North Northamptonshire: local authority assessment

The local authority worked with people, partners, and the local community to make available a range of services, facilities, resources, and other measures to promote independence, and to prevent, delay or reduce the need for care and support. The local authority developed its Health and Wellbeing Strategy 2024–2029 with the intention of enabling residents to lead healthier, more independent lives. Through collaboration with communities, health professionals, voluntary organisations, and system partners, the strategy focused on addressing wider health determinants and reducing inequalities. Its five priorities included tackling smoking and vaping, increasing physical activity, improving mental health, supporting children and young people, and enhancing financial resilience.

Delivery was structured through Local Area Partnerships and Place Delivery Boards, supported by dedicated sponsors. The local authority stated this was monitored via live action plans overseen by a Strategy Oversight Group. Co-production and sustainability were embedded within the strategy, though not yet fully embedded in practice. While implementation began in 2024, measurable impact had yet to be established at the time of reporting.

To prevent escalation of needs in the community, the local authority launched initiatives like Support North Northamptonshire (SNN), a multi-agency programme designed to connect residents with early support. This involved voluntary sector partners and a strengths-based approach to guide people to appropriate pathways before statutory intervention was required. Additional support included trusted assessors in locality teams, provision of equipment and adaptations, and use of assistive technology.

Strategic practice initiatives included embedding strengths-based approaches, promoting early conversations through its Practice Framework, and developing targeted roles such as Progression Workers to help working-age adults build functional skills. The Age Well Programme focused on older adults, offering befriending, appointment support, and access to assistive equipment to maintain independence. Each locality hub, of which there were 4; Corby, Kettering, Wellingborough and East, had Age Well Workers aligned to GP practices that worked with any person aged 65 and over regardless of whether they had eligible care needs. Data from the Adult Social Care Survey 2023/24 showed 94.59% of people who used services felt clean and presentable and 74.77% reported spending time doing things they value or enjoy. This was somewhat better than the England averages of 93.28% and 69.09%, respectively.

Tools like Ideal Outcomes Meetings (IOMs) supported early decision-making rooted in informal and community-based solutions. Community engagement involved public health initiatives such as Men’s Shed, outdoor gyms, and gardening groups. Although, scrutiny committees identified the absence of a fully embedded strategy within neighbourhood planning. The local authority had created an Occupational Therapy Strategy to improve early intervention and co-produced care; however, this was still in draft and had not yet been implemented.

The local authority demonstrated some instances of individual impact from preventative services, such as the Support North Northamptonshire programme assisting people in navigating complex systems and accessing health, housing, and community support. These cases showed improved independence and resilience, as well as early intervention that helped avoid escalation into statutory services. There was limited evidence that the local authority consistently monitored how such outcomes aligned with Care Act wellbeing duties or contributed to reducing long-term care needs. This restricted its ability to evaluate and evidence the effectiveness of prevention across the system. Data from the Adult Social Care Outcomes Framework 2023/34 indicated that 74.55% of people who received short term support no longer needed support, this was somewhat worse than the England average of 79.39% suggesting more focus was required to enable the local authority to understand and address this.

Specific consideration was given to unpaid carers through the commissioned carer service. The local authority told us they co-produced their Carers Strategy 2024-2025 with carers and partners. Through carers strategy workshops the local authority identified key priorities for carers which included carers breaks, telling their story once, and identifying hidden carers. They found carers were not feeling recognised and carer poverty was a concern. These were also found to be themes in the Carers Joint Strategic Needs Assessment from 2020.

The Carers Strategy stated that the local authority supported carers' health and wellbeing through respite services, carer grants (e.g. for household repairs), mental health support for young carers, and social prescribing for isolated carers. There were also community asset groups for carers which included different forums supporting carers around dementia, diabetes, coronary heart disease and they were starting neuro diverse groups and acquired brain injury. They stated these interventions helped prevent carer breakdown, supported mental health, and promoted physical and emotional resilience. The strategy also recognised gaps in awareness among underrepresented groups and committed to increasing registration among carers from diverse backgrounds. It planned to create age-appropriate materials and improve accessibility across platforms. While implementation began in 2024, measurable impact had yet to be established at the time of reporting.

