Adult social care commissioning, transformation and performance service plan 2025-28

A. Overview

Organisation chart

Achievements in 2024/25

All successful achievements are the result of co-ordinated action across the Adult Social Care Teams, the wider Council and with partners.  

In Transformation, we have achieved the following: 

• Delivered over £2m of full year impact savings as part of the DCASC Recovery Plan.
• Progressed the ASC Asset Strategy; the first phase being development of four modern buildings to support redesign of the Directorate’s supported living; day opportunity and respite services. Building work started in January 2025 on the respite provision.  
• Initiated the Digital Transformation Programme in August 2024; completing discovery work and implementing new Mosaic safeguarding pathways. 
• Introduced a new ASC front door model, bringing the Voluntary & Community Sector to work alongside social workers and occupational therapists to support people at a much earlier point in the customer journey.  
• Designed reablement pathways for people with mental health needs and preparing for adulthood, increasing the independence of over 50 people we support.  
• Redesigned the Commissioning & Client Finances Services to ensure that the DCASC have the right resource and focus to deliver future priorities.  
• Revised and updated advice on the Council website so that information is accurate, relevant and easily accessible for staff, partners and the people we support.  
• Installed over 120 ‘pattern of life sensors’ in people’s homes and worked with the University of Reading to explore the impact of this technology in enabling people to remain at home.  
• Reviewed and redesigned the DCASC offer to support people with sensory needs.   

In Striving for Excellence, we have: 

• Co-ordinated and supported the Directorate through the entire CQC Assurance process, including: 
  • Facilitation of the comprehensive Self-assessment and Information return. 
  • End-to-end support for statutory case audits both for CQC and business as usual. 
  • CQC Assurance training and preparation for all staff and external partners. 
  • Co-ordination of the DLT pre-inspection meeting with CQC. 
  • Onsite logistics when CQC were at the Civic and co-ordination of post visit information requests from CQC.  
• Formed ‘the Working Together Group’ – ASC’s first co-production group; promoting awareness of co-production and enabling active participation of people we support and carers in senior officer interviews and projects such as the VCS front door. 
• Supported implementation of the Tri-X portal to ensure all ASC policies and procedures are easily accessible. 

In Integration, we have: 

• Launched the Community Wellness Outreach program which, working with health and VCS partners, will provide at least 5000 Health Checks and holistic care to people across Reading by June 2025. The program has already reached over 2500 people, 57% of whom are from ethnically diverse populations.  
• Overseen delivery of key projects; including: 
  • The Joy Social Prescribing Platform to improve awareness of community provision across Reading.  
  • Phase 1 of the development of the Falls & Frailty Service – the Diagnostic Review to inform service design.   
  • Mental Health outreach through Compass Recovery College 
• Co-designed a pilot Carer’s breaks and respite care offer using Accelerated Reform Funding (ARF); alongside joint work with Health and other LAs to support carer identification.  
• Allocated grants to 10 high-impact community projects to reduce avoidable hospital admission and improve timely discharge.  

In Commissioning, we have: 

• Completed and published the 2025-2028 Market Position Statement. 
• Commissioned a new Supported Employment Service to support people with learning disabilities and autism to find employment.  
• Researched best practice, evaluated cost of care and engaged with providers, staff and people we support to prepare for the commission of new home care and supported living frameworks for 2026 onwards.  
• Commissioned a Discharge to Assess residential care service and a reablement home care service which both support timely hospital discharge and enable people to regain independence after ill-health.  
• Supported local providers to improve service quality and contributed to the borough’s largest nursing care home achieving a CQC good rating after being rated ‘requires improvement’ for 4 years.  
• Analysed need across the Borough and worked with the VCS to co-produce Closing the Gap in preparation for the commission of the refresh of community early help and preventative services from November 2025.  
• Delivered cost efficiencies through effective negotiation with providers and initiated a supported living efficiency project to ensure sustainable investment in the market and improve outcomes for people we support.  
• Further embedded the new Direct Payment Support Service which has seen an increase in the number of Direct Payments throughout the year. 

