London Borough of Ealing adult social care preparation for assurance peer challenge report

Background

1. The London Borough of Ealing requested that the Local Government Association (LGA) undertake an Adult Social Care Preparation for Assurance Peer Challenge at the council and with partners. The work was commissioned by Kerry Stevens, Acting Strategic Lead Adults and Public Health (DASS). He was seeking an external view on the readiness of the Adults directorate for the arrival of the Care Quality Commission’s Assurance inspections and a view on how the council can deliver value for money, quality, effectiveness, and the most personal outcome focused offer for local people.  

2. A peer challenge is designed to help an authority and its partners assess current achievements, areas for development and capacity to change. The peer challenge is not an inspection. Instead, it offers a supportive approach, undertaken by friends – albeit ‘critical friends’ with no surprises. All information was collected on a non-attributable basis to promote an open and honest dialogue and feedback from the team of peers is given in good faith. 

3. Prior to the onsite peer challenge work the Adults directorate team completed a self-assessment on the work of the service, and collated evidence against key lines of enquiry. The peer challenge team arrived at their feedback after considering the evidence provided, what they heard and saw whilst onsite.  

4. The members of the peer challenge team were: 

• Georgia Chimbani, Director of Adult Social Care, Suffolk County Council 
• Councillor Khevyn Limbajee, Cabinet Member for Community Safety, Waltham Forest Council 
• Tiffany Adonis-French, Assistant Director, Adult Services, Brent Council 
• Leee Calvert, Assistant Director, Adult Social Care, Cheshire West and Chester Council 
• Carol Baxter, Principal Social Worker and Head of Service Quality and Prevention, Barnet Council 
• Marcus Coulson, Challenge Manager, Local Government Association  

5. The team were onsite in Ealing between 7-9th February 2023. The programme included activities designed to enable members of the peer team to meet and talk to a range of internal and external stakeholders. These activities included:  

• interviews and discussions with councillors, officers and partners 
• meetings with managers, practitioners, frontline staff and those people with a lived experience and carers 
• reading documents provided by the council, including a self-assessment and a range of other material, consideration of different data and completion of a case file audit. 

6. The framework the peer team used was the Care Quality Commission’s proposed four Domains of Assurance, relevant as published at the time of the peer review. 

7. The peer challenge team would like to thank councillors, all staff, those people with a lived experience, carers, partners and providers for their open and constructive responses during the peer challenge process. All information was collected on a non-attributable basis. The team was made very welcome and would in particular like to thank Andrew Knox, Change and Transformation Programme Manager and Chrissy Leonard, Change and Transformation Project Manager in the Future Ealing Programme Management Office, for their invaluable assistance for the support to the peer team, both prior to and whilst onsite, in planning and undertaking this peer challenge which was very well planned and delivered.   

8. Prior to being on-site peer team members spoke to a number of people with a lived experience, five carers and a day centre manager and considered eleven case files. The peer team read at least 189 documents including a self-assessment. Throughout the peer challenge the team had more than thirty-five meetings with at least sixty-four different people from adult social care, health, the third sector and other partners. The peer challenge team had spent over 196 hours with the Adults directorate at Ealing and its documentation, the equivalent of twenty-eight working days.   

9. Our feedback to the council on the last day of the peer challenge gave an overview of the key messages. This report builds on the initial findings and gives a detailed account of the peer challenge. 

