Supporting approaches

Since defining our vision as being one of ‘promoting independence’, our direction of travel has been to challenge ourselves to innovate by moving from:

• transactional towards strengths-based care management
• tactical towards strategic commissioning
• consultation towards co-production with people
• contracting with to working in partnership with providers
• organisational towards system and joint working
• assuming dependence to promoting independence
• ongoing care by default towards short-term support
• use of care homes towards keeping people at home in the community
• institutional settings towards housing with support
• day centres to enabling day opportunities

With change management and governance now in place, we are now developing our approach by:

• using our updated ‘Promoting Independence’ vision and ‘Living Well’, ‘Ageing Well’ and ‘Caring Well’ strategies to frame our change priorities
• bringing together changes required by financial sustainability, government reform, and operational recovery from the pandemic into one programme, including those articulated in our strategies
• taking a more systematic approach to improvement identification, prioritisation, planning and delivery drawing on learning from our Peer Challenge and our Self-Assessment process and revised Performance and Assurance Board arrangements
• scheduling our programme plan into future years aligned to our Medium Term Financial Strategy, in recognition that we currently don’t have the capacity to deliver everything we would like to
• using our Extended Leadership Team to determine priorities and the phasing of the programmes and projects that will deliver them
• better aligning our adult social care priorities and our corporate and ‘One Devon’ system strategies and plans by ensuring that the voice of adult social care is prominent in both

Our current work plan is shifting focus from securing financial sustainability to service improvement under the priority headings of ‘enabling and effective working’, ‘delivering best value’ and ‘improving our practice’, while freeing the capacity necessary to deliver on corporate priorities such as local government reorganisation and devolution, ensuring that any new contractual commitments or staffing restructures are aligned to that timetable.

Our approach to prevention, information and advice

In our health and care system, we consider prevention at three levels:

• Primary prevention focusses on reducing the incidence of conditions that lead to health and care needs developing through universal public health approaches.
• Secondary prevention concerns targeted early interventions to delay and reduce those needs and any requirement for ongoing support.
• Tertiary prevention works with people already receiving care and support to maximise their independence through approaches such as reablement and enablement.

Our public health offer considers the wider determinants of health and wellbeing impacting on our population through the Joint Strategic Needs Assessment and defines priorities for addressing them in the Joint Health and Wellbeing Strategy:

• Promoting healthier lifestyles through our One Small Step programme.
• Mitigating the risks of COVID-19 and other infectious diseases through our Local Outbreak Management and health protection arrangements.
• Promoting volunteering as part of our wider approach to developing and working with the voluntary and community sector. 

In our vision, we emphasise the importance of people being informed to make the best choices for them to maintain or maximise their independence:

• Online through our website that offers facilities such as information and advice relating to adult social care, guided self-help, online self-assessment, a directory of local support, and advice on equipment that assists in independent living.
• Over the phone, via our Customer Service Centre Care Direct service and, where an assessment of needs is required, via our telephone-based Care Direct Plus or face-to-face Community Health and Social Care Teams.
• Specialist advice for groups such as carers and people with mental health needs through our partners Devon Carers and the Devon Partnership Trust and for people with disabilities.

Our telephone and IT systems have historically enabled us to provide an improved telephone-based service differentiated according to people’s needs. We have now deployed technology to enable people to interact with us online. As we implement the next generation of care management systems we will further develop our capabilities to improve how people can contact us to find the help they need.

Over the last decade, we have put increasing emphasis on how we work with people to maximise their independence, especially through short-term support:

• Through Social Care Reablement mainly targeted at older people to avoid admissions into hospital, facilitate their discharge from hospital, and promote their recovery, rehabilitation and reablement after a crisis.
• Through the Urgent Community Response team and First Response services of our NHS partners.
• Through Reaching for Independence, which works with younger adults with disabilities to maximise their capacity for independent living.
• Through the use of Technology Enabled Care Services, alerting us to when people need assistance, and increasingly supporting them directly in other ways.

Our approach to developing the adult social care market

For most people in Devon, their experience of adult social care is through independent and voluntary sector providers, from personal assistants to national organisations.

The local authority has a duty to ensure a diverse, high-quality market and to assess needs, arranging funding for those who are eligible. However, everyday care is mainly delivered by these providers.

We work with adult social care providers in Devon through the Provider Engagement Network and facilitate locality and sector specific forums as well as online resources, communicating via a regular newsletter and topic-based webinars, offering support with:

• contracting with Devon County Council
• our approach to Quality Assurance
• funding opportunities
• business continuity planning
• our Market Position Statement, Market Sustainability Plan, and Cost of Care assessment
• managing outbreaks of infectious diseases such as coronavirus, influenza, and norovirus
• vaccination for staff and service users
• workforce development and wellbeing
• a directory of local and national resources

The adult social care commissioning function is structured to maintain a diverse, high quality, sufficient and affordable adult social care provider market; to work in partnership on co-producing more innovative solutions to meet people’s needs; and deliver on our vision, strategies and resulting Market Position Statement and its commissioning intentions.

