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Final report: September 2023
Background
Trafford Council asked the Local Government Association to undertake an Adult Social Care Preparation for Assurance Peer Challenge at the Council and with partners. The work was commissioned by Nathan Atkinson, Corporate Director Adults and Wellbeing (DASS) The DASS was seeking an independent perspective on how prepared adult social services are for a Care Quality Commission (CQC) inspection.
A peer challenge is designed to help an authority and its partners assess current achievements, areas for development and capacity to change. Peer challenges are improvement focused and are not an inspection. The peer team used their experience and knowledge of local government and Adult Social Care to reflect on the information presented to them by people they met, and material that they read.
As Preparation for Assurance Peer Challenge teams typically spend three days onsite conducting the challenge, this process should be seen as a snapshot of the client department’s work rather than being totally comprehensive.
All information was collected on a non-attributable basis to promote an open and honest dialogue and findings were arrived at after triangulating the evidence presented.
The members of the peer challenge team were:
- Victoria Collins Director of Adult Services Milton Keynes City Council, Lead Peer
- Councillor Chris McEwan Deputy Leader and Economy Portfolio Holder, Darlington Borough Council
- Phil Hornsby Interim Corporate Director of Wellbeing, Bournemouth, Christchurch and Poole Council
- Gavin Butler* and Alex Pitcher PSW and Practice improvement lead, Cheshire West and Chester Council
- Charlotte Hammond Head of Service Adult Social Care Learning Disabilities and Autism Lancashire County Council
- Sally McGrail Transformation and Improvement Lead Warrington Borough Council
- Kathy Clark Challenge Manager, LGA Associate.
*Gavin Butler attended for the three days 26 – 28 September. Alex Pitcher attended for the case audit and stakeholder meetings 12 – 13 September.
The team were in Trafford for three days between 26 – 28 September. Two of the team spent 12 – 13 September in Trafford to undertake a case audit and to meet with stakeholders.
In arriving at their findings, the peer team:
- Held interviews and discussions with councillors, officers, partners, and carers
- Held meetings with managers, practitioners, team leaders and frontline staff,
- Read a range of documents provided by Trafford Council, including a self-assessment, and completed a case file audit of 12 cases.
Specifically, the peer team’s work was focused on the Care Quality Commission (CQC) framework of four assurance themes for the up-coming adult social care assurance process. They are:
Care Quality Commission Assurance themes |
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Theme 1: Working with peopleThis theme covers:
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Theme 2: Providing supportThis theme covers:
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Theme 3: How the local authority ensures safety within the system This theme covers:
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Theme 4: LeadershipThis theme covers:
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The peer team were given access to at least 150 documents including a self-assessment. Throughout the peer challenge the team had more than 31 meetings with at least 100 different people. The peer challenge team spent over 200 hours with Trafford Council the equivalent of 26 working days.
Initial feedback was presented to the Council on the last day of the peer challenge and gave an overview of the key messages. This report builds on the presentation and gives a more detailed account of the findings of the peer team.
Key messages
There are a number of observations and suggestions within the main section of the report. The following are the peer team’s key messages to the council:
Developing the Neighbourhood Model
Trafford has a strong focus on integrated work with health and health outcomes, particularly around hospital discharge and admission avoidance. The development of a Neighbourhood model should offer opportunities to co-produce with communities and develop a broader Adult Social Care focus in integrated teams, supporting people to live the life they want and fully embedding an early intervention and prevention approach.
Getting it right at the Front Door
Trafford has a range of preventive and early intervention offers, but access relies heavily on social workers to undertake the First Conversations, which may not be the best use of resources and skills. More could be done to develop information advice and guidance, make access easier through a variety of channels, and providing self- serve options.
Safeguarding
There is work to do to ensure your thresholds for concerns and enquiries are working well, and that you have the right balance in skills and resources across all teams to ensure concerns and enquiries can be responded to in a timely and person-centred way.
Strategic direction and commissioning strategies
The golden thread from corporate strategy and vision needs to be developed to support a simple clear vision for Adult Social Care, which can shape your plans and strategies. These need to be supported by SMART plans for delivery and improvement for the next 3 – 5 years.
