The Care Quality Commission (CQC), has rated Bath and North East Somerset Council as requires improvement, in how well they are meeting their responsibilities to ensure people have access to 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 looked at nine areas spread across four themes to assess how well the authority is meeting their responsibilities in order to create their requires improvement rating. CQC has given each of these nine areas a score out of four with one being the evidence shows significant shortfalls, and four showing an exceptional standard.
James Bullion, CQC’s chief inspector of adult social care and integrated care, said:
“At this assessment, we found that people’s experiences of accessing Bath and North East Somerset’s adult social care services were mixed. We found some people were having to wait a long time to either access services or have reviews. We also saw that leaders had identified where improvements were needed to make sure plans were more person-centred and flexible to meet people’s needs.
“Over 70% of people receiving long term support had been reviewed. However, some people’s care needs hadn’t been reviewed in over two years due to an increase in demand and workload. People told us that they could access services easily, but people who were less comfortable using digital platforms found it difficult to find relevant information online.
“Unpaid carers told us that they found it difficult to access advice and information on available support. Their assessments were sometimes delayed, and people weren’t always aware of the benefits of having an assessment. The local authority had identified the need to improve the experiences of carers and were working more closely with a carers group to help shape available support. Feedback from the carers group had been positive.
“Leaders found it difficult to monitor people’s access to assessments effectively to make improvements because they were only collecting a limited amount of data. This had been recognised and work was underway to improve data collection.
“CQC’s assessment took place when transformation in both adult social care services and the wider local authority was taking place. The training offer was accessible, informative and relevant which helped improve the services people had access to. However, wider transformation in the organisation had caused uncertainty.
“The local authority sought people’s views and feedback to help improve services and accessibility. People using services told us that they felt listened to and respected. They said they were looking forward to seeing how their views would improve services. The local authority’s staff were described as kind, dedicated and passionate by people who used services.
“Bath and North East Somerset were recognised for their strong relationships with partners and commitment to working in partnership, which was rated as good. They worked well with partners to make sure they were meeting people’s needs. Adult social care services, health partners and the community and voluntary sector were working well collaboratively to support people. Voluntary services had supported people to return home from hospital quickly when they were ready to do so.
“The authority are aware of areas where improvements need to be made to provide a better experience for people using the service. We look forward to seeing the changes they have made and the impact it has had on people’s experiences.”
The assessment team found:
- People told us that reviews of care and carers assessments were inconsistent and on occasion relied on people contacting the local authority themselves to request a review.
- Staff told us that people who didn’t require a Care Act assessment would be signposted to appropriate services, but this information wasn’t recorded. This made it harder for leaders to have an overview of this work.
- Delays in occupational therapy assessments and putting long term support in place following reablement meant that some people were at risk of losing their independence and needing further support.
- Some leaders didn’t fully understand the at-risk groups and diverse communities in their area.
- Some staff felt they had not received the correct training and guidance to work with people with more complex or specialist needs. Leaders told us that they had started to make improvements to their learning offer.
- The local authority acknowledged that the uptake of direct payments was low and below the England average.
- Some organisations raised concerns around capacity due to an increase in referrals from the local authority.
- More resources for people whose first language wasn’t English were needed. Staff spoke about difficulties accessing the translation service contracted by the authority. This could delay information, advice, and assessments.
However, the assessment team also found:
- National data on short and long term support showed that 71.72% of people receiving long term support had been reviewed, compared to the England average of 58.77%.
- People who were funding their own care were supported to find services, with approximately 60% of people needing services self-funding.
- People’s experience of adult social care services was above average according to national data.
- Staff told us the training offer has improved since moving back in house and that training was easily accessible, informative and relevant to their job roles.
- Staff worked with partners to meet people's needs holistically. An example highlighted was the work carried out by the voluntary service supporting people with minimal care and support needs to return home quickly and effectively from hospital.
- The local authority and health partners understood and valued the contributions of the voluntary sector in providing services for people.
- Adult social care and public health had worked together to reach out to the boating, traveller and LGBTQ+ communities.