The Care Quality Commission (CQC), has published a report indicating that Lincolnshire County Council is ensuring people have access to a good standard of adult social care and support.
CQC has a new responsibility to assess how local authorities meet their duties under Part 1 of the Care Act (2014). CQC has been piloting its approach to these new assessments in five local authorities who volunteered to participate. This assessment of Lincolnshire County Council was part of the pilots. CQC will be incorporating any learning from the pilots and evaluation into the formal assessment approach.
CQC looked at nine areas to assess how well the authority is meeting their responsibilities in order to create their indicative good rating. CQC has given each of these nine areas an indicative scoring out of four with one being evidence shows significant shortfalls, and four showing an exceptional standard:
- how the local authority works with people – indicative score of three
- supporting people to lead healthier lives – indicative score of three
- equity in experience and outcomes – indicative score of three
- providing support (care provision, integration and continuity) – indicative score of three
- partnership and communities – indicative score of three
- how the local authority ensures safety in the system – indicative score of three
- safeguarding – indicative score of three
- leadership – indicative score of three
- learning, improvement and innovation – indicative score of three.
James Bullion, CQC’s chief inspector of adult social care and integrated care, said:
During our assessment of Lincolnshire County Council’s adult social care responsibilities, it was impressive to see the ways in which they were not just meeting people’s immediate care needs, but had a real focus on preventative healthcare and improving the quality of life of people living in Lincolnshire.
The authority showed real commitment to promoting people’s independence and encouraging them to develop their own skills, with the aim of delaying the need for formal care and support. We saw a diverse range of services available aimed at doing just that, by supporting people’s well-being.
Lincolnshire had a very strong leadership team who were clear on what needed to be done from an oversight and risk management point of view, with effective systems in both these areas helping to ensure people using services were being kept safe.
They also had a really clear understanding of the local inequalities and geographical challenges their county posed, which was reflected in formal strategies to ensure people in these communities had access to the care they needed.
We saw a workforce committed to understanding people’s needs, and this was reflected in what people told us. People using services spoke highly of individual staff members and told us they generally had positive experiences because of the effective assessment and support planning process. Waiting times for assessments and support were minimal.
However, there were some areas that required improvement. There were issues with financial assessments and delays in direct payment processing, which the local authority was already aware of and actively addressing. There also needed to be greater clarity in the pathways for autistic people and also young people transitioning to adult services.
Lincolnshire County Council have a great foundation for the future and we look forward to seeing them build on the work we found in our assessment.
The assessment team found:
- There was a range of services on offer to people with the aim of supporting people’s wellbeing. The front-line teams used a strengths-based approach to assessment and support planning which enabled them to consider people’s strengths as well as areas of their life where they may need some support. This approach was being rolled out to partner organisations to ensure a consistent approach.
- There had been a reduction in the number of missed calls.
- People were given opportunities to help design services and felt able to voice their opinions with confidence that their feedback would lead to meaningful action.
- The focus on partnership working and collaboration was strongly embedded with staff supporting this approach. The expectation of staff to build relationships and work effectively with partner organisations, even in the teams which were not fully integrated, was clearly understood.
- Staff morale was high, with staff confirming they had good opportunities for learning and development. Investment has taken place to develop the workforce internally as well as in partnership with regulated providers to try to address some of the workforce challenges in the area.
- The local authority had a commitment to commissioning other organisations to provide services where it was felt that they had the skills and experience to do so to a high standard.
However, the assessment team also found:
- Safeguarding practices were meeting Care Act duties, but there was room for improved communication with partner organisations. There were times when partner organisations did not understand the threshold for a Section 42 safeguarding enquiry or what action was being taken if a formal enquiry did not take place.
- There were issues with the arrangements for financial assessments to be carried out for direct payments and delays in the actual payment of these. The local authority was already aware of these issues and had started to take action to address them.
- The pathway for autistic people was not entirely clear, with no social work team identified specifically to support them. They were allocated to either the learning disability team, the mental health team or the adult frailty and long-term conditions team. The local authority is a key partner in the autism partner board and it is expected that further work will be developed in respect of the support offer for autistic people.
The assessment team found:
- People’s needs were assessed in a timely way, focusing on their abilities, needs and wishes. Staff told CQC this approach meant assessments were more holistic and there was a good flow from the first point of contact through to assessment of needs.
- Social workers described how responsive the local authority was and everyone who called in would get a response.
- The assessment team saw that the local authority worked well with other organisations, particularly the voluntary sector and the use of social prescribing. This is where GP’s can refer people to local community groups and services, improving people’s ability to manage their own health in relation to needs that are not eligible for support from the local authority.
- There was an open culture within the local authority, with clear leadership and a learning culture which was embedded across the organisation and with partners.
- Most people had good open relationships with social workers who supported them to achieve their outcomes.
- Unpaid carers told the assessment team they had access to a range of activities to support their wellbeing.
- Staff told CQC they worked closely with family carers, considering the whole family’s support to prevent a crisis. They told the assessment team, support for the family carer was central and they ensured carers were in touch with the wider networks as part of the assessment. Carers told CQC they felt involved in the assessment for the person they were caring for and felt listened to in the process.