Mental health
There is a need to review your mental health services as there is a strong indication that they are not are Care Act compliant.
Case file audit findings
The peer team considered 12 cases in the case audit.
Strengths
- The peer reviewers saw some good practice, with recording demonstrating a person centred, strength-based approach, but it was patchy.
- There were some files where it was clear that outcomes had been agreed with the person, but this was not consistent in all files.
- Access to support was timely and there were no or minimal delays in securing services once an assessment had been completed. This is to be celebrated.
Considerations
- Mental Capacity Act considerations were inconsistent.
- Least restrictive approaches were not easily apparent.
- Neighbourhood Team safeguarding could be stronger on Making Safeguarding Personal.
Theme 1: Working with people
This relates to assessing needs (including that of unpaid carers), supporting people to live healthier lives, prevention, well-being, and information and advice.
Strengths
Trafford’s practice model has the potential to be strong, and is based on the Three Conversations approach, offering a strength and community asset-based focus. Based on what they heard from a number of meetings, the peer team found there is more confidence that your borough wide teams can deliver your Let’s Talk model, compared to some of the neighbourhood teams. This fits with the self-assessment, but to assure CQC of consistency this needs to be extended to the neighbourhood teams.
Trafford has some good case stories which the peer team heard about from hospital discharge teams, where outcomes for people were clearly evidenced with positive feedback from people and relatives, including, impressively, for someone where the initial discharge was not entirely successful. Teams worked collectively together to keep people safe, stabilise them and return them home with the right support. It would be good to be able to provide other examples of practice in other teams is making a difference to people’s lives.
Trafford’s Business Unit is highly valued as a support to allow social work staff to focus on working with people, rather than administrative matters. The unit clearly has good links across teams and with providers and partners. Their work not only enables social work staff to free up time, it also provides a more joined up response across process flows making the arrangement of support more timely.
There were many references from staff to the good working partnerships with the voluntary community faith and social enterprise sector (VCFSE), and how the sector offers opportunities for people to be linked with their community and supported without the need for formal packages of care. It would be good to make VCFSE partners more visible, in the self-assessment and in any meetings. Some real-life examples of the outcomes of their work with people would also help evidence your strengths.
The Community Link workers are valued by social work teams for their strength-based practice. Social workers reported that this resource meant that people could receive a timely response and these workers held a lot of knowledge about preventative community resources. They also free up the capacity of the social work teams. You may want to consider capacity of these workers as the response varied depending on whether they were able to take referrals.
The peer team was encouraged to hear of Trafford’s corporate staff equalities, diversity and inclusion (EDI) networks, champions, and the training offer. There is already an awareness of the need to do more to understand data and the issues and barriers to equity of access and experience for people needing support. The peer team heard about efforts to embed equality and equity in your responses to Trafford residents.
The peer team was able to see data on waiting lists and that Trafford has made good inroads to reducing waits for assessments although there is still more to do. Waiting lists reduced from over 300 in February 2023 to 96 in August 2023. The team did not look in detail at how risks around waiting lists managed but heard that service managers do oversee the process.
The peer team heard from various sources that the Direct Payments (DPs) support service is offering positive support to Direct Payment recipients. The support team is resourced to be able to offer practical support and they are focussed on ensuring outcomes are met as well as auditing the use of money. They have clear links with the Social Care teams and are thinking creatively about how to develop access to a wider range of support. This is welcome as the peer team heard that many DPs are still used with home care agencies, and only 20% use the DP to employ Personal Assistants (PAs). The team noted that the Portal is about to go live to support the recruitment of Personal Assistants.
Trafford has included helpful evidence in the self-assessment of the impact in some areas of working with people. For example:
- The increase in confidence in using technology and digital offers, reported by people who had been supported by the Digital Enablement Team as set out in your self-assessment.
- Ascot House provides a positive residential step-down offer, successfully helping people return to their own homes after a hospital stay.