Carers and staff told us about a recent local ‘carers marketplace’ event set up to support and identify carers. However, attendance was reported to be low, which carers attributed to a late venue change and limited advertising. Feedback from carers suggested that additional outreach events could assist in identifying hidden carers and improving information access. Working carers reported challenges in accessing forums or group support due to scheduling issues and limited availability outside standard working hours. Despite these reported difficulties, data from the Survey of Adult Carers 2023/24 indicated 91.11% of carers found information and advice helpful, with 66.67% finding it easy to access information, both somewhat better than the England averages of 85.22% and 59.06%, respectively.

The local authority worked with partners to deliver intermediate care and reablement services that enabled people to return to their optimal independence. They worked in partnership with health providers and voluntary organisations to deliver a range of reablement and intermediate care services aimed at promoting independence and reducing reliance on long-term care. Key provision included a jointly funded (health and social care) bed-based reablement at Thackley Green and a purpose-built facility in Corby.

The Adults Services & Health Partnerships Service Plan (2024–25) emphasised proactive reablement to avoid hospital admissions, including responses to non-injurious falls. The local authority partnered in a tripartite Integrated Falls Project, which utilised the ‘HelpFall’ app and ‘Raizer’ chair to assist individuals post-fall without ambulance involvement, thereby preventing escalation and supporting wellbeing.

According to local authority data, community reablement teams achieved an 83% rate of people remaining at home with reduced or no care needs, and timely access was demonstrated through rapid caseload turnover. Data from the Adult Social Care Outcomes Framework 2023/24 indicated 2.17% of people aged 65+ received reablement/rehabilitation services in North Northamptonshire after discharge from hospital. This was somewhat worse than the England average of 3.00%. However, of those people who received reablement 88.68% of people were still at home 91 days after discharge which was somewhat better than the England average of 83.70%.

Partners reported the local authority supported delivering timely and effective reablement services, particularly in the context of hospital discharge. They said assessments were completed promptly, often enabling next-day discharge, which helped minimise unnecessary hospital stays and supported quicker recovery at home. Partners indicated the local authority’s use of intermediate care pathways was responsive and well-integrated.

People can access equipment and minor home adaptations to maintain their independence and continue living in their own homes, however, there were delays in support which could impact the effectiveness of supporting people to maintain their independence. The Occupational Therapy (OT) service formed part of the local authority’s broader adult social care and prevention strategy, with a focus on early intervention, enabling independence, and improving quality of life. The OT service delivered community-based support through assessments, provision of minor and major equipment adaptations, education, reablement, and access to assistive technology.

Referrals were typically received via the Customer Service Centre and triaged by a clinician before allocation. The draft Occupational Therapy strategy outlined performance expectations, aiming for a maximum 6-week wait for standard cases and 5 working days for priority referrals. The local authority told us, over the last 12 months, they had consistently met the 5-day target timescale for people assessed as priority. They provided data which indicated from April to June 2025 89.9% of priority 1 referrals were allocated within 5 days with a median wait of 3 days. Data also evidenced that between January and June 2025, 79.5% of referrals for priority 2 cases, and 27.6% for priority 3 cases were allocated within the 6-week target, with a median wait of 22 and 73 days, respectively. This demonstrated that the local authority was mostly meeting high priority targets but there was area for improvement in meeting lower priority targets. The local authority did not provide data to indicate the time from allocation to intervention or closure of occupational therapy referrals.

Trusted assessors within locality teams were able to order low-level equipment, increasing responsiveness at the point of need. The local authority also co-produced a “Waiting Well” pack to support people and carers awaiting adult social care input including OT services, which included guidance on the referral journey and signposting to wider resources. Additionally, the local authority highlighted the role of its Specialist Moving and Handling Team, which focused on upskilling partners in safe handling techniques.

Feedback from staff and leaders highlighted variability in access and delivery across North Northamptonshire’s equipment and adaptation services. Staff reported hospital discharge teams were able to provide prompt assessments and same-day delivery of low-level equipment, enabling safe and timely transitions home. However, staff raised concerns about lengthy waiting lists for aids and adaptations in the community.

