Blackpool Council: local authority assessment

People were not being treated equally, standards of care and support differed depending on people’s individual and multiple needs. These were not new issues for the local authority to address. They had published shortfalls in people’s experiences within its own Joint Strategic Needs Assessment (JSNA) and a peer review was undertaken 2 years previous to the CQC assessment that raised concerns about equity in peoples experiences and outcomes. However, there was a lack of local strategy and action to reduce inequalities in people’s access to care and support, their experiences and outcomes.

The local authority lacked priority and focus to demonstrate what was being done to address inequalities in the area. There were some actions within an adult social care improvement plan, however they had failed to progress shortfalls. The local authority had a corporate focus to review demographic profiles of staff, but there was no evidence of how this impacted frontline work and people’s experiences. Results from both Employer Standards Health Check for Registered Social Workers 2024 and 2025 reports suggested corporate efforts to focus on equality, diversity and inclusion across the workforce had not been effective in improving or challenging discriminatory behaviours.

Intersectionality is a term that can be used to describe how race, class, gender and other personal characteristics ‘intersect’ and overlap. Staff told us they were increasingly identifying people with multiple needs and risks, however there was a lack of understanding of wider themes that negatively impacted people who were most likely to experience inequality. The local authority’s Annual Public Health Report 2024 identified people were more likely to have shorter lifespans than other people living in other areas of the country, and statistically people living in Blackpool experienced higher levels of mental health problems, lower levels of self-reported wellbeing and were more likely to have problems with drug and/or alcohol use. People were almost four times as likely to die from drug use, and mental health needs were identified as a priority, with suicide rates said to be significantly higher in Blackpool than in other local areas.

The local authority had a separate Autism Team to provide autistic people in Blackpool consistent and specialist trained assessment and intervention support. The number of autistic people was predicted to rise and senior leaders told us a pathway to join up health and social care services was under development. Data sourced from health partners by the local authority showed there were more people with a learning disability and autistic people in a hospital setting than what had been locally planned and agreed, and we heard people with a learning disability and autistic people waited the longest for community Care Act assessment which could have a direct link to higher hospital admissions as some people were not supported early enough in their communities. A senior leader also told us autistic people were highly represented in transgender communities. An autistic person had stepped forward to share their own transgender awareness presentation.. Following the CQC site visit, senior leaders told us the same autistic person had been involved in developing further presentations with the Autism team and LGBTQ+ awareness was built into the newly qualified social workers programme. It had not been rolled out to wider teams and it was too early to determine how effective the learning had been as staff gave mixed accounts of confidence and knowledge.

The local authority identified Blackpool as having one of the largest communities of people who represent a diverse range of sexualities and gender identities. LGBTQIA+ stands for lesbian, gay, bisexual, transgender, queer (or sometimes questioning), intersex, asexual, and other identities. 4.9% of 16-year-olds and above in Blackpool identified as lesbian, gay, or bisexual (with a further 6.66% of the population choosing not to answer, compared to national data of 3.8% of people identifying as LGB and 7.5% choosing not to answer). 0.58% of people reported having a gender identity different from their sex at birth which was slightly higher than the England average of 0.55% (ONS, 2023). An independent local report had been led by a charity through surveys and face-to-face interviews with local people. It outlined historic isolation from rights and services for people in Blackpool and the need to build trust across professionals and services. A senior leader told us some people within the LGBTQIA+ community presented with more vulnerability and having staff representation of the population was helpful. We found there was a lack of strategic direction within adult social care to reduce barriers for people with care and support needs and their unpaid carers, or safeguard people with these protected characteristics. People’s accounts highlighted the need for more mental health support in Blackpool that catered for LGBTQIA+ needs and people did not feel that services were tailored for them. There was a fear of accessing services and there were a number of recommendations from the report made to the local authority and key system partners to empower people to engage with current services but also ensure services were knowledgeable about the specific needs of people within the LGBTQIA+ community. For example, awareness training, a directory of approved services, a local charter mark to show they are supportive and knowledgeable about the LGBTQIA+ community, and strong equality and diversity policies to be coproduced. The local authority had published an action plan on their website that listed aspirations. For example, actions in relation to safeguarding and wellbeing were reliant on funding being approved and some timelines reached 2026. However, following the CQC site visit senior leaders told us some progress had been made. For example, health and wellbeing focused peer and social support groups had been developed, 1 to 1 specialist support which extended to linking people’s needs to adult social care assessment, and free counselling for the LGBTQIA+ community if they were accessing formal support. There were aspirations to join up charity services and adult social care to share knowledge, creating a more accessible and inclusive service for all. However, at the time of CQC assessment there was no evidence to demonstrate any progress that positively impacted people’s outcomes.

