CQC rates County Durham Council’s adult social care provision as good

The Care Quality Commission (CQC), has rated County Durham Council as good, 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 good 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.

1. assessing people’s needs - 2
2. supporting people to lead healthier lives - 3
3. equity in experience and outcomes - 2
4. care provision, integration and continuity of care - 3
5. partnership and communities - 3
6. safe pathways, systems and transitions - 3
7. safeguarding - 2
8. governance, management and sustainability - 3
9. learning, improvement and innovation - 3

James Bullion, CQC’s chief inspector of adult social care and integrated care, said:

“At this assessment, we found leaders and staff were proud of the work they did and to work for the local authority. They had a good understanding of the health and care needs of people living in the area and worked well with partners to agree plans and priorities for people living across County Durham. This was also reflected in what we heard from people receiving services, as well as their carers.

“This partnership working resulted in minimal to no waiting times for people who were using services, such as homecare or a residential placement. Also, the local authority was working with providers to look at a more preventative approach to reablement care. This aimed to reduce admission to hospital and prevent or reduce people’s long term needs at an earlier stage.

“We found the authority was doing good work to rise to the significant challenge of poor mental health in County Durham where one in five people have poor mental health.  They had formed close links with other organisations to make a single point of access for referrals, so people didn’t have to keep repeating their story, which everyone involved felt was making a positive difference.

“They were also rising to some staffing challenges creatively via the formation of a Care Academy for the personal development of staff. For example, after identifying low numbers of carers who could drive which affected provision in rural parts of the county, they supported individuals to complete their driving test to add more capacity.

“Overall, we mainly heard positive feedback from people about their experiences of care across County Durham, they felt listened to and that their assessments and care plans reflected their needs and wishes. 63% of people were satisfied with the care and support they received.

“Although, we did receive mixed feedback from carers. Those who had continuity of social workers often felt they had a better experience, but others described it as a battle to get help. Some carers also told us that they chose to provide care to their loved ones themselves because they didn’t think that the care and support required was provided by the local authority. However, most carers felt the local authority communicated well with them and they were included in the support planning.

“The authority also needed to do better to understand the needs of people whose identity and characteristics such as those from the LGBT or traveller community were different and ensure this is reflected in the services available in the area.

“Durham County Council should be really pleased with this assessment. They’ve built a great foundation on which to build their future plans and make improvements. We look forward to returning to see how they’ve done this and how their current plans mature.”

The assessment team found:

1. Over 85% of CQC regulated care provision in the county was rated as good or outstanding
2. A trusted assessor approach was in place in Durham to support the effective and timely assessment of people’s needs within care settings. This is where staff received additional training to enable them to carry out assessments
3. Most carers felt the support they had received from the local authority had helped them with their own mental wellbeing. They were signposted to appropriate services for their needs and 88% of carers found information and advice helpful
4. 95% of equipment aimed at supporting people’s independence, such as bathing aids were delivered on time, sometimes on the same day. Major installation of equipment, such as stairlifts, were in place within approximately two months. This was mainly due to manufacturing time rather than delays in the local authority
5. The local authority had retained phone lines and customer services points to facilitate appropriate access for people who found the website difficult to navigate or who were unable to access it. Information was regularly provided in languages other than English
6. There was minimal need for people to use services or support in places outside of their local area. When support was being accessed from outside of the area, this was usually due to personal choice or to be close to family
7. People had access to interpreters and translation services where needed
8. There were some delays in mental health provision, linked to mixed diagnosis of people or providers not being able to meet people’s needs. However, commissioners were working together with a local NHS trust to find placements for people.

However, the assessment team also found:

1. Not everyone in the county received the same quality of safeguarding support
2. There were challenges in sourcing flexible respite services for people with a learning disability, and single person accommodation for people with mental health needs and people with a learning disability
3. Specific needs for older people who were part of the lesbian, gay, bi-sexual, transgender community, for example, were not always considered in the way services were commissioned across the area. There was limited understanding evident during the assessment of the ways the different parts of people’s identity combined to affect their experiences and outcomes
4. Staff felt financial assessments took a long time and affected the timeliness of assessments. While this did not prevent services from being provided, it did cause anxiety and risked people incurring debts whilst waiting to understand what financial contributions they would receive.