The Care Quality Commission (CQC), has published a report indicating that North Lincolnshire 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 North Lincolnshire 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 two
- 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:
In our assessment of North Lincolnshire Council’s adult social care responsibilities, it was really impressive to see the ways in which they were not just meeting people’s immediate care needs, but looking ahead to preventative healthcare, and how to provide more innovative, inclusive care.
We saw how they worked alongside voluntary and other sector partners in community hubs to make every contact count. Using every contact with people who needed a specific piece of advice or support to signpost them to other information and support, was having a preventative effect on people’s lives.
They had some really strong relationships with people who draw on care and support across the safeguarding system and with local health and care providers. Good integration ensured people had support in their local communities to maintain their independence and prevent or delay future care needs.
The supported housing and homelessness function had also been brought into the authority’s adult social care services which enabled better early intervention and support among people who are made vulnerable by their circumstances. This enabled people’s housing needs to be better met when leaving other organisations such as mental health hospitals or prisons, which can help to prevent homelessness and also improve people’s health outcomes from other interventions.
People generally gave us good feedback on their interactions with the local authority, telling us they were responded to quickly, getting the help they needed.
However, we’ve told the authority they do have some more proactive work to do in making sure those with certain protected characteristics have the same access to care as older people.
They 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:
- 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.
- At the time of this assessment, there was nobody waiting for assessment from the frontline team.
- North Lincolnshire Council had a high take up of direct payments, 42% of people which compared to the England average of 26%. The local authority told us they used direct payments as a way of increasing autonomy and choice for people that needed support. Social workers said this gave them the freedom to be creative in the way they used services. They also told the assessment team how this could be good for people from ethnic minority groups as it enabled care packages that were more culturally appropriate.
- The local authority’s adult social care strategy focused on a preventative approach, based around promoting people’s independence and support in the community. Through this approach 93% of people who had received short term care and support no longer required support. This was above the national average and demonstrated the focus on support to enable people to maintain independence to prevent or delay long term needs for care.
However, the assessment team also found:
- There needed to be a greater focus on identifying and understanding the needs of seldom heard groups, and groups who find access to local authority services more difficult. While front line teams worked hard to engage local communities, there was no strategic oversight to ensure that all voices were heard, and communities felt able to access services. While the local authority was engaging some local groups, the assessment team heard from some community groups that there needed to be more flexibility and consideration given to approaches to engage people from different communities. Faith leaders were keen to strengthen the faith covenant (a set of principles to guide engagement between faith communities and the local authority) and improve understanding of the work of faith communities.
- The local authority had identified they needed to improve co production around substance misuse and homelessness.
- Data had been used to evaluate the preventative approach and the resultant savings in services to support people, but more work was needed to plan ahead, to ensure this will enable them to meet the needs of the rapidly ageing population in the north Lincolnshire area.