In Performance and Data, we have: 

• Successfully submitted the first Client Level Data set to NHS England.  
• Designed, developed and published reports using Power BI business intelligence software; helping staff across ASC to use up-to-date data to support day to day operations and improve case management.  
• Recruited a permanent team manager to stabilise, empower and lead the team.
• Developed and provided performance data to support the Directorate’s CQC Information Return and assurance process.  

In Client Finances, we have: 

• Successfully established and developed a new Client Finance service to provide a joined-up approach to customer charging and deliver a concise service to residents, including debt management and recovery.  
• Completed almost 500 financial assessments, supported 270 customers with Deputyship to manage finances as well as introduced a new Appointeeship service.  
• Undertaken Direct Payment Monitoring to recover funds in excess of £100,000 in unspent care packages. 

Business-as-usual services

Transformation & Striving for Excellence: 

• Co-ordinating and supporting the Directorate’s Transformation Programme; the Striving for Excellence Improvement Plan and Financial Recovery Plan. 
• Driving the development of co-production in Adult Social Care and facilitating monthly ‘Working Together’ Focus Groups with people with living experience and ASC staff.  

Commissioning  

• Managing the annual fee uplift process for commissioned services to achieve value for money whilst ensuring a sustainable market to meet people’s care and support needs. 
• Overseeing procurement of new services for Adult Social Care.   
• Contract Management of over 300 Adult Social Care provider contracts to ensure that providers are delivering to the Council’s requirements. 
• Quality monitoring of local care provision; working with providers, Safeguarding and CQC to check on and improve quality. This includes both planned quality monitoring as well as reactive work to address arising issues of concern.  
• Brokerage and sourcing of care services to meet people’s assessed need, including care homes, home care, supported living and extra care.  
• -Direct Payments – set up and support for people who want to have more control over their care and support. Around 270 people in Reading have a Direct Payment and we are aiming to increase this number over the coming year.  
• Governance checks for new providers and price negotiation to ensure that services are costed at a fair and reasonable price.  
• Resolution of any invoice queries which come up as part of the agreed payment schedule. At present, the number of queries averages 131 per month. This will be reduced significantly through the Digital Transformation Programme.  
• Service Improvement: Scanning the markets, risk assessing, speaking to providers, people we support and operations to gather intelligence to develop and shape markets and work practices.  

Integration 

• Co-ordination of the Reading Integration Board –  a monthly multi-disciplinary board which brings together system partners including health, social care, housing and the voluntary and community sector.  
• Oversight and co-ordination of the Better Care Fund Plan to improve health and wellbeing of Reading residents through integrated working across the Health and Social Care System. This includes plans to reduce avoidable hospital admission, make sure people are discharged quickly and, where possible, are supported to regain independence and return home.  
• Management of the Section 75 Framework Agreement incorporating the Better Care Funding, Discharge Funding and Health Inequalities Funding.  
• Monitoring and reporting of performance against the Better Care Fund Metrics and Projects funded through BCF, to the Reading Integration Board, Health and Wellbeing Board and NHS England.   

Performance & Data 

• Submission of all ASC statutory data returns to NHS England. This includes the  Client Level Data Return, the Adult Social Care User Survey, the Survey of Adult Carers in England and the Safeguarding Adults Collection. 
• Collection, analysis and publication of internal reports and dashboards to support oversight of day-to-day activity within ASC; waiting time management and Better Care Fund outcomes.  
• Management of appropriate storage and access to social care databases. 
• Skilled support to ASC to interpret and develop data and reports to support the Directorate in delivering outcomes.  

Client Finances 

• The Finance & Benefits Service completes financial assessments for people receiving a service from ASC.  
• Deputy’s Office provides financial management for 270 customers. 
• The Direct Payment Monitoring and Client Charging Teams ensure that Direct Payment packages are monitored, and client charges collected and, with the support of Legal Services and Operational Team follows up on debts.  
• ASC Debt Recovery team manage all customer charging accounts to ensure RBC receive all ASC income.

