London Borough of Harrow: local authority assessment

The London Borough of Harrow had seen significant change at a senior level over the past two years and the Director of Adult Social Services (DASS) was also relatively new in post, having been appointed in an Interim role 3 months prior to our assessment.

The adult social care senior management team were aware of the need to create stability and a clear sense of direction for the workforce. This was reflected in feedback we heard from some staff who told us they were uncertain about how the new structures of their teams and how this would affect their workloads.

There were systems in place to provide visibility and assurance on the delivery of Care Act 2014 duties, for example through the Adult Social Care Strategy. Updating the strategy to reflect the objectives over the next three years would be a priority for the permanent DASS when they were appointed. Audits had been introduced to monitor and improve quality. They had conducted a service-wide audit which identified some areas for improvement, such as the identification of unpaid carers. This led to training for staff and a rolling quality review and audit process for each staff member.

The local authority had good oversight of the performance of adult social care in Harrow. Assurance was given through quarterly performance meetings focused on Adult Social Care and understood risks and underperformance relating to reviews/ DOLs/ Safeguarding. The leader understood the risk profile of adult social care and held senior officers to account in ensuring mitigating actions were in place to address them.

Senior leaders produced performance related reports which showed areas of improvement and challenges and held regular meetings to monitor progress.

Senior leaders recognised that the authority’s business intelligence function needed to have a closer partnership with adult social care. They told us that analysis of data was one of the authority’s biggest challenges and they were addressing the need to collect and use more and better data. This would need an investment in technology. One team told us they were not confident the data for waiting lists was accurate. Another told us they did not believe all their work was being captured by the local authority’s data system and data the leaders used did not reflect the breadth of the work they did. Whilst the local authority accepted that data was an area for improvement, this shortfall meant that local authority processes were not working well at the time of the assessment. This did not always provide consistent oversight and produce good outcomes for people overall. There was a workforce strategy for adult social care which included a focus on knowledge, skills, behaviours, recruitment, retention and succession.

The adult social care leadership team had clear roles, responsibilities and accountabilities. Staff told us the layout of the new Civic Hub meant they now had easy access to senior leaders and Council Members which had resulted in greater engagement and improved integration. They said they now felt more confident to be able to raise any issues with the leadership team if they needed to.

The local authority used information about risks, performance, inequalities and outcomes to inform its adult social strategy and plans and deliver the actions needed to improve care and support outcomes for people and local communities. However, due to recent changes in leadership within the local authority, some of the strategies had yet to be reviewed and actioned. The local authority was aware of this and had plans to address it.

The Harrow Borough Based Partnership Strategy for Carers in Harrow was a detailed, clear and effective strategy which had been reviewed for 2023-26. It stated their vision, commitment, context and local policy. This had been developed in partnership with North-West London Integrated Care system and Harrow Carers. The Carers strategy highlighted key initiatives Harrow Council had already implemented, such as a Carer Engagement lead. A carer’s organisation confirmed the strategy had been co-produced and was being implemented at a strategic level. Staffing levels and funding were however impacting on frontline services and actions were not always met. For example, post-diagnosis dementia support for carers was not always available.

A senior leader told us they wanted to invest in people and staff for a management competency programme to deliver skilled managers and equip managers to learn and use new technology and utilise data to focus resources and deliver change.

Religious groups told us the local authority were supportive of faith groups and they engaged with group leaders on a strategic level.

Registered care providers told us the local authority communicated well and provided opportunity to share ideas and suggestions. One provider told us they had been involved in the refresh of some strategies, but information about changes to the to some of the local authority processes had not been consistently communicated to all providers.

The local authority had arrangements to maintain the security, availability, integrity and confidentiality of data, records and data management systems. Staff used secure systems to share information with relevant stakeholders where required. Laptops were updated each week and staff had data protection training.

The local authority had an information governance team and Caldicot Guardian with oversight of this. A Caldicott Guardian is the senior person responsible for protecting the confidentiality of people’s health and care information. They gave an example of a recent minor data breach which resulted in learning, training for staff and action to address the breach.