Blackpool Council: local authority assessment

The local authority had various pathways and roles to process requests for assessment or review of assessment including new information about risk or safeguarding. Business support staff took most calls, reviewed and responded to emails and recorded receipt of online assessment from professionals, unpaid carers, people with care and support needs and members of the public. Information was taken and passed to duty staff within different teams depending on a person’s identified needs or if they were already known to the local authority. For example, if a person had a learning disability or a primary mental health need, the request for assessment or review would go directly to those teams. Business support staff could make early referrals to voluntary and health services on behalf of and with advice from duty staff. Staff also told us if a person did not appear to have an adult social care need, business support could signpost the referrer to another service and the information would not need to be reviewed by a duty worker. For example, staff told us if a person appeared to only need help with their bins, they would signpost them to another department and would not record this contact on the adult social care system. Staff also told us ‘minor changes’ to people’s care and support could take place to respond to people’s needs without the need for immediate review, this could be actioned by brokerage staff with managers’ approval. Processes to respond to incoming requests and information failed to provide assurances. There was no formal audit, limited staff competency checks and limited data collection to evidence any effectiveness of the current function. This meant senior leaders did not have a clear picture of who could be signposted away from adult social care, who waited longer than others for assessment and whether this decision making was appropriate and effective which could lead to negative outcomes including unmet risk for some groups of people.

Staff told us people repeatedly contacted the local authority. There were a number of reasons why this happened, for example people’s needs changing or people’s needs not initially being met effectively. However, there was no formal monitoring or internal assurance audits for the quality of the contacts and responses to ensure people were consistently directed to the right team or service. There was more to do to ensure any actions taken did not have negative outcomes for people such as understanding an unmet need or risks.

Following the CQC site visit in March 2025, senior leaders updated staff guidance in response to concerns raised. This clarified the role of business support staff was not to make a decision around a person’s needs, risks, care planning. Senior leaders told us this was to support any staff misunderstanding. Senior leaders also told us staff were encouraged to attend any training offered that would enhance their knowledge and that staff competency was monitored regularly by line management, and there was a process between the business support and social work manager to share information and address any issues arising. However, there was no evidence this assurance was embedded within staff practice, monitored effectively by senior leaders to address potential risks to people who maybe signposted away from adult social care.

The local authority had commissioned a consultancy organisation to support them to codesign and deliver change across Care Act assessment and interventions. One of the aims was to introduce and embed a more strength and asset-based approach to conversations with people when they contacted the local authority. Despite the roll out spanning over 2 years so far, not all staff were trained to undertake this approach confidently. Following the CQC site visit senior leaders told us the time the roll out had taken was a combination of reasons including pilot stages, evaluation, and issues that emerged were not straightforward to resolve. Most staff told us the changes to how staff were expected to approach assessment and intervention was not effective, particularly for people they felt contacted the local authority with established needs. In contrast, some staff could see the benefit in the change as it helped them to build on links or connect people to their own communities and source solutions to their needs that were individual to them. Senior leaders told us developments through staff feedback was continuing, and they had an aspiration to deliver an effective cultural and systemic change in practice and process.

There was mixed feedback about how people experienced advice, signposting, assessment, and intervention in the local authority. Staff gave varied accounts of when strength-based conversations should start and how many times people needed to tell staff their situation. For example, most staff were not clear when a person’s ‘first conversation’ happened. Staff told us people could speak to business support staff first to gather information and some signposting to other services could happen. Other staff felt it would be when a duty worker made contact to establish if a safeguarding or needs assessment was needed. Other staff told us the ‘first conversation’ did not happen until it was allocated to a worker after duty. Processes to avoid people repeating conversations were not effective. The aim was to allocate ongoing assessment and intervention to the duty worker that initially contacted the person. However, staff told us allocations often took place based on availability rather than familiarity to prioritise demands within teams. Staff and senior leaders consistently told us the new assessment and intervention approach was not yet embedded. We found some staff had created ‘work arounds’ due to the ineffectiveness of the roll out so far. For example, one staff member told us they used old templates and copied and pasted into the new digital template to move on to the next steps. Other staff told us there were now challenges to see outstanding assessments and reviews on the digital system which led to confusion about who was waiting and for how long. Quality checks of assessments took place on a 1:1 basis with staff through manager approvals on the digital system. However, there was more to do to implement new approaches, templates, training and practice to evidence any positive outcomes for people in Blackpool. There was a draft quality assurance framework which set out all audit aspirations. Current practice audits were focused on safeguarding practice as a priority. Other audits were taking place but were not currently brought together to evidence quality assurance around all areas of assessment including the effectiveness of applying strength and asset-based approaches within staff practice.