Staff from both Trafford Council and health partners demonstrated pride about the work they do. There is confidence about the Council and Better Care Fund resources invested in integrated working to support hospital discharge, which is making a difference to supporting people to live at home. Staff are encouraged to identify areas for improvement, and the team heard of examples such as the Business Unit where these have been adopted.
Considerations
There are some strengths which Trafford identified in the self-assessment where the peer team found only limited evidence set out or show-cased in either the self-assessment or the sessions. There were some of Working with People strengths identified by Trafford, which the team thought might be better linked to other themes. This included:
- Driving high quality care services. The peer team thought if this is a strength more evidence is needed from feedback and evaluation systems about the quality of operational processes to work with people. The feedback from the carers and Direct Payment stakeholder groups did not support this view. Both groups reported experiencing their interactions with the Council as frustrating. The peer team recognise that this was a small group and so there may be other views, but the team did not see examples of where the Directorate is regularly engaging with people with lived experience to hear their views and use these to shape the offer beyond planned surveys.
- The peer team suggests that avoiding provider market failure might sit better under Theme 2.
- The strong links with the VCFSE sector support could have been illustrated more fully, including specific examples of the groups who work with the Council to support adults with social care needs and examples of outcomes for people and how this will be developed in the proposed new neighbourhood model.
- Trafford Learning Academy and Staff Wellbeing might fit better under Leadership.
The Council is aware there is work to do to develop an operating model for Adult Social Care. The peer team thought Trafford could offer a more effective pathway at the Front Door, which would both make better use of resources and increase the number of people who could be supported quicker, and with a community offer. It may mean that Trafford is missing opportunities to prevent, reduce and delay Care Act needs. For example:
- Many councils triage more of the requests for support at earlier stage, often using unqualified but trained staff, with access to support form qualified practitioners for advice. These staff can undertake Conversation One before it is passed to a social worker.
- When testing how easy it was to access information advice or support the peer team found that the online portal goes direct to a referral for an assessment and had difficulty locating information about accessing information advice or guidance through other channels than the online form. This will also reflect potential barriers form an EDI perspective about access.
The team felt the range of prevention offers in Trafford would benefit from a review to make sure they form a coherent whole. Across a number of meetings the team heard that:
- Community Link workers do not always have capacity to take new work.
- The equipment and adaptations service has long waiting times, except for hospital discharge, and you still require assessments for simple services, including key safes and community alarm services. A Centre for Independent Living approach could offer people opportunities to self-serve a wide range of aids and adaptations.
- There is no Local Authority Occupational Therapy (OT) capacity and access to an OT is prioritised for hospital discharges. Social workers felt this hampers efforts to support independence.
Public Health colleagues were keen to work with Adult Social Care but are currently working mainly on longer term health improvements. Stronger collaboration on, for example, falls prevention, weight reduction and diabetes prevention could have an earlier impact on the demand for social care support. The draft Prevention strategy is very Public Health focussed and appears to be professionally produced rather than co-produced with Trafford residents.
It was the teams view that more work is needed to develop the new Neighbourhood model to ensure early intervention and prevention are central to the model and there is a clear social care offer. The team heard that work is planned, but the documents seen suggested that the focus is still on health and health improvement.
Trafford knows that to support good practice, practitioners need to feel connected and supported.
- The Principal Social Worker (PSW) is relatively new in post and has good ambitions for practice but has been required to resolve operational Deprivation of Liberty Safeguards (DoLS) work. The team felt the role needs more clarity, to be supported to use Greater Manchester (GM), regional and national PSW networks and resources (such as the Chief Social Worker's PSW training) and to be more visible to frontline staff across the borough.
- There may be value in looking at a practice lead for Occupational Therapists, if you are able to develop the social care OT capacity in your operating model.
- Ambitions on the numbers of practice audits could be higher, to provide a stronger understanding of the strengths and areas for development around practice.
- The Council knows here is much to do to address issues with the adult social care Mental Health offer. The self-assessment and information gathered during the visit indicates that social workers in the mental health trust are still working to a Care Programme Approach model and may be covering colleagues’ health tasks. Those who are not supported through secondary mental health services are referred to neighbourhood teams, who do not always feel they have the skill, experience or time to respond effectively. It is not clear, therefore whether statutory Care Act responsibilities are discharged adequately or well in your mental health services.
