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July 2023
Executive summary
1. There is a clear vision for Adult Social Care in the council, and the Peer Team heard about areas of good practice, innovation, and things that should be celebrated and built on. There are many good ideas, and staff are incredibly enthusiastic, committed, and supportive of the Directorate and its work. This provides an essential foundation for the transformation of approach and delivery that may need to be embedded over the coming years. Scaling up pilots and change at pace when there is evidence these are working (or have been found to work elsewhere) may involve some risk, but offset against the risk of rolling good work out too cautiously. This will include some change in practice (for instance around asset- and strengths-based approaches), and an increased focus on practice assurance and consistency (already in train with e.g. new supervision policies, or future plans around quality assurance).
2. Good plans have been developed to back up the vision for transformation and sustainable delivery. These would benefit from greater evidence of how they will be, and are being delivered, not only to provide assurance against risk, but also to evidence improving outcomes for local people. These include plans relating to waiting lists and development of the provider market due to a current reliance on smaller single location providers, savings and mitigations for these, practice assurance, and wider service transformation. Detailed plans will be required for Senior Management and Transformation Teams, and need to be disseminated to, and used with, relevant staff across wider teams. At the same time higher level summaries and progress reports will be needed to raise the profile of risks and opportunities for Adult Social Care and its partnerships, both within and beyond the council, and to maintain Corporate, Political and stakeholder support.
3. Listening to and engaging with people who use council services provides a strong foundation for coproduction. However, there is now a need to move from “you said we heard” to “we said we did” in order to embed co-design and coproduction in the approach to both service design and delivery; and to be in a position to feed back to people involved in coproduction, and wider stakeholders and communities what the impact of their involvement has been. Embedding coproduction as an approach will begin to see greater engagement not only in service planning and delivery, but also within individual care planning, assessment and review (and aggregated learning from these), all of which will support improved outcomes in future assurance.
4. Adult Social Care is working in a very challenging financial environment, with extensive savings targets. There is clear recognition of the wider council need for savings and efficiencies, and the significant part that Adult Social Care will need to play in these (given the proportion of the overall council budget that it is responsible for). However, it is equally important to recognise that the more sustainable service transformation that is needed is not just an “in year” saving. Longer-term transformational work, including around asset- and strengths-based approaches, has the opportunity to deliver greater financial sustainability than only looking at short-term benefit; but this will require development to drive culture change and equip the workforce with the necessary skills, and time to embed and fully realise the benefits. Consideration should be given as to how best to balance the risk that a focus on short-term savings may impact on delivery of those things that will arguably support longer term sustainability in adult social care, improved outcomes for the people it supports, and which the Care Quality Commission (CQC) are likely to look for in future assurance, preparedness for which is the purpose of the present Challenge.
5. Whether short- or longer-term, savings and improvement will need to be delivered in partnership with the NHS, Districts, communities, providers, and the Voluntary and Community Sector. Corporate support from other council directorates, and Executive and Political Leadership, will also be essential to finding opportunities for collaboration and synergies in the work of Adult Social Care and its partners, as well as to manage expectations and the purpose, impact, and pace of change. The CQC will want to see evidence of supportive leadership at all levels; there is a very new Corporate Management Team and Integrated Care Board leadership, and it will be important that time and space is available to further develop an environment of mutual understanding and trust in order to deliver system change and sustainability.
6. Preparations for this Peer Challenge have been excellent, and everyone has been welcoming, honest, responsive, and well-coordinated throughout the process. This is good preparation for future statutory assurance, and the proposal to incorporate action planning arising from the Challenge into wider transformation plans will help to maintain focus on outcomes, quality, and innovation.
Background
7. Devon County Council (The Council) requested the Local Government Association (LGA) to undertake an Adult Social Care Preparation for Assurance Peer Challenge within the council and with partners. The work in Devon was led by Tandra Forster, Director of Integrated Adult Social Care at the council, and supported on-site by a dedicated team.
8. The LGA was contracted to deliver the Peer Challenge process based on its knowledge and experience of delivering this type of work for over ten years. The LGA sourced the members of the Peer Challenge team and provided off-site administrative support.