There were 223 people waiting for equipment which included referrals under OT and assistive technology. The average wait time to receive equipment post assistive technology assessment was 1 week, and post OT assessment was 4 days. This suggested the delays were associated with the assessment phase rather than the actual provision of equipment. Some staff reported there were delays in equipment delivery which they overcame by carrying basic items themselves to ensure timely support.

As of June 2025, there were 504 people awaiting an occupational therapy assessment with a median wait time 41 days and a maximum of 137 days. There were 401 people awaiting an assistive technology assessment with a median wait time of 77 days and a maximum of 145 days. Feedback from people reported significant waits for assessment and equipment, people said they felt there was inconsistent communication and limited guidance which they said left them feeling frustrated and unsupported at times.

Some people could access information and advice, though more development was needed to ensure sufficient information was available for people who need adapted or translated communications or were digitally excluded.

The local authority provided a publicly accessible Care Services Directory, offering guidance on staying independent at home, equipment, and occupational therapy. A downloadable ‘Waiting Well’ pack was available via the local authority’s website, outlining steps following referral to adult social care and signposting to NHS and local community resources. Referral links to advocacy services were functional and easy to navigate. Online content on safeguarding, eligibility, assessment, and support planning was available and up to date as of December 2024. Targeted resources also included the Preparing for Adulthood section, which covered transitions for young people and included accessible versions of the Mental Capacity Act (2005).

The local authority (via their adult care strategy) committed to improving visibility of support services via tools such as a Carers Portal, digital directories, and co-produced information resources. However, several gaps in accessibility were noted. Key content such as finance and charging guidance lacked easy-read formats, potentially limiting access for people with additional support needs. Additionally, while the local authority’s website included a translation feature to support users whose first language was not English, this function did not operate reliably. People reported that translated pages reverted to English when navigating between links, reducing the effectiveness of the tool and potentially excluding non-English speakers from accessing essential information.

Feedback from people and partners regarding accessibility of information and advice in North Northamptonshire indicated that while some people had positive experiences, notable barriers remained in ensuring equitable access in line with Care Act responsibilities. Partners reported that people frequently faced difficulties navigating the local authority’s website, citing poor digital inclusion and a lack of clear, user-friendly information. Some carers felt unaware of available groups or missed support due to insufficient promotion or unclear access points, others described receiving useful signposting and advice. Some people described the website as containing jargon and acronyms that may confuse those unfamiliar with adult social care.

Data from the Adult Social Care Survey and Survey of Adult Carers 2023/24 showed 65.7% of people who used services said they found it easy to locate information about support which was similar to the England average of 67.12%. Additionally, 66.67% of carers found it easy to access advice, which was somewhat better than the England average of 59.06%.

There was average uptake of direct payments. People had ongoing access to information, advice, and support to use direct payments. The local authority provided guidance on direct payments for both staff and people, setting out the assessment process, eligibility, and payment options. While the documentation explained how direct payments were monitored by a dedicated team and how reconciliation was handled, there was minimal reference to considerations such as mental capacity or the promotion of direct payments to eligible individuals.

During the reporting period from February 2024 to January 2025, 116 direct payments were ended while 119 were initiated, with limited insight into the underlying reasons for either change. Feedback from the local authority noted a rise in complex employment issues among direct payment holders employing personal assistants (PAs), prompting the Direct Payments Team to seek employment law advice to support users. A number of users opted to return to framework providers, citing challenges associated with employer responsibilities. Data from the Adult Social Care Outcomes Framework and Short- and Long-Term Support 2023/24 reported the percentage of people using services receiving a direct payment was 27.99% which was similar to the England average of 25.48%. The percentage of carers receiving a direct payment was much lower than the England Average suggesting more needed to be done to promote the use of carers direct payments.

Staff reported that people retained choice and control over whether to receive direct payments, with referrals processed consistently and packages allocated promptly. However, significant challenges were noted. Staff described ongoing shortages of PAs, especially for smaller care packages, which limited people’s ability to use their allocated funding effectively and impacted independence outcomes. Staff were unsure if any action had been taken to address these areas of challenge.