B. Key Performance Indicators

The metrics that tell us how well our business-as-usual services are performing and whether we are delivering the objectives set out in section C overleaf. 

You should aim to have a KPI which describes how well each key business-as-usual activity is operating.  This could be the quantity of work (e.g. bins collected) or/and the quality of work (e.g. missed bins).  These should be focused on the main business-as-usual activities that need tracking and are specifically of interest to senior management and Members. They should be within the Council’s control and are your ‘normal level’ of activity. 

If you are proposing to improve the service, through a project or initiative that you may be including below, then you should have a target which shows what that improvement/change will bring (e.g. normal number of bins missed is x%, target following project is y%). 

Under “definition” explain how the indicator is defined and the formula used. E.g. recycling rate = household waste recycled in the month / total household waste collected (kg). “Target type” should say whether the target is “flat”, i.e. the same each month/quarter (e.g. 50%), or cumulative, i.e. increasing each month/quarter (e.g. for measuring total library visits in the year to date). If the target has a variable profile/seasonal targets, please detail this. 

Measure	Definition	Unit	Better (bigger or smaller)	Frequency (monthly, quarterly)	Target type (flat or cumulative)	Normal level/ Target 25/26	Normal level/ Target 26/27	Normal level/ Target 27/28	Council Plan KPI (Y/N)	Data Provider
Number of carers supported to maintain their caring role	Number of carer’s assessments completed	Number	Bigger	Monthly	Flat	752	790	830	Y	Ben Fisher
Percentage of people with a learning disability in paid employment	People with a learning disability in paid employment compared with the total cohort	%	Bigger	Quarterly	Flat	5.0	5.25	5.5	N	Ben Fisher
Percentage of service users supported to live independently in the community	People under ASC who remain to live in their homes, rather than in care settings	%	Bigger	Monthly	Flat	78	79	80	N	Ben Fisher
Percentage of new contacts to the Advice & Wellbeing hub resulting in a successful outcome not requiring an on-going service	People who are supported by ASC front door service do not require long term care and support.	%	Bigger	Monthly	Flat	84	87	87	Y	Ben Fisher
Percentage of local care providers rated as good or outstanding.	Percentage of local providers registered with CQC with a good or outstanding rating	%	Bigger	Annual	Flat	65%	65%	65%	N	Eloise Cromwell
The number of older adults whose long-term care needs are met by admission to residential or nursing care.	Reduction in the number of people requiring long term care in Care Home placements.	Rate per 100k population of 65+	Smaller	Quarterly	Cumulative	889	889	889	Y	Bev Nicholson
The number of emergency hospital admissions due to falls in people aged 65 and over.	Reduction in the number of emergency admissions due to a Fall.	Rate per 100k population	Smaller	Quarterly	Cumulative	1,102	1,102	1,102	N	Bev Nicholson
Proportion of people receiving short-term reablement following hospital discharge	Increase in the number of people receiving reablement following a hospital discharge	number	Bigger	Quarterly	Flat	840	840	840	N	Ben Fisher
Reduction in Adult Social Care Debit	ASC Debt Recovery	%	Bigger	Monthly	Flat	90%	90%	90%	Y	Jo Maslen
Direct Debit use for Client Charging	Percentage of client charges that are paid by Direct Debits.	%	Bigger	Quarterly	Cumulative	Current baseline 19% / Target level of 30%	Current baseline 19% / Target level of 35%	Current baseline 19% / Target level of 40%	N	Jo Maslen
Supported Living Efficiencies	Reduction in spend against the Supported Living placements budget	£	Smaller	Monthly	Flat	£376k reduction	£575k reduction	£576k reduction	N	Lizzie Angove
Number of invoice queries raised by Care at Home Providers	Reduction in number of queries achieved by implementation of Provider Portal (current baseline 131 per month)	Number	Smaller	Monthly	Flat	100	80	50	N	Lizzie Angove

C. Objectives for 2025-28

The most important changes your service is aiming to deliver over the period of this service plan. 