Strengths 

• The new administration has a very clear political direction driven by the Leader and his team 
• The Manifesto is clearly reflected in the Corporate Plan 
• High level, innovative bold and ambitious vision and priorities to create a dynamic organisation
• The new Chief Executive is putting in place a revised senior staff structure to support the ambitions for the communities served in Ealing.
• Portfolio Holder for Healthy Lives gives clear leadership for the Adults directorate, understands the business of adult social care (ASC) and guides and monitors improvement 
• The Acting Strategic Director of ASC and PH has a good understanding of strategic oversight and operational service delivery 
• Two Assistant Directors and a number of Heads of Service manage a service that deals with increased demand in both numbers and complexity 
• This peer challenge is designed to prepare Ealing for CQC regulation and to support the Adults directorate as it prepares. 
• The self-assessment for this work demonstrated a high level of self-awareness. You know yourselves. 
• There is good senior leader visibility 
• There are strong relationships with care providers 
• Partners report positive relationships with ASC 
• Staff report feeling supported to successfully enact their roles and were able to demonstrate links between organisational priorities and their day-to-day activity 
• Staff training and support is widely available and promoted. 
• There is a positive environment that promotes equality, diversity, and inclusion.  
• You recognise that recruitment and retention is a challenge and there is an opportunity to ‘grow your own’ more consistently 
• There is more work to do with the mental health team following the end of the 
  s.75 arrangements 
• There were some good examples of co-production although more focus is required to embed this further 
• There is more work to do to ensure that the voice of those with lived experience is heard consistently 
• SAB well led, clear priorities, effective work streams, partners are well engaged 
• Manageable case load numbers and evidence of quality assurance and supervision 
• Wellbeing at forefront of managers engagement and there is an experienced staff group 
• There is strong evidence of Better Lives, but the approach could be more personalised in case recording 
• Your approach to Transitions demonstrates best practice. 

Considerations 

• Clarify the adult social care vision and priorities and how it delivers the Corporate Plan 
• Ensure the Corporate Transformation Plan creates a clear narrative and roadmap for adult social care and is closely linked to the MTFS 
• Invest in capacity in both the corporate centre and adult social care to deliver the Corporate Plan 
• Clarify how adult social care influences and delivers jointly on ICS ambitions 
   

10. LB Ealing has a relatively new political administration with a very clear political direction articulated and driven by the Leader and his Cabinet team. The Manifesto upon which he was elected is reflected in the Corporate Plan which includes a high level, innovative, bold and ambitious vision and priorities focused on creating a dynamic organisation. The new chief executive is putting in place a revised senior staff structure that will be completed in the near future.  

11. The Portfolio Holder for Healthy Lives gives clear leadership for the Adults directorate, and he understands the business of adult social care, guiding and monitoring improvement.  

12. Kerry Stevens the Acting Strategic Director of Adult Social Care has a good understanding of strategic oversight and operational service delivery for the Adults directorate and is ably supported by two Assistant Directors and a number of Heads of Service. As with all adult social care departments at this time they are seeking to manage the twin challenges of increased demand in both absolute numbers of people asking for help as well as increased levels of complexity of those demands. These together create significant challenges.  

13. This LGA Adult Social Care Preparation for Assurance Peer Challenge was designed to prepare the Adults directorate for the impending arrival of regulation by the Care Quality Commission (CQC). With this in mind the self-assessment completed by the Adults directorate for this work demonstrated a high level of self-awareness. If regulation is a test of self-awareness, then this is a good place to start. Whilst there were a few operational suggestions made by the team to improve specific areas of activity, the vast majority of our feedback and conversations with senior leaders were about things of which they were aware. In that sense they know themselves.  

14. Staff across the Adults directorate told the peer team that there is good senior leader visibility and care providers reported that they feel they have strong relationships with those senior leaders and their representatives so that issues of the day can be discussed in an open and constructive manner. This was echoed with a wide variety of partners with whom the peer team spoke as they told us that they feel they have positive relationships with adult social care.  

15. It was interesting to the peer team that staff reported feeling supported to successfully enact their roles and were able to demonstrate links between the organisation’s vision and priorities and their own day-to-day activity.  

16. Staff training and support is widely available and promoted by the Adults directorate and there is a positive environment that promotes equality, diversity and inclusion. The service recognises that recruitment and retention is a challenge (as it is in many places across the country) and that there is an opportunity to ‘Grow Your Own’ more consistently.  

