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Adult Social Care Local Account 2021 to 2023

The purpose of the Local Account is to provide information on where Cambridgeshire County Council Adult Social Care is doing things well, where we think we can improve and how we are planning for the opportunities and challenges ahead.

The Local Account reflects on our achievements during 2021-23. It includes feedback that we have received through surveys carried out by the council and updates on priorities co-produced with our Adult Social Care Partnership Boards and other experts by experience groups/networks. 

Activity Overview for 2021-22 and 2022-23

Below is an overview of the number of people we have worked with in 2022-2023 and how different it was from the previous year. 

  • 22602 – The number of contacts from people who needed some support or information and advice. There were slightly fewer requests the year before, 21450. ​
  • 2344 – The number of people who received a technology enabled care assessment. There were more people the previous year, 3187.​
  • 4026 – The number of people to whom we provided a short period of support to recover from illness or a stay in hospital. There were slightly fewer people the year before, 3960. ​
  • 7891 – The number of people to whom we provided some longer-term care and support. There were slightly fewer people the year before, 7760.

How we spent our budget in 2021-22

Where we spent the money in 2021-22

  • £142.1 million on care and support purchased
  • £13.9 million on social care staff
  • £13.3 million on directly provided support
  • £29.5 million on other things
pie chart showing money spent in 2021 to 2022

Who we supported in 2021-22

  • 4,681 older people
  • 1,819 people with learning disabilities
  • 1,099 people with physical disabilities
  • 757 people who needed mental health support
pie chart showing people supported in 2021 to 2022

How we spent our budget in 2022-23

Where we spent the money in 2022-23

  • £160.1 million for care and support purchased
  • £15.7 million for social care staff
  • £15.3 million for directly provided support
  • £20.2 million for other things
pie chart showing money spent in 2022 to 2023

Who we supported in 2022-23

  • 5,162 older people
  • 1,891 people with learning disabilities
  • 796 people who needed mental health support
  • 675 people with physical disabilities
pie chart showing people supported in 2022 to 2023

Top three achievements and challenges for 2021-2023

As a core part of the Sector Led Improvement programme in the Eastern Region led by the Association of Directors of Adult Social Services (ADASS), councils are asked to complete a self-assessment. The self-assessment covers a wide range of themes. Cambridgeshire County Council submitted a self-assessment on 31 March 2022 which covered the previous 12 months. Subsequently the council met with a former Director of Adult Social Services for an external challenge session in July 2022 and took part in a regional challenge event in September 2022.

To enhance the council’s assurance process and to begin preparations for the introduction of external assurance by the Care Quality Commission, the council also invited the Local Government Association (LGA) to undertake a peer review building upon the self-assessment. The LGA peer review team gathered a substantial amount of evidence and spent a day auditing cases prior to three days field work during September 2022.

Top three achievements

Our self-assessment highlighted the following three areas as our key achievements for 2021-22:

Joint working with Public Health

During 2020-22 joint working with Public Health has delivered significant results. In particular, work with care providers around infection control and around Covid de-escalation, including supporting day services with ventilation surveys.

Partnership working with the health sector

Partnership working and good engagement with Primary Care Networks, especially in our Care Together pilot area. Strengths-based training has been provided to social prescribers and we have been jointly developing best practice in co-production with our user forums and the primary care personalised care network and wider health system. This collaboration has extended to digital solutions where the council is a key partner in the implementation of the Shared Care Record and are also actively involved in the project to roll out Joy, a social prescribing referral management system and public-facing directory across Cambridgeshire and Peterborough.

Strong safeguarding structures

We have a strong and well-established Safeguarding Adults Board and an effective Multi Agency Safeguarding Hub (MASH) with no backlogs or delays. Learning around Safeguarding Adult Reviews is effectively shared by wider Safeguarding Adults Board partners.

Top three challenges

The self-assessment identified the following three areas as our biggest challenges:

Adult Social Care workforce

The most critical risk is the pressure around workforce capacity, recruitment and retention across the local authority and care providers.

Lack of clarity over social care reforms

Our capacity to deliver future social care reform in respect of workforce and digital preparedness is of concern and is exacerbated by the lack of clarity on funding and delays to guidance. The movement of the Liberty Protection Safeguards implementation timelines to potentially overlap with operational change in relation to the cap on care costs will also add to resourcing pressures.