Theme 2: Providing support
This relates to markets (including commissioning), workforce equality, integration and partnership working.
Strengths
Providers were positive about relationships with the Council.
- Day to day working relationships with providers are well resourced with contract officer quality visits and opportunities for direct support, which providers welcome. Providers reported that problems are sorted quickly.
- Provider Forums have restarted after pausing during COVID-19.
The peer team heard that data from GM and the North West (NW) is used to complement the understanding of quality through contract visits and Trafford has high percentages for CQC Good and Outstanding ratings. The I-Tool for quality monitoring is respected and the data collected provides robust and structured intelligence and has informed targeted work in areas such as falls.
Trafford’s investment in the Real Living Wage has been welcomed. Providers were not raising issues over fees with the peer team.
The peer team heard about positive working relationships between commissioners and assessors to address immediate tactical requirements for support. This included:
- Ensuring a speedy response to hospital discharges.
- Commissioning of housing options for Discharge to Assess.
- Use of providers as Trusted Assessors in Supported Living
- Commissioning specialist provision for people with complex needs based on good information sharing between teams.
- Responding to emerging pressures.
The peer team heard about some innovative providers, for example in Learning Disability (LD), developing solutions such as Good Neighbours. The team also heard about collaborative work with providers on change and improvement.
Commissioners and staff were proud of the strong links with the VCFSE. It would be good to set out what this looks like, which organisations the council is working with and what innovations they are bringing to the local support market.
Data and staff provided evidence that the market in Trafford is able to respond to requests for support, and data indicates low numbers having to wait for support, except for nursing care. The peer team heard about work with health partners and providers to explore ways to address this shortage.
Trafford has a good story about work to provide integrated support, and the peer team heard from staff and saw in your self-assessment that this works particularly with the NHS and the Trafford Local Care Organisation (LCO), and in setting up multi-disciplinary plans for people with learning disabilities. The strategic working relationships and management of the Better Care Fund (BCF) were reported to be positive. The LCO Plans to increase community Occupational Therapy capacity were welcomed, although this may still focus on hospital discharge and avoidance rather than broader independence.
Considerations
The peer team considered that your commissioning feels more tactical than strategic, responding to day-to-day challenges but less clear on your longer-term needs and plans. The DASS is aware that the understanding and articulation of needs requires development.
- Providers that the team spoke to were not aware of your vision and told us they hear about the Council’s requirements sometimes only when a tender comes out.
- Setting out the direction for alternatives to traditional support models would help to shape the market, including:
- Accommodation and support for people with complex lives.
- Support for young people reaching adulthood.
- Day support opportunities.
- Training offer for Personal Assistants.
Trafford may find it useful to revisit the work on Commissioning for Better Outcomes, produced by University of Birmingham to support the work to shift to a more strategic commissioning approach.
The team were pleased to hear about external support to develop capacity in this area, including to produce a Market Position Statement. This should help to provide the messages providers need about the direction of travel in Trafford.
The team heard about the strengths of the Carers Centre but considered the Carers offer could be more robust.
- Carers’ feedback was that they experience frustrations in securing support for the people they care for. The peer team were not sure that Trafford is hearing from carers about their experiences.
- The new Carers Strategy appears to rely on the Carers Centre to deliver much of the strategy. Although the peer team heard that the strategy had been co-produced with carers it was not clear how far this was with people who were in caring roles and how far with the Carers Centre. The team formed the impression that there is limited representation of people undertaking caring roles on the Carers Partnership Board.
- Current support for carers health and wellbeing was thought by the peer team to be somewhat limited and restrictive, for example in the use of DPs, which were described as a set amount (£350 a year) with limitations on what this could be used for.
The team heard that experience around Direct Payments, generally, was that it could be more useful if there was more flexibility about how they can be used.
Providers reported some issues over delays in payments for support provided and over client billing.