9. The council was seeking an external view about the preparation and readiness of the Adult Social Care Directorate for the arrival of the Care Quality Commission’s (CQC) Local Authority Assurance inspections; as well as to inform their improvement planning, and with particular reference to:
- Practice quality, assurance, and safeguarding
- Outcomes including around self-directed support and support to carers
- Front door prevention and early intervention
- Market Sustainability Plan (and delivery against it).
10. The members of this Adult Social Care Preparation for Assurance Peer Challenge Team were:
- David Watts, Executive Director of Adults, Health Partnerships & Housing (DASS), North Northamptonshire Council
- Councillor Sue Woolley, Cabinet Member, Lincolnshire County Council for NHS Liaison, Community Engagement, Registration & Coroners and Chairman of the Lincolnshire Health & Wellbeing Board.
- Kate Sibthorp, Co-Chair of the National Coproduction Advisory Group, peer with lived experience
- Moira Wood, Principal Social Worker, Gloucestershire County Council
- Dawn Bowman, Lead Occupational Therapist, Hampshire County Council
- Helen Style, Assistant Director, Hampshire County Council
- Niki Shaw, Assurance Lead, Somerset Council
- Chris Rowland, Challenge Manager, Local Government Association
11. The team was on site from 19th – 21st July 2023. The programme for the on-site phase included activities designed to enable members of the team to meet and talk to a range of internal and external stakeholders. These included:
- interviews, focus groups, and discussions, with Councillors, people with lived experience, managers, practitioners, frontline staff, and partner representatives; in total 44 meetings were on the timetable, and the team gathered views from over 300 people within these;
- preparatory work including a bespoke case file audit covering 23 case files and reading documents provided by the council both in advance of and during the Challenge; this included a self-assessment of progress, strengths, and areas for improvement and more than 40 documents;
12. The Peer Challenge was based on the four Assurance themes confirmed by the CQC in February 2023; the Challenge Team grouped evidence with reference to these questions, and this report is structured around them. They are:
Care Quality Commission Adult Social Care Assurance Themes
1: Working with people
- Assessing needs
- Supporting people to live healthier lives
- Equity in experience and outcomes
2: Providing support
- Care provision, integration and continuity
- Partnerships and communities
3: Ensuring safety
- Safe systems, pathways and transitions
- Safeguarding
4: Leadership
- Governance, management and sustainability
- Learning, improvement and innovation
13. The findings and recommendations in this summary report are based on the presentation delivered to the council on 21 July 2023, and should be read with reference to it. The supporting detail and recommendations that it contains are founded on a triangulation of what the team have read, heard, and seen. All information was collected on the basis that no recommendation or finding is directly attributed to any comment or view from any individual or group. This encourages participants to be open and honest with the team. The report covers those areas most pertinent to the remit of the challenge only, and has been structured around the CQC Themes as outlined in paragraph 12 above.
14. Peer Challenge is not an inspection, and it does not deliver a formal judgement; nor does this report suggest a definitive response against the CQC themes. Rather it offers a supportive approach, undertaken by friends, albeit ‘critical friends’, and an overview of key findings, with the intention of supporting the council to form its own view, and to continue its improvement journey where necessary. It is designed to help to assess current achievements and areas for development, within the agreed scope of the Challenge. It aims to help identify the council’s current strengths, and examples of good practice are included under the relevant sections of the report. But it should also provide the council with a basis for further improvement in a way that is proportionate to the remit of the Challenge, and recommendations where appropriate are included within the relevant sections of the report (as well as highlighted in the Recommendations section at the end of the report).
15. The Peer Challenge process offers an opportunity for a limited diagnostic approach to material which is provided (whether through written materials, or through on-site interviews, focus-groups, or observations), as well as a critical appraisal and strategic positioning of this. It reflects a balance of views within the team, based on their experience, and the material made available to them. However, the level of “assurance” (whether of quality, outcomes, or good / poor practice, etc) which can be provided through this format is strictly limited. A Peer Challenge is, whilst intensive, not comprehensive. Peer Challenge is not therefore an alternative to inspection, or indeed, to routine or exceptional internal quality assurance, and the council is strongly encouraged to continue such work, hopefully informed by the findings of the Challenge.
