St Helens Borough Council: local authority assessment

There were clear governance, management, and accountability arrangements at all levels within St Helens. The local authority was committed to supporting a whole council approach to adult social care, recognising the wider determinates of health impacting on the lives of people. Senior leaders told us they understood the impact inequalities had on communities and over the last 12 months had agreed several strategies across adult social care. New scrutiny arrangements had led to improved performance and finance monitoring to support the development of new ways of working and of new services.

Senior leaders explained how Cheshire and Mersey ICS had made a commitment to support a place-based approach to integrated commissioning arrangements across health and adult social care in St Helens. The Executive Director for People was also the NHS place Director which further enabled integration, joined up governance, and integrated decision making.

The local authority’s political and executive leaders were well informed about the potential risks facing adult social care. These were reflected in the corporate risk register and considered in decisions across the wider council. St Helens worked closely with the ICS and ICB, with the Executive Director of People representing both the local authority and health at the ICB alongside the Chief Executive, Council leader and the adult social care portfolio holder. The portfolio holder also represented the local authority at the health and care partnership.

There were clear risk management and escalation arrangements, including escalation internally and externally as required. Staff and leaders told us they worked with wider council directorates and partners to ensure people were supported throughout their lives, with a focus on preventative services to reduce the need for longer term care or crisis interventions. Staff and leaders shared the adult social care risk register, with identified risks including financial pressures impacting meeting future demand for services, the retendering of the Community Falls Service and an increase in the number of people on the daily hospital discharge delay tracking list.

Staff and leaders told us adult social care in St Helens was committed to visibility and assurance on the delivery of Care Act 2014 duties, quality, and sustainability, identifying risks to delivery, and people’s care and support experiences and outcomes. This was delivered through St Helens’ Peoples Plan, the Adult Social Care Strategy (2024-2027) and the Corporate Council Strategy, which were all co-produced with people who used services and unpaid carers. These key documents shaped the delivery of adult social care in the Borough and enabled a whole council and Place approach to supporting people in their own homes close to their local community where possible.

There was a stable adult social care leadership team with clear roles, responsibilities, and accountabilities. There had been a change in both Leader of the Council and the portfolio holder following recent elections and good relationships had been built with both. There were effective processes in place to brief members and allow for overview and scrutiny of adult social care both operationally and strategically.

Senior leaders told us the whole Cabinet were involved in discussions and decision making, with challenge undertaken through the Scrutiny Committees. Committees received performance reports and key performance indicators, with weekly oversight meetings and monthly detailed finance and performance scrutiny. The Cabinet also reviewed ASCOF data quarterly in line with the Borough strategy priorities linked to adult social care and were currently focused on mental health and wellbeing.

People told us they were involved in Partnership Boards, including strategic work and the design and implementation of services. They said the local authority actively wanted to involve people with lived experiences to be part of consultations exercises and in informing good practice and training of frontline teams.

Staff and leaders explained how the Departmental Review Standards set clear expectations for conducting quality assurance reviews, including timelines, staff roles, and an escalation process for care planning issues. The local authority’s Case Recording and Record Keeping Policy and Guidance emphasized the importance of accurate documentation and case audits, whilst the Supervision Policy and Procedures defined the expectations for professional and managerial supervision. The Workload Management Tool provided guidelines on appropriate caseloads, facilitating effective resource allocation and management. The local authority had a workload management tool, completed monthly. The tool had weighted scores and indicated what level each worker should be working at.

Partners told us senior leaders were visible, capable, and compassionate. They could raise issues with the local authority through reports following research/ surveys which went to the People Board and the DASS, as well as the head of safeguarding and head of commissioning. Partners gave an example of a review completed by the local authority of Contact Cares after they raised concerns about people struggling to get through. This resulted in changes to the service including more capacity to manage calls.

