Staffordshire County Council: local authority assessment

The local authority worked with people, partners, and the local community to make available a range of services, facilities, resources and other measures to promote independence, and to prevent, delay or reduce the need for care and support. These included befriending groups, access to lower-cost food, financial support for unpaid carers, provision of low-level equipment, and home adaptations. Information about resources and services could be accessed via Supportive Communities (a range of voluntary, community, faith and social enterprise voluntary and community sector (VCFSE) led initiatives, providing advice, information and training), Community Help Points across the county, and through the local authority’s Happy at Home website. Access to effective resources that supported people to keep themselves and their families nutritionally well, for example, was reflected by national data which indicated 94.95% of people who used services had access to adequate food and drink. This was better than the England average of 93.71% (Adult Social Care Survey, October 2024).

Most services and other measures were universally available to prevent, delay or reduce the need for care and support, and any charges for these services were transparent. Leaders understood the diverse demography of the county meant that some services, such as befriending support in rural areas, were difficult to recruit to and this was leading to some people requiring commissioned care to fill the gap. However, they confirmed work was underway to ensure people had equity of access to preventative support regardless of which locality they lived in.

There were clear strategies and a coherent and adequately resourced delivery plan to prevent, delay, or reduce people’s needs for care and support. The local authority’s Prevent, Reduce, or Delay Need for Care and Support strategy laid out the existing prevention offer, while the Public Health and Prevention Delivery Plan 2024 - 2025 outlined joint public health and adult social care priorities. These were informed by local data and aligned with the strategies and priorities of local partners. This was exemplified by a Personalisation and Social Inclusion (PSI) service, which provided integrated short-term support to people in line with the local authority’s preventative strategy and was producing positive adult social care outcomes for people with specialist needs, including people living with learning disabilities or a mental health condition. People’s feedback also indicated there was a shared commitment between the local authority and providers to promote their independence and reduce their long-term care needs. For example, a family member told us a care provider helped keep their loved one mentally and physically active by engaging them in singing groups and outdoor walks.

The local authority had embedded adult social care into other plans and strategies across the locality to support preventative care, and work was ongoing to promote this further. For example, a specialist falls response service established in 2022 was being delivered in collaboration with health partners and fire and rescue agencies to support people to remain in their homes after a fall where appropriate, reducing hospital admissions. This had resulted in positive outcomes for people by reducing their need for more intensive care. Additionally, the local authority and key partners had developed a multi-agency five-year Staffordshire ‘Housing with Care Strategy’ (2024-2029) which set out their commissioning vision and future priorities for accommodation options that helped meet peoples’ care needs. This work aimed to ensure good quality care and support in housing with care schemes to optimise peoples’ independence, health, and wellbeing.

The local authority took steps to identify and target people who had needs for care and support that were under met or not met at all to stay independent, such as people with non-eligible neurodivergent or learning disability needs. For example, leaders told us a two-year pilot focused on supporting adults with a learning disability and/or a neurodivergent diagnosis to access employment was underway, with the aim of promoting their long-term wellbeing and independence.

Specific consideration was given to people at greatest risk of a decline in their independence and wellbeing, for example, young adults with care needs and unpaid carers who did not recognise themselves as unpaid carers. For example, an unpaid carer told us the local authority had prioritised the independence of the young person they cared for by ensuring they continued to engage with the community and activities they enjoyed after they left formal education, and this supported the person’s wellbeing and that of the unpaid carer. Positive feedback from unpaid carers about access to information about local authority support was reflective of national data: 87.22% of unpaid carers found information and advice about available resources helpful, which was similar to the England average of 85.22% (Survey of Adult Carers, June 2024).

Arrangements were in place to monitor and evaluate the impact of the local authority’s prevention strategies and outcomes for individuals and the community. For example, the local authority chaired a multi-agency Health and Wellbeing Board which oversaw and evaluated the impact of adult social care priorities against the county’s Health and Wellbeing strategy on a quarterly basis, such as those priorities focused on Healthy Ageing in the county. Feedback from people, staff, and partners indicated that preventative services were having a positive impact on well-being outcomes for people. This was also reflected in national data that indicated 98.42% of people who received short term support no longer required support after this intervention. This was significantly better than the England average of 77.55% (Adult Social Care Outcomes Framework, December 2024).

