Sandwell Metropolitan Borough Council: local authority assessment

Where concerns were raised in relation to people’s safety, they were addressed swiftly. For example, one person raised some concerns about a piece of equipment incorrectly set up with the local authority and this issue was resolved quickly and to the person’s satisfaction.

Staff worked to ensure people were supported and their safety managed. The mental health social work team and Approved Mental Health Professionals (AMHPs) ensured people with mental health needs living in the community stayed well and independent as far as possible. For example, AMHP's provided 24 hour 7 days a week cover.

In terms of the emergency duty service, effective exchanges of information took place between staff teams to the out-of-hours team and back again to the teams in the day. There was an established pool of sessional social workers used by the local authority on a long-standing basis with very few issues. All the staff were qualified and experienced social workers, however it was noted new recruits of social workers to the pool were scarce. All incoming calls were answered and triaged by the duty manager (with extra support staff over the weekend). Children's concerns were re-routed to children's workers and the manager screened adult concerns, re-routing mental health concerns to the mental health service. The manager managed low level concerns, which was around 90% of all calls concerning adults, and allocated cases requiring social worker support to the sessional social workers. Decision making, risk assessments and deployment of staff was arranged by managers. Workers handed over to the duty manager when their shift ended and the duty manager signposted further calls for allocation in the morning.

Partnership working ensured a system approach around safety with health colleagues. Teams told us where step up services were required, for example, to prevent hospital admission, 72 hour wrap around care could be provided swiftly and was reviewed at 48 hours by a member of a virtual ward team which included clinical staff.

Partners told us housing challenges such as hoarding and unsuitable environments had increasingly delayed hospital discharges, however the local authority provided wraparound support to people accordingly. The local authority also provided a community alarms service 24 hours a day, 7 days a week for people living in the community.

The local authority had a proactive Safeguarding Adults Board working with 4 other Boards such as the Health and Wellbeing Board and the Community Safety Partnership, to form the '5 Boards Arena' working together on themes to improve safe systems.

Leadership development programmes emphasised the role of managers in supporting safe practice, supervision and decision making. This aimed to reduce risk and promote high-quality pathways across teams. Frontline staff were provided with equipment including personal alarms to promote their personal safety when out in the community.

People’s experience during periods of transitions varied. One person’s experience of family members’ transition from children to adult’s was problematic, as was another person being discharged from hospital. However, for other people, their experiences were better. For example, people’s experience of the 12-week pathway in building their skills and confidence.

The local authority aimed to ensure a safe and smooth transition of young people to adult services with system and partnership working. As part of their transformation programme and together with partners, the local authority was reviewing their current processes to ensure they were robust. Partners confirmed the local authority were planning to facilitate conversations between public health, the VCSE organisations and the children and young people's forum, along with other partners, to discuss transitions from children's to adult services. Their aim was to ensure people did not work in silos and had access to the necessary links for the VCSE to support people through this transition.

The local authority told us there were 2 transformation workstreams currently in place to address issues. A team specific transformation plan focusing on the processes and practices within the Young Adults Team to include collaboratively working with other teams and partners, so the most creative and person centred planning took place at the earliest possible point. Also, a wider transformation approach to review the pathways and partnership working.

The Young Adults Team worked with young people from 14 to 25 years of age with Learning Disabilities/Autism, mental health, physical and sensory disabilities and their families to enable a smooth transition as part of preparation for adulthood. The team promoted areas of development including independence, work/activities of interest and being part of the community. Referrals to the Young Adults Team came from a variety of places including a Preparing for Adulthood panel and schools. The team completed an assessment by the time the person was 18, then completed annual reviews until the person was transferred to the appropriate adult locality team at around 25.

Most referrals were received from children's services with assessments and support planning taking place from the ages of 17 to 18. Although Pathways to Adulthood began from the age of 14 officially, referrals had not always been forthcoming at this time from other agencies and a large volume of referrals were often received from young people's families via the front door service.

