Hammersmith and Fulham: local authority assessment

Hammersmith and Fulham were reviewing their governance and performance management across adult social care following a senior management restructure in May 2024. This was to provide more visibility and assurance on Care Act duties, risk to delivery, quality and sustainability, and people’s care support and outcomes. Work had begun on improvements, like defining front door processes, developing a policy portal and improving performance reporting so that the local authority could define and manage standards expected within the directorate.

The local authority was improving the information they had about risk, performance, and inequalities to inform strategy, allocate resources and deliver the actions needed to improve care and support outcomes for people in the community.

Following the restructure and appointment of senior leaders the team had developed positive relationships, and though the Director of Adult Social Care (DASS) appointed in June 2024 was not a direct line report to the Chief Executive they had regular meetings to agree priorities in adult social care. The leadership team was committed and stable and had been focused on making permanent recruitment to key senior posts and this was an improving picture, for example, the Principal Social Worker was an agency member of staff at the time of assessment, but there were plans to recruit permanently.

There was a clear commitment in the senior leadership to adult social care improvement and they were on a journey of embedding equality, human rights, and diversity principles into their work. This was reflected in their passion to include residents in co-production and their commitment to providing care without charge, as was the case for home care support.

We heard and saw how the local authority had listened to people through co-production exercises across a range of strategy developments, plans and engagements. In the past implementing recommendations had been slow; plans, people’s feedback and board documents showed that there was not a culture of identifying performance indicators so that projects and boards could be held accountable. When things had not gone as planned, where projects had faltered, or commissioning had failed there was no documented evidence of reflection of lessons learnt for improvement. However, the leadership team had recognised this and had put in place a Director of Commissioning, Transformation and Health Partnerships to ensure that there was an alignment of strategic priorities, improvements and partnership activities going forward.

The DASS and the Principal Social Worker regularly met with social care staff, and in response to feedback from the staff survey, they had created further opportunities for staff to engage with them and had made progress in the short time they had been in post.

The leadership team were sighted on risks and told us about areas of development and improvement that they were putting in place to mitigate risk, like providing more resources to screen people awaiting care act assessment and improving safeguarding processes. However, the current risks and mitigations were not clearly articulated in the risk register, which meant that oversight was not fully robust. There was a risk escalation arrangement so staff could report individual events or risks to senior leaders.

Where there were shortfalls in delivery of Care Act duties these had been identified and actions were in place to mitigate the shortfalls, for example there had been investment in the review project team to reduce waiting times for review of Care Act assessments. There were areas where mitigation still needed to be provided, for example in actions to improve timeliness of Occupational Therapy assessments. But actions were being taken to ensure that improvements to adult social care were made in the longer term.

Hammersmith and Fulham had started using data to help them understand productivity in adult social care teams. The local authority recognised that the use of data would support them to understand people’s health and social care journey and could be used in partnership to inform risk and resource management.

The local authority’s Cabinet Members, Shadow Cabinet Members, Executive directors and other leaders were passionate about adult social care delivery. Core Cabinet members and leaders felt well informed and had influence over service planning and strategic issues such as co-production and providing care without charge. Councillors told us that residents were at the heart of what they did and they were keen to support in a cross-party way to deliver on this aim.

Scrutiny arrangements worked to allow the full range of adult social care responsibilities to be discussed and challenged. Through this process, 4 Labour non-executive members, 1 opposition non-executive members and 3 co-opted members participated in scrutinising adult social care.

Adult social care was prominent in the wider Council’s resource allocation and the Council has invested additional resources as needed to support effective delivery of Care Act duties.

Hammersmith and Fulham had a Corporate Plan for 2023-26 with a cross-cutting set of ambitions for the organisation with a vision that ‘Hammersmith & Fulham is a wonderful place in which to live work and do business’. There was a set of outcome measures which were relevant to practice in adult social care for example ‘More Disabled residents experience the same control, choice and freedom as any other resident’.

The Directorate Leadership Team knew more work was needed to ensure that delivery plans and strategies were in place, fully resourced and accountable. They had developed a vision for adult social care which was ‘Working compassionately with our young people and adults so that they enjoy independent, healthy and fulfilling lives’. The plan was to communicate this with staff as part of the broader improvement program. We did not see evidence that the vision for adult social care had been co-produced with residents and partners.

There was evidence of recent improvement plans which had clear targets and were resourced, for example in conducting quality audits of Care Act assessments and in the safeguarding improvement plan. Improvement plans were on track to improve the shortfalls identified in the delivery of Care Act duties and outcomes for local people.

Within the Adult Social Care and Public Health Directorate Leadership Team (DLT), there were many ambitions and targets set through different workstreams coming from residents, other departments, partners, and political priorities. Health and care system partners agreed that there was more work to do on developing the collective sense of purpose and ambition within the borough partnership, and greater clarity was needed on what they were trying to achieve through working together and improving the alignment of strategic plans.

The local authority had governance and standards in place for information security and Caldicott Guardians, who were the senior leaders responsible for information being used legally, ethically and appropriately. There was information on Hammersmith & Fulham’s website about people’s data and access rights.

The local authority had information-sharing agreements with partners. In some areas these were being developed, for example in mental health an IT strategy and information-sharing agreement were identified as a priority for 2023/24 in their memorandum of understanding between the local authority and the NHS trust.

Social workers had to attend mandatory General Data Protection Regulations (GDPR) training and Care Act assessments were audited and met GDPR in most cases.