There are some areas identified as strengths in the self-assessment where the peer team felt there is limited evidence to showcase what the impact is for Trafford residents. For example:
- Strategic Partnership working – the self-assessment links this to the Health and Wellbeing Strategy but does not set out the impact of the strategy on the support available to residents.
Theme 3: Ensuring safety
This area relates to safeguarding, safe systems, and continuity of care.
Strengths
Trafford’s focus on safeguarding with providers is significant, with the specialist offer from the Safeguarding Hub as well as the support around quality concerns from contract officers. It would be good to set out some examples of where this has made a difference.
Work within the Safeguarding Hub was reported to support multi-agency working, including good working relationships with the Police.
The team noted Trafford benchmarks above average in the NW for resolution of risks and at or just above average for the Making Safeguarding Personal (MSP) indicators about outcomes.
The Hospital Discharge arrangements are strong, with multi-disciplinary and co-ordinated working, and with motivated and committed staff. As outlined in Theme 1, there are some good stories about the experience for people and their families. The peer team heard how risks around Home First discharges are managed together to ensure that any concerns about unsafe discharges are addressed quickly, and positively.
Staff reported that information from the pilot of a new rapid assessment in care homes was very encouraging, with four of the nine people in the pilot returning home. This is important because the numbers on Pathway 3 for discharge (considered by hospitals to be likely to need long term residential care) seem high (over 30%). The peer team were impressed by the discharge teams’ determination to focus on Home First and ensure decisions on long term needed were taken outside a hospital setting.
The peer team was very impressed by the work and approach to Domestic Abuse. There was an energy and passion from staff involved, with a determination to listen to the voice of victims and with a good focus on prevention. Trafford’s strategy is well developed, and plans are ambitious and well thought out. The focus on prevention in the strategy and action plan was impressive.
Considerations
The peer team heard that neighbourhood safeguarding work can feel a “very lonely place”. There is a perception that the new Safeguarding Hub and its multi- agency offer is less connected to the neighbourhood safeguarding responses, and this is impacting on the ability to respond as well as staff would like. This raised questions from the peer team about whether the focus in the Safeguarding Hub on Providers offers the best use of resources, given the high level of engagement with providers you also have in your commissioning teams.
Although the Safeguarding Hub will screen concerns, the peer team were not confident that there is always a timely and safe response. They heard that at times enquiries can be held pending in a neighbourhood team but could not establish whether safeguarding enquiries can be tracked and monitored separately within the neighbourhood waiting lists. This would clearly bring risks if that is not the case.
Trafford is an outlier in the region for the number of concerns reported (high) and for the conversion of concerns to Section 42 enquiries (low), which suggests there is work to do with partners to understand what is being reported in which does not meet the threshold for a safeguarding enquiry and to refresh multi-agency understanding of thresholds.
During the visit the peer team heard little about how Trafford has embedded Making Safeguarding Personal into practice. Whilst the MSP data collection about outcomes looks to be at or just above average for the NW, there is no reference to MSP in the self-assessment, and the case audit suggested MSP practice is not always strongly recorded.
Linked to the challenges around the mental health social work practice considered under Theme 1 the peer team heard of additional challenges around the impact of two recording systems for mental health, which results in information needing to be rekeyed into the Council’s IT system. This brings risk around information not being transferred accurately and information about transfers of care and of risks not being easily available to all who might need it.
The self-assessment acknowledged that strategic safeguarding work was paused as a result of two key roles with the Safeguarding Adults Board vacant for a period of time. This was confirmed during the peer team’s visit, with for example key statutory requirements such as Safeguarding Adults Reviews (SARs) not being progressed. The new Board Manager and Independent Chair will help get Trafford back on track, but the responsibilities sit with statutory partners, not just the Board officials. You may want to consider the role of the wider senior team such as the PSW and Corporate Director Adults and Wellbeing in ensuring learning is embedded in practice.
The peer team heard about good ambitions to improve transitions and Preparing for Adulthood. The plans sound encouraging, but progress and impact need to be tracked and measured. Future needs analysis and service development will be essential, and plans need to be resourced.
The self-assessment identified safety as a priority for everyone, but the team did not hear what this means or what the evidence for this is.