People who were offered an assessment had face to face assessments and interventions. There were support workers in teams to meet people’s immediate needs such as accessing food banks, supporting with energy payments and carrying out ‘welfare checks’. If there was a risk of hospital admission, they could refer for rapid response support. Requests for assessment or review were checked daily by a team manager.

Most people had choice in either a commissioned care home or home care providers to meet their assessed needs. National data showed 67.42% of people were satisfied with care and support in Blackpool. This was somewhat better than the England average (62.72%). And 82.53% of people felt that they had control over their daily life. This was somewhat better than the England average of 77.62% (NHS Digital, 2023-2024). There were options for overnight home care in Blackpool provided by their in-house provider and a commissioned provider, as well as offering the use of direct payments. However, not all staff were aware of these services as solutions for people with overnight risks and care needs at home. Some people were eligible for temporary support options such as the inhouse 24/7 rehabilitation centre. However, there was a culture of making decisions for people with care and support needs often with the intention of protecting them rather than allowing them to make their own choices. For example, one partner told us local authority assessment did not always put people at the heart of decision making and there was a lack of people’s voices being listened to. Another partner told us there could be a ‘knowing best’ approach to assessment from the local authority which led to making decisions without involving people themselves, unpaid carers and partner services. For some people this meant there were risks to their wellbeing and not all people had their human rights respected and protected. For example, one person told us they were not involved throughout in decisions, and this was evidenced within care planning. A second person, who was living in a care home told us they had never had the need for residential care, did not want to be there, and were not listened to. A third person told us they could not understand how they had ended up in a care home and did not feel that their wishes had been taken in to account. A review of their needs stated that the person could make their own decisions, and they expressed a wish to return to their home. However, this had not been acted on and the person felt that others had made a lot of decisions for them. The local authority had more to do to ensure all options to meet people’s risks and needs were explored with them, and that a person’s voice was at the forefront of all decision making. Whilst senior leaders did not accept this was the culture within assessment practice, they did acknowledge the period of change being an area for further attention including the embedding of strength-based practice and the need for a ‘cultural shift.’