This should include Council Plan objectives and any additional objectives at service level. 

Example: “Prevent the escalation of children’s needs through developing family hubs.” Objectives should: 

• Clearly and concisely state the outcome we are trying to achieve and how we will deliver it. 
• Be realistic given available resources and relevant to the priorities set out in the Council Plan. 
• Have an associated KPI that tells us whether we have achieved the objective. 

See the annex for a full list of Council Plan priorities and objectives. 

Objectives	Council Plan objective? (Y/N)	Relevant Council Plan priority
1. We will implement our improved carers offer, including employing a dedicated carers lead and delivering carers breaks.	Y	Safeguard and Support the health and well being or Reading’s adults and children. Improve our offer for unpaid carers, ensuring they are supported to live well and can sustain their caring role. Prevent and reduce health inequalities within the population of Reading and improve and protect the health and wellbeing of all its communities.
2. We will deliver four remodelled Adult Social Care support services – supported living for people with mental health needs; respite and day opportunities for people with profound and multiple learning disabilities and day opportunities for older people by replacing existing buildings that are no longer fit for purpose and redesigning services to support people to achieve their outcomes, retain and develop life skills and independence and to support community connection.	Y	Safeguard and Support the health and well-being or Reading’s adults and children. To ensure sufficient supply. Support those who need social care services to live as independently as possible in a place they call home with improved wellbeing.
3. We will Implement technology systems to support people to live independently at home by improving support to customers at the Social Care front door – improving our digital offer so that it easier for people to find the information they need and initiate a Care Act assessment on our website; and by working with the voluntary sector to provide early help and preventative guidance and support.	Y	Work with our partners in health and the voluntary sector to provide support solutions for those with complex health and social care needs to improve outcomes. Deliver good, accessible services for our customers
4. We will review and extend reablement and short term support for people when they first make contact with Adult Social Care, enabling them to gain or regain independence and reducing the need for long term support.	N	Support those who need social care services to live as independently as possible in a place they call home with improved wellbeing.
5. We will review and improve care pathways and our digital case management system to support staff in offering timely assessment, services and review to people who need Adult Social Care Support.	N	Deliver good, accessible services for our customers Invest in technology that is secure and helps deliver effective services.
6. We will refresh our existing Home Care and Supported Living Provider frameworks to make sure we have access to good quality, affordable and outcome focused support for people to live in their own homes; and to return home after hospital admission.	Y	Work with our partners in health and the voluntary sector to provide support solutions for adults with complex health and social care needs to improve outcomes.  Support those who need social care services to live as independently as possible in a place they call home with improved wellbeing. Use procurement of goods and services to secure greater social value and spend locally.
7. We will review and remodel Extra Care Housing provision as an alternative to reach a wider cohort of people and reduce reliance on care homes. This will include consideration of people under the age of 55 and people with more complex needs.	N	Support those who need social care services to live as independently as possible in a place they call home with improved wellbeing. Work with our partners in health and the voluntary sector to provide support solutions for those with complex health and social care needs to improve outcomes.
8. We will deliver the Supported Living Efficiency Programme, working with our local providers to ensure that that people are receiving the right amount of support to meet their needs and maximise their independence through enablement approaches and ‘technology enabled care’ (TEC) whilst ensuring we pay a fair rate of care to our providers.	N	Support those who need social care services to live as independently as possible in a place they call home with improved wellbeing. Secure best value from all Council spending
9. We will initiate and develop the ‘Spending Wisely’ programme to ensure that all spending is necessary, gets the best outcomes for our customers and that the whole staff team champion best value.	N	Secure best value from all Council spending
10. We will deliver improved Income Recovery with better pathways, the introduction of digital financial assessment and enhanced support to customers to understand their financial contribution and eligibility for Welfare Benefits, slicker client charging and integrated debt recovery.	N	Secure best value from all Council spending
11. We will improve the efficiency of provider payments and reduce invoice queries through the introduction of a Provider Portal.	N	Secure best value from all Council spending
12. Working with system partners as part of the Integration Board, we will reduce the proportion of unplanned hospital admissions and improve the proportion of people returning home after a hospital admission with a range of measures to improve health and wellbeing by a range of community measures, development of the Falls Prevention Service.	N	Prevent and reduce health inequalities within the population of Reading and improve and protect the health and wellbeing of all its communities.
13. We will embed co-production into Adult Social Care and will increase the involvement of residents when we are commissioning and designing services, reviewing policies and interviewing new staff.	N	Work with our partners in health and the voluntary sector to provide support solutions for adults with complex health and social care needs to improve outcomes. Deliver good, accessible services for our customers
14. We will extend the availability of accessible performance data to monitor and improve performance and support proactive and evidence based decision making within Adult Social Care.	N	Support those who need social care services to live as independently as possible in their homes with improved wellbeing. Invest in technology that is secure and helps deliver effective services.
15. We increase the uptake of Direct Payments and pilot an Individual Support Fund offer which will enable people to have more control over their care and support	N	Support those who need social care services to live as independently as possible in a place they call home with improved wellbeing.
16. We will support more adults with learning disabilities to find employment by embedding the Supported Employment Service and maximising other opportunities to support people into work.	N	Support those who need social care services to live as independently as possible in a place they call home with improved wellbeing.

