Adult social care strategy 2026 to 2028

Foreword

Foreword by the portfolio holder

Welcome to our Adult Social Care strategy for 2026-2028 for Lincolnshire. This two-year strategy sets out our ambitious commitments to improve outcomes for people as well as ensure value for money for the public purse. I recognise that Adult Social Care, in common with all public services, is under significant pressure from rising demand and costs.

Lincolnshire has a growing aging population. Economic inequality due to long-term ill-health is also rising amongst adults of working age. People living in our more deprived communities may face greater barriers to living independently. We also have a growing number of unpaid carers, who provide immense care and support to their loved ones, yet often are themselves aging.  I want to acknowledge and applaud the massive contribution carers, paid and unpaid, make to our county. There is an urgent need to protect and strengthen the community and voluntary sector services who are the custodians of universal support and ultimately of people’s wellbeing.

My ambition is to empower people to lead healthy, independent lives through innovative, person-centred, cost-effective services. I am committed to addressing over-reliance on social care by shifting from risk-averse practices to a strengths-based approach that encourages positive risk taking, avoids or delays the need to access formal care, and focuses on what individuals can achieve with family and community support.

This cultural shift will be challenging, but it will enhance our ability to transform issues such as workforce shortages, financial pressures, and integration gaps from being problems into being opportunities. Enhancing digital innovation, strengthening partnerships, and co-producing strategies with colleagues, NHS partners, voluntary sector bodies, carers, and (especially) people who draw on care and support, will be vital to achieving this.

We are focused on reducing health and economic inequalities. By listening actively and fostering collaboration, we can elevate care professionals, support unpaid carers, and develop market-shaping to promote self-reliance, improve lives, bolster communities and drive economic growth in Lincolnshire.

I would like to thank our residents who draw on care and support, carers, staff and members of the Adult Care and Public Health Scrutiny Committee for their contributions in shaping this strategy.

I commend this strategy to the council and to the people of Lincolnshire.

Councillor Steve Clegg
Executive Councillor for Adult Care and Health

Foreword by the executive director

As the statutory Director of Adult Social Services (DASS) for Lincolnshire, I am proud to present our Adult Social Care Strategy. We have developed this statement to reflect our collective commitment to delivering high-quality, person-centred care, with the goal of enabling people to lead the lives they choose, as full members of the communities they live in. It sets out our vision and values, our ambition and commitment, and our accountability to the people of Lincolnshire.

This strategy highlights the progress we have made, especially over the two years since we were first inspected by the Care Quality Commission. We have sought to be frank and self-aware about the challenges we continue to face. We have set out the actions we are taking to improve what we do, and we have been honest about the level of progress achieved: excellent in some areas, more work to do in others.

As ever, our focus remains on enabling people to live independent, fulfilling lives, drawing where needed on services that are compassionate, responsive, and rooted in co-production. Through these means, we seek to avoid or reduce people developing needs that require formal care, and hence to ensure our services are financially sustainable.

The strength of this strategy lies in the voices behind it. This is not simply what we think of ourselves. The strategy has in part been co-produced with people who draw on care and support, unpaid carers, and practitioners, and has been written in consultation with elected members and partners across our system. Their insights have shaped our understanding and have sharpened our priorities. We are embedding a culture of learning and improvement, underpinned by robust data and analysis, strong governance, and a clear vision for the future.

I want to thank all my colleagues across Adult Social Care for their dedication and resilience, and our partners for their collaboration. Together, we are building a system that listens, learns, and delivers for Lincolnshire people.

Martin Samuels
Executive Director for Adult Care and Community Wellbeing

Summary and introduction

Executive summary

In successive social care surveys, Lincolnshire residents report having a good quality of life and being satisfied with the services they draw upon. People are ambitious about their health and wellbeing outcomes, despite the challenges they may face. The Council’s Adult Social Care services work through these challenges to support people’s wellbeing, in collaboration with the individuals and communities we serve and all our many stakeholders. Our workforce is committed to the values of the Council. The service has an open and honest relationship with the public. We listen to people and value feedback. The service actively promotes people taking responsibility for their own health and wellbeing.

