Adult social care strategy 2026 to 2028

Strategic commissioning

Commissioning is the continuous cycle of identifying needs, prioritising, specifying outcomes to be achieved, planning, procuring and contracting for services to meet the needs, monitoring delivery and reviewing. This is a strategic action that requires us to look forward and predict future service requirements and more specifically the outcomes people are expecting to achieve.

Our commissioning activities are informed by a broad range of intelligence, including, the Joint Strategic Needs Assessment (JSNA), Market Analysis and Position Statement, feedback via our engagement and co-production networks, performance and contract management, findings from our Quality Assurance activities, and identified strategic risks, as well as national policy and guidance, and local political decision making.  

The service has access to intelligence capabilities through the ICS Joint Intelligence Dataset, and other evaluation tools, as well as projections modelling facilities. We are working to ensure we:

• commission effective, inclusive and sustainable adult social care services that enhance the quality of life, promote independence, and ensure the safety and wellbeing of individuals, while delivering value for money, maximising resources, and fostering collaboration amongst stakeholders
• enable successful joint commissioning and efficiency gained through strong collaboration and co-ordination with partners, reducing duplication and delivering integrated, person-centred care that meets needs effectively. This is underpinned by system-wide leadership, oversight and robust relationships to drive strategic alignment and collective impact
• maintain strong collaboration with the market to maximise opportunities and ensure the availability of suitable, viable and sustainable services that meet diverse needs

Success will be showcased through demonstrating value for money and meeting emerging needs, and building on our commissioning confidence. We will use our shared data analytical capabilities to improve how we plan, develop, and evaluate services to improve outcomes for our population. We will outline our intentions, set out the evidence that underpins our approach, including the data and findings from engagement, and set out our key milestones.

Strategic goals

• deliver coordinated, outcome-focused commissioning across adult social care
• deliver successful joint commissioning through strong collaboration and co-ordination with partners, reducing duplication and delivering integrated, person-centered care that meets needs effectively
• collaboration with the market to maximise opportunities and ensure the availability of suitable, viable, and sustainable services that meet diverse needs
• evaluate the impact of our services on people who draw on care and support to find opportunities for continuous improvement
• develop opportunities for creative care & support that builds on people’s strengths and utilises our community assets by engaging people with lived experience in decision-making, involving them in shaping the priorities and outcomes

Workforce development

Central to the services we deliver are our staff, whether employed directly by the council or by external providers, and the passion, expertise and commitment with which they carry out their professional duties. Our staff are hugely motivated to make a difference and have a positive impact on people’s lives and our local communities.

There are approximately 25,000 social care posts across the sector. Of these, around 22,500 posts are currently filled. The total number of posts has increased by 4 per cent, representing an increase of 850 posts. There are approximately 2,200 vacancies across the sector. The number of vacancies has decreased by 4 per cent, equating to a reduction of 75 vacancies.

Social care is delivered across 414 CQC‑regulated settings, including 293 residential care services and 121 community support services. Most filled posts are within independent sector providers, accounting for 89 per cent of the workforce. A further 3 per cent of filled posts are within other sectors, 3 per cent are within the local authority, and 5 per cent are roles working directly for people using direct payments.

The average age of the workforce is 45 years. Around 30 per cent of workers are aged 55 and over, while 9 per cent are aged under 25. Women make up approximately 82 per cent of the workforce in Lincolnshire. Looking ahead, around 6,200 posts are expected to reach retirement age within the next 10 years.

Our workforce strategy sets out our ambitions for social care staff and is informed by regular staff surveys, data and intelligence, learning and feedback.   In collaboration with the ICB, Lincolnshire Care Association, and Skills for Care’s Governance toolkit delegated healthcare activities, we have developed a workforce plan, “Bridging the Gap”,  that focuses on the wider social care staff employed by the sector.  We acknowledge, and seek to address, workforce risks, as well as seize the many opportunities presented. We outline career pathways and opportunities that enable all staff to learn, grow and fulfil their full potential. We recognise staff individual skills, achievements and developments that help improve care and thereby enhance the outcomes for the people we serve.

