The Care Quality Commission (CQC), has rated London Borough of Richmond upon Thames 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: 3
2. supporting people to lead healthier lives: 3
3. equity in experience and outcomes: 3
4. care provision, integration and continuity of care: 3
5. partnership and communities: 3
6. safe pathways, systems and transitions: 3
7. safeguarding: 3
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:
“Adult social care works best when local authorities, communities and partners pull together around what matters to people. In Richmond upon Thames, we saw strong collaboration that helped create positive experiences for residents and carers.
Most people generally had positive experiences, and told us they felt listened to and involved in decisions about their care. Assessments were person-centred and strengths-based, meaning they focused on what mattered to people and supporting them to maintain their independence.
“We saw that strong partnership working well in how they were supporting people to regain their independence and return home safely after a hospital stay. Around 97% of people aged 65 and over remained at home 91 days after discharge into reablement or rehabilitation services, higher than the England average of 84%. In addition, there were also significant levels of people receiving short-term support that no longer required further assistance, indicating a focus on promoting independence.
“Richmond also performed well in carrying out timely reviews of care. About 77% of people receiving long-term support had a review, compared with 59% nationally.
“Unpaid carers told us they felt supported and involved. They felt involved in discussions about the care of their loved ones and felt their own needs were understood. They told us this helped them feel less isolated and more confident in their caring role.
“Although many people had positive experiences, some families told us that transitions from children’s to adult services weren’t always consistent.
“Overall, Richmond should be really pleased with the many positive findings in our report and their good rating. Richmond has a stable leadership team, a committed workforce and good partnership arrangements. We look forward to seeing how their improvement plans progress.”
The assessment team found:
- The local authority had embedded working with people who use services across commissioning and strategic planning. People with lived experience of accessing care influenced the design of supported accommodation, carers’ assessments and the introduction of care technology.
- The local authority increased support for unpaid carers through direct payments over two years. A higher proportion of people received direct payments than the England average providing flexibility and enabling carers to tailor support to meet their own individual circumstances.
- Richmond had strong arrangements in place to support people who lacked mental capacity. The local authority ensured all people in this situation had support from an advocate, family member or friend.
- The local authority trialled digital solutions, including AI-enabled systems and robotic process automation, to reduce administrative burden enabling staff to spend more time with people needing support.
- Staff described a positive culture of learning and development. Leaders improved retention of newly qualified social workers significantly over the previous year.
However, the assessment team also found:
- Some people experienced delays and unclear communication when applying for home adaptations. In a small number of cases, they were told months after an occupational therapy visit that they were not eligible, with limited explanation. This caused frustration and, in some cases, affected their independence.