CQC rates Gloucestershire County Council’s adult social care provision as requires improvement

Published: 31 January 2025 Page last updated: 31 January 2025
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The Care Quality Commission (CQC), has rated Gloucestershire County 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.

  1. Assessing people’s needs – 2
  2. Supporting people to lead healthier lives – 2
  3. Equity in experience and outcomes – 2
  4. Care provision, integration and continuity of care - 2
  5. Partnership and communities – 2
  6. Safe pathways, systems and transitions - 2
  7. Safeguarding - 2
  8. Governance, management and sustainability - 2
  9. Learning, improvement and innovation - 2

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

At this assessment of Gloucestershire County Council, we found people had mixed experiences of the adult social care system in the county. This was starting to be addressed by the authority’s large-scale transformation that was underway, but people’s journey through the system remained disjointed whilst it is completed.

We also found some inequality in the system, with people’s waiting times for assessments varying by which part of the county they lived in. As a county with pockets of deprivation the authority needs to make sure their action is having an impact on reducing this. Gloucestershire has started some good work to identify these inequalities and make improvements, but the work wasn’t embedded or helping them to achieve their vision yet.

People told us information about their care reviews wasn’t always accessible or timely. They also told they felt reviews sometimes focused more on reducing support than meeting their individual needs and they didn’t always feel fully involved, although there had been some recent improvement. However, the authority told us plans were in development to improve communications with people around review outcomes.

Gloucestershire need to tackle the significant backlog of people awaiting financial assessments. People gave consistently negative feedback about this as it forced them to make decisions about care without fully knowing the costs. There were several examples where contribution calculations didn’t consider additional costs relating to a person’s disability, such as additional laundry or mobility aids leaving people struggling to make ends meet.

However, we also saw a passionate and committed workforce, who worked well with other partners, to make sure people were discharged from hospital into care quickly. They also pooled budgets with partners in a creative approach to provide people with mental health care and support that was reducing the demand for inpatient hospital treatment.

It was also good to see a number of initiatives aimed at supporting people to stay healthy and remain independent, with specialist resources for autistic people and people with a learning disability.

Overall, leaders at Gloucestershire have started the work they need to do and are aware of where improvements need to be made. We look forward to returning to see how they’ve done this and how their current plans mature.

The assessment team found:

  1. People were not always informed of their choices or fully involved in their assessments.
  2. Gloucestershire missed opportunities to introduce minor adaptions and equipment to people’s homes to help them remain independent due to inconsistent joint work between social work staff and occupational therapists.
  3. People waited a long time for deprivation of liberty assessments, which could put them at risk of abuse. The authority was aware and undertaking work to reduce waiting lists, but the work was at too early a stage to demonstrate a meaningful impact yet.
  4. Staff spoke positively of the emergency out-of-hours broker service which matched people needing care with the most appropriate support available at the time. However, this was less effective when it was non-urgent, which could cause delays to care planning.
  5. Unpaid carers said they would often only find out they could be entitled to support from other organisations, rather than from the local authority themselves. This was demonstrated in the local authority’s last carers survey for 2021 to 2022 which showed unpaid carers often felt tired, depressed and stressed due to a lack of support.
  6. Due to the end of funding, voluntary partners found running services and activities could be a challenge in some areas. This had led to some gaps in voluntary services like warm homes and food provision.

However, the assessment team also found:

  1. The local authority worked with partners and the local community to organise a range of resources to promote independence and to reduce future care needs.
  2. People found direct payments useful and were using these to plan their care in a personalised way. However, only 11.71% of service users received a direct payment, which was a significantly lower than the England average.
  3. The local authority had identified the transition of young people into adult services as an area for improvement and had put plans in place to prepare young people for transition at an earlier stage to overcome some of those challenges.
  4. There was partnership working with the integrated care system to support better recruitment and retention of staff. This had resulted in an increase in the number of adult social care workers in the Gloucestershire area.
  5. The local authority gathered feedback on people’s experiences of community services, such as people being supported with their mental health or substance misuse. People’s feedback was positive about the impact these services had on improving their lives.
  6. Gloucestershire had led a number of initiatives as part of the system-wide prevention activity to support people to maintain their independence and to stay healthy. These included focus on promoting healthy lifestyles, reducing frailty and support for people with drug and alcohol dependency.

The assessment will be published on CQC’s website on Friday 31 January.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.