The local authority worked with health partners to deliver intermediate care and reablement services that enable people to return to their optimal independence. These services were provided to people to prevent deterioration in their well-being and to avoid unnecessary admission to hospital, and to people who were being discharged from hospital to regain their independence. National data indicated 3.99% of people aged over 65 received reablement or rehabilitation services after discharge from hospital, which was better than the England average of 3.00% (Adult Social Care Outcomes Framework, December 2024).

There were differing approaches to discharge, intermediate, and reablement support in different areas, due to differences in partnerships and joint care arrangements with health providers in the north and south of the county. However, feedback from staff and partners regarding the effectiveness of multi-agency discharge and reablement processes cross-county, was positive. Additionally, people told us they had experienced good outcomes when supported by the local authority’s reablement team. This indicated the approaches taken in different areas by the local authority were minimising the need for ongoing support. National data reflected this, indicating 86.73% of people over the age of 65 years were still at home 91 days after discharge from hospital into reablement or rehabilitation services, which was slightly better than the England average of 83.7% (Adult Social Care Outcomes Framework, December 2024).

People could independently access or work with local authority staff to procure low-level equipment or minor home adaptations to help them maintain independence and continue living in their own homes. Information and guidance on accessing low-level equipment was available via the local authority’s Happy at Home website, and staff demonstrated how equipment from the “box of trix” (a range of low-cost equipment used to assist with daily tasks) supported people to maximise their independence in their own homes. Leaders had oversight of the routes by which people could access equipment and advice on how to use it, including through occupational therapy practitioners and the local authority’s first contact team.

Waits for the provision of standard equipment had reduced significantly over the six months prior to our assessment as a result of the local authority’s equipment provider addressing vacancy issues. In December 2024, seven people were waiting for a standard item of equipment, which was a reduction from 91 people in August 2024. Additionally, the maximum wait had reduced from 119 days in the year prior to August 2024 to 35 days in the 12 months prior to December 2024. However, staff told us timescales for the provision of specialist equipment, such as bariatric equipment, could be lengthy due to inconsistencies in the process of authorising purchases. Staff were supported by leaders to navigate this process, including presenting people’s cases for specialist equipment to authorisation panels. People with the greatest risk to their well-being were prioritised for assessment and equipment, and where people waited longer for specialist equipment, advice, information and support was provided to manage the risk to their wellbeing and keep them safe.

People, including unpaid carers, told us they could easily access information and advice on their rights under the Care Act 2014 and ways to meet their care and support needs. Staff understood that signposting and providing people with information about community resources, including people who funded their own care, was critical to supporting people’s independence and wellbeing. This was reflected by national data which indicated 63.39% of people who used services found it easy to find information about support, which was in line with the England average of 67.12% (Adult Social Care Survey, October 2024). Additionally, 65.98% of unpaid carers found it easy to access information and advice, which was slightly better than the England average of 59.06% (Survey of Adult Carers, June 2024).

The local authority worked with partner agencies through the Supportive Communities programme and county-wide Community Help Points to provide information that was accurate, coherent, accessible and available to all people in the county when and how they needed it, irrespective of their needs and communication methods. Work had been done to improve the accessibility of information available via the local authority and Happy at Home websites, for example, the recent introduction of the capability to translate text to British Sign Language (BSL) on the webpages. Leaders said there was an aim to develop this work further.

National data indicated that, although a similar number of people took up direct payments in Staffordshire (23.66%) compared with the England average (25.48%), including those aged between 18 and 64 years (34.17% compared with the England average of 37.12%), uptake by people over the age of 65 (12.09%) was slightly lower than the England average of 14.32% (Adult Social Care Outcomes Framework, December 2024). Additionally, a partner told us some of the unpaid carers they supported were not aware they were entitled to a direct payment to pay for care and support to enable them to have time for themselves.

Leaders were aware direct payment uptake within the county had decreased and work had been undertaken to understand the reasons for this. Staff feedback indicated there was uncertainty within the workforce about how and when to support people with care needs to take up direct payments. Additionally, people fed back to the local authority that the rigid rules around how direct payments were to be used were creating barriers for people to take them up. Efforts were ongoing to address these issues. For example, the local authority was actively working with staff, unpaid carers, and people receiving care and support to increase awareness of direct payments and how they could improve people’s choice and control around how their care and support needs were met. Work was being done with staff and at a senior level to review language around direct payments to help people understand what they could access rather than the limitations of the support. Additionally, work to streamline the local authority’s direct payments process was ongoing and included plans to introduce a dedicated direct payments support team to ensure timely and ongoing access to information, advice and support for people navigating the range of support available. The aim of this work was to increase equity of uptake across the population and promote people’s independence and choice around their care.