North Northamptonshire: local authority assessment

The local authority had foundational processes and guidance in place to support key transitions, including hospital discharges and young people moving into adulthood. These were facilitated through locality-based teams and specialist sub-teams such as Age Well, providing targeted support across different service areas. The overall structure of care pathways was not clearly defined, which made it challenging to understand the routes people might follow throughout their care journey. Variations in practice were evident across teams, influenced by the approaches of individual practitioners, and staff expressed surprise upon learning how different teams operated. This highlighted an opportunity for greater consistency and clarity in pathway documentation and guidance.

The local authority had a risk register in place, which outlined priority concerns within its operational framework. Notably, the absence of out-of-hours Approved Mental Health Professionals (AMHPs) was recorded as the highest risk, followed by limited review capacity. The risk register did not consistently articulate the potential impact of these risks on people, nor did it detail sufficient mitigating actions. For example, the suggested approach to address the shortfall in review capacity involved senior leadership teams identifying priority areas for focused attention, a valuable step, though not a direct mitigation measure. A 'waiting well' protocol existed that could have supported risk mitigation, but it was not consistently applied across all teams. As a result, while the presence of the risk register demonstrated a recognition of challenges, it was not effectively utilised as a robust tool for managing risk.

The local authority did not share an out-of-hours (OOH) policy or guidance, and there was limited awareness among the workforce of any such documentation. The local authority did have a lone working policy which was embedded in some system documents, however, staff indicated they were not adhering to this including the use of risk assessments and lone working training for staff.

Staff explained that governance for OOH services remained under the remit of the Children’s Trust, which influenced the training programme to focus predominantly on children’s services. As a result, adult-specific training was described as infrequent and limited in scope. Staff also shared that lone night shifts presented particular challenges, including reduced capacity to conduct face-to-face visits after 1am, due to the presence of only 1 worker responsible for managing referrals and monitoring incoming calls.

These circumstances occasionally created challenges in responding promptly to urgent safeguarding or mental health situations, which could result in delays in assessments and support for people at risk. Staff also highlighted the need for greater support for AMHPs, reporting that formal supervision was infrequent and needed to be more consistent. Additional concerns included the absence of real-time IT support during out-of-hours periods, with some systems described as not meeting operational needs. In such instances, staff reported experiencing feelings of isolation and increased pressure when making decisions, particularly when technical systems were unavailable.

Despite these pressures, staff highlighted effective multi-agency working with police, ambulance, and housing services, and the use of mapping tools to improve referral accuracy. Statutory Mental Health Act assessments were conducted during out-of-hours, and the safeguarding process was used to appropriately prioritise urgent cases.

Following the assessment the local authority told us the OOH service moved from the children’s service to North Northamptonshire Council on 1st September 2025, and the team now works to local guidance and procedures including specific guidance for working out of hours, with access to a full learning and development offer.

From age 14, the local authority began preparing young people for adulthood by attending school reviews, engaging with families, and coordinating across agencies. Multi-agency forums such as the Transitions Operational Group oversee referrals and planning, helping ensure that young people with complex needs were supported early and consistently. Protocols like the Preparing for Adulthood Framework, created in partnership with neighbouring local authorities, clearly defined referral routes, timelines, and expectations, placing young people at the heart of decisions.

Dedicated transitions workers supported young people throughout their journey, attending Education Health Care Plan (EHCP) meetings and liaising with families and education teams. Despite efforts to ensure continuity, some workers told us they experienced overwhelming caseloads, which occasionally led to delays in care planning. Some people shared concerns, with examples including a family in a transitional move from one area to North Northamptonshire describing the move as challenging and difficult to access services, resulting in a period where they felt unsupported. Other people told us their experience of transitioning to adulthood was positive. Some providers reported inconsistent communication from the local authority during transitions, which they said impacted young peoples’ confidence.

Hospital discharge practices included daily virtual meetings for discharge planning and contributed to responsive discharge support. The local authority undertook assessments in people’s homes, which they reported allowed for better understanding of individual needs and environments. They felt this supported more accurate care planning and helped reduce unnecessary admissions to residential settings.

Partners reported receiving detailed discharge paperwork ahead of transitions from hospital, which enabled smoother coordination of services. Partners reported reablement pathways were effective, with some patients discharged the day after assessment. However, partners also raised concerns about the lack of consistent weekend services and delays in Care Act assessments for externally commissioned care packages, which meant people sometimes remained in hospital longer than necessary, with increased risks to wellbeing due to being in hospital longer than required.

Escalation processes were in place, including daily system calls involving a senior member of the adult social care team. Staff reported that these processes were not always fully embedded and were sometimes used in a more reactive manner. They also highlighted ongoing communication challenges between health and social care services during hospital transitions. Partners told us the escalation and complaints processes within adult social care were not always clearly understood, which they felt made it more difficult to report issues during transitions from hospital.

The local authority had developed tailored business continuity plans for individual teams, outlining specific mitigation strategies and operational guidance for managing service disruptions. In addition, a structured Care Home, Supported Living & Community Support Provider Closure Protocol was in place, setting out a collaborative framework for responding to provider failure or closure across a range of care settings.

The protocol clearly assigned coordination responsibilities to the Quality and Provider Assurance Team, who were expected to lead the development and implementation of action plans in partnership with providers and system partners. It also included practical tools such as templates for documenting action plans, sharing information, recording meeting minutes, and tracking progress. This approach reflected a commitment to managing provider-related risks in a planned and coordinated manner, supporting service resilience, and contributing to the continuity of care expected under the Care Act.

The local authority proactively undertook an audit of eight people affected by closures and seven provider failures. The audit identified gaps in documentation and communication, as well as instances where practice had diverged from agreed protocols. Six categories of issues were outlined, and a series of recommendations were made to strengthen compliance. The local authority reported that all actions arising from the audit had been completed and that feedback gathered from people was positive.