The ambition of this two-year strategy is to go beyond “good” and to do so sustainably, both financially and in the levels of resilience we facilitate in our communities. People who draw on care and support are at the heart of this strategy. They, and the staff who support them, have co-produced many aspects of this strategy.  We have agreed a strong vision that galvanises our collaboration. People have expressed principles that guide the strategy development and its implementation.

We recognise services must improve further, particularly considering the new and ongoing challenges faced by our communities, not only rurality and isolation but also health and economic inequalities. Based on what we hear from the experiences of people who draw on care and support, we are working to secure service improvements in key areas. Our aim is to tackle health inequalities and ensure our services are responsive to people’s needs, deliver their desired outcomes, and support their aspirations to live independent lives.

The strategy puts forward a Target Operating Model (TOM) that brings together our efforts, for preventative support, access to technology, and early help to reduce the escalation of needs. Central to the TOM is the notion of empowering individuals and communities. It is framed by practical, person-centred, strengths-based approaches, to support and safeguard people from harm. Prevention, in the form of information, advice and guidance, promoting self-help, and early help and support, forms part of a robust approach to reducing need and hence demand for formal care services.

We recognise the power of co-production with people who draw on care and support in harnessing the best ideas for innovation. We aim to build on our long history of partnership working with people in Lincolnshire, the NHS Integrated Care Board, Police, NHS Trusts, Primary Care services, the voluntary and independent sectors, and our wider communities. Achieving greater personalisation of care and support has the potential to ensure people are more in control of their life outcomes, while also guiding services to address what matters most to people, thereby avoiding inefficiencies and unnecessary costs.

Introduction

This two-year strategy sets out our commitments, priorities and strategic goals for transforming Adult Social Care services for working age adults and older people.

The vision for Adult Social Care in Lincolnshire is: ‘People stay as healthy, safe and independent as possible within their communities.’

As a society, people are generally enjoying longer lives. As we grow older, some of us require a greater level of care and support. We want to create an environment that empowers Lincolnshire people to thrive and lead healthier, more independent, self-reliant and confident lives, making best use of the resources available. Good health and wellbeing are the foundation for people’s independence and resilience.

This strategy promotes good health and wellbeing through tackling health inequalities and making care and support more accessible and effective in meeting people’s outcomes. To achieve this, we will forge greater collaborative and integrated working arrangements across the whole community, including people who draw on care and support, unpaid carers, formal health and social care providers, and independent and voluntary services.  Many people in Lincolnshire choose to buy and arrange their own care and support, using their own resources. It is vital that all people have access to high quality information, advice and guidance, as well as an effective social care market that offers people choice and value for money. While our adult social care services have done well in supporting people and demonstrating value for money for the council, the call on public funds is growing annually. We aim to improve to meet the twin challenges of rising cost and demand in the future, through transforming how we arrange and deliver services going forward.

We will ensure that people who draw on care and support play the central role in determining their own futures, making the most of the informal support from their families, friends, as well as local ties and connections in their neighbourhoods. We adopt strength–based and person-centred approaches.  We have worked with people who draw on care and support and carers to co-produce this strategy.

Turning our vision into reality

Our strategic goals and operational actions are guided by the “I Statements”, part of the Making It Real framework, developed nationally by  Think Local Act Personal (TLAP) as part of their work with people with lived experience of health and care services, and partners. This framework is endorsed by the Care Quality Commission (CQC) and the Local Government Association (LGA). These statements include:

  • I have care and support that enables me to live as I want to, seeing me as a unique person with skills, strengths, and personal goals.
  • I have care and support that is co-ordinated, and everyone works well together and with me.
  • When I move between services, settings or areas, there is a plan for what happens next and who will do what, and all the practical arrangements are in place before change happens.
  • I am supported by people who listen carefully, so they know what matters to me and how to support me to live the life I want.

Guiding principles developed by our co-production group

These guiding principles have been expressed by people who draw on care and support in Lincolnshire, who contribute to our Co-production Group:

  • when support is needed, it is flexible, progressive, person-led, with the power and space to be creative and change, to suit people’s circumstances
  • we will work in a collaborative way with other services to improve the quality of people’s experience
  • we focus on what matters to people and work to enable people to achieve their goals
  • we have an open and learning culture that helps us learn from what works for people, adapt and improve our offer continually
  • our relationships are built on trust, equal partnership with people, shared decision making and a common and positive language
  • empowering people to live as independently as possible in their own home and communities

What is adult social care?