16. The LGA Peer Challenge Team would like to thank Councillors, people and carers with lived experience, staff, and representatives of partner agencies for their open and constructive responses during the challenge process. The team was made very welcome and would in particular like to thank Tandra Forster, Director of Integrated Adult Social Care, who sponsored the Challenge; and Damian Furniss, Gabrielle Lester-Smith, Lorna Cook, and Sarah Ford for their invaluable and excellent support to the peer team, both prior to and whilst on site.
4. Leadership
Governance, management and sustainability: We have clear responsibilities, roles, systems of accountability and good governance to manage and deliver good quality, sustainable care, treatment and support. We act on the best information about risk, performance and outcomes, and we share this securely with others when appropriate.
Learning, improvement and innovation: We focus on continuous learning, innovation and improvement across our organisation and the local system. We encourage creative ways of delivering equality of experience, outcome and quality of life for people. We actively contribute to safe, effective practice and research.
Quality statements from the CQC Interim Guidance for Local Authority Assessments, February 2023
61. Devon appears to have good strategic governance arrangements in place; these are well-established and help to enable place leadership across a wide range of issues and a large, rural geography. This was evidenced through conversations with Councillors, NHS leads, providers, and other partners such as the VCS. The Peer Team heard of this being a key juncture in developing a refreshed strategic direction and leadership across the County with recently appointed (within the last 12 months) Chief Executive, Director of Adult Services, Director of Children’s Services, Director of Finance and HR Director; as well as Integrated Care Board senior leadership roles recently appointed in the NHS. New relationships and directions will take time to form and shape which represents a challenge given the (necessary) pace of change. But it can also offer an opportunity to raise the profile of Adult Social Care and what is needed to deliver sustainable transformation within its partnerships and service models going forward. Maintaining a high profile and strong voice within Corporate and wider management structures of the council, and in key partnership governance arrangements such as the ICB, will therefore be an essential investment of senior management time over the coming months.
62. Partnerships appear to work well within governance arrangements across Devon, and give an impression of a can-do approach that is enhanced by partners but not disproportionately driven by them. The peer team heard of examples of excellent partnership working through these governance structures (such as work with health partners to address key locally identified mental health issues). Direction and challenges are clear and there is a sense of long-standing relationships that will help the respective organisations deal with difficulties. Joint leadership during Covid was cited as an example of the tested partnerships working under strain to agree new ways of working that were tailored to Devon’s care market and geography. There was a sense of challenges being managed locally with subsequent escalation to strategic leadership or a partnership board if local single agency solutions need to be enhanced or can be better funded or resolved by joint working. Conversely, leaders seemed to be able to disagree and decline to proceed on a recommendation and this is a signal of a mature partnership: of partners that work well together, but equally well “apart”.
63. The council’s governance combines horizon scanning from differing perspectives and provides a structure for joint discussions about strategic priorities. This is supported and informed by good data and intelligence to help agree and set informed priorities for combined efforts and better outcomes. Peers saw evidence of joint intelligence on key issues. More generally the Peer Team were very impressed by the excellent suite of detailed data reports and intelligence that Adult Social Care commissioners have access to; these can be used within the Directorate, and with partners to inform planning, and to help them monitor and take informed decisions when it comes to shaping the care market, managing risk, and wider service transformation and delivery.
64. Elected Members are engaged in understanding the challenges facing Adult Social Care and are represented on key governance groups. It will be important to maintain this engagement and support (and across the council) over coming months, and to raise awareness of the adult social care agenda, including its opportunities and risks and their mitigations, in available council structures such as Scrutiny and wider member engagement activities.
65. The Devon Audit Partnership expressed confidence in relation to how the Adult Social Care Directorate “manages risks and seeks support”, with a risk ‘champion’ who serves as an effective corporate ambassador in role modelling routine risk identification and mitigation. Risk management is a key part of assurance activity and reports into the Assurance Board, and it was good to hear Audit describing Adult Social Care as “not a Directorate we are concerned about [in terms of their approach to risk and its management]”.