Cost of Care

The volume and number of self-funders approaching the council to commission care on their behalf and the impact on a fragile market recovering from the impact of the Covid-19 pandemic is significant. The fair cost of care and a single rate for providers will potentially see providers leaving the local market if no longer financially viable.

Partnerships with other organisations

Collaborative working continues with the Cambridgeshire and Peterborough Integrated Care System and our Primary Care Networks partners.

This partnership working is integral to our approach to place-based commissioning through the Care Together programme, supporting people to find local solutions to help them remain independent and well for as long as possible. During this period, we have continued our collaboration with health partners around digital solutions such as the Shared Care Record and implementation of the Joy Social Prescribing referral management system to improve the quality of referrals from primary care to our Adult Early Help team.

Also, alongside these activities, we have worked closely with health partners and other local stakeholders to develop a shared commitment and approach to co-production across the health and social care system within Cambridgeshire and Peterborough.


There has been range of Public Health programmes which protect and promote the health and wellbeing of our communities:

  • Stay Well this Winter
  • Network for Addressing Isolation and Loneliness in Cambridgeshire and Peterborough (NAILCAP)
  • Warm spaces / Warm Hubs work with District Councils and voluntary and community sector partners such as Cambridgeshire Acre
  • Cambridgeshire and Peterborough Suicide Prevention Strategy 2022-25 work
  • campaigns related to the Covid-19 pandemic including the Vaccinators on Tour Covid-19 vaccine walk-in clinics

Good practice example

The Stay Well this Winter multi-agency campaign which works across the local health and social care system.

The campaign works to mitigate the risks associated with cold weather to the health and wellbeing of the most vulnerable members of the community, who live in cold homes due to fuel poverty. It aims to:

  • provide appropriate information to the public and frontline professionals
  • provide key information for support and access to resources
  • distribute grants for heating and minor repairs to vulnerable groups
  • promote and increase the uptake of the flu vaccine amongst vulnerable groups

In 2022-23, the Stay Well annual fuel poverty grants programme:

  • received 563 applications from 24 organisations
  • gave out £105,000 to over 1,300 beneficiaries

Also, the Stay Well this Winter campaign:

  • distributed 20,000 annual Stay Well information packs and 3,000 Easy Read Stay Well information packs to residents in Cambridgeshire and Peterborough

Health and social care working together​

A Section 75 Agreement delegates the responsibility for mental health social work to the Cambridgeshire and Peterborough NHS Foundation Trust (CPFT). This enables a close working relationship between the council and CPFT and for health and social care needs to be considered jointly. A CPFT lead for social work is in place to ensure this is a high priority. CPFT has developed an Annual Work Plan for Mental Health which is reported against regularly.

There is strong engagement with voluntary sector mental health support organisations. Services are jointly commissioned with the Cambridgeshire and Peterborough Integrated Care System where appropriate. The Good Life service provides a recovery and community inclusion service accommodating needs across the whole mental health pathway.

In 2021-22 a robust transitions pathway for managing the transition from child to adulthood was developed.

How Are You Cambridgeshire and Peterborough

The council has worked closely with How Are You Cambridgeshire and Peterborough to share information about local services and groups that support mental health and wellbeing. How Are You (HAY) Cambridgeshire and Peterborough is a community engagement team working within CPFT who think creatively about solutions to mental health need and connect community assets to clinical care.

The team manage a set of local websites which bring together everything in the local community that is good for wellbeing. They use the websites to share knowledge with both the general public and those working and volunteering to support people across the county: How Are You Cambridgeshire and Peterborough | H.A.Y. Home (

The council launched the new Special Educational Needs and Disabilities (SEND) Information Hub website. The website was developed and co-produced with Cambridgeshire parents and carers of children with special educational needs to help them find advice and support.

The hub provides information on a range of topics including targeted support, health, education, and preparing for adult life.

We have positive relationships with District Councils and both housing and supported housing providers. The County Council is also an active member of the Sub Regional Housing Board and is working with partners to consider the requirements and implications of the new Supported Housing Act 2023.

Work is currently underway to produce a Future Accommodation Strategy that will set out the County Council’s priorities for housing and support across Cambridgeshire. The strategy will cover older people and those with learning disabilities, autism, or mental health needs.

