Hartlepool Borough Council: local authority assessment

The local authority provided multiple routes to access care and support services, with self-referral options, information, and advice online.

The local authority had introduced a Community Led Support (CLS) programme to design and deliver different ways of working to maximise people’s strengths and community connections. The support hub, based in the community hubs, delivered this approach and acted as a front door for adult social care services, referral and assessment.

The community hubs were based in the centre and south locality areas, with a dispersed offer provided in the north of the borough, co-location with the library offer and close to transport links. There is also a virtual online community hub.

People had options on how they wanted to contact the local authority and how they received information and advice. People told us their communication needs were discussed at assessment and documented, although we heard from other people who said the options to contact adult social care did not always meet their needs for accessible communication.

National data from the Adult Social Care Survey (ASCS) 2023-2024 showed 68.42% people were satisfied with their care and support, which was slightly better than the England average of 62.72%.

Assessment and care planning was person centred, and strength based and reflected what people wanted to achieve and how they wished to live their lives. The community hub teams received training in motivational interviewing to support conversations to understand people’s goals. Local authority staff and partners worked closely together and screened referrals for assessment and services, and people could access services though walk-ins at community hubs as well as telephone and email. The approach focused on having a ‘good conversation’ which was solution focused and concentrated on maximising people’s opportunities to live the life they wanted to live. The Integrated Single Point of Access (ISPA), established in 2018 encompassed a multi-disciplinary team approach with teams from health, adult social care, housing and reablement. Leaders told us the ISPA showed how partners championed integration of care and support services.

People told us they were asked about their choices and opinions. One person told us the assessment included good person-centred information and showed how the social worker had supported them to maintain relationships.

A policy and procedure, the ‘Care and Support Customer Pathway for Adults and their Carers’ was in place. The pathway highlighted the principles for staff and the local authority’s strength-based approach. People had access to information to help them understand their options so they could access appropriate support.

The assessment documentation reflected the Care Act 2014 and assessments we reviewed contained person centred and strength-based information. Local authority audits gathered feedback from people about their experiences. The feedback on communication was generally positive, however the local authority received feedback that social care documents could be long and difficult to read. People described how they were supported in navigating and understanding the complexity of financial assessments. The local authority told us they were working with people to test clarity and readability of documents and had factsheets in place.

Staff teams told us they adopted an approach to promoting independence and supporting people to stay at home where this was their preference. The local authority and assessment teams were competent to carry out assessments, including specialist assessments. We heard all social workers were trained in mental capacity assessments. A senior leader told us the practice framework was being further developed to simplify assessment documentation and processes.

At the point of first contact with the local authority and through a ‘good conversation’ approach, people were given timely information, advice, signposting, or referral for assessment. Staff told us how they discussed and worked with people to understand how the local authority could support them.

The local authority had oversight of waiting lists. The local authority’s data showed since October 2024, waiting lists for Care Act assessments had reduced from June 2024 with a median waiting time of 13 days (from 18 days) and a maximum waiting time of 30 days (from 44 days), with 49 cases waiting. The local authority data showed the average waiting time for Care Act assessment was 14 days with no one waiting longer than 64 days.

National data showed 83.02% of people receiving long-term support had their needs reviewed which was significantly better than the England average of 58.77%. Short and Long Term Support (SALT) 2023/2024.

Staff told us waiting lists were proactively managed with risk assessments completed and they used a ‘waiting well’ approach and made weekly contact with individuals waiting for assessment. This approach enabled staff to identify any change in risk and re-prioritise if necessary. The local authority told us reducing waiting times was a priority and they had used Market Sustainability and Improvement Funding to increase capacity in reablement, financial assessment and occupational therapy teams. Processes were in place for Care Act assessments and care plan reviews to identify, record and review risk and to make decisions and prioritise cases into 4 priorities based on risk. If new information was received the priority allocation was reviewed and updated.

The local authority told us they carried out assessments and reviews in a timely manner. For example, one provider told us there could be a delay in reducing the level of care, but there were no delays when a person’s needs increased. Another provider said they were kept informed, and reviews were carried out professionally. The local authority told us they do not reduce support for people until they are assured that change in support can be sustained.

The needs of unpaid carers were recognised as distinct from the person with care needs; assessments, support plans and reviews for unpaid carers were undertaken separately.

The local authority transitioned from providing statutory unpaid carers assessments in house to contracting with a local carer support organisation for assessment, review, and support in 2022-2023. Staff told us it had worked well, and the provider was seen as a partner with adult social care teams and embedded in the adult social care offer. Joint visits to unpaid carers could be undertaken.

The local authority had unpaid carer lead roles working within social work teams and hubs offering support to identify unpaid carers to enable early intervention and support to reduce increased need. Staff told us there was a short on-line form to refer unpaid carers including young carers to the carer support organisation and the unpaid carer was contacted within 24 hours of the referral being made. This organisation and social workers could carry out joint statutory carer assessments.

Local authority data showed there were no waiting lists for statutory carer assessments and assessments were completed within 7-10 days of referral. The carer support organisation told us there was only one instance in the last 2 years when the 10 day target was exceeded by 1 day. Unpaid carers told us the assessment was a positive process, carried out quickly and their needs were also reviewed annually. One unpaid carer told us they felt heard and valued by the local authority. This is reflected in national data, which showed 57.76% of carers in Hartlepool were satisfied with social services, which was significantly better than the England average of 36.83% (Survey of Adult Carers in England (SACE) 2023-24).