66. The Peer Team heard an awareness of the scale of the challenge for the council in delivering sustainability, both financially and in terms of e.g. workforce. Savings associated with Adult Social Care are challenging, both in-year and for future budget cycles, and are compounded by both cost and performance pressures from Children’s Services (whose poor OFSTED Inspection and subsequent Intervention necessarily requires improvement focus and resource, including financial support, within this area). It will be equally important as resources become more stretched in Adult Social Care that the political and officer leadership of the council continue to maintain as rigorous a focus on quality and outcomes in provision as it does on sustainability. Developing plans for sustainability and savings in Adult Social Care that are owned and delivered across the council and with partners can help not only to demonstrate and mitigate associated risks, but can also develop buy-in from both internal and external partners, including District and Borough councils that play an important role in planning accommodation for their populations that include people that draw on social care services. This could help to demonstrate how (with wider support) medium-term savings can be developed which align with improved practice and support better outcomes for people (focussing on asset- or strengths-based models of support for example).
67. Despite the extensive governance meetings being available, reference was also made to some of the more detailed and in-depth work that has been and is being undertaken on reducing costs, and plans to achieve savings; and that, to some extent and through necessity, preparatory work on the council’s savings was undertaken within the council, with less early warning for trusted partners than they might have hoped for. Cited examples of this included District and Borough Councils reacting adversely to a proposal for reduction of support for homelessness and housing (regarding what the local impact of that reduction may be); and care providers referencing cuts that will significantly impact preventative work that helps stop people from reaching crisis point. There is a risk during times of financial stress of retrenchment, just at a time when better solutions may lie in the greater and more transparent sharing of risk with partners, and managed transitions of reductions in funding. Consideration might therefore be given to whether leadership discussions with a small core group of Place leaders may enhance the governance arrangements to ensure as far as is possible a “no surprises” culture remains.
68. There is further opportunity to evidence wider partnership working with health system partners so services work seamlessly for people. The council leads and delivers outcomes across a large and complex geography – working very closely with eight districts, four Acute hospitals and one ICB as an example. The Peer Team heard of examples of integration with NHS and wider health partners that have been in place for many years in some instances: integration of local delivery is working well at an operational level, and has been happening for the past 15 years with joint funding panels, management and team meetings. Evidence was provided for the peer team of joint budgets and pooling of discharge to assess (D2A) funding for discharges. These examples of extensive and in-depth working between the council and the NHS and secondary care partners are particularly positive in a climate where D2A funding has a hard stop and is being withdrawn in neighbouring ICB areas and across other parts of the Country. And it is testament to the hard work of senior managers working on joint solutions for the front line that a significant winter fund for 2023/24 is going to be made available for joint discharges across Devon.
69. It was good to meet with leads in jointly integrated posts but practical challenges remain. Whilst teams benefit from being co-located, they struggle with information sharing because of the use of two different systems and recording mechanisms, and lack of system access from the council through into NHS systems and vice versa. Staff articulated some frustrations on systems and access, and these can become disproportionate barriers to further success, as energy is dispersed on unnecessary steps to retrieve data from more than one system. Whilst budgets are to some extent shared at patient level, executive posts and strategic budgets are not wholly joint.
70. It is important to create and sustain a culture of innovation and positive risk taking through creating an environment of trust, and with an equal focus on medium term transformation as on short term benefit. Delivering cultural change will need investment in people, training, and sufficient timescales. Overall, the council feel very connected to good practice and national initiatives: following feedback, the council website is at 98% rating for accessibility, with the council using a Digital by design and not default methodology; and staff demonstrate ambition to try new things and do things better, and DHSC and Skills for Care showcase local work with external providers.
71. What was less in evidence is a deep dive into innovations for solutions and to some extent, this is accepted as the norm. Whilst there is significant pilot activity the translation of successful pilots into business as usual and new ways of working was cited as being low. There is a sense that more radical solutions for the challenging years ahead will be needed to try to stem demand and increase prevention activities (for instance, around asset- or strengths-based practice, or upstream prevention). Officers have worked together in Devon for many years in some teams and whilst this provides a foundation for trust and acceptance, some challenge through leadership is also needed to help engender a stretch factor for the significant challenges ahead. Leadership in that context needs to help to establish a framework for some positive disruption and managed risk taking, to allow strong ideas to take hold and to extend trials for the medium term - to provide a chance for results to embed.
