The Care Quality Commission (CQC), has rated Westmorland and Furness 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: 2
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:
“During our inspection of Westmorland and Furness Council, we found an authority which wasn’t far off from providing good access to services in all the areas we looked at. It had strong leaders who were aware of the challenges they faced, and were on an improvement journey to ensure people have more positive experiences of adult social care.
“The local authority needed to improve waiting times for both allocation of a social worker and occupational therapy assessments and reviews, as people didn’t always receive them in a timely way. This resulted in people waiting longer for support and could lead to them deteriorating.
“Partners told us the local authority was supporting people to receive therapy services after they had been discharged from hospital. However, we heard there had been challenges with people receiving this due to demand, and the lack of availability which needs to be addressed.
“We also heard how the ageing population in Westmorland and Furness was a significant challenge, and put additional pressure on services. To help overcome this, the authority was working with partners to look at preventative measures, in areas such as falls and frailty. This was to support older people and reduce their need for reliance on adult social care services.
“Additionally, we were told about the authority working with partners to set up a wellness programme, to help reduce people being re-admitted to hospital. This included a 12-week pilot which saw the authority working in new improved ways with health organisations. During this time no-one was re-admitted to hospital, however if it wasn’t for the pilot, data showed some people would have been re-admitted within eight weeks.
“Leaders understand what needs to change and have started building the right foundations to deliver better support. We look forward to returning to see how their plans mature and the impact this has on their community.”
The assessment team found:
- Unpaid carers didn’t always have access to respite care for the person they were caring for, in both planned and unplanned situations. This was especially difficult for people in rural areas.
- Leaders recognised there were gaps in specialist supported housing for people which needed addressing, including those with complex mental health needs and autistic people.
- Some people felt the financial assessments process was unclear. They were repeatedly sent bills asking them to pay money towards their care, without a clear explanation of what they were being asked to pay for.
- 263 people were waiting for occupational therapy reviews at the time of the assessment. Leaders were making plans to improve this.
- The local authority recognised there were many rural areas where access to care was an issue and people were at risk of feeling isolated.
However, the assessment team also found:
- The authority learned from people’s feedback around their experiences of care and support, to enable them to make improvements to its services.
- Leaders had created strong partnerships with the Voluntary, Community, Faith and Social Enterprise (VCFSE) sector to develop initiatives such as the ‘take home and settle’ service. This aimed to prevent people from being in hospital unnecessarily and to ensure they were discharged quickly.
- Leaders ensured that all staff involved in safeguarding were fully trained so they could provide appropriate support to meet people’s needs.