According to national data, requests for care and support in Blackpool per 100,000 adults were significantly above England averages (2,980 requests for support for people aged 18 – 64, England average: 1,785, and 15,795 requests for support for people aged 65 or over, England average: 13,285, NHS Digital 2024). Staff told us there was a high volume of contacts coming in, some people would make contact regularly and there was an answer phone facility when people couldn't get through due to the lines being busy. Staff would aim to respond to all calls within the working day. Many people had a quick response to requests for assessment and intervention this was seen in the local authority’s own data showing 65% of assessments were identified as ‘urgent’ and the median wait time for assessment and unplanned reviews was 3 days (February 2024 - February 2025, and again in May 2025). However, there were some groups of people who waited longer. A senior leader told us over the past 5 years the local authority had experienced a reduced workforce capability which had led to increased staff workloads and had impacted negatively on their ability to respond quickly to people’s requests for assessment and intervention. Senior leaders told us they had since been in a recovery position and had seen improvements to reduce very high waiting lists. However, data provided by the local authority varied, and senior leaders told us they had some recording issues. Another senior leader told us this meant the local authority could not always accurately understand how many people were actually waiting and for how long. According to data the maximum recorded waits for assessments over a twelve month period were as high as 343 days. 405 assessments (8.75%) were started after 8 weeks. Of these there were waits of 28 weeks or more for 62 people. 13 people waited for 44 weeks or more (February 2024 - February 2025). In August 2024, 150 people were waiting for assessments, this had reduced slightly in February 2025 to 124 people. However, in May 2025 the local authority’s own data showed there was a minimum of 244 people waiting for assessment or an unplanned review which was an increase from August 2024. A minimum of 156 people were waiting for assessment within the mental health teams (this did not include any waits within the Primary Intermediate Mental Health team which had the higher median wait times up 42.5 days and maximum wait of 343 days). The Autism team had 24 people waiting, with a median wait time of 3 days but maximum of 321 days. The Learning Disabilities team number of people waiting was not provided, but the local authority told us it had a median wait time of 0 days but a maximum wait of 374 days which was an increase from February 2025. Senior leaders told us waits for people with learning disabilities reflected the way the local authority recorded transitions between children’s and adults services, as young people could be referred before, they turned 18 years old. The local authority had more to do to reduce any inequity for those people that waited the longest and understand the impact that waiting for assessment had on people particularly those with learning disabilities, mental health needs and autistic people. There had been a 'waiting tool’ created, however it remained in draft form, waiting for senior leaders sign off before implementation with all teams. In the interim, most staff were ‘checking in’ with people who were waiting, with no formal process or evidence that this was happening beyond verbal discussions and individual recording. Following the CQC site visit senior leaders told us managers had access to a report that showed allocated assessments that had not started within 28 days. This was to enable managers to support staff and progress any barriers. However, this was not proving effective as the number of people waiting and maximum days waiting was not reducing. Therefore, more needed to be done to ensure there was effective use of resources and robust processes to support staff to ensure peoples wellbeing and safety was a priority beyond urgent response work.

For planned reviews the median wait over the 12 month period was 8 days and the maximum was 335 days (February 2024 - February 2025). 3195 reviews of peoples care and support were started within 8 weeks of the planned review date (89.5%), and 374 planned reviews started more than 8 weeks after the planned date. Of these 42 people waited longer than 28 weeks from the planned date of their review. The local authority had commissioned an external agency to undertake 600 planned reviews. However, despite the additional agency support, there remained 807 people overdue a planned review in February 2025. National data showed 43.70% of people had been reviewed with long term support needs in Blackpool. This was somewhat worse than England average (57.14%, NHS Digital 2024). A senior leader told us the agency was a temporary measure and there was an awareness the reviews would come back. There were said to be conversations happening and senior leaders were evaluating the work to address this as a risk. Following the CQC site visit senior leaders told us annual reviews were being incorporated into a new process that was being developed for the community team. However, it was too early to demonstrate if this would be effective in responsiveness and managing both assessment and review waiting times for people in Blackpool.

Staff could carry out carers assessments alongside people’s care and support assessments. There were also options for unpaid carers to have separate carers assessments if they preferred.

According to the local authority’s analysis of its own data in May 2025 215 out of 419 carers assessments started on the day they were identified and the maximum wait was 240 days. Over a 12-month period 59 unpaid carers had assessments started within 7 days of the request for support. In total, 353 of the 419 assessments were completed within 28 days of a request for support. However, 66 unpaid carers took more than 28 days (April 2024-March 2025) this was more than what senior leaders had told us in March 2025 which was 7 people requesting a carers assessment had not met the 28-day target to start the assessment within the past 6 months. In May 2025, the local authority told us the maximum wait had reduced slightly by 5 days to 235 days. The overall differences supported the mixed feedback we heard from unpaid carers, with some receiving consistent support and others facing delays.