17. The Acting Director and his team are aware that there is more work to do with the Mental Health Team following the end of the Section.75 arrangements and that in a very real way the need for this team to feel supported and fully involved in the service once again after a period of change.  

18. The peer team heard about some good examples of co-production to develop services although more focus is required to embed this further. There is also more work to do to ensure that the voice of those with lived experience is heard consistently across the work of adult social care.  

19. The Safeguarding Adults board is well led with clear priorities, effective work streams and the partners are well engaged.  

20. Frontline staff appeared to have manageable case load numbers and there was good evidence of quality assurance and supervision activities to support staff in their work.  

21. It was of interest to the peer team that the wellbeing of staff was at the forefront of managers engagement with them, they repeatedly referenced it and its importance in their conversations. Furthermore, those with whom the peer team spoke saw the stable and experienced staff group as a strength of the Adults directorate and the council as a whole, as did the staff themselves.  

22. The peer team read and heard strong evidence for the Better Lives initiative although the approach could be more personalised in case recording.  

23. Whilst onsite the peer team heard about the Adults directorate’s approach to Transitions which was well designed, thoughtfully enacted, very well manged and guided and obviously demonstrated best practice in the sector. Other councils would do well to make the effort to learn from Ealing about how they have achieved this and the benefits it is delivering.  

24. In terms of some overall considerations that the Adults directorate may want to address, it would be useful to clarify the Adult social care vision and priorities and how it delivers the Corporate Plan. The political administration wishes to foster community and its development through activity across departments, Adult social care will be involved in this important work and should clearly set out its role in this work.  

25. The Adult social care plan outlining how it delivers the Corporate Transformation 
Plan needs to have a clear narrative and roadmap that is closely linked to the Medium Term Financial Strategy. This would help to ensure that Adult social care priorities deliver positive outcomes for residents in a sustainable way.  

26. To deliver the above the council should seek to invest in capacity in both the corporate centre and the Adults directorate to ensure delivery of the Corporate Plan objectives. The Adults directorate senior management team work well together delivering positive outcomes. However, their capacity has limits and further demands upon the team will need to be adequately resourced.  

27. In the changing landscape of the wider sub-regional Integrated Care System and its ambitions the Adults directorate should also clarify how Adult social care delivers jointly on these ambitions. It will then be able to fully evidence the demands that may require further investment in capacity.  
 

This relates to assessing needs (including that of unpaid carers), supporting people to live healthier lives, prevention, well-being, and information and advice.  

Strengths 

• The peer challenge team had the pleasure of meeting the staff at Ealing who are committed, passionate and invested in the lives of local people 
• Better Lives embedded with staff speaking passionately about it 
• Staff value the availability and quality of training which is developed directly with them 
• All Age Autism Strategy developed with People with Lived Experience 
• Continuation of co-location post s.75 
• BAME staff identify opportunities to progress and feel safe to raise any challenges 
• Staff talk proudly about the Grow Your Own culture 
• Staff feel team and managers are supportive, there is regular supervision both formal and informal 
• Case File Audit: 
  * good evidencing of signposting and that financial discussions take place 
  * clear evidence of staff achieving outcomes and the unblocking of challenges creating positive outcomes for residents 
  * social workers holding the role of social care and ensuring the correct outcomes for the adult at point of discharge 
• Emerging evidence of good cross departmental working between adult social care, housing, and commissioning 

28. The peer challenge team had the pleasure of meeting the staff of the Adults directorate at Ealing who by their words and their actions are committed, passionate and invested in the lives of local people. This strong local identity is a real strength and suggests a robust, supportive culture. Staff spoke passionately about the Better Lives initiative and how it was embedded and has changed their practice. They also value the availability and quality of training which is developed directly with them in an open way.  

29. Furthermore, staff talked proudly about the ‘Grow Your Own’ culture at Ealing with a significant number of people being able to identify those in the organisation who have been developed by the council, which is seen as a strength. As an example of the positive culture, team leaders and managers are supportive with staff and there is regular supervision both formal and informal to support effective working, service delivery and the wellbeing of the staff.  