- It might be helpful to be more specific and perhaps set out high risk, escalation, and complex case decision-making processes.
- A number of questions were raised about whether the safeguarding partners are robust in responding together to self-neglect and hoarding.
Theme 4: Leadership
This relates to capable and compassionate leaders, learning, improvement, and innovation.
Strengths
Trafford has a range of governance boards and groups to oversee integrated working, with senior level engagement and commitment. There is considerable pride in the way that integration is led and championed across partners. Community Health and Adult Social Care is overseen by a ‘one system’ Board, and the new Neighbourhood Integrated Teams, including the VCFSE partners are being designed to deliver the vision.
Political and corporate leadership was seen to be strong in the Council, based on observations and interviews. Trafford has a relatively new Leader and Executive Member for Health and Care, who are both experienced and showed a strong interest and understanding of Health and Adult Social Care. The DASS is also new, having joined the council in January 2023 and taken up responsibility in March 2023. and this has provided an opportunity to reflect and review priorities for development. Both the DASS and the Chief Executive demonstrated commitment to visiting and listening to teams across the borough.
Trafford has a strong and visible vision at corporate level (EPIC Our EPIC Values | greater jobs) and your developing directorate level vision around Improving Lives Every Day will make it easier to communicate your ambitions, values, and priorities. Two of the three corporate priorities relate to health and wellbeing.
The peer team experienced a strong sense of the Trafford focus on partnerships, neighbourhoods and provider relationships.
There was evidence from staff that where Senior Leadership Team has identified issues, action has been taken, for example to address retention and recruitment issues for social workers, with a market supplement being offered which has successfully addressed both recruitment and retention issues.
The Council is focussed on workforce as a key enabler to delivering good services and to achieving ambitions, Whist the self-assessment identifies completion of the workforce strategy as a direction of travel, the peer team heard that the council already has a positive offer, including the Trafford Learning Academy, which offers career development and apprenticeship opportunities, and training for external providers. The team heard about some of the staff welfare initiatives including the staff Carers Group, which offers staff a valued chance to receive peer support. Social workers talked positively about opportunities for career progression and being encouraged to apply for training opportunities.
The ‘SWAY’ communications for staff were seen by some staff as a good development to encourage communication from top to bottom and bottom to top of the department.
As a council, Trafford appears to be relatively financially stable and to have managed pressures to date. There are ongoing cost pressures, and a vibrant self-funder market adds additional risks, with high fee levels, but the team heard that there are opportunities to bid for opportunities to invest to save.
The peer team were pleased to see specific examples of innovation in your evidence library, and it might be helpful to include some of these in your self-assessment. The team heard of some ideas that have been adopted, which came from staff, for the example: the Business Unit and the Control Room.
Considerations
The peer team did not see evidence of a ‘Golden Thread’ of your vision and strategy, or a consistent awareness and understanding evident throughout the teams that peers met. Development of a refreshed Social Care Vision, an operating model and commissioning strategies will provide the opportunity to communicate Trafford’s ambitions in clearer, consolidated and more coherent way.
The peer team heard a limited amount about delivery plans, and although there was recognition of the need for various improvements in the meetings with senior staff, the team sometimes heard the need for improvement acknowledged but no immediate sense of how the council will respond and deliver improvements. Setting out what capacity there is to deliver change, and whether there is a Trafford approach to managing change (for example, robust project and programme management) would be beneficial.
Whilst there is a range of Boards which meet regularly, it might help to be able to show examples of tangible differences that the integrated governance is making and to set out what arrangements exist for risk sharing. Much of the focus is currently on hospital discharge, for understandable reasons (Trafford is part of the Greater Manchester Integrated Care System is in Tier 1 for discharge performance), but the team would recommend some consideration what the right balance might be between managing hospital flows and investing in prevention and community-based support. It may be that the new Neighbourhood teams will help to rebalance the focus, and you may be able to monitor agreed key success measures.
Whilst there is strong governance for the integration for health and social care more broadly, mental health integration governance is weak. Trafford needs to strengthen oversight of the delivery of Care Act responsibilities.
