CQC rates Telford & Wrekin Council’s adult social care provision as good

The Care Quality Commission (CQC), has rated Telford & Wrekin 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 – 2
3. equity in experience and outcomes – 3
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 staff enjoyed working for the local authority and they felt there was a culture of support and openness which had a positive impact on the quality of services offered to people. Also, leaders and staff 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 Telford and Wrekin.

This partnership working was ensuring people’s journey through the system was co-ordinated across different services. For example, there was a team of staff who could assess less-complex cases and provide equipment to people quickly, which allowed more qualified staff to focus on complex cases, which reduced waiting times for both.

Also, the authority was working well with partners to ensure people had safe discharges from hospital, to help prevent them from being re-admitted. People’s experiences of their support around this were positive, and whilst discharges to residential and nursing care services took longer than if they were going home, people felt they were managed well and focused on their individual needs.

Additionally, partnership working was taking place to support young carers. Assessments involved working with schools and health partners to provide wrap around support for both the family and young carer. Also, help was available for carers aged 18 to 24 around education and employment, as well as one to one support.

Another priority for the local authority was improving supported accommodation to meet demand for people with a learning disability, mental health needs, and people with complex needs such as dementia. The authority was working with people with lived experience, as well as occupational therapy teams, and housing teams to support the design and planning of this accommodation to ensure it meets people’s needs.

Overall feedback from partner organisations was positive, especially around the authority’s continuous learning, partnership working and shaping the care to meet local people’s needs. However, they did feel some improvements needed to be made around direct payments, deprivation of liberty safeguards and accessible information.

Telford & Wrekin 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. Staff and leaders felt partnership working with people with lived experience to develop adult social care services was an essential part of the authority’s work. Leaders developed, discussed, promoted and implemented innovative ways of involving people in developing services which exceeded best practice.
2. The local authority learned from people’s feedback. There were processes to ensure learning happened when things went wrong, and from examples of good practice.
3. Senior leaders worked closely with housing, public health, and health partners to identify health inequalities.
4. The local authority ensured people could access equipment, assistive technologies, and home adaptations to maintain their independence and continue living in their own homes.
5. There were joint working initiatives with the voluntary and community sector, with jointly run calm cafes open daily to tackle social isolation for people with mental health needs.
6. There were community engagement opportunities including access to community hubs, the Independent Living Centre, and awareness events (such as disability pride and LGBTQ+ events, where local authority staff set up pop-up tents to offer advice, information, and signposting people to support services).
7. Partner organisations described how changes to local services for autistic people meant people could be assessed more locally, reducing cancellations, and ensuring people got the right support and access to services.
8. Most people reported positive experiences of transitions between children and adult services, although there were some examples of inconsistent staff approaches to communication and consultation, despite clear processes in place.

However, the assessment team also found:

1. Partner organisations felt there was an overreliance on families translating for people who did not speak English as their first language during the assessment and review processes.
2. Some unpaid carers had difficulties accessing respite services and using digital information systems, there was also confusion around direct payments. Also, some unpaid carers experienced poor communication, and lack of control over decisions being made around care and support needs.
3. There were a number of areas of inconsistent approach towards safeguarding processes, including delays in local authority staff keeping relevant partner organisations updated. However, systems, processes, and practices, including partnership working, reduced risks to people from abuse, neglect, and exploitation. Also, the local authority had recently introduced a new feedback process to address inconsistencies.

The assessment will be published on CQC’s website on Friday 15 November.