Stockton-on-Tees Borough Council: local authority assessment

The local authority was committed to working in partnership with other stakeholders to achieve better outcomes for local people. This was supported by partners who told us the local authority now worked more openly and collaboratively with them. There was recognition by leaders of the need to work collaboratively to address the significant inequalities in the area and that no single agency could achieve this on its own. Collaborative relationships with partners, were facilitated through forums such as the Coalition of the Willing, a multi-agency partnership established to focus on supporting admission avoidance, and the Place Leadership Board, also known as Team Stockton, as well as co-production initiatives such as the Making It Real Board. A monthly multi-agency special educational needs and disability (SEND) development group had been introduced as part of a joint governance structure to provide strategic oversight of provision. There was also strong co-working in areas such as public health, housing, and safeguarding.

Despite being a small authority within a large Integrated Care System, the local authority had a voice at all levels. Health and adult social care leaders said partnerships such as the Coalition of the Willing group allowed space for constructive challenge and relationships at a senior level were strong. Collaborative work was being done to refresh the borough’s Joint Strategic Needs Assessment (JSNA) to reflect changes in the local demographics. Staff had also collaborated to develop a Learning Disability Network based on feedback from a care provider forum. Through those forums, the local authority was working with partners to agree and align strategic priorities, plans and responsibilities for people in the area.

Relationships between local authority staff, health professionals, and the voluntary and community sector (VCS) were good, and arrangements, such as a 9-month occupational therapy rotation system with a local hospital, was strengthening links with health colleagues. Some voluntary partners told us they wanted to be included more in the local authority’s decision-making discussions, whilst some acknowledging this had improved. Partners also wanted a greater voice in forums such as the Health and Wellbeing Board to more effectively influence strategy based on their community level knowledge of current and future needs. Multi-agency initiatives were ongoing, including a project to increase physical activity in the borough, and this indicated a move towards greater collaboration between the local authority and the voluntary sector.

The local authority had integrated aspects of its care and support functions with partner agencies where this was best practice and when it showed evidence of improved outcomes for people. For example, services to promote effective and timely hospital discharge and longer-term arrangements for hospital admission avoidance.

Where formal partnerships were in place, there were arrangements for governance, accountability, monitoring, quality assurance and information sharing, and roles and responsibilities were clear. These existed at system, place, and local authority level. 

There was an intention to improve the sharing of performance and population inequalities data between agencies to ensure a share understanding of key issues and to align priorities and reduce duplication of effort. Leaders aimed to utilise partnerships such as Team Stockon to link service data effectively and visualise themes to target population needs and reduce duplication across the system.

Section 75 agreements (a legal mechanism for pooling budgets with health partners) were in place for delivery of the Better Care Fund (BCF). Robust governance and accountability processes were in place to set strategic direction and partnership arrangements for the BCF, with a particular focus on long-term care admission avoidance. Additionally, leaders were seeking opportunities for place-based funding opportunities, for example, by leading discussions around pooled budgets external to the Better Care Fund. This indicated an ambition towards joint preventative work at place.

Other joint funding arrangements were in place for falls prevention activity, community equipment, commissioning of nursing home and home care provision. Processes were in place to govern and facilitate decisions about how to use joint budgets and there was evidence of monitoring of the impact. For example, joint arrangements for falls reduction support had shown positive outcomes for people. Other specific joint initiatives with health partners such as peer inspections and a ‘Hospital at Home’ program had produced positive admission avoidance outcomes and strengthened inter-agency relationships. The Hospital at Home programme supported people to have their care needs met at home instead of in a hospital setting, saving an estimated 300 days in admission avoidance.

Changes in senior leadership in recent years and the introduction of new partnership forums such as the Coalition of the Willing, had driven a refresh of the functioning and strategic direction of the Health and Wellbeing Board. A new strategy for 2025-2030 had just been published and there was a clear ambition for this to drive meaningful change and a shift towards a more preventative approach to social care and health interventions. This included oversight and monitoring by the Health and Wellbeing Board to ensure a system-wide perspective was taken.

At a wider, system level, the local authority was working with partners to deliver the Stockton-on-Tees’ regeneration programme, which was a long-term programme of work tackling systemic inequalities in the area.

Arrangements for partnership working with the voluntary and community sector (VCS) were mostly effective. For example, one VCS group told us about annual engagement events held in partnership with the local authority to gather feedback from people about how their social care needs were being met in Stockton-on-Tees. This helped both partners focus resources on specific areas of need in the community, for example, support for migrant populations. Despite mixed feedback about voluntary partner involvement in strategic decision-making, most partners felt valued by and had a positive relationship with the local authority.

The local authority monitored and evaluated the impact of its partnership working on the outcomes for people and used this to inform development and continuous improvement. For example, effective partnership working between health and social care had led to timely hospital discharges for people and falls prevention activity had shown positive impact in respect of falls reduction. Community awards received by the local authority highlighted that the impact of its work across areas such as community engagement were being recognised by partners.

Delivery of the local authority’s Well-Led Leadership Development programme by its nationally recognised Transformation team had led to 61% of care homes registering for National Institute for Health and Care Research (NIHR) Enabling Research in Care Homes (ENRICH) programs. Additionally, positive feedback from providers about the local authority’s quarterly Learning Disability Network sessions indicated this partnership forum helped facilitate information sharing between providers. They told us the sessions were helping to raise the profile of learning disability services and promote improvement in the offer available to those in the community.

Partnerships with the Integrated Care Board and care providers enabled the local authority to have insight into local trading conditions and challenges partners and care providers were experiencing. We were told of an example when this insight had informed a decision to make contractual changes to strengthen the domiciliary care offer. There was also evidence that insights from partnerships had contributed to improvement in working arrangements between front-line practitioners. For example, staff said joint forums between health and social care staff had facilitated the sharing of skills and positive risk-taking in support of strengths-based care.

The local authority was working with housing partners to explore options to reprovision existing housing stock to provide accommodation options for those with care and support needs.

The local authority worked collaboratively with voluntary and charitable organisations directly and through a voluntary and community sector (VCS) infrastructure organisation, Catalyst, to understand and meet local social care needs. Catalyst represented the voluntary sector on key strategic boards and committees and worked in partnership with the local authority to drive forward their People Power strategy, which involved co-locating voluntary sector staff, coordinating Community Champions, and supporting ‘Mind the Gap’ work. Mind the Gap had facilitated the redesign of communication materials to improve awareness and access for seldom heard groups and worked to include local residents on local authority care service commissioning panels). The organisation supported between 250 and 400 voluntary organisations across the borough and engaged in multidisciplinary initiatives such as the Wellbeing Hub. Feedback from voluntary sector partners was generally positive and many said the local authority was listening to them.

Partnership working with the voluntary and charity sector had led to positive outcomes, such as increased engagement with people and their families around designing services including older persons’ extra care provision. However, VCS groups told us engagement by the local authority was usually consultative rather than co-produced. Leaders had recognised the need to develop and improve its coproduction approach to truly include people’s voices.

Leaders told us partnership work with VCS groups had been ongoing to address key issues in the borough such as rough sleeping. We were also told by VCS partners that they were being increasingly encouraged to share case studies with the local authority to demonstrate the impact of their work, which groups said was positive.