30. Black and Minority Ethnic (BAME) staff openly described an inclusive and supportive environment with equality of opportunities to progress. The organisation has a culture that celebrates diversity, promotes equality, and creates a safe environment that gives staff confidence to escalate concerns if any arise. This is a significant strength.  

31. It was interesting for the peer team to note that this approach to engagement was also seen through the All-Age Autism Strategy that was developed with People with Lived Experience. This was also the case with the Carers Strategy where the commissioners listened to the experiences of people first before creating the policy.  

32. The Adults directorate recently took the decision to discontinue the Section 75 agreement with the West London NHS Trust which provides mental health and community services across a wide footprint of West London including Ealing. Those leading the adult social care Adults directorate recognise that there needs to be clear and robust support system put in place for the returning mental health teams, so they feel appreciated and even loved by the service they are actively re-joining. This should include availability and clear messaging around the support and communication channels that’s other teams spoke positively about.  

33. Members of the peer challenge team completed a case file audit prior to being onsite. The findings of this were that there was good evidencing of signposting in the cases considered and that financial discussions take place with those who use the service. There was clear evidence of staff achieving outcomes and the unblocking of challenges creating positive outcomes for residents. The auditors felt that social workers were holding the role of social care and ensuring the correct outcomes for the adult at point of discharge, which takes a good deal of skill.  

34. The leader of the council and chief executive have instigated a change in the working arrangements for leading members and the senior management team by encouraging them to sit together in an open plan office space. The aim is to create a positive one team culture that promotes good cross departmental working. There is now emerging evidence of positive links being made between adult social care, housing, and commissioning as a result.  

For consideration 

•    There is strong evidence of Better Lives, but the approach could be more personalised for example, by using the person’s name in case recording practice 
•    There is an opportunity to rebalance workforce to increase the number of nonqualified staff 
•    Need to raise the profile of the community offer 
•    Explore options for digital: self-service and an enhanced generic digital offer 
•    Reinstate the Making Safeguarding Personal questionnaire and further develop it for other interventions 
•    Reinvigorate the partnership boards 
•    Opportunity for assessments to be more proportionate 
•    You recognise the need to develop and increase the direct payments offer 

35. As has been described above there is strong evidence from the staff themselves for the embedded nature of Better Lives but the approach could be more personalised and the forms less transactional. Case recording evidenced the staff undertaking a large amount of work to ensure outcomes and task were achieved but there was little evidence of the person’s voice and wishes. There is also the opportunity for assessments to be more proportionate. It is noted that the assessment forms were co-designed by staff which is a positive however these are lengthy with some repetitions and consideration could be given to streamline the approach.  

36. The peer team suggest that the council may wish to explore the options for digital developments in the adult social care service. The peer team appreciate that the experience of digital was soured in the North West London sub-region when councils adopted the approach early on some years ago. This is now recognised that this was because at the time the technology was not as ‘cutting edge’ as at first thought. However, that time has passed and now there are clear opportunities that can add value and save money in tried and tested ways, and it is probably time to look again at these possibilities.  

37. The peer team recommend the reinstatement of the Making Safeguarding Personal questionnaire and further develop it for other interventions, such as more general feedback from Adults that have had an assessment, to support engagement and learning from feedback. It is recommended that frontline staff could consider using the name of the person in case recording practice to ensure a more personalised approach and enable the individual to feel the assessment is about them.  

38. The Adults directorate should grasp the opportunity to rebalance the workforce to increase the number of non-qualified staff. This could provide Adult social care with a good mix of alternatively experienced and qualified staff better able to respond to the continuing challenges of recruitment and retention of Social Workers and Occupational Therapists.  

39. There is the need to raise the profile of the political administration’s council wide Community Development ambition, so that all departments recognise its role in delivering on this agenda. This could be promoted both within the local authority and the community. The council may wish to consider roles such as: Community Navigators, Prevention and Wellbeing Leads and Engagement and Coproduction Leads to support and embed this within the council as well as promoting and engaging further with the community.  