The local authority commissioned a service to provide assessment and support for unpaid carers in Blackpool. Identification of young carers and accessible support was part of an early help offer in within children’s services and education. Staff within adult social care had referred 2 young people aged between 5 years and 17 years old to the commissioned service for a young carers assessment over the past year, this accounted for 1% of young carers referrals received from a total of 285 referrals across all referrers in Blackpool (including children’s services and voluntary and charity sector, April 2024- March 2025). Senior leaders told us a multiagency development group was in place to support improvement in the identification and response to young carers. There had been recent learning around the role of an unpaid carer rolled out with newly qualified social workers, and there were aspirations to expand this to all staff. Senior leaders also told us there were plans to improve sharing of information between children’s social care and the carer’s services. There would also be development of a system wide memorandum of understanding to formalise joint responsibility to identify carers and offer support. However, these had not yet been implemented.

Unpaid carers and staff spoke positively about the commissioned carers service. For example, one unpaid carer told us they felt isolated before being connected to the carers service and they had received essential support to help them continue in their role. This was seen in national data showing 44.68% of carers were satisfied with social services. This was somewhat better than the England average (36.83%). Additionally, 71.08% of carers felt involved or consulted as much as they wanted to be in discussions. This was also somewhat better than the England average (66.56%, NHS Digital 2024). Some unpaid carers told us they experienced communication issues with local authority staff which had led to disengagement. National data supported this, showing only 16.98% of carers felt that they had control over their daily life. This was somewhat worse than the England average (21.53%, NHS Digital 2024).

The local authority had an online public directory of services for information on health, social care and community services. Senior leaders also told us people could access face to face information and advice through the local library service for help with non-eligible care and support needs.

There was a flexible approach to meeting people’s non-eligible needs once they had been allocated for assessment. Staff told us they could signpost people to other services, and support workers within assessment teams could provide 1:1 support that might be needed. Staff told us they connected internally across teams to build on professional relationships for advice and they found out about different services through talking to each other. They valued the use of digital instant messaging to see if a colleague was online which made connecting more accessible and found colleagues were always happy to help out. One staff member told us 'I love Blackpool I've worked in other local authorities, its different here for example, social workers complete housing applications, we do more and its more flexible. If there isn't an obvious Care Act need, we still do it anyway, it’s what we do'. Another told us 'we are so proactive and passionate, genuinely, the conversations we hear in the office, we get that from our managers, I have never been told my time could be better used elsewhere'.

There was staff guidance for meeting people’s needs who ‘fall below the eligibility threshold’. It provided generic information about signposting people to resources such as ‘meals on wheels’ or for ‘medication dosette boxes’. There was reference to services for social support or caring support such as libraries or joining clubs. However, the guidance was not specific to what services were available in Blackpool and had not yet been formally ratified for implementation with staff.

The local authority’s online assessment tool could be used by people to identify their own eligibility for care and support, it could be accessed 24/7 and had animated videos to guide people through the process.

When staff completed Care Act assessments with people, the templates used showed clear outcomes of eligibility. There was also staff guidance, information and a tool for establishing eligibility produced after learning from a safeguarding adult review. There was mixed feedback from people. For example, one person felt their assessment was not accurate and they had not received a copy. Another person’s assessment provided details about the person's needs, how these would be met and clearly demonstrated how the person met the eligibility criteria.

Senior leaders had originally told us they had no appeals for Care Act assessments, or support and care funding over the past 12 months. However, in March 2025 they reviewed their information and told us between 2023- 2024 they had received 5 complaints or appeals in relation to the outcome of care assessments (including eligibility), or the quality of assessment, 2 were upheld, and senior leaders told us ‘lessons were noted from all’. From January 2024 they had 3 complaints or appeals related to the outcome of care assessments (including eligibility), 2 were partially upheld with lessons learned.

In Blackpool 73.23% of people did not buy any additional care or support privately or pay more to 'top up' their care and support in Blackpool. This was better than the England average (64.39%, NHS Digital 2024). Senior leaders told us this was a result of people’s needs being met by the local authority. There was staff guidance for meeting people’s needs who self-funded their own care. It stated there would be no difference for assessment or support planning for people who self-fund. However, the guidance had not yet been formally ratified for implementation with staff.

