populations to meet the government’s commitment of providing more care closer to home, increasing the focus on prevention so that people are living healthier and more independent lives, and harnessing digital technology to transform care
• review and strengthen initiatives that help people manage their complex health needs at home and avoid hospital admission through the Better Care Fund objectives and priorities

Strategic goals

As part of the Lincolnshire Integrated Care System, we are working on our shared ambition underpinned by four strategic goals for the health and care system in Lincolnshire, which are to: 

• deliver enhanced on prevention and early intervention
• tackle inequalities and equity of service provision to meet population needs
• deliver transformational change to improve health and wellbeing
• take collective action on health and wellbeing across a range of organisations

Professional practice

‘Professional practice’ describes the planning and active engagement with people that help co-create the outcomes they want to achieve, in line with the vision of Social Care Futures: “For everyone to live in a place they call home, with the people and things they love, in communities where they look out for one another, doing the things that matter to them.”   

This approach empowers staff to focus on improving wellbeing outcomes for people in line with our professional duties and standards of practice. It empowers individuals to live in their chosen homes, surrounded by their loved ones, and within supportive communities.

We will maintain professional standards and ensure strong community links through collaborating across service areas and working with community organisations, tailoring services to individual needs, and working in person-centred and strengths-based ways, to ensure services are inclusive and empowering, so everyone can lead fulfilling lives regardless of their circumstances. 

All professionals use a strengths-based approach to engage with people to promote dignity and respect. This includes providing information, advice, and guidance; taking early action and offering timely support; and delivering proportionate assessments, support plans, and reviews as required.  

Strategic goals

• ensure consistent quality standards and practices across all areas, resulting in improved service delivery, communication and accountability via continuous monitoring and auditing
• ensure individuals regain independence and confidence in daily activities
• provide tailored training programmes that enhance staff skills and competencies, leading to better service provision and job satisfaction
• identify and implement the best practice protocol and standards for trusted reviews, leading to more timely and reliable re-assessments and proportionate support plans to aid independence