40. On a related but different issue the Adults directorate recognises the need to reinvigorate some of the Partnership Boards. This may include restating the purpose of each board, ensuring members understand their roles and know how to engage to deliver the board work plan as well as encouraging good attendance. Discussions on these boards should then be focused upon the delivery of outcomes rather than internal board processes. It is likely that the regulator will have a remorseless focus on the outcomes that boards have delivered rather than the processes involved to get there.  

41. The Adults directorate recognises the need to develop and increase the direct payments offer to further promote the aims of independence, choice, and control. This narrative will need to be developed and shared widely so that the regulator can easily grasp it.  

This relates to markets (including commissioning), workforce equality, integration and partnership working.

Strengths 

• Argyle GP Surgery a very good initiative and you have recognised the opportunity to place a contracts manager to streamline the engagement process 
• Strong domiciliary care offer with effective brokerage and use of a dynamic purchasing system 
• Pooled VCS budgets for next four years 
• All Age commissioning approach 
• Strong reablement transformation plan 
• In-house provider services with good connections to practitioners 

42. Members of the peer team heard about The Argyle Care Home Service (TACHS) that provides routine medical and urgent General Practice care to sixteen nursing homes across the borough of Ealing and thirty-six homes across the West London area covering 1200 out of a total of 1550 nursing beds in this geography. The service looks after all age ranges, end of life patients, dementia patients, patients with co-morbidities and patients with learning disabilities. This is a very good initiative funded by the NHS that supports the care homes to provide a high quality of care to their residents. In discussions between the peer team and the Acting Director there was recognition of an opportunity for improvement by placing a contracts manager from adult social care with The Argyle Care Home Service to better connect with, and factor in, social care support services for residents.  

43. The Adults directorate has a strong relationship with care providers. Feedback evidenced that Ealing works collaboratively with care providers and having a named officer for support works well. The person in this role identifies issues, gives advice, and promotes good service delivery, thereby seeking to avoid service failure. The use of a dynamic purchasing system was viewed positively resulting in effective brokerage. With fast turnaround of requests for services and a reported healthy level of provision in the Borough.  

44. There is a pooled budget between the Integrated Care Board and Ealing to fund the commissioning of voluntary, community and faith sector services over the next four years. There is a positive All Age commissioning approach with the joint commissioning team clearly recognising this which is particularly related the recent mental health work.  

For consideration 

• Consider a prevention and wellbeing service as part of your offer including identifying further community resources 
• You may want to review statutory responsibilities in domestic abuse cases 
• Review the allocation of hoarding cases currently in the safeguarding team
• Engage smaller community organisations to enhance the community-based offer 
• Inclusion of operations in commissioning and market shaping 
• Opportunity for a joint workforce strategy with the NHS e.g., Occupational Therapists 

45. The Adults directorate may wish to consider a prevention and wellbeing service or community navigator model as part of the wider adult social care prevention offer. This may include identifying further links with the voluntary community and faith sector, as well as other community resources. In addition to supporting linking individuals under the prevention approach and to support independence and wellbeing. The aim would be to further drive prevention work and reduce the pressure of those presenting to the adult social care front door.  

46. The Adults directorate may want to consider engaging smaller community organisations to enhance the community-based offer. At present larger organisations are engaged but there is an opportunity to increase the number and variety of small providers thereby widening and diversifying the offer to people with a lived experience.  

47. The Adults directorate may want to review the statutory responsibilities in domestic abuse cases by exploring the role of adult social care and the role of other organisations such as domestic violence services. This would be to consider who is best placed to support and work with the individuals to ensure safety and avoid duplication and confusion that can further increase the risk.  

48. Review the allocation of hoarding cases currently in the safeguarding team. Hoarding cases are often long term and complex which could result in a capacity issue in the safeguarding team who may be better placed to make the initial decision, recommendations and then pass on the longer-term work to a locality team.  