Adult social care is the provision of professional social work, personal care, protection, and social support, founded on a strengths-based assessment of people's needs. It provides support for people with needs for care and support that are above national thresholds, in a way that promotes wellbeing, independence, and safety, with clear duties on local authorities and rights for individuals and carers. Adult social care encompasses a range of services and support designed to help individuals who need extra assistance to live as independently as possible.

The single most important legal duty of social care is safeguarding. This involves protecting people from harm and abuse, and responding to such concerns with a rapid and proportionate enquiry into the allegations, focused on the wishes of the person at risk and on stopping the abuse happening again. The service has a duty to support the Lincolnshire Safeguarding Adults Board, a multi-agency partnership for ensuring safeguarding for vulnerable adults.

In Lincolnshire, social care services are designed to meet the unique needs of individuals, focusing on promoting independence, preventing, reducing and delaying need for statutory services, and integrating healthcare and social care to provide coordinated and effective support. Engaging people, offering an initial Care Act assessment of needs, and delivering any necessary support is rooted in a strengths-based approach, in line with statutory guidance to ensure a prompt and proportionate service response.

  • 11,00 people are supported by social care
  • 817 Staff are employed by LCC’s Social Care Directorate
  • 48,000 Requests for support were made to social care in 2024/25, up 9% for Older People
  • 3,745 People age 18-64 are supported by social care
  • 7,255 People age 65+ are supported by social care
  • 3.77% of older people in Lincolnshire are supported by social care compared to England 5.19% and the East Midlands 4.82%

Our legal responsibilities

National and regional context

This section outlines some of the national and regional factors shaping the lives of people and services in Lincolnshire.

Greater Lincolnshire Mayoral Combined County Authority: The Devolution Deal

The creation of the Greater Lincolnshire Combined County Authority marks a pivotal shift in regional governance. With a £720 million investment fund over 30 years, the devolution deal will support infrastructure improvements in housing, transport, digital access, and skills. Adult Social Care is preparing itself to make the most these changes, ensuring continuity of care and responsiveness to new governance structures.

NHS long-term plan

The Government’s 10-Year Health Plan, published on 3 July 2025  sets out a vision for a future-ready model of care, grounded in the founding principles of the NHS: universal access, free at the point of delivery, based on clinical need, and funded through general taxation. This signposts an urgent need for transformation, based on the Darzi Report (2024), which concluded the NHS was in a critical state, with public satisfaction reaching an all-time low, waiting times for treatment increasing, and the overall health of the population declining.  Led by the Department of Health and Social Care (DHSC), the Plan pushes the NHS to shift focus urgently in three distinct directions:

  1. From Hospital to Community – the Neighbourhood Health Service designed around you: The creation of a new Neighbourhood Health and Wellbeing Service, to bring care closer to communities.
  2. From Analogue to Digital – Power in your Hands: Empowering individuals by placing more control in their hands.
  3. From Sickness to Prevention – Power to Make the Healthy Choice: Empowering individuals to make healthier choices, the ambition is to halve the gap in healthy life expectancy between the richest and poorest regions, while increasing healthy life expectancy for everyone.

NHS Lincolnshire joint forward plan

The NHS Lincolnshire Joint Forward Plan describes the priorities that the local NHS will focus on over the next five years, to meet the physical and mental health needs of the Lincolnshire population, in the context of the overall Integrated Care Strategy ambition and aims. These priorities are:

  • a better relationship with the people of Lincolnshire
  • living well, staying well
  • improving access
  • delivering integrated community care
  • a happy and valued workforce

More information: Lincolnshire ICB - Supporting healthcare for the population of Lincolnshire

Local context

This section outlines some of the local factors that shape the strategy and will determine its delivery.

Demography: people and place

Lincolnshire is the third largest council in England by area, shaped by its scale, geography and diverse communities. Beyond the city of Lincoln, people live in market towns, such as Grantham, Boston, and Gainsborough, and in rural villages. The county’s large size and dispersed population make Lincolnshire distinct from other rural areas, creating unique challenges in accessing health and social care services. Lincolnshire Health Intelligence Hub has significant detail.

