Surrey County Council: local authority assessment

The local authority had a number of initiatives to understand and reduce barriers to care and support and reduce inequalities. Staff were particularly proud of the progress of some of this work to date, however felt there was more to be done.

Local authority staff involved in carrying out Care Act duties had a good understanding of the areas of diversity within Surrey and spoke passionately about the work they were involved with. Surrey County Council created an organisation-wide strategy with a vision for 2030. The principle of this was 'no one left behind' with a target to reduce health inequality and inequity of opportunity. Staff explained this golden thread was considered the backbone of the local authority approach but the challenge of implementing such a vision lay in ensuring that every action taken genuinely supported inclusivity and no one was overlooked.

Senior staff told us they felt Surrey was an amazing county but misunderstood. It was seen as a county of affluence whereas in reality, there were areas of real deprivation. This meant as a local authority they had to be innovative and creative in their approaches. As a whole county, they had a comparatively financially well off, able older population, but some areas of the county were much less affluent, and in the lowest 20% in the country in terms of deprivation with some areas having high levels of need and disadvantage.

The local authority understood its local population profile and demographics by analysing equality data on social care users to identify and reduce inequalities in people’s experiences and outcomes. The local authority had identified groups of people and geographical communities of deprivation as ‘Priority Populations’ across the integrated care system in Surrey. Equality Impact Assessments were undertaken when the local authority commissioned services and defined strategies identifying potential risks and impact to people, including those identified as being at risk of experiencing inequalities, to avoid or reduce negative impacts.

To identify and reduce inequalities, the local authority had worked with over 250 people in Surrey and 100 partner organisations in 2023/24 to actively seek out information in co-design work along with their Communities & Prevention team. Staff told us about the wide range of services in the community that could support people with specific needs for example groups that supported refugees or the Traveller community.

The local authority commissioned a Surrey Minority Ethnic Forum group to support and represent the needs and aspirations of an increasing ethnic minority population in Surrey. In December 2023 the local authority commissioned an ‘Equality Diversity and Inclusion Discovery Report’, with an initial focus on ethnicity. This was to help understand more about some of the potential barriers people experienced in accessing social care services delivered by the local authority in community settings. The report aimed to explore the experiences of black, mixed and Gypsy, Roma and Traveller communities. For example, factors contributing to under-representation, an acceleration or amplification of care needs for some people compared to others, and factors leading to a decline in independence.

The local authority proactively engaged with people and groups where inequalities had been identified, to understand and address the specific risks and issues experienced by them. In conjunction with health partners, there were 21 local neighbourhoods with local co-ordinators who engaged with people in these areas. Staff explained this approach was the key to the work because unless they heard the voices of people with this lived experience, they would not get things right. It was felt work particularly with the LGBTQ+ community could be improved as well as the Gypsy, Roma and Traveller communities. Commissioned research work was taking place with seldom heard groups to directly hear from those groups to better engage with them and some partners told us about this.

Examples of work taking place were one partner working with ethnic minority groups in relation to topics which carried a stigma or were taboo topics within some communities such as men's mental health. Also work had taken place with partners to secure funding on work to improve outcomes for adults experiencing multiple disadvantage to provide additional, tailored support to individuals who are homeless or at risk of homelessness, and other vulnerable adults, to help them rebuild their lives.

The local authority worked with partners in identifying and tackling inequalities in experiences and outcomes for people with learning disabilities by using a 'systems' approach. For example, it had been identified that by increasing health checks for people acted as an enabler to reach more people and better identify their needs.

One senior leader told us working closely with the learning disability sector had underscored the importance of understanding and integrating diverse perspectives. Issues that may seem straightforward, like signage or options, can present significant challenges for individuals with different needs. This highlighted the necessity for thoughtful design and planning of services to ensure accessibility and inclusivity.

Local authority staff explained through the fostering of an inclusive environment, maintaining strong community ties, and supporting diverse cultural and personal needs, Surrey demonstrated a commitment to equality, diversity, and inclusion (EDI). Staff passionately explained Surrey had made significant strides in EDI, with the active involvement of external partners and internal staff. The view was over the past three years, Surrey's commitment had paid off, which they felt had led to meaningful changes taking place. They described an ‘explosion’ of EDI staff networks and conscious efforts to make a difference for people.

Internally programs like reverse mentoring had been introduced. This was where more junior staff take on the role of mentor for a more senior staff member. Senior staff actively participated in network meetings to support and promote equality, diversity and inclusion. The practice framework that adult social care staff worked to had been developed with teams and practitioners. Staff told us they were committed to ensuring that everything they did was accessible and inclusive for people. For example, people with lived experience had been involved in interviewing potential local authority senior leaders to ensure that only staff with the right approach, knowledge and understanding were recruited.

Some partners felt the local authority could benefit further from employing more people with lived experience to enhance their work. Others felt there could be better monitoring of care providers to ensure they effectively understand cultural issues. Also, education on cultural practices for staff to share key messages and to foster a better understanding.

There were sufficient inclusion and accessibility arrangements in place so that people could engage with the local authority in ways that suited them, for example British Sign Language or by using interpreter services. Staff explained there was a strong preference for having interpreters physically present to ensure accurate communication. Difficulty arose in finding interpreters for less common languages, such as Vietnamese, which could lead to delays. In areas with significant communities, community members might assist with translation, but professional interpreters were preferred for accuracy and to ensure the standards of professional interpreters, which were crucial for accurate and unbiased translation.

Staff told us about inclusion and diversity, recognising the importance of meeting people’s cultural needs. Meeting the person to understand how they wished to be identified in terms of gender and noting any reasonable adjustments. During assessments, people’s characteristics were gathered, such as their religion, but this also looked at what this meant for people, so was broader than just data.

Easy read documents were used by staff for example for people with a learning disability and autistic people. Examples were given when these had been used meaningfully to assess mental capacity, discuss reablement services or future options with people.

One key issue identified was in relation to technology as not everyone had access to internet broadband. The local authority was funding a project to target seldom heard groups at a local level to provide support accessing information digitally.

Guidance encouraged staff to be mindful that any information produced or provided to people within Surrey needed to meet quality standards such as simple language, right tone and no jargon. A number of processes were available to assist staff to better support people. For example, the Accessibility Guidance February 2023 demonstrated the local authority had inclusion and accessibility arrangements in place to support people to engage in differing ways. The guide included useful tips and best practice to help staff. The Inclusive and Accessible Language Guide set out the kind of organisation Surrey aimed to be, demonstrating an awareness of language changing and how people describe themselves can vary, even when people share a particular characteristic, links to further sources of information were given to support staff further.

Some partners felt improvements were needed in written information people received. However, another partner explained they had been involved with some work on an easy read document with the local authority to benefit people in terms of accessibility to information.