These strategic plans set out our central focus on recruiting and retaining, developing and training our staff across all service functions, based on regular training needs analysis.  We are consolidating various workforce development initiatives, including apprenticeships, to build a skilled and resilient workforce.  We are working to develop an environment and working conditions that promote growth, good work and life balance, equity and opportunity for all, that empower our workforce to thrive and innovate.

Strategic goals

• ensure practitioners are skilled and capable through Training Needs Analysis and succession planning and providing learning and development opportunities
• support staff growth and development throughout their careers, including Continuous Professional Development (CPD) and student placements
• offer leadership, influence, and challenge to practitioners, practice leaders, commissioners, senior managers, and partners to deliver excellence in care
• learn from local and national best practices, implementing practice frameworks and approaches across the service and partner agencies, nurturing a culture of continuous improvement, learning, innovation and celebration of excellent practice
• work closely with operational colleagues across organisations to test different practice models and embed quality standards in practice
• provide a quality assurance function to the Adult Care and Community Wellbeing directorate, ensuring services are safe, effective, and positively experienced by people

Accommodation

Most people who draw on care and support live independently in their own homes, drawing on a mix of informal oversight from their families, friends, social network and formal care. For a small number of people, this option may not be safe, and the council has a duty to provide care and support that includes suitable accommodation.

Given the size of the county and its sparsely populated rural communities, accommodation must be provided in the right place, of the right type, tenure and size, to offer people choice to maintain family life and social relationships. This includes appropriate levels of support, particularly when people with complex needs are discharged from hospital and it is not in their best interest to receive care and support at home.  Individuals may require accommodation solutions, to meet specific needs, arising from conditions such as stroke, physical disability, sensory impairments, dementia, severe and enduring mental illness, learning disability and many other conditions.

The Council contracts with more than 340 residential homes and over 40 Extra Care & Community Supported Living providers, offering various care types. We aim to support an innovative, diverse, and sustainable market to meet residents' social care-related accommodation needs.

Strategic goals

• develop an accommodation commissioning plan that will outline how the council delivers the optimum balance of accommodation options for people to maximise best value while also maintaining or increasing people's independence, with the overall aim of achieving a proportionate reduction in use of residential and nursing care
• develop a clear family support offer: that will help to maximise the number of people living independently or with family and friends
• secure strategic partners to develop community supported living and extra care capacity
• identify opportunities to deliver accommodation services at better value for money through the Better Lives and commissioning programmes

Adult safeguarding

Local authorities under the Care Act 2014 have a legal duty to take lead responsibility for safeguarding adults with care and support needs, in partnership with other agencies. The Lincolnshire Safeguarding Adults Board (LSAB) has developed a strategic plan Strategic Plan – LSAB, outlining how it works to prevent abuse and neglect and to protect individuals with care and support needs who may be at risk. All LSAB partners abide by the principles of the Care Act.

• empowerment - people are supported and encouraged to make their own decision and informed consent
• prevention - it’s better to take action before harm occurs
• proportionality - Aim for the least intrusive response that is appropriate to the risk presented
• protection - Provide support and protection for those in greatest need
• partnership - Services should work with their communities to provide local solutions
• accountability - Practices in safeguarding adults should be accountable and transparent

The LSAB priorities are reviewed annually, with a focus on key actions aimed at improving the outcomes of people who are subject to adult safeguarding measures as below:

• making safeguarding personal – ensuring safeguarding work is centred on the individual, supporting choice, control and outcomes that matter to the person
• learning and shaping future practice – using learning from safeguarding activity, reviews and feedback to improve professional practice and system responses
• safeguarding effectiveness – strengthening how safeguarding arrangements operate to ensure timely, proportionate and effective responses

We are committed to seeking to avoid safeguarding concerns from arising in the first place, by practising proportionate risk management and intervening as early as possible. Making Safeguarding Personal (MSP) is central to all safeguarding work and requires services to support and empower each adult to make choices and have control over how they want to live their own life. 

We ensure safeguarding practices are maintained at a high standard through regular training and professional development support. Effective safeguarding requires a co-ordinated approach where all stakeholders, including statutory organisations and voluntary sector groups, work collaboratively to ensure practices are truly person-centred.