Lincolnshire population overview

  • Lincolnshire has an estimated population of approximately 768,000 people
  • the county covers a large geographical area with a dispersed population

Age profile

  • a higher proportion of residents are aged 65 and over compared to the national average
  • by 2043, the population aged 65+ is projected to increase significantly
  • the working‑age population is proportionally smaller than in England overall

Disability and long‑term conditions

  • around one in five adults report a long‑term illness or disability
  • a significant proportion of older residents live with multiple long‑term conditions
  • dementia prevalence increases sharply in older age groups

Ethnicity

  • the majority of the population identifies as White British
  • small but growing minority ethnic communities are concentrated in urban areas

Wider determinants of health

  • nearly one quarter of adults live in areas classified as deprived
  • over one quarter of households experience fuel poverty
  • housing quality and access to transport vary significantly by district

Health disparities are evident, particularly in deprived areas, including the east coast and in urban centres such as Lincoln and Gainsborough, where life expectancy is lower for people experiencing social inequalities. Addressing these challenges is crucial for the county’s health and social care services (Lincolnshire County Council, Director of Public Health Report 2022).

Health outcomes and life expectancy vary across the county, in large measure driven by differences in deprivation levels. While county-level deprivation rates are similar to the national average, significant deprivation exists in many communities, particularly in the north and east of the county. Deprivation drives health inequalities, with those in the most deprived areas more likely to experience poor health, develop multi-morbidity earlier, and die prematurely (Health Inequalities Dashboard). Small pockets of deprivation can exist within more affluent areas, sometimes masking the true scale of need.

Deprivation in Lincolnshire

  • deprivation is unevenly distributed across the county
  • East Lindsey, Boston and South Holland have the highest levels of deprivation
  • Coastal towns such as Skegness and Mablethorpe are among the 10% most deprived areas nationally
  • urban areas such as Lincoln and Gainsborough contain pockets of deprivation comparable to coastal areas
  • approximately 17% of Lincolnshire residents live in the 20% most deprived communities in England
  • western districts generally experience lower levels of deprivation
  • east Lindsey, Boston & South Holland have high levels of deprivation
  • resort towns, such as Skegness and Mablethorpe are among the 10% most deprived localities in England
  • Lincolnshire’s towns and urban areas appear relatively affluent, but contain pockets of deprivation that are comparable to the coast, e.g. Lincoln and Gainsborough
  • health deprivation mirrors overall deprivation, with the east coast and parts of Lincoln displaying high levels of health deprivation, and west Lincolnshire displaying the lowest
  • 17% of Lincolnshire people live in the 20% most deprived communities nationally

Frailty, and conditions such as dementia and other long-term conditions, are placing greater pressure on services for older adults. In Lincolnshire, 27% of people aged over 65 struggle with everyday activities due to long-term illnesses, with most having two or more long-term conditions (Director of Public Health Annual Report 2023). Meeting these demands requires a holistic and integrated approach that combines early action, timely treatment and long term support in a way that is both person-centred and sustainable.

Life expectancy

  • average life expectancy in Lincolnshire is approximately 78 years for males and 82 years for females
  • the gap in healthy life expectancy between the most and least deprived areas exceeds 10 years

Health inequalities

  • residents in deprived areas experience poorer health outcomes earlier in life
  • people in deprived communities are more likely to die at a younger age

Disease burden

  • the most common long‑term conditions include hypertension, depression, obesity, diabetes and asthma
  • mental health needs and musculoskeletal conditions are significant contributors to demand for services

Joint Health and Wellbeing Strategy (JHWS)

The JHWS sets out the vision and focus for improving health and wellbeing for people in Lincolnshire and reducing health inequalities through establishing shared priorities and clear outcomes. Based on Lincolnshire’s Joint Strategic Needs Assessment (JSNA), the strategy identifies five key priorities: unpaid carers, healthy weight, homes for independence, mental health / dementia, and physical activity.

