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

The Care Quality Commission (CQC), has rated South Gloucestershire Council as requires improvement, in how well they are meeting their responsibilities to ensure people have access to adult social care and support under the Care Act (2014).

CQC has a new duty under the Act to assess how local authorities work with their communities and partners to meet their responsibilities. This includes promoting the wellbeing and independence of working age disabled adults, older people, and their unpaid carers to reduce their need for formal support where appropriate. Where support is needed it should provide people with choice and control of how their care needs are met.

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 – 3
3. Equity in experience and outcomes – 2
4. Care provision, integration and continuity of care - 2
5. Partnership and communities – 3
6. Safe pathways, systems and transitions - 2
7. Safeguarding - 3
8. Governance, management and sustainability - 3
9. Learning, improvement and innovation - 2

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

“At this inspection, we saw an authority that was looking to the future. They were innovative, worked well with partners and were supporting people to stay healthy to prevent them from needing future support. However, we heard from people who had mixed experiences of accessing and receiving care and support in South Gloucestershire now.

“Some things the authority was doing well, including people accessing individualised care and support services that met their needs in a variety of ways. However, there were some gaps in provision which they were aware of and had plans in place to address. One example of this was the gaps in integration between hospital discharge and adult social care services.

“Staff listened to people and actively involved them in their care planning, respecting their right to choose how they wanted to live their lives. People’s care and treatment reflected their personal goals. Some people experienced delays waiting for an assessment, care planning and reviews, but leaders were taking action to manage and reduce the time people waited.

“The authority had developed a scheme to specifically identify, support and connect with people living in rural and isolated communities. They made a range of services, facilities and resources available by working with people using services, partners and the communities involved. These included setting up a food bank and organising seated yoga sessions. This helped promote independence and prevent, delay or reduce the need for care and support.

“Although the authority listened to unpaid carers and recognised them as distinct from the person they cared for, we heard mixed feedback about how well carers felt supported. The unpaid carers we spoke to had mixed experiences of the advice and information provided, with some feeling that the information was useful while others would prefer more concise and easy-to-read resources.

“South Gloucestershire worked closely with partners to make sure there was a diverse range of effective support options. The authority had recognised it needed to improve the data it collected to better understand the demographics of the local population. This would help them provide more tailored services.

“Systems and processes generally helped protect people from abuse and neglect, but people were waiting too long to have their Deprivation of Liberty Safeguards (DoLs) applications assessed. In some cases people waited an unacceptably long time given their needs and risks. This meant that people experiencing delays were put at significant risk of not receiving tailored care and support, especially if their needs changed while waiting for assessment. The authority knew about these risks and were taking steps to address them.

“South Gloucestershire Council are aware of the areas that need addressing and have begun putting improvement plans in place. Staff should be pleased with the many positive areas that we found in this report, which has built a foundation for them to build on. We look forward to visiting again and seeing their progress and how their plans have matured.”

The assessment team found:

1. People had mixed experiences of accessing information and guidance, with some telling inspectors that it was difficult to find what they needed on the authority’s website.
2. The authority had a waiting list for occupational therapy and there was increased pressure on the service. This was due to an aging population, problems recruiting staff and required safety reviews for equipment.
3. Leaders didn’t always oversee the service effectively or make sure it was sustainable.
4. People didn’t have a consistent contact which was sometimes a barrier for them asking for help.
5. Adult social care teams and mental health teams needed to work more collaboratively to improve people’s experiences.
6. Leaders had identified hospital discharge support services as an area where more focus was needed.
7. The authority didn’t always make sure people could access equipment or minor home adaptations in a timely manner.
8. The authority knew that some people were waiting too long for a financial assessment.

However, the assessment team also found:

1. The leadership team was stable and had clear roles and responsibilities. They provided clear management oversight. Staff felt respected and listened to.
2. People knew how to access direct payments. The authority had a good uptake of direct payments which was higher than the England average. However, some people felt they were complicated to use.
3. The authority worked closely with partners to deliver intermediate care and reablement services that helped people retain their independence.
4. People had good experiences of transitioning from children to adult services. Staff involved people, their families and other professionals early in the process to support a smooth transition and the timely sharing of information.
5. The authority had an inclusive and positive culture of learning and improvement. Leaders listened to people’s feedback on their experiences, which helped shape strategy and decision making.
6. South Gloucestershire had effective working relationships with health, voluntary and community and other local authority partners.