The intention is to develop a system where safeguarding enquiries will take place within front line services, in localities and, where possible, are undertaken by practitioners who may be involved the care and support of the individual to ensure continuity and reduce duplication. We monitor and measure safeguarding performance and report to the LSAB.

Strategic goals

• ensure that safeguarding identification and triaging is carried out as early as possible at the to help prevent many more concerns escalating and reducing the risk of harm to the individual rapidly
• maintain focus on early intervention, making safeguarding personal, Learning and development, effectiveness
• additional focus areas being addressed in the safeguarding strategic plan include:
  • homelessness and rough sleeping
  • exploitation
  • improved application of the Mental Capacity Act
  • transitional safeguarding
• review the safeguarding strategic plan, we will also work to strengthen project management, governance and accountability

Hospital discharge and intermediate care planning

We work collaboratively with primary care, community health and voluntary services to identify people whose health and care needs are escalating, and we act quickly to support them to seek early help to remain at home and where possible to avoid a hospital admission altogether. This is not always possible, and emergency medical admissions will sometimes rise. We know that when people’s hospital treatment is long and protracted, they are at greater risk of losing their independence.

Our dedicated Hospital Discharge Team facilitates discharges of people with complex needs, following completion of their acute medical treatment and supports them to move to the environment best suited to meet any ongoing health and care needs. This can range from going home with little or no additional care, to a short-term package of care and recovery support in the community, with assessment of any longer-term care needs to follow from there.  Whether at home or in a community setting, people are discharged to the best place for them to continue their recovery in a safe, appropriate and timely manner.

Timeliness of discharge is critical to people’s recovery. We therefore use the discharge to assess model and home first approach. This is based on evidence that the most effective way to support people is to ensure they are discharged safely when they are clinically ready, with appropriate recovery support if needed. Our teams work alongside the person being discharged, their carer or family where relevant, to plan the person’s discharge. The service works as part of multidisciplinary discharge teams, comprising professionals from all relevant services, including health, social care, housing, and the voluntary and community sector.

Strategic goals

• support people with complex needs living at home to regain independence and confidence in daily activities, with the aim of improving overall health and wellbeing of individuals
• deliver holistic and co-ordinated care plans tailored to individual needs, with increased efficiency through collaborative delivery, and enabling improved health outcomes through integrated care
• ensure enhanced community support and resources, leading to increased social inclusion and better mental health for individuals
• continuously improve people’s experience, based on direct feedback and insight from people being discharged, growing a culture strengths-based and responsive care services, as part of an overall intermediate care service plan

Carers

We value our unpaid carers, who provide significant care and support to their loved ones. We recognise the important role carers undertake and how vital their commitment and contribution is. Based on the 2021 Census, there could be as many as 70,387 unpaid carers in Lincolnshire.

Carers are recognised as equal partners in care by the council. The Lincolnshire Carers Service, commissioned by the Council and delivered in partnership with Carers First and the Care & Wellbeing Hub, offers a comprehensive support model. This includes strengths-based carer conversations, personalised support planning, statutory carers assessments, and access to practical and emotional support. Carers can receive information, advice, and guidance, as well as targeted support for complex needs, bereavement, and transitions such as employment or education. The service also provides emergency planning, hospital-in-reach, and benefits advice, with a single point of access available Monday to Friday. Digital resources and peer networks are available via Connect to Support Lincolnshire and Carers First. For more information or to request support, carers can visit our carers page.

By enhancing access to information and ensuring carers are involved in decisions about the care they provide, the service promotes greater autonomy and resilience, particularly amongst older and young carers aged 16+. The service works closely with the Council’s Young Carers Service, who help young carers balance their caring responsibilities with education and personal development.

Employment and workforce support initiatives, such as Carers Passports, staff carer networks, and employer training, are being developed to help carers maintain employment while managing their caring responsibilities. Digital solutions are also expanding, with self-help tools, digital literacy initiatives and the integration of technology-enabled care playing a crucial role in improving accessibility. A whole family approach is being implemented, to provide targeted support for those in vulnerable communities in establishing effective contingencies where carers’ support may be at risk of breaking down. These initiatives aim to create a comprehensive support system that meets the diverse needs of unpaid carers.