Our Strategic Commissioning and Market Development Team focus on strategic commissioning: 

• Assessing future demand for services and the market capacity and capability to meet that demand.  
• Developing commissioning strategies based on that analysis focussed on sufficiency, quality, affordability, and choice. 
• Developing business cases and options appraisals to secure services that deliver on those commissioning intentions, including working with providers on innovations including through technology.  
• Designing services and developing service specifications and contract monitoring requirements.  
• Agreeing the approach to procurement through tenders and contracts. 
• Continually assessing and acting on strategic market and workforce risks.  
• Leading on market engagement and provider communication.  
• Management of countywide contracts including those relating to equipment and carers.  
• Evaluating the outcomes achieved through strategic commissioning of services and other solutions.  

Key products of our strategic commissioning include the Market Position Statement and Market Sufficiency Statement.  

Our Quality and Contract Management Team focus on contract management and quality assurance and improvement: 

• Service Monitoring and Support, ensuring effective service delivery through regular reviews and interventions aimed at continuous market improvement. 
• Contract Management, maintaining strong provider relationships, upholding provider contract terms, and ensuring services meet quality/contract standards. 
• Financial Oversight, monitoring the financial aspects of contracts addressing discrepancies, and upholding service standards. 
• Quality Assurance, ongoing monitoring of service quality against benchmarks, proactive risk management, and driving performance improvements. 
• Supporting providers, offering guidance to providers facing challenges and assisting with smooth introduction of newly contracted services. 

The approach aims to be supportive while reserving the right to suspend activity where services are judged to be Inadequate or there are serious safeguarding concerns. 

Devon County Council works with its voluntary, community and social enterprise sector through umbrella organisations including: 

The Devon VCSE Assembly, part of a UK network of VCSE alliances seeking to strengthen the voice of the sector and share good practice, working across the area of the Devon Integrated Care Partnership Board and complemented by local networks. 

• Devon Communities Together, the Community Council of Devon, whose vision is to inspire and support rural communities in devon to be dynamic and sustainable places to live and work.  
• The Devon Mental Health Alliance, a partnership between six organisations dedicated to providing support for people experiencing challenges with their mental health whose goal is to improve access to services and identify new opportunities to support people across all of Devon’s communities. 
• Healthwatch Devon, the independent consumer champion for health and social care in the area of the Devon Integrated Care Partnership Board, linking in with voice organisations across the sector.  
• Local VCSE consortia that provide key services to us such as the Devon Advocacy Consortium and Devon Disability Voice within the Devon Engagement Service all coordinated by Living Options Devon.  

In Integrated Adult Social Care, we work with our colleagues within the Communities function of our Public Health directorate to ensure our work with the VCSE sector is coordinated with best use made of available grant funding.

Our approach to developing the social care workforce

Over 28,000 people work in adult social care in Devon (Skills for Care Workforce Intelligence, 2023-2024), majority working in the independent and voluntary sector. Without an adequate, committed, experienced and well qualified workforce, the adult social care sector cannot deliver sufficient, diverse, and high-quality services to meet the needs of our population, whether they fund their own care or are supported by the local authority or NHS.

Our workforce vision for adult social care (ASC) in Devon  

The workforce vision sets out the adult social care challenges and how they impact upon the workforce. It also sets out Devon County Council’s ambition in terms of how we plan to respond to those challenges, what we want to achieve and what we need from an adult social care workforce now and in the future. 

• Everyone in every role feels valued, motivated and committed, and people are at the heart of everything we do. 
• Everyone in every role lives ‘our values’ and has the support and the tools to do what they came into adult social care to do. 
• Everyone in every role delivers adult social care as a springboard to what they want to achieve. 
• Our practice continually evolves, and we embrace the new and the innovative. 
• Everyone can see a career pathway and opportunities to develop, grow and advance. 
• The adult social care workforce is more diverse, and people aspire to work and remain in it because it is inclusive and rewarding, and they can see the difference they can make. 
• People can access quality and safe care and support because there is a sufficient and sustainable workforce.  

What we are going to do 

Working with independent providers (including personal assistants) 

• We will be clear on our promoting independence approach, and that will shape our work with the independent provider market in delivering our duties. 
• We will develop a shared understanding of what a strengths-based approach means and looks like. 
• We will be clear, through our Market Position Statement, what a sufficient care market looks like across Devon, and the opportunities that exist. 
• We will be clear on our quality expectations and be explicit on our role in supporting providers to meet these expectations. 
• We will be clear on how we support independent providers to recruit and retain a high quality and skilled workforce, providing and signposting to tools and training such as safeguarding, to help them with the responsibilities they have.  

