CQC publishes report on London Borough of Ealing’s care act responsibilities

The Care Quality Commission (CQC), has rated the London Borough of Ealing as requires improvement, in how well they are meeting their responsibilities to ensure people have access to adult social care and support.

CQC has a new responsibility to assess how local authorities meet their duties under Part 1 of the Care Act (2014).

CQC looked at nine areas spread across four themes to assess how well the authority is meeting their responsibilities in order to create their rating. CQC has given each of these nine areas a score out of four with one being the evidence shows significant shortfalls, and four showing an exceptional standard.

James Bullion, CQC’s chief inspector of adult social care and integrated care, said:

“At this assessment, we found the London Borough of Ealing were committed to inclusivity and innovation, with clear strategies aimed at addressing inequalities and improving outcomes for all residents. Ealing's reablement services, which help people to remain independent, provide effective care and achieve significant results. However, significant delays in assessments, as well as accessing care and support, remain key challenges.  

“We were pleased to see efforts to include people in decision-making through co-production groups and strong partnerships with community organisations. These steps are helping Ealing design services around the needs and preferences of its diverse population.

“National data on short and long-term support shows that 90.48% of people aged 65 and over remained at home 91 days after discharge from hospital, significantly outperforming the England average of 82.18%. Staff worked closely with health professionals to tailor reablement support to individual needs such as through the provision of mobility aids. This helped support people regain independence after a stay in hospital and avoid longer term support where possible.

"However, there are areas where Ealing needs to make improvement. The median waiting time for an assessment of needs is 17 weeks, and although waiting lists have shown improvement over recent months, challenges to sustain this remain. Some staff have expressed concerns that the service is struggling to meet demand, with low staff numbers significantly impacting the speed at which residents can have their needs assessed by the borough.

“People’s experiences of accessing adult social care in Ealing were mixed. While some described positive assessment experiences with knowledgeable and caring staff, others highlighted delays and challenges in communication. Once care was in place, people said it generally supported their preferences, but there were opportunities to improve how services connected them to further support in the community such as with voluntary groups which may enrich their lives.

“Overall, the London Borough of Ealing has demonstrated a clear understanding of the areas requiring improvement and is committed to addressing these challenges. We look forward to returning to see how their plans mature and the positive changes this will have on the community.”

The assessment team found:

1. There were effective partnership arrangements with external and internal partners in place in Ealing, including hospital discharge and transitions for young people.
2. Young people moving from children’s to adult services and those discharged from hospital reported positive experiences, with tailored support to help them navigate these significant life changes.
3. People often had choice of care providers, especially when considering homecare provision. People told us they received care and support that considered their cultural, ethnic, and religious needs.
4. Staff were proud of the work they did in Ealing. Staff demonstrated a strong commitment to delivering person-centred, strength-based care. They were knowledgeable about services in the community and could signpost people to services that would meet their needs.
5. The local authority had implemented assessment review and resource review panels to support improved practice and opportunities for learning. The local authority is embracing technology and trialling innovations, such as artificial intelligence, to streamline administrative work. This has freed up staff time to focus on direct support for people.
6. There was a positive culture of learning and innovation at the local authority. Staff felt able to share their ideas and concerns and they were listened to.

However, the assessment team also found:

1. There were concerns about an overreliance on online information, digital information was not accessible for everyone in Ealing. Some people who used services told us that the local authority’s website was difficult to navigate, and that it was hard to find information in a way which was understandable.
2. Carers reported difficulty accessing long-term support, and many were unaware of the services available to them. Young carers were not always recognised, though efforts are being made to address this in the borough’s developing Carers Strategy.
3. People reported long delays in receiving equipment and home adaptations needed to support independence.
4. Rising demand and increasing complexity of needs in the borough have strained resources, leaving staff under pressure and impacting the timeliness and quality of care delivery.