The strategy takes a life course approach, recognising that health inequalities are the product of many factors (including individual, socio-economic and environmental factors, maternal health, family and social networks) impacting on people throughout their lives. It seeks to promote and improve health at all ages, particularly as people get older, since evidence shows the need and demand for health and social care services increases with age. More information at: Joint Health & Wellbeing Strategy 

Lincolnshire Integrated Care Partnership (ICP) Strategy

The Integrated Care Partnership Strategy sets out the key enablers the health and care system will focus integration efforts on to support delivery of the JHWS and its priorities, and the system’s overarching ambition and aims. This ICP strategy, also known as Better Lives Lincolnshire Strategy (Better Lives Lincolnshire Strategy) brings together our system thinking into one place, ensuring we have stronger connectivity between statutory bodies, the Voluntary, Community, Faith and Social Enterprise (VCFSE) and independent sector to maximise the capacity and capabilities available to the people of Lincolnshire.

The ICP strategy identifies 5 strategic enablers that will focus the minds of all partners in delivering our collective aims, ensuring that engagement and co-production is embedded into the delivery arrangements, which are: Prevention and Health Inequalities; Workforce and Skills in the health and care sector; Personalisation; Digital Technology; and Data & Intelligence.

Although the government has announced plans to abolish ICPs, as part of national changes to Integrated Care Boards (ICBs), we will continue to work with our partners to ensure effective approaches to integrating the design and delivery of care and support.

Better Care Framework

Through the Better Care Framework (2025), we are working with all partner organisations to develop Integrated Neighbourhood Health and Wellbeing services with the goals of: providing more care closer to home, increasing focus on prevention so that people are living healthier and more independent lives, and harnessing digital technology to transform care. The Council works collaboratively with the ICB and their commissioned community health and hospital service to ensure a seamless service experience for people in Lincolnshire.

The Better Care Framework sets out the guidance from DHSC on how the Council and the ICB jointly invest the Better Care Fund (BCF). The BCF is aimed at delivering integrated health and social care services for people with complex needs, to enable them to receive preventative treatment, care and support at home or in the community and avoid unnecessary admission to a hospital. The pooled BCF budget of £361.8m for 2025/26 supports these efforts, with Adult Social Care playing a key role in joint planning and delivery. We have recently reviewed the Lincolnshire BCF and will take forward improvements, guided by updated national guidance.

What we are doing well

Based on the national published annual Adult Social Care Outcomes Framework (ASCOF) performance measures, Lincolnshire performs well in many areas. In particular, people who draw on care and support in Lincolnshire report they enjoy a higher quality of life than compared to our statistical neighbours.

  • 91.7% of older people discharged from hospital received reablement support (ASCOF 2D)
  • 76% of people receiving long-term support report feeling in control of their daily life (ASCOF 3A)
  • more than 3,000 people use Direct Payments to shape their own care
  • our reablement services have been highly effective in helping people regain their independence after hospital stays. Lincolnshire is ranked 18th nationally
  • 89.2% of individuals supported with long-term care were reviewed in 2023/24, a 5% increase from the previous year
  • 99% of adults receive self-directed support. Above the national average of 93.5%
  • 91% of people starting reablement did not require further long-term care (ASCOF 2A)
  • 91% of carers report feeling included in care discussions (ASCOF 3B), fostering a collaborative approach to care
  • 539.8 per 100,000 Adults require long-term care, compared to the national average of 566 per 100,000 (ASCOF 2C)
  • 43% of people support by social care receive Direct Payments, this remains higher than the national average
  • ranked 26th nationally in supporting people to remain as independent as possible, with 90.7% of people who received a short-term intervention during the year going on to lower or no ongoing support
  • 80% of people using our services report having control over their daily life (ASCOF 3A)
  • 0.55% Complaints received of all open Adult Social Care cases in 2024/25

Lincolnshire’s adult social care system is built on a culture of continuous improvement, where feedback, reflection and innovation are used to make services better for people. Complaints, compliments, colleagues’ insights, and audits are not treated as isolated events, but rather as opportunities to learn.

