The Care Quality Commission (CQC), has rated Cumberland 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: 2
2. supporting people to lead healthier lives: 2
3. equity in experience and outcomes: 2
4. care provision, integration and continuity of care: 2
5. partnership and communities: 3
6. safe pathways, systems and transitions: 2
7. safeguarding: 2
8. governance, management and sustainability: 2
9. learning, improvement and innovation: 2
Chris Badger, CQC’s chief inspector of adult social care and integrated care, said:
"At this inspection, we found Cumberland Council needed to make improvements in how it's providing adult social care to people living in the area. While we saw strong partnership working and genuine commitment to person-centred care, the local authority does have further work to do to ensure people are consistently receiving the support they need.
“We found people were waiting too long for occupational therapy assessments, equipment, financial assessments and annual reviews, with people with a learning disability waiting the longest for their review. There was also limited access to specialist support for people with mental health needs, dementia or a learning disability, which meant families could have to travel further away to see their loved one. Additionally, due to Cumberland being so rural, it created challenges for some people accessing home care support, and nursing care in a timely way.
“Unpaid carers were positive about the support they received from an external carers service, including receiving useful information and advice. However, most of them found their caring roles challenging. They didn’t always get the chance to take breaks, and respite care was limited in some areas, which affected their wellbeing. They were also concerned that contingency plans for support weren’t always in place which made them feel nervous about who would look after their loved one if they couldn’t.
“However, the authority worked well with health partners to support people's independence. For example, we heard about a pilot between the local authority and integrated care board to support the discharge of people who had a stroke. Aimed at supporting them in the community to help prevent unnecessary hospital re-admissions, the pilot had saved 100 care hours and improved people's independence.
“Additionally, the local authority had improved their systems to manage safeguarding risks in a timely manner, and staff felt that they received strong support and guidance from leaders to help keep people safe.
"Cumberland Council has clear plans to address the issues identified, including improving direct payments processes. We'll continue to monitor progress and look forward to seeing how their future plans mature."
The assessment team found:
- The local authority didn’t always provide people with access to information in a way that was convenient for them, such as easy-read formats. Also, people sometimes found it difficult to access a British Sign Language interpreter, as there was only three being used in the west of Cumberland.
- The local authority was experiencing staffing pressures across services. Therefore, they were using agency staff who weren’t always local and didn’t know the area.
- The local authority recognised that they need to do more work to engage with seldom-heard communities, to identify what support they needed.
- The authority had a significant Deprivation of Liberty Safeguards (DoLS) authorisation waiting list. This left people at risk of being deprived of their liberty unlawfully.
However, the assessment team also found:
- Most people were satisfied with their care and support and felt that they had choice and control over their daily lives.
- Leaders were visible and accessible for staff. They were also supportive and ensured that new staff received any necessary training.
- Most young people were safely supported to move from children to adults’ services.