Somerset Council responded to a projected £13m overspend in adult social care by launching a system-wide transformation programme. Through collaborative diagnosis, they identified opportunities to better support people to maintain or regain independence, avoiding unnecessary escalation into long-term care. Improvements in reablement delivery, assessment processes and progression planning contributed to better outcomes for residents and a projected £10m in savings between 2022/23 and 2024/25.
Delivering on statutory adult social care duties while maintaining service quality and financial sustainability requires not only robust planning but also the ability to transform the operating model. Traditional service pathways can result in high-cost, long-term care arrangements that may not deliver the best outcomes for individuals or value for money. Against this backdrop, councils are rethinking their approach, shifting towards prevention, independence and earlier intervention, and supported by strong financial governance and data-led decision making.
The challenge
In 2022, Somerset’s adult social care service faced rising demand, a projected £13m overspend and significant operational pressures. In response, the council undertook a diagnostic review to understand what was working well and where there were areas of opportunities, with a focus on improving outcomes for the people we support. Through collaborative workshops with social work teams, NHS colleagues, children’s social care, and the voluntary, community, faith and social enterprise (VCFSE) sector, we asked: “Did we achieve the ideal outcome for this person – and if not, why not?”
While examples of excellent practice were evident, the findings made clear that delivering consistently strong outcomes required exploring new ways of working. The resulting transformation programme – named ‘My Life, My Future’ – aimed to support people to maintain or regain independence, whether through enhanced short-term services following a crisis, supporting people differently to remain at home rather than moving them to a residential placement or helping individuals develop new skills to do more for themselves. This focus on independence for people aims to allow people to live the lives they want but also reduce or avoid increases in the level of long-term care provision and support required from the local authority, resulting in financial savings.
The action
The programme began with a diagnostic phase, which produced a set of prioritised opportunities for change aligned with our adult social care strategy that were focused on improving outcomes, experiences and financial sustainability. From summer 2023, each of the four core workstreams progressed through a consistent change approach, beginning with a design phase combining subject matter expertise and deep data analysis, followed by targeted trials of new ways of working within specific teams or localities. These trials enabled iterative refinement, backed by clear key performance indicator (KPI) tracking to determine effectiveness. Proven changes were then rolled out during the implementation phase.
For example, the reablement workstream aimed to improve two core KPIs: the number of individuals completing a period of reablement each week and the effectiveness of that support in increasing their level of independence. To achieve this, we:
- rolled out new ways of working with our provider partners, including shared visibility of caseloads, enabling more timely case progression and reduction in delays, as well as setting and tracking individual reablement goals
- revised team roles to prioritise social care assessments at the end of reablement journeys and improved the self-funder pathways to exit the service
- built a robust demand and capacity model to inform sustainability planning and guide future commissioning.
By autumn 2024, we entered the sustain phase, aiming to maintain improvements as dedicated programme support tapered. During the programme, Somerset Council worked in partnership with Newton, ensuring the approach remained collaborative, practitioner led and grounded in real operational insight.
The outcome
The programme has delivered measurable improvements across all focus areas, supporting more residents to achieve better outcomes that promote or maintain independence, thereby reducing (or avoiding growth in) commissioned care spend. It is on track to deliver financial benefits as planned, including £10m in savings between 2022/23 and 2024/25. The council is also confident of achieving a further £3.7m in savings in 2025/26. Key achievements to date include:
- enabling forty additional individuals per month to access the reablement service
- increasing the effectiveness of reablement in supporting independence
- reducing residential placement starts for older adults by fifty compared to projections
- a 27% increase in completed Care Act assessments and an 8% rise in reviews
- actively engaging more than 40 individuals with learning disabilities in progression planning
- earlier initiation of assessments for young people transitioning to adulthood (assessments are being initiated over two years earlier than was typical at the start of the programme).
These outcomes not only represent financial benefit in financial year 2024/25 but also lay the foundation for further gains in financial year 2025/26 and beyond. As improvements continue to be made and operational changes are sustained, the programme is expected to deliver long-term value while improving the lives of residents.
Reflection
To ensure the sustainability of improvements, we embedded a strong focus on data-driven decision making and continuous performance oversight. Programme metrics are reported regularly into service governance forums, while operational dashboards provide live, granular visibility of team-level performance across the service. This approach enables early identification of risks and timely interventions. For example, in autumn 2024, a routine KPI review highlighted a rise in commissioned community-based support hours. Dashboards developed through the programme helped pinpoint the cause – additional support for existing service users across multiple localities rather than new starts or a shift in one particularly locality – prompting targeted action through governance forums. These included reviewing double-handed care packages, staff training and reviewing short-term provision, which successfully brought performance back in line.
A clear and consistent change methodology underpinned the programme from the outset, helping to define problems, identify root causes and align cross-organisational efforts (including with NHS and provider partners). This disciplined, evidence-based approach fostered a culture of shared accountability and proactive improvement across the adult social care system.
7 July 2025
Contact information
Emily Fulbrook
Service Director of Operations, Adult Services
emily.fulbrook@somerset.gov.uk
