The Care Quality Commission (CQC), has rated Bolton as good, 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 good 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: 3
5. partnership and communities: 3
6. safe pathways, systems and transitions: 3
7. safeguarding: 2
8. governance, management and sustainability: 3
9. learning, improvement and innovation: 3
Chris Badger, CQC’s chief inspector of adult social care and integrated care, said:
“At our assessment of Bolton Council’s adult social care services, we found strong leaders who cared about their staff and worked well with partners and people using services to understand their care and support needs. This ensured that those living in Bolton had good access to health and social care services.
“The local authority had a focus on prevention, to help reduce people’s long-term dependency on adult social care services and promote their independence. For example, we heard how people received equipment and any necessary minor home adaptations quickly.
“Also, people were positive about their experience of being discharged from hospital and moving between services. They told us that social workers coordinated their care efficiently and helped them move into appropriate accommodation in a safe and well-managed way. This helped them regain their independence and made them feel more confident.
“However, unpaid carers had mixed experiences. Some told us they felt isolated, unsupported, and hadn’t had a carer’s assessment. For some who had received an assessment, we heard how this had been carried out over the phone which they felt was impersonal. Additionally, some weren’t aware of services available to enable them to take a break from caring for their loved one, and described reaching crisis point, which placed additional strain and worry on them.
“Overall, Bolton Council should be pleased with the many positive findings in our report and their good rating. They’ve already told us how they’re planning to build on this further with improvement plans and we look forward to returning to see how their plans mature.”
The assessment team also found:
- The local authority arranged services to reduce poverty and support people, including rough sleeper services and emotional support for people who had survived a stroke. One of the services available was a café which supported people experiencing a mental health crisis, offering a relaxed alternative to an emergency department.
- The authority learnt from complaints to improve services. For example, complaints regarding people’s finances led to updates in IT systems, changes to letters, and prompts for staff to record people’s financial information.
- Leaders implemented a process to help prevent people with a learning disability and autistic people from being admitted to a mental health hospital, reducing the risk of any unnecessary admissions.
- Staff used direct payments to support people’s choice and independence, to meet their individual needs. People felt this helped them maintain independence and access necessary support.
- Staff described the local authority as nurturing and encouraging. Social work Apprenticeships and Assessed Supported Year in Employment (ASYE) placements were offered across all teams, which built expertise and confidence to help support people.
However:
- Staff told inspectors there were sometimes delays with them being able to access British Sign Language and Somali interpreters. Also, partners felt deaf awareness training was an area which required improvement. The local authority acknowledged these issues and were addressing them at the time of the assessment.
- Staff weren’t always able to respond to safeguarding referrals or complete reviews in a timely way due to pressures on capacity, which could put people at risk. However, the local authority was taking action to address this at the time we visited.