Agenda and minutes

To note any apologies for absence from Members.

Apologies for absence were received from Councillors Liz Wardlaw and Sue Adams. Councillors Andrew Kolker and Sally Holland were present as substitutes.

To provide an opportunity for Members and Officers to declare any disclosable pecuniary interests, other registerable interests, and non-registerable interests in any item on the agenda.

In the interests of openness and transparency, the following declarations of interests were made:

Councillor Carol Bulman declared that, in relation to Item 7, she was the Ward Member for Middlewich, where the Willowmere Extra Care Housing facility was located.

To approve as a correct record the minutes of the previous meeting held on 23 June 2025.

RESOLVED:

That the minutes of the previous meeting held on 23 June 2025 be approved as a correct record.

In accordance with paragraph 2.24 of the Council’s Committee Procedure Rules and Appendix on Public Speaking, set out in the Constitution, a total period of 15 minutes is allocated for members of the public to put questions to the committee on any matter relating to this agenda. Each member of the public will be allowed up to two minutes each to speak, and the Chair will have discretion to vary this where they consider it appropriate.

Members of the public wishing to speak are required to provide notice of this at least three clear working days’ in advance of the meeting.

Petitions - To receive any petitions which have met the criteria - Petitions Scheme Criteria, and falls within the remit of the Committee. Petition organisers will be allowed up to three minutes to speak.

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Mr John Moulton spoke on behalf of residents of the Oakmere and Willowmere Extra Care Housing residents, in connection with Item 7, and stated that he had lived in Willowmere since it had opened. Mr Moulton said that he and other residents had worked closely with Cheshire East’s Communities Team to look at how the on-site restaurant could be re-opened in a way which would satisfy the residents, the council and an operator. Mr Moulton stated that residents viewed it as essential that there was provision for a hot nutritional meal to be provided, not only for their physical well-being, but for their mental well-being as the restaurant provided important social interaction for residents. Mr Moulton also noted the important role which the previous restaurant played in supporting the wider community of Middlewich and strongly supported the recommendations within the report and committed to continue to work alongside any new provider and Cheshire East Council.

To note and comment on the First Financial Review and Performance Position of 2025/2026.

Councillor John Place arrived at the commencement of this item.

The committee considered a report on the First Financial Review and Performance Position of 2025/2026.

It was noted that the Adults and Health Committee were reporting forecast of £0.3 million underspent. However, there was uncertainty in fluctuating care costs which could influence this; it was noted that there was an “optimistic” forecast for the Adults and Health Committee of £0.7 million underspent and a “pessimistic” forecast of £4.6 million overspent – the difference between best and worst cast for FR1 was £5.3 million.

Members were updated that 52% of placements in 2025 / 2026 were at the guide price, but there were several scenarios as to how the finances could play out for the rest of the year and a significant level of risk in the forecasts. It was noted that at FR2 the most likely case was balanced position, and not £700,000 underspend; due to unplanned activity in hospitals in July 2025 but this was starting to level out. It was noted that activity was closely related to challenges faced by NHS partners, and conversations were taking place regarding S117 aftercare and agreement of continuing healthcare packages.

It was noted that Cheshire East Council was also seeing an increased number of resident self-funders who were running out of funds at a higher-than-normal rate and earlier in the year. It was noted that the transformation plan savings were profiled to be realised later in the financial year and that active monitoring was taking place. It was noted that we were likely to see emergent winter pressures.

Members were updated that reserves that the council holds will continue to be monitored against the position and level of risks in the service committee and council as a whole.

It was noted that Cheshire East Council was working closely with partners on commissioning, but the conversations with the NHS and Integrated Care Board was increasingly complex.

Members were updated that the public health ringfenced reserves could only be spent on specific costs, and over time the amount may reduce. It was noted that the national guidance was to hold 5% of reserves to cover any emergency local health issues, and that the reserves may be used to increase the levels of vaccination and immunisation uptake and awareness.

Members were updated that it was expected that the 4-year MTFS set in Feb 2025 anticipated that the Adults and Health Committee budgets would flatline, but this may change dependant on unforeseen demand.

RESOLVED (Unanimously):

That the Adults and Health Committee:

1.    Review the factors leading to a forecast adverse Net Revenue financial pressure of £3.1m against a revised budget of £440.5m (0.7%). To scrutinise the contents of Annex 1, Section 2 and review progress on the delivery of the MTFS approved budget policy change items, the RAG ratings and latest forecasts, and to understand the actions to be taken to address any adverse variances from the approved budget.

2.    Review the in-year forecast capital  ...  view the full minutes text for item 19.

To consider a report which seeks approval from Members to recommission the ‘Accommodation with Care’ contract (Residential and Nursing Care Homes) ahead of the contract expiry date 31^st March 2026.

