North Northamptonshire: local authority assessment

The local authority demonstrated an informed approach to understanding the diverse care and support needs within its population. By drawing from a wide range of local insight packs, Joint Strategic Needs Assessment (JSNA) data, and partnership profiles, it was able to explore key indicators such as public health outcomes, employment patterns, deprivation levels, and future demographic projections.

Detailed assessments of specialist needs, such as those relating to autism, physical and sensory impairments, and learning disabilities reflected a commitment to inclusive planning. The local authority considered prevalence data, service uptake, co-existing health conditions, and associated benefit profiles to shape its commissioning and target interventions. Carers’ experiences and care leavers’ outcomes were also clearly recognised, supported by demographic forecasts and national research which informed local service response and strategic direction.

Evidence from the ‘Homelessness and Alcohol’ JSNAs highlighted overlapping vulnerabilities that may contribute to wider social care needs. The local authority demonstrated awareness of how factors such as housing challenges, substance misuse, and socioeconomic inequalities could increase demand on adult social care services. Area-specific Local Area Partnership (LAP) profiles enabled a more granular understanding of community assets and challenges, ensuring local services could respond effectively to the distinct needs of different neighbourhoods.

The local authority also made use of market insight and future forecasting, including projections for autism and dementia rates. This helped ensure care provision remained sustainable and reflective of anticipated demand. Through engagement with service users, carers, and providers, the local authority strengthened personalisation and choice within its service design. While some governance arrangements were still being refined, the local authority's efforts to work within its statutory duties and promote coordinated, inclusive care were evident across its strategic documentation.

People were able to access a selection of local support services. While a comprehensive commissioning strategy was still being developed, there were targeted commissioning activities in place for particular service areas. Staff noted that commissioning was evolving as part of the local authority’s ongoing journey to embed and strengthen its practices.

Commissioning activity covered a wide range of services, including residential and nursing care, home care, day opportunities, and independent living schemes. The local authority made use of dynamic purchasing systems to increase and diversify its provider base and improve access to support across sectors. Fee structures were reviewed through annual inflationary uplifts and benchmarking exercises, which the local authority told us were informed by provider feedback and wider market intelligence, to support financial viability and recruitment where needed. Independent living schemes and Extra Care housing units provided alternative accommodation options for older adults seeking supported living environments. Where gaps were identified, such as limited evening and weekend support for younger adults, or the need for specialised accommodation, the local authority undertook planning and development activity, including consultation with assessment teams and people with lived experience to commission services to meet local needs. For example, at the time of the assessment, there were 2 new extra care schemes in development.

The local authority demonstrated some consideration for culturally specific care provision with the inclusion of several providers able to offer support tailored to diverse needs. Providers were specifically asked about specialisms during procurement which was built into a brokerage intelligence base. Brokerage teams reported that where specific cultural requirements were identified, support was sourced on a case-by-case basis, including the use of ‘spot’ providers where appropriate. While this flexible approach allowed some responsiveness, it was not underpinned by a dedicated commissioning framework for culturally specific services, and provision was largely reactive rather than strategically embedded.

Feedback from people, staff and partners highlighted areas where services could be strengthened. Support for younger people with learning disabilities was noted to be less available during evenings and weekends, leaving some needs unmet. Several partners expressed concern regarding access to dementia-specialist care, suggesting that in its absence, people could be placed in settings that did not fully reflect their specific support requirements. Additionally, carers shared that residential respite care options felt limited, pointing to opportunities for enhancing short-term relief provisions. This was reflected in data from the Adult Social Care Survey 2023/24 which indicated 63.16% of people who used services felt they had a choice over services; this was somewhat worse than the England average of 70.28%. Additionally, data from the Survey of Adult Carers England 2023/24 indicated the number of carers accessing supporting allowing them to take a break for longer than 24 hours was 10.34%, again somewhat worse than the England average of 16.14%.

The data provided by the local authority suggested that they made active efforts to improve care provision capacity, but challenges remained in meeting full demand across all service areas.

The recommissioning of the homecare framework in late 2023, with 114 providers onboarded, helped increase market capacity and reportedly reduced hospital discharge delays. Similarly, redesigning reablement pathways contributed to a 7.6% reduction in residential care admissions and a 7.5% increase in people supported to live at home, indicating progress toward more preventative and strength-based approaches. Brokerage operations improved referral processing speed, with completion times decreasing from 35 to 24 days, and service availability was expanded through increased use of residential respite and block contracts. The local authority also told us they operated a priority process when brokering care which ensured people at higher risk were prioritised. There was an average wait time of 12.6 days for commissioned care.

Partner feedback indicated that delays in hospital discharge had occurred due to limited capacity, particularly in relation to pathway 3 residential services. Between January and May 2025, data from the local authority showed an average wait time of 13 days for discharge under pathway 3, compared to an average of 3 days for pathway 1 (home-based care), or 5 days for more complex cases. These figures suggested that some people may have remained in hospital longer than necessary while awaiting appropriate care arrangements, which could have implications for their ongoing health and wellbeing.