Staff feedback about the support offered was good. The team told us the 12-Week Pathway offered by the local authority was available for those with a learning disability diagnosis, dual diagnosis and autism only diagnosis, and was a valuable assessment tool which effectively managed risk and ensured recommendations were made enabling effective care planning at the earliest stages for young people. Referrals to the pathway focused on strengths as the basis for support which could range from areas like travel training, work experience or access to community facilities such as libraries.

Senior staff told us they had addressed the transitions waiting lists which were now down to 15 in July 2025. However, the caseload volumes of the teams holding these still needed to be reviewed.

Partners described transitions as an area where there could be disagreements over responsibilities at times. Feedback from the local authority, however, was they worked very closely with their partners who support children and young people with disabilities and those who are care experienced so that they can engage in their support planning at the earliest possible appropriate point from the age of 14 years. This enabled them to ensure that for the young person the transition process was well thought out and planned in advance of their 18th birthday and that they and their care givers have the maximum opportunity for choice and control over their future. This approach meant that young people were well supported throughout their transition. The local authority have also trained a number of children’s services staff in relation to legal frameworks and strengths-based approaches when assessing and supporting adults to enable an enhanced understanding of the process and journey for the young person.

Young people were supported in a variety of settings and areas. Staff currently had a small number of cases of people detained in prison systems and visits to the young person were carried out as required. The young person's team told us of a small number of out-of-borough placements, where young people were placed mainly by Children's Services due to the need for specialist support. The team always looked at all possible ways to move the young person closer to home or to keep them where they were according to where their needs were best met and the person's preferences.

Although there were not usually waits for people in terms of hospital discharge in Sandwell, it was identified there could be improvements in communication and planning sometimes with partners. An Integrated Discharge Hub coordinated hospital discharges and care planning across health and social care. The Hub supported timely hospital discharges and prevented unnecessary admissions. Staff were borough wide and operated 7 days a week. The team had a ‘Home first and why not today" approach working across locations including the 2 main hospitals in the area. The team carried out Care Act Assessments and support planning, unpaid carers assessments, mental capacity assessments, 4-week reviews, safeguarding, duty work, and DoLS assessments. The team operated a Discharge to Assess model which set out 4 pathways for discharge from hospital.

Although we had feedback from people stating that there had not always been future planning in place for the care of their relative, in the local authority Joint Carers Strategy Action Plan there were measures to support carers at risk of exhaustion, stress or breakdown, including plans for better crisis response and targeted training for professionals. Carers emergency plans were introduced to manage crisis situations, helping prevent escalation and ensuring continuity of care during emergencies. Senior staff told us the unpaid carers contingency offer which was aligned to the emergency carers card scheme was currently managed by the local authority and 72 hour wrap around support in the event of carer breakdown or escalation of cared for person's needs with the option to build in an additional 10 hours onto the support plan to cover, for example, carer admission to hospital. The emergency carers card scheme provided direct access to information and contact details in the event of an emergency.

Staff supported people in emergency situations, for example, one person had gone into a short-term care placement whilst their property was made clean and safe. Staff had immediate access to in-house food stores and fuel payment cards for people in need of supplies and domiciliary care could be offered in emergencies, which staff said was usually straightforward to arrange.

Although the work of the Quality and Safety Team was to ensure that services were safe there was also a preventative element to mitigate against services failing because of quality or lack of compliance. The Provider Support Team could go into services and support with bespoke interventions to raise standards or offer training including around health and safety.

Engagement and monitoring arrangements provided the local authority with early warnings of potential service disruption or provider failure and contingency plans were in place to ensure people had continuity of care provision in such events. The local authority had a steering group which met at the earliest opportunity following the indication of a provider failure. There was a clear plan which set out the process, considering the most person-centered support for people who would be affected to ensure their needs were met. Procedures outlined the responsible teams and workers to ensure safe continuity of care for people.

A Health and Social Care Provider Failure Procedure had been developed to identify actions to be taken when there was an actual or prospective failure of one or more providers. This provided a framework for staff to ensure a joined up and effective response from all partners to minimise the impact on people. This procedure was followed for the first time since being developed in February 2025 when a service in Sandwell had issues including quality, leadership and competency of staff to support people with complex needs.