The Care Quality Commission (CQC), has rated North Northamptonshire 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: 2
6. safe pathways, systems and transitions: 2
7. safeguarding: 2
8. governance, management and sustainability: 2
9. learning, improvement and innovation: 2
Chris Badger, CQC’s chief inspector of adult social care and integrated care, said:
“At North Northamptonshire Council, we found a local authority that needed to focus on improving people’s access to care and support pathways and making this consistent and equitable for all. This is especially important in the diverse area the authority covers, with a mix of rural and urban areas and populations. However, the local authority had positive areas of practice and plans in place which it now needs to build on to help improve people’s experiences and outcomes.
“People gave us mixed feedback about engaging with adult social care services in North Northamptonshire. Some people raised concerns about the time they waited for assessments. This included therapy assessments, which led to people waiting a long time to receive support equipment, negatively impacting their independence.
“Our inspectors heard people also had mixed experiences of accessing information and advice, with some able to access relevant resources while others described barriers they faced. The local authority had limited information available for people whose first language wasn’t English and for those who needed information in adapted formats such as easy-read materials.
“However, it was encouraging to hear how staff had regular contact with people they supported and provided tailored support. Staff carried out comprehensive assessments and were aware of wider risks including social isolation. They also made sure they considered people’s individual needs, preferences and ambitions. This helped people receive effective care that helped achieve the best possible outcomes for them.
“We also learned how North Northamptonshire had launched initiatives to help prevent people needing further care in future. This included Support North Northamptonshire, which involved voluntary sector partners and helped people access appropriate support before needing further care and to remain independent.
“We have told leaders at North Northamptonshire the areas they need to develop further and we look forward to visiting again to see how their plans progress.”
The assessment team found:
- Unpaid carers told us that while staff provided individualised support that could meet their needs, they were concerned about contingency planning and access to respite services.
- Many people were waiting for Care Act assessments and reviews. Leaders were actively working to reduce delays and improve responsiveness.
- Leaders made sure people were able to help shape services. However, people lacked clarity on what their role in this process was and wanted more opportunities to contribute meaningfully at an earlier stage of planning.
- North Northamptonshire faced challenges with its care capacity, with delays in residential placements. These particularly affected hospital discharge, mental health and dementia services. Leaders had plans in place to help improve the care capacity.
- The local authority had a growing commitment to understand barriers to care and support, which was important in an area which has affluent areas as well as some of the most deprived areas in the country. However, leaders didn’t analyse equality data consistently enough to identify the unique challenges different groups of people face, and how they could help reduce these inequalities.
However:
- Leaders had clear processes in place to monitor the quality and impact of services by using quality outcomes, compliance measures and a framework in their assessments.
- 88.61% of people who received reablement services after being discharged from hospital were still at home 91 days after discharge. This was better than the England average of 83.70%.
- Leaders had embedded a culture of continuous learning and improvement. Staff used feedback to help improve services and people’s experiences.