Hackney Council: local authority assessment
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Overall summary
Local authority rating and score
Quality statement scores
Summary of people's experiences
People reported that they had good experiences of assessment by social care teams at Hackney Council, and they felt listened to. Assessments considered people’s views, what they wanted to achieve, and the communities to which they belonged. People reported that they had access to advocacy to support them in decision-making. Some assessments and reviews were delayed for people, and complaints indicated communication was not always clear. This meant people felt frustrated and did not always have access to the right information as they journeyed through the care and support system.
Carers were unclear about the services available to them from Hackney Council, and there was a reactive approach to carers’ assessment. Carers’ outcomes were more negative overall than the national average, but carers had been involved in improvements, including developing a carers strategy which was driven by carers’ priorities.
People talked about having access to commissioned services that maintained their independence following assessment. There was evidence that multiprofessional teams came together around a person. Independence outcomes for people were improving but were generally worse than the national average.
There was a range of services to support people’s cultural needs and help them to engage with Hackney Council including advocacy and voluntary and community sector links with communities. There was clear evidence of an anti-racist culture, and people could access local authority services through community groups to support trusted relationships.
Most people received timely care and support to meet their needs. But not everyone had access to care and support in the borough or were offered direct payments; this meant that people sometimes had restricted choice or had to leave the area to get the care and support that they needed. Work was underway to create more supported living provision in the longer term for people to stay in the borough, and people with lived experience were involved in the design of these spaces.
There was some evidence that the approach to risk and safeguarding was personalised for people, but more work was needed to actively seek views from people about their experience of safeguarding. There was mixed evidence about supporting people to plan for contingency and manage their own risks.
People told us that they were involved in some engagement activities with Hackney Council, and everyone we spoke to said this was improving with working on the carer’s strategy, highlighted multiple times. There was also evidence that people were involved in developing the Adult Social Care three-year plan and there was a commitment from Hackney Council to continue this work. People with lived experience talked about areas where coproduction could be improved, including more face-to-face meetings, taking more account of communication needs, and being more open about financial decision-making.
Summary of strengths, areas for development and next steps
There were clear and effective governance, management, and accountability arrangements at all levels within Hackney Council; these provided visibility and assurance on the delivery of Care Act duties, quality and sustainability, and risks to delivery and people’s care and support experiences and outcomes. The local authority identified the areas it needed to improve, and there had been investment in adult social care supported by senior leadership and members.
Hackney Council was going through a transformation process, which was supported by the leadership team’s oversight. There was evidence that adult social care was using this as an opportunity for delivery of its Adult Social Care three-year plan and had consultant support for this. Hackney Council had an ambition to improve its prevention, access, individuality, and quality in its adult social care offer. There was evidence that the local authority was improving how it held itself to account on the delivery of its plans.
As part of the transformation, they reviewed their practice framework and delegated responsibilities to improve the assessment provided. Staff had a good understanding of Care Act duties, taking account of protected characteristics and strength-based approaches. They worked with community partners to support people to have equal access to assessment in a way that was meaningful to them. There were mechanisms to check the quality of practice, which led to enhanced training offers. National data showed that people were less satisfied with their care and support than the national average. Hackney Council was engaged with the data and determined to improve this.
The local authority had delays in assessments and reviews but was working to ensure they gave high-quality information and advice at the front door and that people were triaged appropriately depending on risk. Hackney Council recognised that some people who were triaged under the ‘waiting well’ policy as having low risk had disproportionate and inequitable waiting times. Hackney Council was looking at ways to improve demand management to bring the waiting lists down to within their target timescales of 30 days.
Leaders at Hackney Council wanted to improve the experience for carers, as they knew the local authority had under-identified carers and that the outcomes for carers were not as good as the national average. The local authority undertook engagement with carers and produced a carers strategy that supported positive change. There were long waits for financial assessments, though there had been recent improvements due to process changes. Leaders told us more work was required to reduce wait times.
