The Care Quality Commission (CQC) has published a report indicating that Nottingham City Council, need to make improvements to ensure 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 Suffolk 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 requires improvement 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 two
- supporting people to lead healthier lives – indicative score of two
- 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 two
- how the local authority ensures safety in the system – indicative score of two
- safeguarding – indicative score of three
- leadership – indicative score of two
- 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 Nottingham City Council, we found a workforce who were clearly passionate, and committed to providing the best care and support for the people of Nottingham. However, staff told us that support wasn’t consistent across different teams, with some feeling very well supported while others were struggling with high caseloads and low morale.
Leaders have been taking action to address this, with a renewed focus on recruitment and retention, which was having a positive impact.
People using services spoke positively about their interactions with the authority, but also said they’d experienced delays when trying to contact them, and again when being assessed, which was having a negative impact on their well-being.
Delays in accessing care assessments were a common theme that emerged. These delays were sometimes hampering people’s ability to access other services. One person told us this delayed them being able to progress a housing application, as an occupational therapy assessment was needed first.
Nottingham is in the midst of a transformation in adult social care. Leaders demonstrated an understanding of areas that required improvement and presented plans for progress. Our findings echoed the mixed feedback from staff and identified ongoing work in various areas that needs time to be embedded and built upon. Staff and partners told us they were already seeing a difference in how they were able to work together on an individual level, and we look forward to seeing how this translates into a more formal, structural relationship going forward.
The assessment team found:
- Work was underway in relation to reducing waiting lists for assessment and reviews.
- Prevention was a key focus of Nottingham’s Better Lives Better Outcomes Strategy. There were some good examples in practice like day services promoting independence, and the use of some assistive technology.
- The supported living, reablement and hospital discharge teams were working well to provide effective support to people, and there were plans to develop a new mental health reablement service.
However, the assessment team also found:
- There were gaps identified in the provision of accessible information for people in terms of languages, cultural needs, sensory needs, and easy-read formats. The local authority had already identified this issue and improvements to their website were part of the planned transformation work.
- Staff and partners told the assessment team they struggled to find suitable accommodation for people that needed it, which impacted on staff managing caseloads and providing good support.
- There was some work in supporting people from different cultural and diverse backgrounds, however further co-ordinated work was needed to support people more effectively in these areas.
- Improvements were needed in how pathways between teams worked, and how it worked with partners in a formalised, structural way.