49. The Adults directorate may wish to review the message about provision of night-time care. Although no written evidence was found to support this, feedback suggests that the local authority is limiting the options for support when night-time care is required. The local authority may wish to consider reviewing this approach or the relevant staff understanding of this, in line with statutory guidance and may find the Ombudsman's rulings such as 19 007 855 - Local Government and Social Care Ombudsman, helpful in doing this.  

50. Operational managers described the challenges of recruitment and retention of registered staff with significant challenges around Occupational Therapists. Given the close partnerships between Ealing and the NHS, the adult’s service may want to consider the development of a joint workforce strategy to provide opportunities such as cross organisational working and that may increase retention.  
 

This area relates to safeguarding, safe systems, and continuity of care.  

Strengths 

• The Independent Chair has developed strong relationships with all partners including the administrative leadership 
• There is good engagement from partners, particularly with the police 
• The SAB has a clear plan with supporting policies and procedures 
• Partners use data and insights to complete detailed analysis that informs further work 
• Strong links to provider safeguarding 
• There are SAB sub-groups to address areas of concern with clear work plans 
• There is a very clear structure for the management of safeguarding cases and there is a dedicated central team providing specialist advice to other teams 
• There is a strong training offer that meets different learning styles 
• We heard about good relationships with MARAC and the Safer Communities Team 
• The Learning Disabilities Team have a named link police officer 
• Recent data insights e.g., Eastern European male suicides  

51. The Ealing Safeguarding Adults Board (ESAB) Independent Chair Sheila Lock has developed strong relationships with all partners including the political leadership of the council. This is supported by good engagement from partners, particularly with the Metropolitan Police.  

52. The ESAB has a clear plan with supporting policies and procedures and partners use data and insights to complete detailed analysis that informs further work. There are strong links to provider safeguarding, and the ESAB sub-groups address areas of concern with clear work plans.  

53. The peer team saw evidence of a very clear structure for the management of safeguarding cases and there is a dedicated central team providing specialist advice to other teams. There is also a strong training offer that meets different learning styles.  

54. The peer team heard about good relationships with the Multi-Agency Risk Assessment Conference (MARAC) where information is shared on the highest risk domestic abuse cases between representatives of local police, probation, health, child protection, housing practitioners, Independent Domestic Violence Advisors and other specialists from the statutory and voluntary sector and the Ealing Council’s Safer Communities Team. This partnership working promotes good practice and the safety and wellbeing of the residents in the Borough.  

55. The Learning Disabilities Team have a named link Police Officer. This enables positive communication and partnership working to enable safe and supportive outcomes for the individuals.  

56. A positive example of how ESAB uses data to inform their work was the recent improved awareness of the rates of Eastern European male suicides in the Borough. This information is very recent, and a plan of action is being put together. 

For consideration 

• There is a need to ensure continuity of quality, planning and engagement during the transition to a new Independent Chair 
• Consider the potential risk of the volume of work at the front door, including the CJSM alerts, and create a sustainable long-term solution to address this
•  Define recording requirements on concern and enquiry stages of safeguarding

57. The senior staff in the Adults directorate recognise the need to ensure continuity of quality, planning and engagement during the transition to a new Independent Chair.  

58. The Adults directorate should consider the potential risk of the volume of work at the adult social care front door and create a sustainable long-term solution to address this appropriately. Including a full review of the current capacity to manage workflow and the long-term team structure.

59. The Adults directorate should also clearly define the recording requirements for staff on issues of concern and the enquiry stages of safeguarding cases. It is noted that a lot of enquiry activity is happening at concern decision stage which is likely to impact on the ability to comply with the Pan-London timeframes on concern decisions. 

This relates to capable and compassionate leaders, learning, improvement, and innovation. 

