Islington Council: local authority assessment

The local authority worked collaboratively with partners to agree and align strategic priorities, plans and responsibilities for people in the area. The local authority had a section 75 agreement in place to provide care and support to people with a learning disability, mental ill health and the Islington carers hub. A Section 75 agreement is an agreement between local authorities and NHS bodies which can include arrangements for pooling resources and delegating certain NHS and local authority health-related functions to the other partners.

The local authority worked with the North London NHS Foundation Trust to deliver mental health services across Islington, the teams were co-located and worked collaboratively to meet shared strategic ambitions. Staff told us about positive working relationships with health colleagues, however, there was confusion at times regarding responsibility and accountability particularly around safeguarding concerns. The use of two separate systems could have been a challenge resulting in information being inconsistently recorded across systems which meant information may not have been shared as effectively as it could have. Leaders told us they were aware of this and had plans in place to improve this by ensuring adult social care staff recorded on the adult social care recording system only.

There were positive working relationships with partners and examples of collaborative working which had positive outcomes for people using services. For example, partnership working had achieved good outcomes in hospital discharge with the ‘Take Home and Settle’ programme which supported people to return home before having their care needs assessed. This had reduced delays in discharge from hospital and supported people to return home in a timely manner.

Partners told us of policies and strategies which had been co-produced to support people in Islington such as the Age Friendly Communities, Dementia Friendly Strategy and Islington Carers Strategy. Feedback from partners regarding co-production was positive with partners saying they felt equal, respected and valued. Islington was part of the North Central London Integrated Care System across 5 councils, Islington, Camden, Haringey, Barnet and Enfield. The work carried out covered both Adult Social Care and Children’s Social Care and linked professionals across Health and Social Care to share learning and embed good practice.

The local authority highlighted strong relationships with neighbouring local authorities and described how these relationships had supported people to be placed out of borough when needed, safely and effectively through the sharing of information to maintain oversight of people’s experiences. We heard an example of one person who was placed out of borough told us they were happy with the arrangements and had regular contact with their social worker and a multi-disciplinary team to support their needs. They told us they felt involved and included in any decision making and knew who to contact if they were unhappy with anything.

Internal teams worked well together to ensure a holistic approach to a person’s care and support. There was close working with Housing and Occupational Therapy to prevent, reduce and delay people’s care needs. Staff understood the impact that factors such as health and housing had on people’s social care needs and worked together to holistically meet people’s needs.

The local authority worked effectively with voluntary partners to achieve objectives. The local authority told us they had a good voluntary sector in the borough, and the voluntary sector was a crucial source of support for people and unpaid carers.

When the local authority worked in partnerships with other agencies, there were clear arrangements for governance, accountability, monitoring, quality assurance and information sharing. Roles and responsibilities were clear. Leaders used data and audits to maintain oversight of their section 75 agreements and had regular strategic meetings to discuss any concerns or best practice outcomes. Action had been taken to further monitor section 75 agreements by ensuring staff recorded on the local authority recording system and not the health recording system to ensure continuity of care and improved oversight. There had been inconsistencies in how staff recorded information particularly within the mental health teams and action had been taken to improve this however, this was yet to embed across the teams.

The local authority used opportunities to pool budgets and jointly fund services with partners to achieve better outcomes. For example, Better Care Fund had been used to commission the Islington Carers Hub which was provided by Age UK.

The local authority monitored and evaluated the impact of its partnership working on the costs of social care and the outcomes for people. This informed ongoing development and continuous improvement. For example, the NCL worked together to review the hospital discharge process and created the Discharge project Final Report 2023. Findings from this report created improvements such as the “take home and settle” offer and ensuring people received a strengths-based assessment in the right place at the right time, improving the knowledge of ward staff in relation to strengths-based practice. Leaders told us of work carried out with neighbouring local authorities to improve outcomes for people for example, Islington and Camden had worked together on suicide prevention and had a shared suicide prevention lead to work with people who may be at risk of suicide.

People told us of positive outcomes following support from multi-disciplinary teams and felt this meant they only had to tell their story once. Staff told us they worked well with health partners, and this was evidenced in their multi-disciplinary working. Health partners told us they worked well with the local authority and did not feel like it was separate health and social care and that they worked collaboratively together to reach their shared goals supporting people holistically. Staff gave examples of how partnership working meant people were not waiting for advice, guidance or support as good relationships meant there was always a professional you could go to for advice.

Partners told us they had a good relationship with the local authority, and they were invited to relevant boards and consulted with on important topics. They stated the local authority was supportive if they raised an issue. They also felt the local authority valued the voluntary sector and understood they provided services that the local authority could not. This meant the voluntary sector was able to support the local authority with identifying gaps and issues in the community to enable better support for people living in Islington.

Providers told us they felt listened to and respected as an equal and worked with the local authority to improve services and provided their knowledge and expertise in what was needed in the community. Providers told us how the local authority worked with the provider during a safeguarding concern and did not place blame but focused on how to improve the service to ensure safe care and support for people using services. This allowed providers to be open and honest and seek advice and support to reduce the risk of further safeguarding concerns.

The local authority regularly attended the Safeguarding Adults Board (SAB), the SAB consisted of several agencies including health, adult social care, voluntary sector, police and probation. This meant that safeguarding was everybody’s business and supported the safeguarding process in a holistic way.

The local authority worked collaboratively with voluntary and charity organisations to understand and meet local social care needs. The local authority had established Locality Wellbeing Networks which were collaborative networks of statutory service providers, charities, community groups and residents and were committed to taking an active role in their local community, sharing best practice and collaborating for positive social change. For example, it was identified that the language barrier and fear of professionals may have meant people would not know who to contact if they needed advice and support, work carried out by the local authority and voluntary partners has supported people to reach out for advice and support by building trust and relationships within the community. Feedback from partners was mainly positive and staff understood the importance of working with the voluntary and community sector to prevent, reduce and delay people’s care needs and promote social inclusion.