There was not always sufficient capacity for unpaid carers to access replacement care for the people they supported, in both planned and unplanned circumstances. Daytime short break options were reflected within the key performance indicators for the commissioned service showing targets were being met; however, there had been no equivalent indicators relating to residential replacement care. Staff had expressed uncertainty regarding how such care was arranged, with some unclear whether it was coordinated through the commissioned service or managed internally. This suggested there were gaps in staff knowledge that may have impacted on their ability to support carers in accessing appropriate replacement care.

Local authority data identified that 290 people had entered into service agreements outside the authority area. These arrangements were primarily associated with hospital discharges involving discharge to assess pathways located out of area, personal choice, often to be closer to family, as well as to accommodate complex needs such as acquired brain injuries or autism spectrum disorders. Partners voiced concerns regarding the availability of suitable residential and mental health services within the area. While there was limited formal evidence of a coordinated strategy to support people in returning to the locality, emerging expansion of services within the community suggested a developing commitment in this direction.

The local authority commissioned a range of services in collaboration with partner agencies, including hospital discharge pathways and reablement provision. One example was Thackley Green; a dedicated residential facility designed to offer short-term, specialist support that assisted individuals in their recovery and supported them to regain independence following acute health episodes. Local authority data indicated that the facility was well-utilised.

The local authority demonstrated a clear and structured approach to monitoring the quality and impact of commissioned care and support services, both within its local area and in out-of-area provisions. They utilised a defined set of quality outcomes, contractual compliance measures, and a regulated framework to assess and review services. These arrangements were consistent across internal, external, and out-of-area contracts and were supported by proactive monitoring systems, including the use of a risk matrix, regular review cycles, and collaborative oversight mechanisms.

Where services were found to be inadequate, the local authority prioritised joint reviews with host authorities and partners ensuring swift responses to quality concerns. This reflected a commitment to safeguarding people and maintaining standards regardless of location.

Actions taken to promote quality improvement were evidenced through various strategic initiatives. Staff told us the introduction of a refreshed quality framework contributed to improved provider ratings, enabling more services to reach ‘Good’ or ‘Outstanding’ status. Additionally, the local authority’s commissioning embargos on providers, triggered by concerns such as safeguarding, training deficits, and organisational governance, showed a willingness to take decisive action where standards were not met. In the past year, both homecare and residential services experienced contract suspensions, while a number of providers returned their contracts early due to structural changes and financial pressures. These instances were logged and reviewed systematically, ensuring that the impact on people was appropriately managed.

The local authority’s governance infrastructure reinforced its capacity to respond to risk and support improvements. Risk registers, incident management protocols, and market sustainability plans underpinned a responsive and forward-looking commissioning approach. There was a lack of formal feedback structures between quality, safeguarding, brokerage, and commissioning, instead insights were shared informally limiting opportunity for consistent systemic improvement. However, there was a collaborative Quality and Care Assurance Board which brought together intelligence from partners and stakeholders which enabled informed and coordinated decision-making for emerging risks.

The local authority told us they worked closely with care providers to promote transparency and fairness in the cost of care. This was achieved through provider forums and structured engagement sessions as part of its market sustainability planning. Feedback gathered from these activities via email and one-to-one meetings enabled the local authority to understand and respond to challenges around pay and conditions, financial pressure, and workforce needs.

Providers shared concerns about the timing and transparency of financial communications from the local authority, particularly around annual fee uplifts. They noted that notifications often arrived too close to the start of the financial year, sometimes after providers had already set budgets, making it difficult to plan effectively. They reported this hindered their ability to make timely decisions on staff wages, recruitment, and investment in services, which they felt undermined their efforts to deliver consistent and sustainable care. Some providers told us they had raised this issue repeatedly, requesting earlier and clearer communication to help mitigate financial risk and strengthen operational stability but had seen little change. Other providers told us the lack of prompt uplift decisions led to staff retention challenges, as providers were unable to give assurance around pay adjustments, which contributed to workforce instability and impacted on the continuity of care for people using services.

Market oversight mechanisms such as commissioning monitoring dashboards, regular data collection, and direct engagement with providers enabled the local authority timely identification of financial pressures and potential risks to service provision. The local authority told us through active dialogue they sought to understand the operational challenges providers faced within current trading conditions and offered targeted support where possible. In pursuit of market stability and equitable access, rural pricing and fair cost of care models were introduced, supporting providers to remain financially viable across different geographic areas. Despite these efforts, between February and August 2024, 9 contracted providers exited the market for reasons including financial constraints and service reconfiguration.

The local authority reported that providers could access e-learning training without cost, and they had opened up their ‘in house’ training offer to providers. However, some providers told us they did not know a free training offer was available and some told us they could not access local authority training. This suggested that communication around the training offer for providers could be strengthened to enable them to utilise this offer effectively.

The local authority understood its internal current and future social care workforce needs. Their staff turnover rate and staff sickness rates were similar to the England averages and local authority data indicated that staff turnover rates had improved from 2023/24 to 2024/25.

The local authority told us that a pilot project had been launched within adult services to support staff sickness. As part of this approach, mental health first aiders were made available on-site twice weekly to provide accessible support. Staff could also be referred internally to the leisure team for participation in the ‘Activity on Referral’ programme, and musculoskeletal assessments were offered to support physical wellbeing.