St Helens used information about risks, performance, inequalities, and outcomes to inform its adult social strategy and plans, allocate resources, and to deliver the actions needed to improve care and support outcomes for people and local communities. Senior leaders told us they provided both quantitative and qualitative information to the Executive Boards, Cabinet and the Overview and Scrutiny Committee to inform organisational strategies.

In June 2024, the local authority agreed a 3-year strategy for adult social care, linked to St Helens People’s Plan and the corporate strategy. The Adult Social Care Strategy (2024-2027) was designed, developed, and co-produced by people who used services, their carers and families, and council staff and partners. The Strategy also included the local authority’s new adult social care practice model, focusing on a strength-based approach combined with trauma-informed care and support.

The St Helens Our Borough Strategy (2021-2030) set out 6 key priorities, with progress continually monitored and annual reports available to the public. The Our Borough Strategy annual report for 2023-2024 identified recent achievements in promoting good health, independence, and care across communities. This included the development of the Adult Social Care Strategy (2024-2027), the drive towards an integrated Home First model, and the development of their Technology-Enabled Care Model.

Senior leaders described the adult social care sector as facing several critical challenges, including rising demand, and escalating costs, driven by factors such as an aging population and more complex care needs. Staff and leaders told us they had co-produced and developed several multi- agency strategies along with action and delivery plans in 2023 including an Adults Complaint Policy (2026-2026), and All-age Autism Strategy (2022-2025) action plan, an All-age Carers Strategy (2023) action plan, a Learning Disabilities Strategy (2023) action plan, and a Mental Health Strategy (2023) action plan. These strategy updates had been coordinated and governed by the Transformation and Improvement Board

People and partners told us about the local authority’s All-age Autism Strategy (2022-2025) action plan which established a new partnership board, a transition panel process and oversaw the opening of a new supported living service. The All-age Carers Strategy (2023) focused on providing timely information to support unpaid carers, highlighting available resources, and strengthening families for the future. This included reviewing and enhancing online content such as self-help guides available to unpaid carers and ensuring the local authority and health partner websites featured appropriate and up-to-date links to the commissioned All-age Carer Service.

Partners shared St Helens Borough Housing Strategy (2022–2027) which set out the local authority’s commitment to commissioning and investing in supported and specialist accommodation to meet local needs, including providing aids, adaptations, and assistive technology for independent living. It confirmed new buildings would be wheelchair accessible, addressed accommodation gaps for specific needs groups, and supported veterans, refugees, and asylum seekers with housing.

Senior leaders told us St Helens Community Engagement Strategy (2021-2026) adopted a Locality Operating Model, a framework consisting of 7 Place localities and 4 Care Communities. The model supported the local authority’s coproduction and engagement initiatives by placing people at the centre of identifying solutions to local issues and fostering a more community-focused approach to governance.

St Helens had arrangements to maintain the security, availability, integrity and confidentiality of data, records, and data management systems. Senior leaders told us the local authority had information sharing protocols with people who used services and partner agencies. Privacy notices had been regularly updated and signed off by the Data Protection Officer and Caldicott Guardian. A Caldicott Guardian is the senior person responsible for protecting the confidentiality of people’s health and care information.

Staff and leaders told us they used secure systems to share information with relevant partners where needed. Shared care record systems enabled information to be shared across health and social care, creating a single record of high-level information to support staff to deal effectively with referrals, triage and decision making.

Partners told us there was a shared digital interface between health and adult social care records providing immediate access to relevant information for professionals to read and support people more effectively. Information sharing protocols supported safe, secure, and timely sharing of personal information in ways which protected people’s rights and privacy. The ‘Case Recording and Record Keeping Policy and Guidance’ set out the standards for recording and sharing personal information.

Senior leaders told us on-going training was provided to frontline teams to ensure they understood their responsibilities in collecting, recording, and using personal information to ensure compliance with legislation. comprehensive cyber incident risk register was monitored and updated by the Incident Response Team, and the local authority’s Information Sharing Policy identified good practice relating to information sharing, confidentiality, and consent.