Medway Council: local authority assessment
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Governance, management and sustainability
Score: 2
2 - Evidence shows some shortfalls
The local authority commitment
We have clear responsibilities, roles, systems of accountability and good governance to manage and deliver good quality, sustainable care, treatment and support. We act on the best information about risk, performance and outcomes, and we share this securely with others when appropriate.
Key findings for this quality statement
The local authority was on an improvement journey and had targets to achieve this led by the Director of People (Children and Adults). There had been a recent change in political leadership, which put more of a focus on adult social care.
Medway requested Local Government Association Test of Assurance in 2021 and a second Test of Assurance was completed in 2024. This was to explore the capacity and capability of the senior management team in the People Directorate to meet its responsibilities under the Care Act 2014, to contribute to corporate priorities, and to effectively engage with partners and stakeholders in the Medway Health & Care System.
There were risk management and escalation arrangements within the local authority which included the Chief Executive Officer (CEO) corporate management team, and the ASC portfolio holder who met monthly with the corporate management team. However, there were shortfalls remained with the safeguarding processes which the local authority had started to address.
The local authority’s political and executive leaders were informed about the potential risks facing adult social care which were reflected in the corporate risk registers, for example the backlogs of safeguarding enquiries and shortage of nursing home beds.
Senior leaders told us they had oversight of adult social care including waiting lists by using data, audits, and performance dashboards. Governance mechanisms were in place to scrutinise the use of the BCF, monitor the quality of the JSNA and look at risk and analysis on specific themes.
Health and social care partners worked together in The Adults Social Care Partnership Board to provide challenge and rigour to Medway Adult Social Care with a focus which included core standards, performance, quality and impact to enable people to live the healthy and independent lives possible.
People did not receive a consistent experience of adult social care in areas such as assessment, care planning and reviews. Feedback from people about the contact they had with staff indicated that further work was needed ensure a consistent approach for people to feel valued.
Staff were passionate about their work, and we received positive feedback about some of the senior leaders staff. Staff said they felt the benefit of working for Medway, as a small unitary authority, was the family approach, and they had good working relationships and open communication with leaders. A senior leader described an open-door policy with staff. However, some staff told us they did not feel Medway fostered a culture where all concerns could be raised.
The local authority used information about risks, performance, inequalities and outcomes to inform its adult social strategy, and plans to deliver the actions needed to improve care and support outcomes for people and local communities. The local authority had developed a draft engagement plan with the aim to increase their engagement to co-produce strategies, policies and co-design services. The Medway Council Strategy 2023 - 2024 outlined Medway’s overarching aims and priorities for 2023 to 2024.’
The Adult Social Care Strategy (2021-2025) had central themes to support people to live well and as independently as possible, whilst recognising people's rights to choice.
A senior leader told us Medway was progressing through a pathways program to redesign adult social care to ensure people received a consistent adult social care service, regardless of the locality in which they lived. At the time of our assessment the local authority was in the process of recruiting a Head of Transformation to lead on the implementation of change across adult social care.
Recruitment and retention of staff to meet their Care Act duties was a concern for the local authority as staff vacancies impacted on waiting lists. The ‘right-sizing’ exercise, and a new draft workforce plan, had been produced to improve recruitment and retention at all levels. There was a focus of increasing staff at manager and strategic level to support with improvements and oversight. A Human Resources (HR) partner with appropriate skills in adult social care to support with HR function, had been recently appointed.
The local authority had arrangements to maintain the security, availability, integrity and confidentiality of data, records and data management systems. This included a password-protected system, encrypting information, and locking forwarding mechanisms.