We are also focussed on developing our own workforce through our ‘Unleashing the Potential Programme’ and an ongoing recruitment campaign, by:

• benchmarking salary and other employee benefits across the region
• reviewing our career pathways across the health and care system
• promoting our existing staff benefits including opportunities for secondments, career breaks, flexible retirement, and unpaid leave
• extending our social work apprenticeship scheme and considering similar for occupational therapy as part of our ‘grow our own’ workforce strategy
• looking at international recruitment following successes in the wider sector
• using a range of media, social media, and other opportunities to promote opportunities to work in adult social care in Devon County Council

Our approach to involvement and co-production

Devon County Council is committed to enabling people who receive our support to have their say in the planning, commissioning, and provision of services, whenever possible. We have a number of different ways of engaging with people who use services and carers and the wider public, so we learn from their experience of adult social care, including:

• the Joint Engagement Forum – a quarterly gathering of people who use services, carers, and relevant organisational representatives.
• the Learning Disability Partnership Board – of people with learning disabilities, carers, relevant providers and health and social care managers.
• the Autism Involvement Group – a specialist forum for autistic people, those with attention, deficit, hyperactivity disorder (ADHD) and related conditions and their carers.
• Co-production groups meet to advise officers on co-production opportunities and methods, including running co-produced co-production awareness sessions.
• Carer Ambassadors recruited by Devon Carers to actively represent the views of carers, a number of whom sit on the Carers Partnership Steering Group.
• mental health engagement – services are delivered and jointly commissioned by Devon Partnership NHS Trust who have developed the LEAP programme.
• older people’s engagement – set up to deliver all forms of engagement opportunities with our partners Age UK Devon.

We also commission services that further facilitate the involvement of people with lived experience in making their voices heard:

• Living Options Devon coordinate a network of organisations who help us engage with people through statutory consultations and more informal listening events and surveys.
• The Equalities Reference Group is made up of people from organisations representing each characteristic protected by the Equality Act (2010) and helps us undertake Impact Assessments.
• Healthwatch Devon is the statutory health and social care consumer voice organisation for the Devon County Council area, and receive their reports at our Health and Care Scrutiny Committee and our Health and Wellbeing Board.
• Our corporate Customer Relations service that facilitates formal complaints and other feedback.

We are increasingly going beyond listening to and consulting with people to actively work with them in our Co-Production Working Group whose aim is to develop the council’s approach to participative involvement in commissioning, planning, designing, and evaluating services.

Like other local authorities we participate in statutory surveys of the people who receive adult social care services, annually for service users, and every other year for carers, enabling us to listen to the views of hundreds of people locally on the services they receive and the impact of their lives, and to compare their experiences with those who live elsewhere.

We incorporate these insights into our annual report and share and discuss widely to better understand what factors informed people’s responses.

Our approach to assurance

The Health and Care Act (2022) gave the Care Quality Commission (CQC) new regulatory powers to undertake independent assessment of local authorities’ delivery of regulated care functions set out in Part 1 of the Care Act (2014).

The assessment framework draws on the new CQC approach that defines a set of quality statements that are arranged under topic areas and describe what good care looks like. The framework aims to:

• set out clearly what people should expect a good service or system to look like
• put people’s experiences of care at the heart of judgements
• ensure that gathering and responding to feedback is central to the expectations of those assessed

This assessment framework has been grouped into four key themes, each with several quality statements mapped to them:

• How local authorities work with people – assessing needs, care planning and review, direct payments, charging, supporting people to live healthier lives, prevention, wellbeing, information and advice, equity in access and outcome.
• How local authorities provide support – market shaping, commissioning, workforce capacity and capability, integration and partnership working, supporting carers in their role.
• How local authorities ensure safety – safeguarding enquiries, reviews, Safeguarding Adults Board, safe systems, pathways, transitions, and continuity of care.
• How local authorities lead the care system – culture, strategic planning, learning, improvement, innovation, governance, management, and sustainability.

The CQC began this new inspection regime in December 2023, aiming to inspect all upper tier local authorities within a two-year baselining period. Devon was notified of its inclusion in the inspection regime in February 2025 and is currently waiting to hear when inspectors will be in Devon.

Each year in Devon we have maintained the discipline of writing and sharing an annual report which is our assessment of how we are performing. Since 2022, our annual report extended the range of evidence we use to represent the lived experience of the people we serve to include:

• some key facts about the population of Devon and the people we serve
• the money we spend on those services, activity levels and their cost
• the outcomes we achieve, including those defined by the government in the adult social care outcomes framework which we can benchmark against other local authorities
• what people say about their lives and the difference services make to them, through structured and statistically sampled surveys, at the various involvement groups we facilitate, and through the organisations that give them a voice such as Healthwatch
• how our care management service performs in meeting our statutory responsibilities to assess and review people’s needs and arrange services to meet them
• in particular, how well we fulfil our safeguarding duties compared with other councils, with analysis of who and what concerns are about, and their resolution
• the quality, sufficiency, and affordability of our market of independent and voluntary sector providers of adult social care services
• the recruitment, retention, demographics and continuing professional development of our internal and external workforce
• what we learn from complaints, audits, and other formal feedback

This continues in the 2024 report.

We have revised our Assurance Framework to better align to our updated Vision and Strategies, using the wider evidence base contained in our annual report, and aligned to the structure of the CQC assessment framework.

This has been accompanied by changes to our Assurance Governance to give all stakeholders a clearer and more complete view of our performance. A Performance and Assurance Board has been established to coordinate assurance governance relating to adult social care in Devon County Council by overseeing delivery, gaining insights and determining improvements from performance, quality, risk, complaints and other feedback and audit.

The Board oversees and complements existing performance management and quality improvement arrangements where the detail of assessing and improving performance and quality is undertaken.