There was a need to focus on the experiences of all minority groups in relation to equality, diversity, and inclusion in the area. Councillors were appointed in March 2024 as equality champions representing areas defined as women, race, faith, disability, LGBT+, and older people. These roles were described as ‘bridging the gap for the community.’ For example, councillors had met with community groups and forums and saw themselves as the ‘go between, between community and council.’ However, there was more to do to evidence any positive impact this was having on frontline delivery of services and outcomes for people with care and support needs. Most staff within adult social care teams could not confidently name who the seldom heard groups of people were in Blackpool. Most staff were not sure how accessible their services were to everyone or how they could meet cultural needs. Staff who worked across children and adults’ services had more confidence (than staff that only worked with adults) in recognising diverse communities in Blackpool. They told us they had seen an increase in different nationalities such as Polish, and Portuguese communities and in asylum seekers requiring support. We heard how public health colleagues had begun to deliver a Blackpool demographics learning session to staff teams. Not all staff had attended the session, but line managers had been asked to deliver this to those who could not attend. The session introduced the population of Blackpool such as LGBTQIA+ awareness and local challenges utilising information within the Joint Strategic Needs Assessment (JSNA). Staff had access to corporate equality and diversity training that senior leaders told us had been mandatory for several years. There had been a specific adult social care managers session two years ago. and aimed to build staff confidence and improve identification of unmet needs. However, there was no evidence that this work had been embedded in people’s care and support and made a positive difference to people’s experiences. Staff consistently told us further training and support in cultural competence would be beneficial. This would aim to empower staff to effectively and respectfully work with individuals and communities from diverse cultural backgrounds. At the time of the CQC assessment health and social inequalities were not incorporated into operational practice and intersectionality of peoples protected characteristics were not always understood.

The local authority did not proactively engage with all people and groups where inequalities had been identified to understand and address the specific risks and issues experienced by them. Senior leaders and partners recognised the need to reach out to more groups of people, for example there had been ‘door knocking’ through a charity organisation however examples provided were in relation to health led objectives to reduce accident and emergency hospital attendance finding people faced barriers to accessing community services. A senior leader told us seldom heard groups were welcome to contribute to the council, for example there were aspirations to invite people to bring their voice to scrutiny meetings but at the time this had stopped and plans to reintroduce this had not progressed. Another senior leader told us they were aware of tensions and hostility between groups and communities in Blackpool. For example, there were known tensions between ethnic communities and as a result there was some ongoing work through international funding to support a charity group in understanding some of the tensions and how to address them, however this had an environmental focus as opposed to prevention or support within adult social care. Staff and senior leaders gave examples of racism, homophobia, and high rates of hate crime in the area, a senior leader told us as a result the local authority were mindful of communications they published on corporate social media accounts. For example, there had been public disorder in Blackpool related to national misinformation about asylum seekers, hate spread about the use of LGBTQIA+ flag colours used on local authority funded signs, and concerns rising around potential applications to build a mosque. They had sourced national funding to aid community cohesion over the next 5 years working with the third sector to address this. However, at the time partners told us there was a ‘struggle’ to engage with diverse communities but could not identify specific action or plans to address this. There was more to be done to bring staff, people, unpaid carers, and partners together to take action to reduce inequalities through design, delivery, and evaluation.

All partners told us they were not aware of any recent analysis of social care needs alongside the local population profile and demographics. Senior leaders referenced data within the JSNA however the JSNA had gaps (for example unfinished areas and areas referencing 2014 social care data as its most recent source). Senior leaders told us public health had intentions to work with adult social care to update a social care needs assessment within the JSNA. However, senior leaders and staff told us there were gaps in recording peoples protected characteristics within the adult social care digital system which meant the local authority had further work to do to collect and analyse adult social care data alongside local and national data within the JSNA. For example, recording of people’s sexual orientation was described by one senior leader as ‘less developed’ and there was a reliance on staff inputting personal circumstances within the assessment as ‘free text’ which could not be collected in data reports. Another senior leader described the importance of utilising data in understanding people’s equity in experiences. However, at the time of the CQC assessment strategic planning to understand barriers to care and support and reduce inequalities could be misinformed or not informed by evidence. Therefore, there was more to be done to capture social care information for analysis, progress aspirations with appropriate resource and embed quality of practice within assessment and strategic planning.

People told us their preferred inclusion and accessibility arrangements were not always followed. For example, a person told us they had significant reading difficulties and preferred to have information shared with them verbally as opposed to in writing, but they continued to get letters in the post rather than telephone calls as agreed from the local authority. Another person with a learning disability and some sight loss communicated using technology, however methods outlined in their support plan were not followed by local authority staff and information was sourced from the care provider instead of the person themselves. Staff also told us there were negative impacts on people facing multiple disadvantages, such as people with both mental health needs and needs relating to drug and alcohol use. Staff told us accessing services often relied on people needing to telephone call for support without acknowledging not everyone had access to a telephone or the internet which left them at risk.

There were inclusion and accessibility arrangements in place such as interpreter services so that staff could refer people to engage with their assessments and interventions provided through the local authority in ways that worked for them. Staff told us this was also available outside of usual office hours and they had access to easy read, larger print and some staff had been trained in British sign language. Senior leaders recognised their duty to ensure all people with accessibility needs were identified and supported. For example, 29,700 people aged 18 and over in Blackpool were living with some or severe hearing loss and this was projected to rise. The local authority identified people with hearing loss were at increased risk of falls, dementia, social isolation, depression, and anxiety, as well as reduced physical activities of daily living. Specialist aids and equipment to support the independence of people who had sight loss, hearing loss or dual loss could be provided to people following an assessment by the dual sensory loss and hearing impairment team. Senior leaders recognised it was important when planning for local support and preventative services that the needs of people with hearing loss and those at risk of hearing loss were understood. For example, accessibility of contacting services, training and awareness of people’s different and intersectional needs and provision of communication support. Information was available online and people could email or complete an online form to refer to the local authority. Once a person was allocated to a staff member, they also had the option to communicate through text messages. Staff told us this was also helpful for autistic people who may not prefer to speak over the phone.

There were aspirations to work more closely with partners to close the gaps experienced by people by looking at learning, particularly in relation to safeguarding incidents on how best to support people’s inclusion and accessibility arrangements. However, it was too early to determine how effective or sustainable this would be.