D. Projects

The specific activities and programmes work that will deliver the objectives set out above. 

Projects should be: 

• Focused on tangible deliverables rather than outcomes (e.g. “build a new library and reception area in the Civic Centre” would be preferable to “celebrate Reading’s arts, culture, and heritage”). 
• Time-limited (with a defined beginning and end) and distinct from BAU activity (ongoing activities should be reflected in the “business as usual” section). 

Project name	What will this deliver and what will the benefits be?	Start date (month-year)	End date (month-year)	Budget	What resources is this project dependent on? (e.g. finance, legal, IT)	Relevant Council/Service Plan objective (from table above)	Council Plan project? (Y/N)	Data provider
Digital Transformation	Improve digital front door with implementation of Ask Sara and Access Community Gateway (ACG) to support self- assessment and financial assessment.  Review of care pathways to support business flow and efficiency alongside MOSAIC case management mapping.  Provider Portal to improve provider invoicing and deliver efficiency.	July 2024	December 2025	£1.3m over two years	ASC, Finance, DTAC	Deliver good, accessible services for our customers	Y	Spencer Dainton
VCS Front Door	VCS support offer at an earlier stage in people’s ASC journey, to support connection to community resources using a strength based approach.	January 2024	September 2026	£200k per annum (Better Care Fund)	Project Manager, Commissioning Operational Managers	Support those who need social care services to live as independently as possible in a place they call home with improved wellbeing.	N	Soon Heshe
ASC Assets Service Modeling	4 new buildings.  New service models for Profound and Multiple Learning Disabilities (PMLD) respite and PMLD Day Opportunities / Mental Health Supported Living and Older People’s Day Opportunities.  Support people to achieve their outcomes, retain /develop life skills and independence and continue living at home.	April 2025	December 2027	TBC	Housing / Legal / Finance / Project Manager, Operational managers/staff; Commissioning; Finance	Support those who need social care services to live as independently as possible in a place they call home with improved wellbeing.	Y	Karla Vickers
Income Review	Increased assessed fees and charging income. Reduction in total and % social care debt.	October 2024	March 2026	N/A	HR, Finance	Secure best value from all Council spending	N	Jo Maslen
Supported Living Efficiencies	Care package reviews to right size care in every Supported Living group environment; focus on positive outcomes, reablement and TEC to support independence and move on.	September 2024	December 2027	£270k (covering all three years of the project)	Housing, Operations, Legal	Support those who need social care services to live as independently as possible in a place they call home with improved wellbeing.	N	Lizzie Angove
Reablement	Review reablement offer to identify capacity to extend reablement offer for people when they first approach ASC through the Advice and Wellbeing Hub.	April 2025	March 2026	N/A	Ops Managers, Transformation, Integration, Internal Provider Services	Support those who need social care services to live as independently as possible in a place they call home with improved wellbeing.	N	Beth Whitby
Spending Wisely	Review all ASC financial decision making processes for care; negotiation training, roll out of CareCubed; identification of Champions, Improved monitoring data.	April 2025	March 2026	N/A	Ops, Commissioning, Brokerage, Transformation, Finance	Secure best value from all Council spending	N	Jennifer Simnett
