CQC publishes report on Sheffield City Council’s care act responsibilities

The Care Quality Commission (CQC), has rated Sheffield City 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 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: 2

5.    partnership and communities: 2

6.    safe pathways, systems and transitions: 2

7.    safeguarding: 2

8.    governance, management and sustainability: 2

9.    learning, improvement and innovation: 3

Chris Badger, CQC’s chief inspector of adult social care and integrated care, said:

“During our inspection of Sheffield City Council, we found a mixed picture of people’s experiences accessing adult social care. While leaders had clear plans to improve services, these weren't fully joined up into a single, coherent approach. This made it harder for the local authority to track progress and demonstrate consistent improvements for people.

“People told us they waited longer than expected for assessments and reviews, which disrupted continuity of support and reduced their confidence in the system. Unpaid carers also told us they had the same experience around consistency and often spoke to different duty workers each time they contacted Sheffield. As a result, carers had to repeat their circumstances and this slowed care planning as each duty worker had to familiarise themselves with each person’s unique circumstance.

“However, people consistently praised staff for being kind, dedicated and person-centred. We saw staff supported people to use direct payments flexibly, which enabled greater independence and choice. For example, people used direct payments to access activities that suited them and to purchase equipment that supported independence at home. The uptake of direct payments was significantly higher than the England average.

“Staff spoke positively to our assessment team about the local authority's vision which had been created with them and people using services, and it was clear this had become embedded in how they approached their work. Leaders had made good use of performance data in some areas and were actively supporting innovation and promoting a culture of learning.  Senior leaders had identified the changes they needed to make, and the interim director of adult social care had brought both experience and momentum to drive improvement forward.

“Sheffield City Council's leaders understand what needs to change and have already begun implementing improvements. Staff remain committed to the vision, and there's a strong foundation of workforce development and community partnerships to build on. We'll continue to monitor progress and look forward to returning to see how their plans mature and the impact this has on their community.”

The assessment team found:

1. Some people told CQC the local authority didn’t provide accessible telephone or website options, which made it harder to access information and advice.
2. Sheffield had a wide range of support available, but leaders did not communicate this effectively.
3. Staff, people and unpaid carers told CQC the processes for people aged 65 and over accessing care were frequently interrupted or disjointed, which slowed care planning.
4. People using services and unpaid carers gave mixed feedback about safeguarding and risk management, and leaders needed to improve the consistency of these processes.
5. Staff didn't progress discharges from mental health hospitals at the same pace as acute hospital discharges, which increased out-of-area placements.

However, the assessment team also found:

1. Some people said their assessments were completed promptly and involved their families appropriately.
2. Staff worked effectively with partners, including attending joint reviews, securing health funding and referring people to specialist teams.
3. The local authority demonstrated a strong commitment to equality, diversity and inclusion, with training in cultural competence and anti-racism provided to staff. This translated into person-centred care, for example, staff ensured people's faith and cultural needs were reflected in their assessments and support plans.
4. Leaders had a clear understanding of the adult social care population, including older adults, people with learning disabilities and people with physical disabilities.