Strengths 

• Clear vision over aspiration and direction of travel from the Leader of the council, cabinet member and chief executive
• The leadership has set out its philosophical approach to residents of Ealing to facilitate their needs, empower them to achieve their aspirations 
• Their policy proposals were set out in the manifesto and the administration is serious about delivering on these policies 
• Understanding that there is a need to restructure and reform the council’s organisation to deliver the wider aspirations 
• Clear performance and management information culture 
• A robust and independent Health and Adults Social Services Standing Scrutiny Panel has access to officers and documents, offers challenge and delivers recommendations 
• It is a challenge to deal with the whole range of issues but the working relationship between the main Overview and Scrutiny Committee and Health and Adults Social Services Standing Scrutiny Panel functions well, with the main committee discussing Adults social care items at formal meetings.
• Clear that Scrutiny is valued in the authority and allows backbench members to play a positive role 
• There is clear evidence of positive relationships that that promote effective partnership working 

60. There is a clear vision over the aspiration and direction of travel from the Leader of the Councill, the Portfolio Holder for Healthy Lives and Chief Executive. The leadership has set out its approach for the residents of Ealing to facilitate their needs and empower them to achieve their aspirations. Their policy proposals were set out in the manifesto and the administration is serious about delivering on these policies.  

61. There is a shared understanding of the need to restructure and reform the council to deliver the wider political aspirations which is coupled to a clear performance and management information culture.  

62. There is a robust and independent Health and Adults Social Services Standing Scrutiny Panel that has access to officer resource and timely documentation, offering challenges and recommendations. Whilst it is a challenge to deal with the whole range of issues, the working relationship between the main Overview and Scrutiny Committee and Health and Adults Social Services Standing Scrutiny Panel functions well, with the main committee discussing adult social care items at formal meetings. From discussions with members and officers and the peer team, it was evident that Scrutiny is valued in the authority and allows backbench members to play a positive role. Such robust and independent 
scrutiny is an asset in the assessment of adult social policies and practice at Ealing.  

63. Whilst in Ealing the peer team heard evidence about positive relationships between individuals in key posts from everyone we spoke to. This included corporate partners inside the council as well as with external partners such as representatives of the voluntary and community sector and the variety of different NHS organisations. This is a testament to those involved and from the evidence the peer team saw these good relationships elicit effective partnership working making it easier to have discussions about the arrangements to deliver positive outcomes for people.  

For consideration 

• The is an opportunity to clarify the strategy and plans at Place, Town and PCN level 
• Develop agreed outcome measures with system partners 
• There is a need for planned and clearer communication and engagement with staff, partners, residents, and wider stakeholders 

64. The peer team considered the political aspirations for the whole council being driven by the corporate centre and suggest that it would help if there was greater clarity of the strategy and plans at Place, Town, and Primary Care Network (PCN) level. This would allow a clear vision at each level, clarify the role of PCNs where they are not strictly co-terminus with towns, and be a visible commitment and golden thread to the seven towns community approach of the Corporate Plan. It would also allow agencies and NHS partners to better understand their roles and functions within the plans.  

65. There is an opportunity, fully recognised by adult social care senior staff, to develop agreed outcome measures in the work with system partners such as the Integrated Care Board.  

66. The Adults directorate recognises the need for a clearer communication and engagement plan for both staff and residents with regard to the point previous made about engaging with the community. This can build on the good work already done around staff understanding of the strategic priorities and how staff, partners, residents, and wider stakeholders can further be a part of embedding these.  
 

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. 

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. Kate Herbert, LGA Principal Adviser is the main contact between your authority and the Local Government Association. Her contact details are:

Email: [email protected]
Tel: 07867 632404

There is also Adi Cooper, the London Care and Health Improvement Adviser who can be contacted at:

Email: [email protected]
Tel: 07584 271060

In the meantime, we are keen to continue the relationship we have formed with the council throughout this 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 the London Borough of Ealing, please contact:

Venita Kanwar
LGA Associate
Email: [email protected]
Tel 07865 999 508

Marcus Coulson
Senior Regional Advisor
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.