CQC rates London Borough of Southwark’s adult social care provision as good

The Care Quality Commission (CQC), has rated London Borough of Southwark 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: 3

4.    care provision, integration and continuity of care: 3

5.    partnership and communities: 3

6.    safe pathways, systems and transitions: 2

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 this assessment, we found people using adult social care services in Southwark generally had positive experiences. Most people told us they felt listened to and involved in decisions about their care. Staff carried out assessments that recognised people’s aspirations and abilities. They respected people’s right to choose and supported them with the least restrictive options to promote their independence.

“Southwark assessed most people in good time, with limited waits for most services.  People had good access to advocacy and translation services, and most people and their carers described their assessments as positive interactions where they could express their wishes and shape their support.

“It was encouraging to see the local authority demonstrate strong partnership working that had a clear and positive impact on people’s lives. Working with NHS partners, Southwark delivered integrated intermediate care and reablement services. Following service redesign, leaders reduced waiting lists significantly, and more people received reablement services after hospital discharge. We also found staff worked effectively with health and other partners to ensure assessments and care planning met people’s needs.

“We found leaders showed a clear understanding of local inequalities and set equality objectives to improve outcomes. The workforce reflected the diversity of the community, and the local authority invested in becoming an anti-racist organisation. Leaders worked with people with lived experience to address structural barriers to accessing care.

“Although most people had positive experiences, this was not universal. Some people and unpaid carers reported delays, particularly for occupational therapy assessments, and some were unclear about the support available to them. Leaders also needed to strengthen safeguarding oversight. The local authority recognises these issues and is taking action to address them.

“Overall, Southwark should be really pleased with the many positive findings in our report and their good rating. Southwark has established a focused and capable leadership team, committed staff, and a strong learning culture. We look forward to seeing how their improvement plans continue to develop.”

The assessment team found:

1. Most people gave positive feedback about preventative support that helped them stay independent and in control of their health and care needs. The local authority ran community hubs across the borough delivering prevention services, peer support and self-management groups.
2. CQC saw an inclusive and positive culture of continuous learning and improvement. Most staff felt valued and supported, with good induction, peer support, supervision and career progression opportunities. Leaders encouraged a flat hierarchy where staff were trusted to use their initiative.
3. The local authority’s Ethical Care Charter contributed to improved satisfaction with homecare, increasing from 55% in 2016 to above 95% since 2018. Providers told CQC the charter supported workforce stability, and most participating care homes reported full staffing.
4. Carers in Southwark accessed support to stay in employment at the highest rate nationally, with 10.47% of carers received this support, significantly better than the 2.79% England average.
5. The local authority promoted accessibility and inclusion. It provided information in braille, audio, easy read and large print, and worked with providers to improve access, including adapting lighting in a leisure centre to better support people with sensory needs.

However, the assessment team also found:

1. Staff didn’t sufficiently support some people to access direct payments to manage their care independently. Uptake of direct payments remained below England averages.
2. Some families told CQC that transitions from children's to adult services were not seamless. Some young people and their families experienced delayed assessments, which created anxiety about what support they could expect.