Drivers for change

There are many drivers for change in the way adult social care is commissioned, delivered and experienced by people in Lincolnshire:

  • an aging population, giving rise to a greater demand for care and support
  • Lincolnshire’s Care Quality Commission (CQC) pilot inspection of Adult Social Care functions in June 2023 provided broadly positive feedback, but identified several areas for development. Further feedback is anticipated from the formal inspection undertaken at the end of 2025
  • there has historically been high use of residential care and that trend is set to continue, unless addressed with alternative accommodation options
  • adoption of alternative and innovative models of care has not progressed as quickly in Lincolnshire as in some parts of the country
  • commissioning requires further development to deliver suitable innovative care solutions and capacity within the social care market
  • harnessing digital technology is a priority for improving access, efficiency, and independence
  • feedback from people who draw on care, from unpaid carers, and from partners highlights the need for clearer information, more timely support, and greater choice and control
  • national reforms, such as the creation of the Greater Lincolnshire Mayoral Combined County Authority and changes in local government structure, require the council to adapt its strategy and ensure continuity of care through flexible and responsive service models
  • requests for support continue to be higher than the national average for both working age adults (18-64 years) and older people (65 and over)

Trends in requests for support

  • requests for support for adults aged 18 to 64 have increased steadily since 2020
  • requests for support for adults aged 65 and over have risen sharply since 2021
  • Lincolnshire’s rate of requests for support remains higher than the national average for both age groups
  • growth in demand is driven by population ageing and increased complexity of needs

Use of financial resources

The Adult Social Care service has a well-developed budget planning cycle. The service had an annual budget of some £400m gross, net £208.9m (2024/25). Net expenditure increased by 18% from 2023/24. The vast majority of this spend is allocated to individual care packages.

Physical support

People aged:

  • 18 to 64 net expenditure 2023 to 2024: £20,706
  • 65 and over net expenditure 2023 to 2024: £58,173
  • 18 to 64 net expenditure 2024 to 2025: £22,940
  • 65 and over net expenditure 2024 to 2025: £74,355
  • 18 to 64 net expenditure 2025 to 2026 (up to end of Q3): £19,576
  • 65 and over net expenditure 2025 to 2026 (up to end of Q3): £78,302

Sensory support

People aged:

  • 18 to 64 net expenditure 2023 to 2024: £315,000
  • 65 and over net expenditure 2023 to 2024: £236,000
  • 18 to 64 net expenditure 2024 to 2025: £351,000
  • 65 and over net expenditure 2024 to 2025: £331,000
  • 18 to 64 net expenditure 2025 to 2026 (up to end of Q3): £178,000
  • 65 and over net expenditure 2025 to 2026 (up to end of Q3): £295,000

Support with memory and cognition

People aged:

  • 18 to 64 net expenditure 2023 to 2024: £177,000
  • 65 and over net expenditure 2023 to 2024: £6,003,000
  • 18 to 64 net expenditure 2024 to 2025: £182,000
  • 65 and over net expenditure 2024 to 2025: £7,405,000
  • 18 to 64 net expenditure 2025 to 2026 (up to end of Q3): £206,000
  • 65 and over net expenditure 2025 to 2026 (up to end of Q3): £6,567,000

Learning disability support

People aged:

  • 18 to 64 net expenditure 2023 to 2024: £67,586,000
  • 65 and over net expenditure 2023 to 2024: £7,510,000
  • 18 to 64 net expenditure 2024 to 2025: £74,407,000
  • 65 and over net expenditure 2024 to 2025: £8,267,000
  • 18 to 64 net expenditure 2025 to 2026 (up to end of Q3): £68,228,000
  • 65 and over net expenditure 2025 to 2026 (up to end of Q3): £7,580,000

Mental health support

People aged:

  • 18 to 64 net expenditure 2023 to 2024: £14,249,000
  • 65 and over net expenditure 2023 to 2024: £1,695,000
  • 18 to 64 net expenditure 2024 to 2025: £18,736,000
  • 65 and over net expenditure 2024 to 2025: £1,814,000
  • 18 to 64 net expenditure 2025 to 2026 (up to end of Q3): £20,546,000
  • 65 and over net expenditure 2025 to 2026 (up to end of Q3): £2,032,000

Total

People aged:

  • 18 to 64 net expenditure 2023 to 2024: £103,033,000
  • 65 and over net expenditure 2023 to 2024: £73,617,000
  • 18 to 64 net expenditure 2024 to 2025: £116,616,000
  • 65 and over net expenditure 2024 to 2025: £92,172,000
  • 18 to 64 net expenditure 2025 to 2026 (up to end of Q3): £108,734,000
  • 65 and over net expenditure 2025 to 2026 (up to end of Q3): £94,776,000

Various independent analyses of our expenditure show that the service delivers good value for money for the budget we have, for both working age adults and older people.