There was preventative place-based working within eight neighbourhoods in Hackney; most social care teams were aligned to one of the eight community neighbourhoods to support local multidisciplinary decision-making and reduce the long-term need for care. The partnership was looking at ways to measure the outcomes of this work, with key issues identified in communities being financial problems, social isolation, and housing problems.
There was a drive in Hackney Council to improve the preventative offer and the access to social care services. There had been an analysis of what was working and what needed to change, and the local authority had plans in place for improvements, including in the provision of equipment and adaptations, expansion of reablement, and provision of better information and advice.
Hackney Council embraced the rich ethnic and cultural mixture of people in the community, and there was ownership of this from senior leaders. In adult social care, they had completed an analysis of the coverage of their equality data on the social care records system and from this had identified trends for future investigation. The local authority proactively worked with community groups to build ties, and the local authority was anti-racist and a borough of sanctuary for refugees and asylum seekers. Staff gave examples of how they had worked with people from different backgrounds, regularly reflecting on unconscious biases they might hold.
Within commissioning, they had used some specific needs assessments to identify a need for housing with care, and they had set out how they wanted to work with the market, but broader market planning was not consistent. The local authority was changing the way it was commissioning its care to make the market more predictable and improve value for money. Providers described open, transparent and effective relationships with the local authority, citing the frequency of communication with both commissioning staff and senior leaders as a key strength.
There was sufficient care and support available to meet demand, but this was not all in the borough. The local authority purchased most of its care and support through spot contracts, which reduced oversight and market management opportunities. There was an ambition to move to dynamic frameworks, and one such framework for residential and supported living was out to the market at the time of this assessment. The local authority had a plan to build more accommodation with care in the longer term to improve capacity. There were quality assurance mechanisms in place, though these were less robust for people who were living out of the area due to a backlog in social care reviews.
There was a strong place-based partnership. Positive relationships in health and the voluntary and community sector were supporting an evaluation of the governance structures to support greater integration and planning for the future. The local authority had oversight of partnership arrangements, including its integrated mental health and Learning Disabilities teams, and made changes where they were needed. Better Care Funding was allocated and monitored to support a range of programs across the borough related to discharge services, support for carers, equipment services, a neighbourhood’s programme, and a homelessness pathway. The partnership was working on a set of outcomes that would provide a clearer link between services and what was being delivered for people.
There was a structured programme of support to the voluntary and community sector, which gave the sector a clear understanding of what the local authority was able to provide. The outcomes associated with grants funding were not provided in the past, but the local authority had plans to monitor this going forward.
The local authority understood some of the risks to people across their care journeys; risks were identified and managed proactively in most cases. Several high-risk panels meet monthly to support staff in gaining multi-agency views about risk for people they were working with. There was some evidence that the local authority had collated risk across these networks to drive continuous learning and improvement.
The local authority had some systems in place to provide care and support that were planned and organised with partners and communities to ensure safety across care journeys and continuity of care. There was evidence in hospital discharge that processes were safe and well established; in other areas, like transitions to adults’ services, there was work to improve the offer across all needs. For people who no longer fund their own care, or for people moving to another authority, there was limited evidence that there were systems in place to support safe transition.
There was senior-level oversight of safeguarding work; the local authority worked with the Safeguarding Adults Board and partners to deliver a coordinated approach to safeguarding adults in the area. There was clear progress against the plans that the safeguarding board had made, but people were not yet involved in developing future strategies. Work was underway to clarify policies and procedures that were delegated in mental health as part of a broader transformation.
Staff had a good knowledge of safeguarding practice, and there were opportunities for reflection and to share outcomes of Safeguarding Adult Reviews. Not all safeguarding decisions or enquiries were made promptly, but the local authority had improved its performance and felt this was down to better use of data and additional resources in the Learning Disabilities team had supported this.
The local authority had a good learning and development programme for staff who felt supported in their career development. The local authority had started to work with people on co-production to develop their more recent strategies and programme, though this was not yet consistent across the service. The local authority had invested in this area to ensure improvements. There was a sense of energy in the local authority to improve now that they had recovered core systems after the cyber-attack, and the transforming outcomes programme had helped the local authority to reset and move forward with its priorities for the future.