The committee considered a report which sought approval from Members to recommission the ‘Accommodation with Care’ contract (Residential and Nursing Care Homes) ahead of the contract expiry date 31^st March 2026.

Members were updated that there were 97 Care Homes within Cheshire East through which the council commissioned 1423 beds for adults in long term placements. It was noted that Cheshire East had a framework of requirements with 75 of those care homes which expired on 31 March 26. It was noted that as part of the recommissioning exercise disruption to residents in these homes would be minimised and that Cheshire East would invite the remaining 22 care homes to join their existing framework. There was a proposal for the recommission to be in place for five years with option for a further two years. It was noted that the majority of care homes in Cheshire East were rated as “good” or “outstanding” by the Care Quality Commission (CQC) and where needed the council would work with care homes via an action plan to improve the quality of the care which they delivered.

Members were updated that there were a number of strands within the Transformation Programme to ensure that Cheshire East Council had fewer long-term placements for residents. It was noted that the contract does not guarantee business to care homes but provided them with the opportunity for them to bid for packages to ensure that Cheshire East Council gets the right placements and the right price. It was noted that the council currently had a project underway with self-funders to support them to make decisions which may be alternative to long-term care at an earlier stage and was developing an Accommodation With Care strategy to assist the council in planning where care homes of different styles were likely to be required around the county. It was noted that the planning department encourage the Adults and Health directorate to comment on planning applications which come forward from care home to ensure that the demand is in the right place.

It was noted that the previous contract commenced in 2018, some of the care homes had joined in the intermediary years, but all of the contracts would come to an end on 31 March 2026. It was noted that it was a regulated market and the CQC would have a review of each care home, in addition to this, Cheshire East Council has a risk matrix which was managed monthly which set out all intelligence the council had on providers, which was gathered via social workers, complaints, safeguarding enquiries, etc. and the council’s quality assurance team would work with providers who were struggling to develop an improvement plan and would take an active part in oversight.

Members noted that this was a very significant and costly contract for the council and raised concerns that there were several care homes who had not tendered for a number of years. It was noted that there would be opportunities within the framework  ...  view the full minutes text for item 20.

To consider a report which outlines actions taken to understand the resident’s catering needs, assess market interest in delivering a service in the schemes, and identifies a preferred future service model.

The committee considered a report which outlined the actions taken to understand the resident’s catering needs, assess market interest in delivering a service in the schemes, and identifies a preferred future service model.

Members were updated that there had been a temporary meal service since the original serviced ceased operation in April 2025. It was noted that residents had been heavily involved in the provision of a new scheme, working closely with Cheshire East Council, and there was demand for an on-site provision which would be cost neutral by the end of the contract. It was noted that the aim was for the new provision to be in place by 1 March 2026, and the interim arrangements would remain in place until then. It was noted that their request was for a hot and healthy meal to be available at lunchtime least five days per week.

It was noted that the school catering contract had previously provided the meals on site and that going forward all commercially viable options would be sought, especially those which were sustainable and would have a beneficial impact on the wider community. It was noted that early market engagement suggested that a number of suppliers were interest in the contract and Cheshire East Council would hold several sessions with prospective parties.

It was noted that there was a need to manage expectations with residents, to ensure that that facility was well utilised, and also of the substantial benefits to physical and mental wellbeing associated with sharing a hot meal.

Members thanks residents for their collaborative working with Cheshire East Council.

RESOLVED (Unanimously):

That the Adults and Health Committee:

1.    Note the review of the catering provision in Oakmere and Willowmere (Annex 1) and the findings of that review, including the risk of market failure.

2.    Agree to the procurement of a new service provider via an open procurement and delegate authority to the Executive Director of Adults and Health to undertake the procurement and award a contract to the successful provider(s), on terms and conditions to be agreed in consultation with the Governance, Compliance and Monitoring Officer.

To consider a report which seeks approval to proceed with the recommission of the Integrated Sexual Health Service in Cheshire East.

The committee considered a report which sought approval to proceed with the recommission of the Integrated Sexual Health Service in Cheshire East.

Members were updated that there had been national changes since the contract was last commissioned and there was a need to ensure that it was a service which the public could access easily. It was noted that this was a mandatory service and there was an intention for further reports to the committee in 2026 / 2027 which detailed the preferred procurement process.

Members were updated that sexual health was not just limited to one age group and the service would be reassessed to ensure that it engaged all age groups and was fit for purpose for society. The importance of reaching residents who engaged in higher risk sexual activity was noted.