The local authority told us all unpaid carers identified in Hartlepool had been offered a carers assessment. National data showed 78.10% of carers felt involved or consulted as much as they wanted in discussions, this was better than the England average of 66.56% (SACE). Unpaid carers had choice in their support, for example, those who had chosen not to have a formal assessment, still spoke positively about receiving information and advice and the difference that simply knowing support was available had to their wellbeing.

The Hartlepool Health and Wellbeing Board had endorsed a carers strategy 2019-2024 which was produced by adult social care in partnership with health providers, voluntary and community sector partners and carers. The local authority told us for 2025-2030, a carers strategy and a joint strategic needs assessment for unpaid carers would be co-produced with unpaid carers, public health, staff, and providers. The local authority told us the objective of the co-production was to inform continued strategic development and deliver measurable improved outcomes for unpaid carers.

Staff and leaders told us the support hub, which operates within community hubs, acted as a front door for people with a menu of community solutions to meet non-eligible care and support needs. People were given help, advice, and information about how to access services, facilities and other agencies for support. Support was available in the hubs from multi-agency staff and partners and included community navigators, occupational therapy assistants, substance use support workers and an unpaid carer information, advice and guidance worker.

The local authority told us they co-located services. Co-locating services meant there was access for people to distinct services and staff all in one place. The local authority told us people in Hartlepool benefited from having a range of services co-located, people could easily access for specific support or by ‘dropping in’ to see what support was available.

Staff told us they worked jointly with providers and other agencies to find the best support for non-eligible care and support. Staff told us people could get information and advice and more specific support, for example digital exclusion, handyperson services, small pieces of reablement equipment and income maximisation.

There were processes in place to collect people’s feedback on their support outcomes. Staff told us they used a wellbeing tool to understand the impact of support and activity. People were asked as part of their first contact with services to give a numeric score on their wellbeing using the tool and at the end of the intervention this was repeated. The local authority said, on average, people started with a wellbeing score of 4 and ended with a wellbeing score of 7. Staff told us this gave them confidence interventions were having a positive impact.

The local authority had a framework for eligibility for care and support, linked to Care Act outcomes, within the framework there was a specific section capturing the decision-making process and a review section for senior staff to comment on the decision. Staff used a team-based quality assurance process to encourage a culture of group supervision and decision-making, any decisions could be progressed to a risk panel. The local authority had a risk panel, a High-Risk Adults Panel, and a continuing healthcare panel.

The local authority had developed a Resource Allocation System (RAS) which was publicly available. The RAS operated to principles of transparency, simplicity, sufficiency, control and timeliness. For people being assessed this meant the methodology and detail was available to them, people knew how the decision was reached, the expected outcomes and how people would be enabled to achieve these. The person would know the amount of financial support as soon as possible in the process.

The local authority had appeals and complaints processes for eligibility for care and support. There was a publicly available factsheet which outlined the various ways a complaint could be made together with information on the complaint’s procedure. However, there was not direct access to alternative formats on ways to make a complaint such as easy read documents. The local authority told us alternate formats could be requested. This meant there was a risk people might not, independently, be able to make a complaint or seek clarity around eligibility decisions for care and support. Staff told us they received information on complaint outcomes and incorporated learning and reflection in their team meetings.

Data provided by the local authority showed 2 appeals for care funding through a Disabled Facilities Grant (DFG). A DFG is provided by the local authority to help with the cost of adapting a property to meet the needs of a disabled person. Both appeals had been presented to the local authority risk panel and declined, however, the panels referred the cases for re-housing as the panel determined this was the most effective way to meet the needs of the individuals

The local authority’s framework for assessing and charging adults for care and support was clear, transparent and consistently applied.

However, we heard financial assessments were not always timely. Local authority data showed in June 2024, 148 individuals were waiting for assessment, with a median waiting time of 150 days and a maximum waiting time of 367 days. The local authority had identified this as an area of improvement and invested in capacity within the User Property Finance Team who undertake financial assessments. In October 2024, this had reduced to 131 individuals on the waiting list with a median waiting time of 75 days and a maximum waiting time of 218 days.

Staff told us they were aware that waiting for a financial assessment could cause people anxiety. Staff had undertaken benefits training and could complete an online benefit check tool to help people maximise their benefits to try and minimise shortfalls. To further support the reduction of waiting times, the local authority was developing an online financial assessment tool.

Social workers were trained to carry out mental capacity assessments and to support people to make their own decisions. Where someone had substantial difficulty in being involved in a conversation about their care and support needs the local authority had access to advocacy services.

The local authority commissioned a range of partners to provide independent advocacy services. The advocacy provider told us relationships with individual workers was good and the local authority was able to pick the appropriate advocate for the person receiving the service. There were no waiting lists for advocacy and local authority assessment documentation included a prompt to identify if people needed an advocate.

One person told us a social worker visited them with an advocate to review their care. Staff working with people with a learning disability described how they were able to work with specific advocates matched to the person with care needs, they also said they had easy read information they could give to people. However, accessible easy read or pictorial information for advocacy was not publicly available on the local authority website which may mean people might not be aware of their Care Act right to have an advocate.