The County Council also provides funding for a number of supported housing services which aim to support a wide range of Cambridgeshire residents. These include:

  • Extra Care services which help older people to remain living independently within the community.
  • Visiting support services for older people to help them to remain at home for longer.
  • Services which support adults, young people and families who are homeless or at risk of homelessness.
  • Housing First which works with people with multiple disadvantage and is delivered by the County Council.

Community engagement

To achieve our vision of supporting older adults to live happily and healthily for longer in their own home, Care Together is a place-based programme that engages local communities in identifying solutions that work for local people. These include:

  • Care Micro-Enterprise development
  • Holistic Home Care Assessments
  • Integrated Neighbourhoods (health and social care working together with local partners in each community)
  • seed-funding of innovative approaches to supporting older people or expansion of services into new areas
  • libraries as Community Hubs
  • incorporation of Healthy Lifestyles, especially exercise, in specifications of Adult Social Care Services
  • reducing carbon emissions by developing local provision for Cambridgeshire residents
  • support for carers and development of Age-Friendly and Dementia-Friendly Communities

Healthwatch Cambridgeshire and Peterborough, who are commissioned by the council, bring together individuals and local partners through groups such as the five Adult Social Care Partnership Boards, the Wheelchair Users’ Forum, and their four place-based Health and Care Forums. These groups support the continuous improvement of health and social care across Cambridgeshire and Peterborough. More information on Healthwatch website

Also, we have benefited from other work carried out by Healthwatch, such as:

The council has developed a range of engagement channels for people to give their feedback, including the Adult Social Care Partnership Boards, experts by experience groups and networks, and the Adult Social Care Forum. These include:

  • The SUN Network (empowering those with lived experience to help develop, change and influence mental health and drug and alcohol support services for the better).
  • VoiceAbility | Speak Out Cambridgeshire (a voice for people in Cambridgeshire who are autistic or have a learning disability).
  • Counting Every Adult co-production group (representing people with multiple disadvantages who experience several problems at the same time, such as mental ill health, homelessness, drug and alcohol misuse, offending, and family breakdown).
  • The Adult Social Care Forum, a working group facilitated jointly by Cambridgeshire County Council and Peterborough City Council, which discusses issues about health and social care services in Cambridgeshire and Peterborough. The Adult Social Care Forum looks at key themes raised by experts by experience groups such as the Adult Social Care Partnership Boards, SUN Network, and other participation groups/forums, and uses this information to help improve local health and social care services, acting where needed: More information about the Adult Social Care Forum

The Adult Social Care Forum co-produces an annual shared priorities action plan. View the progress reports for the 2021-22 and 2022-23 plans.


The Adult Social Care Outcomes Framework (ASCOF) measures how well care and support services achieve the outcomes that matter most to people.

The ASCOF is used both locally and nationally to set priorities for care and support, measure progress and strengthen transparency and accountability.

Go to NHS Digital Measures from the Adult Social Care Outcomes Framework webpage.

Social Care Related Quality of Life

The Social Care Related Quality of Life score is made up of indicators around different aspects of people’s lives including nutrition, personal care, safety, social contact, how people are helped, control over daily life and whether people can spend time doing what they want to do. The results below relate to the period 2021-22.

The regional score was 18.9.

Cambridgeshire’s result was better at 19.0.

Indicators where Cambridgeshire did better than the regional average

  • More people receiving self-directed support.
  • More people using social care receiving self-directed support.
  • More adults with learning disabilities who live in their own home or with family.
  • More people who use the services feel safe.
  • Fewer admissions to residential and nursing care homes for those between 18-64.
  • Higher proportion of carers are included and consulted in discussions about people they care for.
  • More people who use services have control over their daily life.
  • More people who use services have as much social contact as they want.
  • Higher overall satisfaction of people with their care and support.

Indicators where Cambridgeshire did worse than the regional average

  • Higher admissions to residential and nursing care homes for older people to support long term needs.
  • Fewer adults are in contact with secondary mental health services when they live independently, with or without support.
  • Fewer people who use the services say those services have made them feel safe and secure.
  • Fewer older people still at home within 91 days of leaving the hospital.
  • Fewer people find it easy to find information about services.
  • Fewer people accessing social care receive direct payments.
  • Fewer adults with learning disabilities in paid employment.
  • Fewer older people offered reablement services following discharge from hospital.