Strategic goals

• embed carers’ needs and priorities into the local health and wellbeing arena, to ensure that carers continue to be recognised and supported across the system at the earliest point possible
•  strengthen joint working and service integration to provide a seamless experience for carers accessing support
• implement best practices and leveraging digital resources, the service aims to enhance its effectiveness and reach
• target interventions for young carers and vulnerable communities will help ensure that those most in need receive appropriate and timely support

Preparing for adulthood

For young people, preparing for adulthood should be a very positive time, looking forward to greater freedom, new experiences and opportunities. Our vision is that every young person in Lincolnshire should have the best opportunities to grow up with confidence. This period, however, may also present challenges to young people with complex needs and who may not have a good social network, support and resources.  This can cause anxiety and stress to both the young person and their families and carers.

In collaboration with young people, families, carers, children’s services and partner organisations, we are developing a strategic guide to preparing for adulthood that will draw on the learning from our CQC inspections and our recent Transitions Peer Review. This will help enhance the preparing for adulthood experience of all involved. We intend this process to be seamless, supportive, and person-centred, empowering young people and their families with the necessary information advice, guidance and support opportunities they require for a successful future.

Lincolnshire preparing for adulthood process

1. identification of young person
2. completion of passport to adulthood
3. submission to transition inbox
4. information and support for families (ages 16 to 17)
5. monthly meetings for other needs
6. weekly review by service area managers
7. transition assessment at age 17
8. determination of needs
9. concluding the transition to adult social care

Strategic goals

• strengthen our collaboration with Children's teams, fostering closer joint working relationships
• actively engage in co-production opportunities to ensure the Preparing for Adulthood offer aligns with the outcomes of young people and their families
• adopt a unified, strengths-based approach, emphasising relationship-based practice to build strong connections with young people and their families, manage expectations and foster greater engagement and co-operation
• focus on early planning, co-ordination and engagement to ensure timely, tailored support, to minimise gaps in care and mobilise services and resources efficiently, providing each young person with the right level of support at the time they need it
• proactively identify any resource gaps that may hinder young people's transition to adulthood, ensuring appropriate accommodation, resources, and employment opportunities are in place, along with meaningful engagement options

Quality Assurance Framework

Our Quality Assurance (QA) Framework outlines the purpose, processes and cycle of activities we undertake to test the quality of professional practice and services, aimed at delivering the best outcomes possible.  We are committed to ensuring that Lincolnshire residents who draw on care and support services have the best experience possible.

Our Quality Assurance process seeks to test our standards of service delivery, and complements our Adult Social Care Practice Framework, which provides the model for our strengths-based approach, the objectives of which are to:

• achieve quality standards across adult care services
• achieve consistency in monitoring and evaluating the quality of service provided
• implement clear and robust governance and oversight for quality assurance
• identify and celebrate good practice and success
• take action to support quality improvements
• promote an ongoing growth and learning culture across the whole organisation
• understand and measure outcomes and impact

Quality Assurance is everybody’s responsibility and relies on ownership at all levels. The data from audits and monitoring are used to support strategic decision making and enable a high challenge, high support culture which listens and learns from people with lived experiences and the expertise of the people who work in our service. Our QA approach is illustrated by the core elements of the framework and the governance board.    

The QA Framework

Practice - we will embed a strengths-based approach to ensure we keep the individual at the heart of what we do, to support them to make the best life choices.

Meaningful measures - we will ensure decision making is driven by a dynamic evidence base that helps us to better understand outcomes for the people we support, variation in our services and challenges why we do things.

Innovation - we embrace change with an open mindset and invest in developing a learning culture, continually seeking ways to improve how we work.

The QA Governance is underpinned by:

• learning from feedback from people we support, families and carers
• learning from feedback from staff, partners and communities
• thematic reviews
• internal reviews
• use of performance data
• practice reviews

Strategic goals

• continue to engage all staff in understanding that quality is everyone's responsibility, supporting continuous improvement
• create consistent feedback mechanisms involving all stakeholders to drive improvements based on experiences
• implement robust reporting systems with structured cycles and exception reporting to focus on areas needing immediate action
• strengthen control measures and data gathering to inform decision making and drive ongoing improvements