CQC rates City of York Council’s adult social care provision as requires improvement

The Care Quality Commission (CQC), has rated City of York Council 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 requires improvement 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: 1

2.    supporting people to lead healthier lives: 2

3.    equity in experience and outcomes: 2

4.    care provision, integration and continuity of care: 1

5.    partnership and communities: 2

6.    safe pathways, systems and transitions: 1

7.    safeguarding: 1

8.    governance, management and sustainability: 2

9.    learning, improvement and innovation: 2

CQC’s assessment gave the quality of City of York Council an overall rating of requires improvement. As a result of the scores of 1, under Section 50(2) of the Health and Social Care Act 2008, CQC has sent a notification letter to the Secretary of State for Health and Social Care outlining the areas where improvements are needed.

Chris Badger, CQC’s chief inspector of adult social care and integrated care, said:

"At this inspection, we found City of York Council requires improvement in how it's delivering adult social care for people living in the area. While we saw some committed staff who wanted to do their best for people, there were significant shortfalls in areas that need immediate attention.

“Leaders recognised the challenges they face and were engaging with staff and people using services to gain feedback, to help make improvements so people living in York have better access to adult social care services.

“However, the authority needs to do more to listen to seldom heard groups. For example, a group of people from the LGBTQIA+ community and people with a learning disability felt that they had a lack of understanding regarding what support is available to them.

“Our team heard about people experiencing long waits for assessments, reviews and equipment. Then when people did receive support, it didn’t always meet their individual needs, which was having a negative impact on their health and wellbeing.

“Also, better partnership working was needed to ensure services were more joined up to help promote people’s independence and choice when they are discharged from hospital. Partners told us that the local authority often provided incorrect or missing information about people’s needs, especially for those reaching the end of their life. Staff told us that they were frustrated that they couldn’t do more to help people.

“However, it was positive to hear that some people felt supported by helpful and kind staff. One person told us that their allocated social worker was excellent and helped them reconnect with their family.

"City of York Council must now act on the concerns we've raised to ensure people receive safe, effective care that meets their needs. We look forward to seeing how their future plans mature."

The assessment team found:

1. The authority didn’t have effective systems and processes in place to manage safeguarding, which potentially put people at risk.
2. Some people struggled to access information and advice in person, and by phone. Also, online options weren’t always up to date and were at times difficult for people to understand.
3. People told inspectors that they had to repeat conversations as they were transferred to or contacted by multiple staff.
4. The local authority had poor access to information and support about direct payments. One person told inspectors that they researched the information from other local authorities to help them understand it, as it was having a negative effect on their wellbeing.
5. The authority had gaps in supported living, specialist dementia care, mental health support and carer break options. Partners fed back that there weren’t enough services in the area to meet people’s needs.
6. Staff told inspectors that there was no dedicated member of staff to engage with people and support them to transfer back to the community after they had been discharged from a mental health hospital.

However, the assessment team also found:

1. The local authority addressed inequity around digital exclusion through their ‘Digital Friendly York’ partnership and strategy. This supported people in York to get online and learn skills using the internet. People could be offered reused equipment and learning free of charge.
2. People with experiences of dementia had been involved in the development of the dementia strategy, and there was a sense of pride around the work taking place including the support for people waiting for diagnosis and to enable people to live independently.