The peer team thinks Trafford could strengthen the professional leadership of your social care practitioners, as set out under Theme 1.
There have been a number of initiatives with short term funding which the peer team were told have heard make longer- term planning and staff retention more difficult. It was clear this is because of government funding.
The Council is already aware of the need and have plans to improve data quality and the use of data and intelligence.
- The Peer team believes there is more to do to enable operational teams to understand and use their own data and performance.
- There is a need to use data and intelligence more to inform longer-term strategic commissioning plans, to inform your understanding of equity and equality and to support performance improvement.
- The team noted some gaps regarding short term services, mental health and carers, which will impact on full oversight and quality assurance in these areas.
- There is a commitment through the Voice of Our People Strategy to improve systems for gaining feedback and a dedicated officer has been appointed to lead this work however the arrangements to date have been focusing on surveys and much more needs to be done to embed co-production throughout the local authority's work.
- The team felt the self-assessment could provide more information on how governance and quality assurance operate and learning from incidents/system wide reviews etc other than complaints. The case audit approach could be stronger and more ambitious, with stronger links to a quality assurance framework.
Top tips for assurance preparation - for consideration
- appoint an adult social care lead
- political briefings
- secure corporate support and buy-in
- maximise the council’s adult social care business intelligence capacity to inform the self-assessment
- get health partners and integrated services leadership on board
- compare and learn from children’s inspections
- gather insights from partners and providers
- be clear on approaches to co-production and responding to diverse needs
- encourage organisational self-awareness.
Lessons learned from other peer challenges
Councils need an authentic narrative for their adult social care service driven by data and personal experience. The narrative needs to be shared with those with a lived experience, carers, frontline staff, team leaders, middle managers, senior staff, corporate centre, politicians, partners in health, third sector and elsewhere. Ideally this story is told consistently and is supported by data and personal experience - don’t hide poor services.
This will probably take the form of:
- What are staff proud to deliver, and what outcomes can they point to?
- What needs to improve?
- What are the plans to improve services?
In the preparation phases, consider putting it on all team agendas asking staff what they do well, what’s not so good and to comment on the plans to improve. Collate the information from this process and add to the self-assessment. Ensure the self-assessment is a living document that is regularly updated.
Immediately prior to CQC arriving, ask staff what they are going to tell the regulator. How is their experience rooted in observable data and adds to the overall departmental narrative? These stories drive the understanding of yourselves and others.
The regulator is interested in outcomes and impact from activity. The self-assessment needs to reflect this as do other documents.
The conversation with the regulator is not a chat. For those interviewed it should be a description of what they do and the impact they have had. Case examples written in the authentic voice of those with a lived experience bring this alive.
Next steps
We appreciate the senior political and managerial leadership will want to reflect on these findings and suggestions to determine how the organisation wishes to take things forward.
Whilst it is not mandatory for the Council to publish their report, we encourage Council’s to do so in the interests of transparency and supporting improvement in the wider sector. If the Council does decide to publish their report, the date at which the Council chooses to do so is entirely at their discretion and would usually be at the culmination of an internal governance process.
As part of the peer challenge process, there is an offer of further activity to support this. The LGA is well placed to provide additional support, advice, and guidance on a number of the areas for development and improvement and we would be happy to discuss this.
Contact details
Claire Hogan is the main contact between your authority and the Local Government Association:
Email: [email protected]
Telephone: 07766 250347
Kathy Clark is the main contact for the LGA Care and Health Improvement Adviser for the North West:
Email: [email protected]
Telephone: 07770 688395
In the meantime, we are keen to continue the relationship we have formed with the Council throughout the peer challenge. We will endeavour to provide signposting to examples of practice and further information and guidance about the issues we have raised in this report to help inform ongoing consideration.
For more information about the Adult Social Care Preparation for Assurance Peer Challenge at Trafford Council please contact:
Marcus Coulson
Senior Advisor – Adults Peer Challenge Programme
Local Government Association
Email: [email protected]
Tel: 07766 252 853
For more information on the peer challenges and the work of the Local Government Association please see our website: Council improvement and peer support | Local Government Association.