Staffordshire County Council: local authority assessment

Local authority leaders understood where there were risks to people’s safety and well-being across their care journeys, for example, quality concerns regarding commissioned care, access to specialist support outside of working hours, and unplanned interruptions to service provision caused by provider failure. There was a senior level of oversight and strategic work carried out to manage and reduce these safety risks. For example, emergency duty teams had adequate capacity and mental health training which enabled them to provide specialist support outside of normal working hours to keep people safe. Additionally, a system partner told us the local authority managed and reduced risks to people if their service provision ended at short notice, by identifying suitable alternative provision and managing their transfer of care.

Actions to reduce safety risks were aligned with system partners involved in people’s care journeys. Partners told us the local authority worked with them to address the risk of exploitation of staff and there were shared priorities and actions to support safe practices around international recruitment. People using local authority services also told us they felt less vulnerable because of the support they had received. System partners had clear roles, responsibilities, and accountabilities for delivering shared priorities. These included the use of the Better Care Fund, hospital discharges, and the Transforming Care Programme, which had produced positive outcomes and reduced people’s risk of harm. For example, 86 people who had been receiving care outside of the county had been supported to move back into the county as part of the Transforming Care Programme.

Information sharing protocols supported safe, secure and timely sharing of personal information in ways that protected people’s rights and privacy. For example, the local authority facilitated International Recruitment Information Sharing Meetings with key system partners to promote safe recruitment practices in the market and manage risk to the safety of people providing and receiving services.

Care and support was planned and organised with people, together with partners and communities in ways that improved their safety across their care journeys and ensured continuity of care. People, staff, leaders, care providers, and voluntary, community, faith and social enterprise sector (VCFSE) partners told us the local authority’s integrated pathways and protocols were clear and reduced risks to care continuity. This included during referrals, admissions and discharge, and where people were moving between services. For example, a VCFSE partner who supported people to return home from hospital said the local authority facilitated multidisciplinary meetings to agree actions ahead of a person’s proposed move back to their home. This ensured continuity of support for the person and reduced the risk of them becoming ‘lost’ in the transition process.

Specific consideration was given to protecting the safety and well-being of people who were using services located away from their local area, and when people moved from one local authority area to another. People receiving care and support out of county received an annual review of their care needs and goals, and oversight of the quality of their care remained with the local authority. When a person planned to move to another area, the local authority notified the person’s new local authority that the person would be moving to their area to ensure continuity of care when they moved. Local authority processes that supported people moving between areas were developed in line with Association of Directors of Adult Social Services (ADASS) guidance to ensure people’s safety during and after transition.

At the time of the assessment, work was ongoing to improve the local authority’s transition arrangements and the experience for young people receiving care and support when responsibility for their care moved from children to adult services. An unpaid carer told us that there had been adequate planning by the local authority with the person they cared for regarding their upcoming transition from children to adult’s services. However, they and the person they cared for had experienced a clear ‘stop’ of children’s support and ‘start’ of adult support with limited cross-over or tapering between services. The young person had experienced difficulty adjusting to the sudden introduction of new people to their support network and the set-up of the adult respite service, which led them to refuse to attend respite as a result. This had a negative impact on their and their unpaid carer’s wellbeing. The local authority had also needed to provide additional support to the family. Leaders were aware of the need to address this issue, and work was ongoing through the Preparing for Adulthood programme and in conjunction with the local authority’s dedicated transition team to improve the support for young people at the point of transition.

Hospital discharge processes and pathways were clear, integrated, and ensured people were discharged safely. Integrated discharge support teams facilitated multidisciplinary meetings with partner agencies about adults preparing for discharge to ensure decisions about care and risks were jointly managed. Care providers, health partners, staff, leaders, and people described people’s transitions from hospitals to their homes or other care settings as seamless. The local authority also worked with care providers through use of the Better Care Fund to ensure people’s needs and risks were identified and managed after they had been discharged from hospital.

The local authority undertook contingency planning to ensure preparedness for possible interruptions in the provision of care and support, such as in the case of provider failure. Corporate contingency plans were also in place to reduce risk and minimise harm to people in the event of a cyber-attack, loss of data, fire, or flooding. Staff and leaders told us how the local authority would respond to different scenarios to mitigate risk to people, for example, following established processes with partner agencies and neighbouring authorities to minimise the risks to people’s safety and wellbeing.

Most people we spoke to said the local authority had or would support them to plan for their future care and support needs, and create contingency plans with them in the case of an emergency.