Striving for Excellence Improvement Plan	This will deliver the ASC priority improvements identified by staff, partners and CQC. Improving efficient services for residents	April 2025	March 2026	None above normal ASC allocation	Front line resource, management oversite and Programme resource.	Safeguard and support the health and wellbeing of Reading’s adults and children	N	Michelle Tenreiro Perez
Falls and Frailty Service	To deliver a cohesive Falls and Frailty Service in Reading, informed by the Diagnostic Review,	April 2025	March 2026	£266k recurrent in Better Care Fund)	Integration, Principal OT / Commissioning / Legal	Safeguard and support the health and wellbeing of Reading’s adults and children	Y	Carole Lee
Community Wellness Outreach Project – Health Checks and wrap around VCS support for wellbeing.	Health and Wellbeing checks in the community, to reach into areas of deprivation and engage people from ethnically diverse groups at higher risk of poor health.	December 2023	June 2025 (Likely to be extended for a further 12 months to June 2026)	£811,000	Integration, Health, Procurement, Legal, Finance	Safeguard and support the health and wellbeing of Reading’s adults and children	N	Bev Nicholson
Adult Social Care Strategy / Co-production	Refresh ASC strategy  Increased involvement of residents in ASC strategy, policy, commissioning and recruitment. Better outcomes achieved through improved engagement.	April 2025	March 2026	£50k	Ops, Communications, Commissioning	Safeguard and support the health and wellbeing of Reading’s adults and children	N	Michelle Tenreiro Perez
Closing The Gap II-Commission	New contracts for the VCS that will clearly link the relevant funding streams and allows flexibility to adapt to changing needs	Started in 2024	October 2025	£1.4m per annum	Finance, legal, Procurement, Commissioning, Transformation, Public Health, Housing and VCS.	Work with our partners in health and the voluntary sector to provide support solutions for adults with complex health and social care needs to improve outcomes.	N	Lara Stavrinou
Home Care and Support Framework Commission	New Framework for Home Care providers to allow for spend control, fast commissioning of service on the framework, standardised T&Cs.	Started in 2024	June 2026	£9m per annum	Legal, Finance, Procurement and Commissioning	Work with our partners in health and the voluntary sector to provide support solutions for adults with complex health and social care needs to improve outcomes.	Y	Lizzie Angove
Supported Living Framework Tender	New Framework for Supported Living providers to allow for spend control, fast commissioning of service on the framework, standardised T&Cs.	Started in 2024	June 2026	£13m per annum	Legal, Finance, Procurement, Transformation Team and Commissioning	Work with our partners in health and the voluntary sector to provide support solutions for adults with complex health and social care needs to improve outcomes.	Y	Natalie Powell
Extra Care Market Development	Expand the offer of Extra Care to young cohorts and expand use for those with Mental Health diagnosis.	October 2024	January 2028	£2m per annum	Legal, Finance, Procurement, Commissioning, Planning, Housing.	Work with our partners in health and the voluntary sector to provide support solutions for adults with complex health and social care needs to improve outcomes.	N	Jamie Ford
Direct Payments	Enable more people to have choice and control of their care	June 2024	June 2026	£5m	Commissioning Team and Operations	Work with our partners in health and the voluntary sector to provide support solutions for adults with complex health and social care needs to improve outcomes.	N	Steve Saunders