Stoke-on-Trent City Council: local authority assessment
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Overall summary
Local authority rating and score
Quality statement scores
Summary of people’s experiences
People who had a Care Act assessment had multiple routes to feedback about their assessment and reported that the process was supportive and that they felt listened to, which was reflected in national data, but people experienced delays in the assessment of needs, both for social care and occupational therapy. We heard that more work was needed to ensure individual differences were captured in the Care Act assessment and that people’s protected characteristics were appropriately identified. Some people did not have a good experience of the financial assessment process due to a delay in assessment or difficulty challenging the outcome.
Carers said that they received good early intervention and prevention support and liked the services on offer, but many did not know about the carers assessment and the benefits of this for them. Carers outcomes were good, but there was development needed to ensure that people had a timely carers assessment and there were contingency plans in place so carers could take respite breaks from their caring role when needed.
People had access to information and advice in their communities through Community Lounges, and this was valued. We heard that access to information online was more difficult, the local authority had refreshed its webpages and was promoting its resident portal and providing digital literacy training for people. People spoke positively of enablement and reablement support and how it helped them to meet their goals and be independent; they told us they wanted the service to last longer. People said that they had long waits for equipment and adaptations to support independence at home, and this caused frustration. People from the D/deaf community reported that they struggled to engage with local authority services.
People had a good experience of discharge from the hospital and felt supported, and the person receiving services and their carers were aware of the process and what was happening. There was evidence that feedback was regularly gathered from people to support improvement of the discharge process.
People who used services said they felt safe, and when asked, people felt that the safeguarding process had met their preferred outcomes, but more work was needed to capture people’s experiences in these areas. People with lived experience worked alongside people with high-risk care and support needs; this approach supported people who lacked trust in the local authority to be engaged and accept support.
Those with lived experience of drawing on care and support were regarded as peers within the local authority, and they provided valuable insight in co-production and training to social workers and wider partners. The local authority knew more work was needed to ensure that the group of people with lived experience was reflective of all the people in the community. There was evidence that the local authority created employment and voluntary opportunities for people who had used services, which supported greater independence. There was a high level of compassion and ambition for people when they were at their lowest, which supported positive outcomes.
Summary of strengths, areas for development and next steps
Provision of adult social care was a clear priority within Stoke-on-Trent, and there was a positive energy amongst staff and members to do the best for people and make Stoke-on-Trent a great place to live and work. There was an open culture that embraced challenges and supported people to take risks and try new things. There were clear and accountable leadership and governance arrangements, and everyone knew what was happening across adult social care and were pulling in the same direction to support people in the community.
Adult social care had been on a data quality improvement journey over the last twelve months, which meant that at the time of assessment, Stoke-on-Trent’s performance in national data sets was not a true reflection of their current position. There had been a marked improvement in performance reporting, and through this, the local authority knew that some people had long waits for Care Act assessments, carer assessments, reviews, occupational therapy and Deprivation of Liberty assessments. They were now using data to support demand management and investment decisions to improve this position. Quality of life indicators came out in line with the national averages or better, across all areas.
There was a transformation program at the local authority, and this was evidencing positive improvements across all project areas and leading to the development of new policies, procedures and operational processes. This was supporting a more effective use of resources and joined up working across adult social care. Staff were very positive about the transformation, and they could see the impact this was having on improving their performance and work with people. There was evidence that due to these changes, more people were receiving early intervention and prevention support to promote independence and prevent, reduce or delay the need for longer term care.
Key positive areas in the local authority were a clear strength-based approach to care assessment with a growing focus on prevention to reduce the need for care and support, which was supported with a good quality training offer and regular audits. There was a good footprint in local communities for people to access information and advice; this allowed a tailored offering to be made within each locality reflecting specific needs and supporting the local authority’s understanding of communities.
The local authority was clear about areas where it needed more accommodation in the community for supported living and better use of extra care, and it had a plan to prevent the need for people to move into long-term care homes too early.
There was a strong partnership working across health and social care with effective use of joint funding to deliver high-quality services. For example, the hospital discharge hub had a clear focus on keeping people independent in the hospital and discharging them to the right setting promptly to reduce a decline in independence and support them into reablement/enablement services as needed. These approaches showed positive outcomes for people.
Individual risk was managed well within the local authority, and there were good examples of partners coming together to support people at high risk with dignity and respect. Lessons learnt from risk management were shared across the local authority, and they were developing training to support a risk enablement approach for people receiving services.
Key areas of improvement included ensuring that people had timely access to Care Act and Carers assessment, as urgent cases were seen, but there were long waits for some people deemed as non-urgent. The local authority had started work to improve the timeliness of assessment as part of the transformation programme. There was a particular focus on improving the carers process as some carers were not accessing assessment when needed, impacting contingency planning. The Occupational Therapy service needed development to ensure that preventative opportunities were not missed. This team felt they lacked a voice in the organisation, and some people had long waits for equipment and adaptations.
There was evidence that the local authority had good internal equality networks, and they were doing more work to make sure that their workforce was reflective of the communities they served. However, there was no strategic oversight of Equality, Diversity and Inclusion work in the provision of adult social care services. There was a clear focus on poverty, but less around how this might impact people differently because of their protected characteristics, and why and how they might need to access services differently.
The local authority had done work to transform the commissioning team function. But Further time was needed to embed new relationships with providers and see the benefits of new contracts that had been put in place to provide for the gaps in the market that had been identified, like supported living for people under 55. There was no clear quality audit guidance in place, though providers did report that they felt supported by the quality improvement process.
In the past, it was not clear that strategies like the Joint All Age Carers Strategy 2021 – 2025 and Joint Dementia Strategy 2020-24 had led to outcomes as there were no clear lines of accountability with delivery plans to provide a narrative on what had improved and reasons why things could not be delivered. Leaders were aware of the need to show clear outcomes from strategic work and had started on this with the transformation programme and were committed to delivering on the new strategies they were developing.
Stoke-on-Trent knew itself well and was working with partners to find creative ways to meet challenges with limited resources. They evidenced that they were on a journey of improvement, and there was a commitment and positivity to deliver good social care outcomes, which evidenced they were on the right track.