The Care Quality Commission (CQC), has rated the London Borough of Newham 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 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: 3
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: 2
9. learning, improvement and innovation: 3
Chris Badger, CQC’s chief inspector of adult social care and integrated care, said:
“During our inspection of the London Borough of Newham, we found a mixed picture of people’s experiences accessing adult social care. While the local authority has many strengths to build upon, there are important areas where improvements are needed to ensure people receive timely support.
“Some unpaid carers told us they weren't always sure who to contact or what support was available to them. The local authority needs to ensure all carers can easily access information about their rights and the support available.
“There also wasn't sufficient care provision in Newham for people living with complex learning disabilities, mental health needs or advanced dementia. People were often placed out of the borough as a result, though the majority were placed in neighbouring boroughs close to Newham.
“However, people's experiences of accessing adult social care were mainly positive. Staff conducted Care Act assessments in a person-centred way, which focused on people's strengths and abilities. People told us they received assessments from kind, dedicated and compassionate staff. Most people were able to access information about services through online, written and verbal communication channels, with translator services for those whose first language wasn’t English.
“The local authority was focused on the prevention and delay of people developing future needs and reducing people's needs on formal services. Staff focused on supporting positive outcomes and promoting independence, such as enabling people to remain safely at home with appropriate equipment.
“Despite instability in senior leadership at Newham, leaders understand what needs to change and have already begun implementing improvements. Staff and partners remain focused on adult social care and the wellbeing and outcomes for the people of Newham. They understand the areas for improvement and have built an effective foundation on which to make them. We look forward to returning to see how their plans mature and the impact this has on their community.”
The assessment team found:
- The local authority was changing its approach to supporting people transitioning between teams and services. People gave mixed feedback about transitions from children’s to adult services, hospital discharge, and moves between teams. The new approach was not yet fully embedded.
- Recruitment and retention remain challenging in some specialist teams such as occupational therapy and learning disabilities.
- Some people felt they were digitally excluded and relied on voluntary sector organisations to support with form filling. For example, some people told CQC they found it difficult to contact the local authority and felt there needed to be more accessible information for people with dyslexia or who had difficulty reading.
However, the assessment team also found:
- Teams in this local authority are well established with long-serving members contributing valuable experience and stability.
- Staff told us leaders were visible and approachable, with an open-door approach. Staff felt confident approaching senior leaders with queries or concerns. Staff said they felt listened to and the local authority was aware of where the gaps were and what improvements needed to be made.
- People felt included and understood with their protected characteristics identified and considered. Equality, diversity and inclusion were embedded throughout practice and at the forefront of the corporate and adult social care vision.
- Waiting lists for assessing people’s care and support needs in Newham were relatively low. Where waiting lists existed, staff used a triage process to prioritise people’s needs appropriately.