It was noted that chlamydia was difficult to test for, and that if low rates are detected it could be difficult to understand if that was because of low levels in the population, or due to low levels of people coming forward for testing. It was noted that some people may choose to go to areas outside of their locality for testing. It was noted that Cheshire East was an area with lower rates of HIV which could also alter attitudes towards testing, leading to people getting tested late and therefore receiving treatment at a later stage.

Members requested more statistical data in the reports and were updated that Cheshire East Council benchmarks its testing with neighbouring local authorities to ensure best practice.

The improvement in education of sexual health over the years was noted by members.

RESOLVED (Unanimously):

That the Adults and Health Committee:

1.    Approve the commencement of work on recommissioning the Integrated Sexual Health Service.

To receive a report which provides an update on the progress of the Adult Social Care Transformation Programme as outlined in a report to January 2025 committee.

The committee received a report which provided an update on the progress of the Adult Social Care Transformation Programme as outlined in a report to January 2025 committee.

Members were updated that the Transformation Plan was currently progressing two major programmes – Prevent, Reduce and Enable, and the Learning Disability Programme, with the aims of improving care to residents, reducing costs, and creating £15 million of savings over the next four years. Members were updated that outline business cases were being produced, and full business cases would be developed. Officers were assessing the results of the Prevent, Reduce and Enable pilot which had been started in June 2025 in Macclesfield. It was noted that there had been a number of case studies where residents had been assisted to be more independent and had been able to move out of care homes and back into their own homes, which was better for residents and more cost effective for all. It was noted that there were finance, enabling and workforce strategies in place to support the transformation plan.

Members were updated that one of the next steps would be to look at Mental Health Services and issues relating to employment and housing as well as how Cheshire East Council could work more closely with the NHS to improve mental health support to residents. It was noted that Cheshire East Council has one of the highest average care package costs for learning disability in the country with a perceived low hourly rate.

It was noted that work was underway to look to reduce admissions to care homes via ongoing assessments with residents, technology improvements, reablement and identification of gaps for other methods of support. It was noted that the transformation was concerned with making financial savings and not cuts for support; and individual needs assessments would be carried out on a case-by-case basis.

Members requested that the committee receive feedback from those who are receiving and using the service, and that the transformation is delivered at pace with KPIs.

RESOLVED (Unanimously):

That the Adults and Health Committee:

1.    Note the content of the report and that further papers will be brought to Adults and Health Committee when there are significant decisions to be made.

To consider a report which presents an evaluation of the Cheshire East Smoking in Pregnancy Incentives Scheme and recommends the transition to the National Smoke-Free Pregnancy Incentive Scheme.

The committee considered a report which presented members with an evaluation of the Cheshire East Smoking in Pregnancy Incentives Scheme and recommended the transition to the National Smoke-Free Pregnancy Incentive Scheme.

It was noted that in Cheshire East the overall rates of smoking at time of delivery had fallen below the national average for England, and that the feedback from the scheme had been positive and women had found the scheme helpful. Lessons learned from the scheme would be fed into the national rollout. It was noted that not as many mothers took up the scheme which was initially hoped, but there was an improvement in uptake when the scheme was transitioned to being delivered directly in a maternity unit.

Members noted the success of the scheme and the value for money which it had proven and that were updated that of those who continue to smoke during pregnancy, it was likely that they were in areas of deprivation and may have more reasons as to why it would be more difficult for them to stop smoking. It was noted that switching to vaping for some mothers had been a useful quitting-aid.

It was noted by Members that foetal alcohol syndrome was also a problem and hoped that the success of this scheme could be built on to help address this issue. Members also noted that it would be useful to have more data regarding the babies of smoking / non-smoking mothers who were in need of specialist care and suffered from infantile asthma and other respiratory illnesses.

RESOLVED (By Majority):

That the Adults and Health Committee:

1.    Scrutinise the report findings.

2.    Agree to the continuation of the household member component of the intervention during the transition to the national model.

3.    Agree to the phasing out of the local scheme for pregnant women and household members as the national offer expands to include significant others.

4.    Agree to retain the option to reintroduce a local scheme if national funding ends. In this case, improve household member engagement through earlier promotion, simplified consent procedures, and remote CO monitoring.

To receive the minutes of the Cheshire East Health and Wellbeing Board – 1 July 2025.

RESOLVED:

That the minutes of the Cheshire East Health and Wellbeing Board from 1 July 2025 be received and noted.

To consider the Work Programme and determine any required amendments.

The committee consider the Work Programme and determine any required amendments. It was noted that due to upcoming changes to the Council’s governance system, the Work Programme would be revised from March 2026.

Members were asked to review the work programme and contact the Chair or Democratic Services with any suggestions of scrutiny items that they would like to put forward for the Committee.

RESOLVED:

Members approved the Work Programme and requested that officers consider whether reports with quantitative indicators of success could be brought to the committee.