There was mixed feedback from people about financial assessments. For example, one person had been incorrectly informed about ‘free’ care charges and an apology was offered. Another person had been distressed about the communication about outstanding care fees. In contrast, a person with learning disabilities spoke positively about the support with budget plans. Another person was appreciative of advice on deferred payments during a difficult time. In March 2025, senior leaders told us between 2023-2024 they had received 12 complaints or appeals in relation to the outcome of financial assessments including deprivation of asset decisions, 2 were withdrawn, 6 were not upheld and 4 were partially upheld. From January 2024 they had 5 complaints or appeals related to financial assessments, payments and charges. Of these, 2 were withdrawn, 2 were not upheld and 1 was partially upheld. Senior leaders told us there were lessons learned.

The local authority had public information posted on their website providing some information about paying for care and support, financial contributions and options to request a financial assessment. However, the information was limited, and people could not understand their contributions without delay. There were online options for people to contact the social care benefits team including about reviews and appeals by telephone, writing or email, and once a person had been assessed as eligible for care and support additional fact sheets were sent out to people who needed a commissioned service.

Financial assessments were carried out by the social care benefits team who had recently transferred to work within the local authority’s adult social care department. Senior leaders told us the social care benefits team move enhanced collaboration with brokerage functions to improve communication and wait times. Some delays were said to be due to some people lacking mental capacity around their finances which could cause challenges in determining financial contributions. In these situations, staff were able to visit people face to face and used national databases to obtain necessary information. At the time of CQC assessment people waited for financial assessment and processes were not consistently meeting the local authority’s target of 28 days. In August 2024, the local authority had a total of 203 people waiting for financial assessments, with a median wait of 13 days and a maximum wait of 151 days.

Senior leaders had identified risks around complaints, late provider payments and potential unpaid carer breakdown relating to financial assessment and outcomes. These risks were being regularly reviewed and there were plans to review recent changes to ensure this was effectively increasing activity, as well as offering direct debits as payment options for people receiving care and support. However, at the time of the CQC assessment it was too early to evidence how effective or sustainable any changes had impacted maximum waiting times and people’s experiences of being charged for care and support.

Where someone could not fully take part in conversation about their needs for care and support and they had no one to help them, the local authority had access to a commissioned advocacy service to support the person’s involvement in their assessment and plans. There was no waiting list for independent advocacy services. However, there was more to do to ensure the local authority was referring all people who needed independent advocacy and staff required more support, training, oversight and learning to fully embrace the benefit of people participating fully in care assessments and care planning processes. There had been a recent complaint in relation to the impartiality of a member of staff when assessing a person’s needs. This resulted in an apology and referral for independent advocacy.

There was mixed feedback from staff about understanding of when to refer someone for independent advocacy support. Some staff told us how they advocated for the person themselves instead of seeking independent advocacy, other staff told us when referrals could be made to ensure a person’s voice would be at the forefront in any decision-making process. A partner also told us there were inconsistencies, as not all staff made timely advocacy referrals. They told us there was an ongoing issue with frontline staff’s awareness of advocacy services. Questions within digital assessment templates to prompt staff to record whether advocacy was considered, or referrals were made, were not mandatory to complete. There was an option to select 'yes' or 'no' but we found neither option could be selected. There was more to do to provide assurances through audit and evidencing impact of learning to ensure all people who needed it were offered or supported by advocacy provision.

Senior leaders and partners told us there had been additional resources to support improvement at the local authority for staff to better understand advocacy services. They had recently seen an increase in advocacy referrals for safeguarding. However, there was still an inconsistency among staff referring for Care Act assessment advocacy. Training for newly qualified social workers had been provided and senior leaders told us advocacy referrals for care act assessments had increased by 61%, referrals for IMCAs had increased by 47% and referrals for IMHAs increased by 46% in the past 2 years. Senior leaders told us this was a direct result from the work done so far to raise awareness and the joint work carried out with the provider.