Despite the overall budget performance, we are facing pressures on the overall cost of care for both working age adults and older people in key service areas such as residential care. The service is working through a suite of cost and demand reduction measures to ensure the Adult Social Care remains financially sustainable.

Our strategic commitments and priorities - page one

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

Foundation one - being prepared to do things differently. Together we:
  • 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
Foundation two - understanding what matters to ourselves and each other. Together we:
  • 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
Foundation three - working together for the well-being of everyone. Together we:
  • 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
Foundation four - conversations with and not about people. Together we:
  • 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
Foundation five - making the most of what we have available to us. Together we:
  • 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

Our strategic commitments and priorities - page two

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

Working towards a new target operating model (TOM)

To meet the challenges of the future, Adult Social Care service must transform. Central to this will be a greater level of preventative support, including early intervention, to prevent, reduce and delay the need for statutory care.

We have developed a new TOM that takes a multi-layered approach to identifying and supporting people who may require support to manage their wellbeing and care needs proactively.

Adult Social Care target operating model (TOM)

  • the model is designed to prevent, reduce and delay the need for statutory care
  • support is organised across four connected levels

Level one: pre‑front door

  • focuses on community wellbeing and prevention
  • includes information, advice and universal services
  • aims to identify need early and avoid escalation

Level two: front door

  • provides skilled advice and wellbeing support
  • includes digital and telephone access to services
  • focuses on early help and short‑term intervention

Level three: targeted prevention

  • provides early intervention for people at increased risk
  • includes reablement and preventative services

Level four: assessment and support

  • provides statutory assessment and ongoing care where required
  • focuses on proportionate, strengths‑based support

Cross‑cutting principles

  • safeguarding applies at all levels
  • strengths‑based practice underpins all interactions
  • technology is used to support independence
  • services are delivered through integrated neighbourhood teams

The TOM brings together the vast array of formal and informal support available to people in Lincolnshire, organising how these work with one another, and monitoring and developing their impact on strengthening support for people in the face of increasing demand and complexity. The four layers do not represent specific services, but rather a model for integrating and maximising the effect of different services operating. The TOM is framed by eight key principles:

  • tackling adult safeguarding concerns as a matter of priority
  • truly person-centred and strengths-based interactions at all levels in assessment and support planning
  • co-producing support through improved listening and focusing on the outcomes that people prioritise
  • information, advice and guidance to enable people to access support they want and determine their own futures
  • a ‘pre-front door’ in relation to adult social care to identify opportunities to intervene before people are referred for an assessment, spotting much earlier people experiencing difficulties and working together to return them to stability
  • early intervention and reablement-led prevention at the Front Door to prevent, reduce and delay the need for statutory care and support
  • technology enabled support at every level
  • care and support plans that help people become more independent, step by step

Performance management, accountability and governance

Our performance management cycle is supported by business intelligence tools that enable managers to access data on the services delivered. Performance measures are scrutinised by the Executive and by the Adult Care and Public Health Scrutiny Committee, and actions taken to improve services accordingly.

We use information and intelligence as an essential strategic enabler in planning for the growing complexity of population needs in Lincolnshire. By embedding data-driven decision making into both operational and strategic processes, we will be better equipped to deliver timely, person-centred care, allocating our finite resources effectively and drive service transformation.

Through our shared data sources and joint analytical capabilities, we create a system that not only supports responsive care delivery but also delays and prevents the need for care, promoting long-term wellbeing by tackling health inequalities and shaping services around emerging needs. To achieve this, we collect and track demand data from all parts of the system.

Implementation and review

This strategy will be implemented through the construction and delivery of annual Service Improvement Plans, with priorities drawn from the strategic goals outlined above and informed by review of delivery performance of the previous period. The plans will address the budget and savings targets set for that year. Their impact will be evaluated and monitored.

The Co-production Group will also review the impact of the strategy every year and shape the priorities for the following year.