Oxfordshire County Council: local authority assessment

There was an inclusive and positive culture of continuous learning and improvement. Staff had ongoing access to learning and support, which supported the Care Act duties to be delivered safely and effectively. Staff described how the positive culture within the organisation enabled them to grow and progress throughout their careers. Continuous professional and personal development was supported, and staff were enabled to acquire new skills and knowledge to perform their roles to a high standard. Teams were offered robust training and individuals were provided with the opportunity to request specific training if staff felt it was needed.

An audit conducted in 2023 identified inconsistent practices across adult social care teams and engagement was not always apparent. The authority had taken steps to improve this through a review of the quality assurance framework, which provided revised learning sessions delivered to support staff to understand the importance of high-quality practice and embedded a process of setting standards. Learning and information sessions were used to focus on practice areas of concern with a focus on supervision documents and guidance, effective screening, hospital placements, and Mental Capacity Act (MCA) assessments. Senior leaders told us there was a focus on continuous improvement within the adult social care team and described this as being driven by “honest energy”. New ideas were harnessed and utilised, without losing sight of the person. Leaders told us they felt privileged to see the "flower open" at Oxfordshire during their time in the role.

The local authority collaborated with providers to address the concerns around staff shortages in the care sector. Staff told us capacity in the care sector was very tough, but the authority had used different ways to retain people. The local authority was looking at different ways to incentivise people to stay in the workforce longer. This included the use of the care app and rewarding people had also been considered. The local authority had also worked with the local university in many areas including recruiting more staff to support homeless services. This generated a number of students offering to work with rough sleepers and led to better support for individuals.

Oxfordshire County Council recognised that co-production was vital to ensuring that people with lived experience worked alongside the authority to shape services. Co-production was used to develop strategies including the recent all-age Carers Strategy. The local authority had recently worked with Oxfordshire partners to co-produce a redesigned short breaks and respite offer as part of a recommissioning process. A co-production event was held to bring people together to talk about what was working well, and what could be better in the future. However, co-production was not consistently embedded into adult social care. Senior leaders told us co-production needed more work to be effective and meaningful as it currently felt like the local authority made decisions, and then brought in people’s voices, rather than being led by people’s voices. The local authority had identified that co-production and equality, diversity, and inclusion needed to be embedded more consistently. The local authority did not have Co-production Strategy but co-production aims were included in the Consultation and Engagement Strategy.

There were mixed views from people about how effective co-production was. Some felt it was limited to the same voices being involved in all the projects and these were no representative of the thoughts and voices of people across the county. It was felt that co-production in some areas was a paid-for service which risked it not being an independent voice. Others felt that it had been positive to participate in many co-production projects with participants in co-production feeling respected and valued. Efforts by the local authority to undertake genuine co-production were recognised but the need to improve was also highlighted. Partners told us they had attended meetings held by the local authority when decisions had already been made, resulting in it feeling more like a "tick-box" exercise, with instances where the views and opinions of carers were not considered.

Staff and leaders engaged with external work, including research to ensure that innovation and new ideas were used to drive performance. Oxfordshire County Council’s award-winning Innovation Service joined the South East Association of Directors of Adult Social Services (ADASS) consortium for the Department of Health and Social Care (DHSC) International Recruitment Fund with an ambition to deliver a technology-based solution to support social care providers in the southeast of England with international recruitment. Borderless was a contract that started in December 2023 and was an International Recruitment project to support adult social care providers to recruit more staff. Staff were also able to take part in joint learning sessions across localities, staff forum meetings, and practice supervisor-led training.

The local authority actively participated in peer reviews and sector-led improvement activity, drawing on external support to improve when necessary. The authority took part in the Oxfordshire Safeguarding Adult Board (OSAB) peer review in 2023-2024. Learning from Safeguarding Adults Reviews (SAR) fed into the Internal Assurance Group and learning for Oxfordshire County Council was shared with the PSW and wider teams.

Oxfordshire County Council was part of a peer challenge with the Local Government Association in March 2024. Senior leaders felt that the peer challenge allowed the authority to recognise what was good and what could be improved.

The local authority had started to develop processes that allowed it to learn from people’s feedback about their experiences of care and support. There had been a significant period of change in the authority which had led to several areas being developed and progressed simultaneously. There was recognition of the need to improve communication with people who use services and their carers and to draw feedback from their experience of care and support. Examples of this included “you said we did” feedback from care home residents, family, and friends. This approach was also designed to support the local authority to review the standards of care in care homes. Work had also begun in response to carers’ feedback in which the local authority had developed plans to amend the Care Act assessment to a more strength-based approach. Staff told us data was collated and reviewed to understand people’s feedback. The data was used to drive improvements within local authority to make changes to policies and processes to make people’s care journeys better. This was also fed directly to the Health and Wellbeing Board.

A report published by Healthwatch called “How People Experience Joined Up Care in Oxfordshire”, published in October 2023 stated that people in Oxfordshire experienced fragmented care, inadequate communication, and significant challenges to navigate the social care system. This was particularly evident for complex cases or where people had multiple services involved. The local authority recognised similar issues and was committed to the improvement of people’s experiences.

The recent peer review identified that more could be done to ensure the commissioning approach was explained clearly. The peer review identified that the local authority’s strategy and intentions were not visible enough to all colleagues, and some staff working in operational teams lacked knowledge of the transformation within the commissioning teams. Staff told us this feedback had informed improvement work to ensure the workforce was engaged with the strategy so that it was meaningful for people.

There was evidence that co-production had improved ways of working. However, people felt currently there was more to do to ensure it was effective. The local authority had begun to use co-production in different areas of work but the Co-production Board was not seen as diverse and did not include people with a range of experiences. Partners felt there had been some positive changes to co-production with a renewed focus on this area of work. They felt there was still work to do to link this work with strategic and service development. However, it was felt that the general ethos had changed in the way the local authority was now doing things.

The local authority told us data from complaints received between 1 April 2023 and 31 March 2024 had been reviewed and on average there were 30 complaints received each quarter. The themes of complaints were reviewed by the Internal Assurance and Governance Group; common issues arising were related to disputes over funding, level of service/ service failure, and lack of contact or action. There were 67 learning actions raised as a result of complaints. Examples included improving communication, being proactive to ensure a timely response, and taking the time to ensure people understood the reason and rationale behind a decision.

There had been a year-on-year improvement in ASCOF data for 2023/24, which demonstrated that changes had been made to ensure people had better experiences of adult social care. Satisfaction reports were shared with the Internal Assurance and Governance Group and key feedback was highlighted to staff via the Adult Social Care Roadshow. It was less clear how this information would become an embedded part of the improvement plan which would be monitored and improved over time.