The Care Quality Commission (CQC), has rated North East Lincolnshire 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 requires improvement 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: 2
4. care provision, integration and continuity of care: 2
5. partnership and communities: 3
6. safe pathways, systems and transitions: 3
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:
"At this inspection, we found North East Lincolnshire Council needed to make improvements in how it's providing people with access to adult social care and support for people living in the area. While we saw strong partnership working and genuine commitment to person-centred care, the local authority does have further work to do to ensure people are consistently receiving the support they need.
“The hospital discharge process was described by partner organisations as gold standard. It was well-coordinated and timely, with 94.8% of people being able to return home after they were discharged. This reduced their stress and improved their recovery.
“Also, it was positive to hear that transitions between services were generally well-managed. Young people and their families had positive experiences when moving from children to adult services.
“However, unpaid carers told us that there were delays in receiving assessments and reviews, and there were limited respite options available for them. Some carers also felt they weren’t involved in decisions made about their loved one’s care, particularly around safeguarding and hospital discharge.
"Additionally, improvements were needed around direct payments. We were told that the process was confusing and time-consuming, with some carers waiting for up to 18 months to receive them. This meant they weren't getting the support they needed in a timely way to carry out their caring role.
"North East Lincolnshire Council has clear plans to address the issues identified, including improving direct payments processes. We'll continue to monitor progress and look forward to seeing how their future plans mature."
The assessment team found:
- Some frontline staff weren't sure how to raise concerns, and partners reported inconsistent safeguarding advice, which could delay appropriate action and affect people's safety.
- Care organisations felt information sometimes lacked detail when the local authority were requesting support for people.
- Data showed that only 48.18% of people who received short-term support no longer required ongoing care, which was significantly lower than the England average of 79.39%.
- Partner organisations reported long waiting times for home adaptations. This increased anxiety and dependency for both people and their carers.
However, the assessment team also found:
- People could access information and advice using a single telephone number (single point of access), aimed at preventing, reducing, and delaying their care needs. People valued this service as they received clear and timely responses.
- The local authority increased the number of inpatient rehabilitation beds, some of which were for people who had a stroke. This helped reduce hospital stays and led to better outcomes for people in terms of helping them regain their independence.
- The local authority actively gained feedback from people receiving care and support, unpaid carers, and staff. This was used to help improve services.
- Staff shared multiple examples of how they are encouraged to be innovative and come up with new ideas in response to local demand and feedback. For example, one member of staff was supported to attend a neurology course so a neuropsychiatry service could be set up to help support people.