Sefton Council: local authority assessment
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Overall summary
Local authority rating and score
Quality statement scores
Summary of people’s experiences
There was positive feedback from people about their experiences of adult social care in Sefton. Where people had been involved in assessments as part of the innovation sites for 3 conversations they reported an overwhelmingly positive experience of assessments and care reviews. People told us Care Act assessments and carers assessments were carried out by knowledgeable and caring staff. The 3 conversations approach meant frontline staff were having open and interested conversations with people and families to explore support needs and was a new way of working in Sefton. Where people received a review over the telephone their experience was less positive, we heard people felt face to face reviews were better and telephone reviews felt impersonal. Unpaid carers were overwhelmingly positive about their experience of accessing support and spoke highly of the services supporting them. The local authority planned to work with unpaid carers to deliver improvements on ensuring they had time away from their caring role with increased choice and access to respite breaks.
Staff, whether they were part of the 3 conversations innovations sites or waiting for the wider rollout of the approach, told us they offered strength-based approaches to prevent, reduce and delay the need for care and support. Wellbeing was embedded in the local authority’s approach, and we heard examples from people who used services about how they felt supported. One person described working with staff to improve sleep patterns and how they were supported to use 5 tips for wellbeing.
People had access to a range of approaches to meet both their eligible and non-eligible care needs supported by a strong voluntary, charity, and faith and social enterprise sector (VCSFE). People and staff gave positive feedback about reablement and access to equipment and adaptations and told us the local authority had increased access and timeliness to basic equipment to support their wellbeing using a mobile occupational therapy clinic.
People told us they could access advice and information, and we heard examples where the local authority had worked with people to ensure information met accessibility needs. Co-production with people enabled adult social care to understand how to improve people’s experience of services and to co-design new delivery.
The care market in Sefton was stable and providers described how they were involved with adult social care through forums and engagement to shape the market. The local authority had identified the need to improve choice and to divert people from long-term residential placements to a home first approach. The local authority wanted people to be enabled to live independently longer and remain in their communities to improve wellbeing and health outcomes.
Relationships with external partners were effective and there was integration between adult social care, physical and mental health services across the system. This included co-location and multi-agency working with arrangements to share information, share concerns and plan resources. Voluntary and community sector groups had a good relationship with adult social care and were part of decision-making groups, development of strategies and the multi-agency approach to supporting people in Sefton.
Summary of strengths, areas for development and next steps
In July 2024, two major incidents occurred in Southport. The local authority, working with partner organisations, stepped-up to respond to these incidents, establishing a number of work programmes including a focus on psychological care co-ordination to develop support for children, families and adults affected. This was an immediate priority, and these groups remain in place. At the time of the assessment, staff, leaders, community groups and partner organisations continued to work together to maintain and build on community recovery, reset and resilience.
The local authority adult social care department have been deeply involved in the response to the tragedy and it is a key strength they have been able to continue on their improvement journey against the backdrop of the events of the Summer of 2024, including reorganisation of staff and teams, work to improve people’s experiences of moving to adulthood or between care and support services and piloting 3 conversations
Staff and managers told us they felt valued and motivated and enjoyed working at Sefton Council. The local authority said staff were community focused and promoted the vision for adult social care: for people who live in Sefton to live as independently as possible for as long as possible. The workforce was resilient, staff told us they were supportive of each other and supported by leaders. Leaders were visible and approachable; they were not isolated from the wider workforce or external partnerships. We heard from staff how they interacted and engaged with people and partners. For example, sharing data with partners and arranging joint visits for assessments and reviews with people.
There was good use of data and information to support strategic planning. Leaders and staff had access to real time data to monitor waiting lists, assess trends and manage resources. Where there were waiting lists, staff and leaders were able to describe how these were managed and prioritised.
Partners, people and providers told us there was a mixed picture in relation to waiting times and timeliness of Care Act assessments and annual reviews with some areas having no waits for services and others being longer and we heard people did not always receive support early enough when moving into adulthood. For example, there were longer waiting times for young people in transitions, autistic people and people with a learning disability and in Deprivation of Liberty Safeguards (DoLS). Partners said there could be issues with DoLS authorisations allowing enough time for meaningful advocacy. The Mental Capacity Act 2005 ensures people who cannot consent to care arrangements are protected, the use of advocates to represent people are safeguards within the Act.
People who used services mostly talked positively about their experience of assessment and interaction with frontline staff, although they identified some delays when contacting the front door. The local authority had plans in place to strengthen options for people including the implementation of triage at the front door, live calls and the move to a 3 conversations approach across adult social care. Staff we spoke with, in adult social care teams, articulated how they used a strength-based approach and focused on having good conversations and working in partnership with people to find positive solutions and good outcomes. Staff were able to give examples of where they were creative in supporting people to achieve good outcomes, for example, staff told us they enabled a young adult to access safe sexual material to divert from potentially online harmful content.
Unpaid carers told us the partnership with adult social care and the commissioned unpaid carers services was good. Partnerships developed by the local authority enabled proactive identification, assessment, and access to support for unpaid carers and they felt supported and, where needed, did not have to wait too long for an assessment.
There was cross partnership working with health to reduce pathways to residential care, we heard about developments in home first, implementation of Better at Home and discharge pathways. At the time of the assessment, it was too early in the transformation process to have a clear understanding of the impact for people.
Experience and timeliness of transitions required improvements. A reorganisation had taken place to create new teams for autistic people and people with a learning disability and a transitions team. Work was underway across the authority to improve pathways between departments. There were processes in place to screen for risk and people were prioritised by staff and managers. Leaders were aware of pressures in accessing supported living arrangements and extra care housing and plans were in place to address choice and availability. We were told by people there was strong co-production and involvement to hear people’s voices and design solutions together within social care and commissioners.
There was a clear offer for those with non-eligible needs, with strong partnerships between the voluntary and community sector and adult social care which supported prevention, reduction and delay. There had been innovative work to improve access to reablement, for example the mobile clinics to assess for and supply equipment to people immediately in their own homes and the use of trusted assessors in the voluntary and community sector.
There was a strong thread across the local authority of co-production, and we heard examples of how people had been involved in a range of strategies and projects. There were clear adult social care strategies and implementation plans and practice frameworks and guidance in place for staff.
People who used services told us information and advice was mostly accessible. The local authority had a consistent approach to equity and understood their community, there was support for staff and communities in place and senior leaders told us there was a comprehensive use of Equality Impact Assessments. Staff were able to tell us about work and training in equality, diversity, and inclusion.
There were effective systems, processes, and practice in place for safeguarding. Staff had the relevant support, supervision, and training, including trauma informed practice training. Safeguarding was described by some people, partners, and providers as good, but we were told some safeguarding outcomes and learning was not always communicated to providers and could be improved.
Senior leaders were proud of the workforce and told us staff were confident practitioners, which reinforced a strength-based approach when working with people. There were strategies for recruitment, retention and to support staff development. The local authority championed a ‘grow your own’ approach, looked for progression routes for new employees and feedback was sought from their teams to support continuous improvement.