72. Ceding some control through recognising the strengths of other statutory and non-statutory partners, communities and people, might support or facilitate innovation. A good start has been made in developing a culture of collaboration with VCS and communities, and the council might consider how it could better engage the creative energy and community-engaged offer of the sector through dialogue, or a more “open” approach to grant and other funding.
73. Whilst peers heard of some concerns from staff that corporate colleagues do not fully understand the pressures facing adult social care (particularly in relation to the fragility of the social care workforce, housing challenges, and the impact of cost of living and inflation on communities, the care market and individuals), staff mainly exhibited trust in senior managers and provided examples of feeling supported to redirect and adapt. The Peer Team heard that despite a focus on achieving savings, client outcomes were maintained as being central. This style of supportive leadership will be fundamental in approaching the challenging years ahead for social care in general, and successful achievement of savings in particular, including setting the tone for new ways of enabling more commercially astute social care in Devon. Staff and people who use services recognise a council with stable workforce which promotes continuity, and the Peer Team met and heard about committed and able staff who want to problem solve and improve their service offer. Clear and values-led professional leadership can be supported to deliver ideas for improving practice and how to deliver transformational change, backed up by strong data, information and intelligence to inform and support decision-making.
74. The Peer Team were not able to assess the success or outcomes on leadership of new savings plans as this had only recently been announced. However, the Team heard about successful attainment of reductions of costs of care for older adults through review work, and this offers a foundation for wider practice development. Adaptive leadership of key issues was also evidenced through teams tackling challenges of managing packages of care (hours) in different ways across client groups – lessons from Older Adults reviews being ported across to reviews of Learning Disability clients, for example.
Preparing for assurance
75. The council worked very hard to prepare for and facilitate an excellent Peer Challenge process. Dedicated time and resource and leadership were identified at an early stage and were consistently available throughout the process. There can be a risk of under-estimating both the lead-time (including for different aspects of the preparations) and necessary resources needed to prepare for a Peer Challenge (or future CQC assurance process); whilst this was not the case here, those involved nevertheless described the degree of “stretch” during the process itself, which might suggest a need for increased resource whilst an assurance team is on-site.
76. The council developed an excellent online Position Statement which helped to guide the Challenge Team in their thinking, along with a comprehensive set of supporting materials. These were delivered in a timely way, and connected through the Position Statement with clickable links, which provides a helpful means of aligning evidence to key statements or sections. Whilst there were some issues for the Peer Challenge Team in accessing some of the online resources (in particular those maintained within the confidential Sharepoint site) this may not present an issue in a future CQC Assurance process if they (for instance) develop a secure portal to upload evidence and information to. However, other mechanisms for communicating materials are worth considering as a fall back.
77. Further consideration could be given as to how to more routinely develop evidence of outcomes for people who use or have contact with your services, and how to align this to your position statement and other evidence as part of an assurance process. Similarly, for evidencing the impact (or progress) of changes or improvements that you are planning, for instance around strengths-based practice, or coproduction. Some of this might be developed through your care management system and future case file audits, as well as through regular reporting on transformation and improvement plans. But evidence of this kind will also come through contact and conversation with front-line staff, and more time to engage with staff groups in any future assurance process would help the team to build a picture of this.
78. There was a specific request to include a Peer with lived experience in the Challenge Team, and funding made available to support this. This was facilitated by the LGA and was a very positive part of the Challenge overall, both in planning and delivery, and a positive reflection on the Directorate’s intent and approach to it. However, further consideration could be given as to how to more fully involve people with lived experience in the preparation for future assurance processes, as well as in the process itself. The team felt there was less opportunity to hear from people who rely on or may need to use council services than they would have found helpful. For future planning purposes the council might want to consider how to increase access to these groups, either during the Challenge, or indeed through bespoke or more routine focus groups in advance of it, thereby increasing the range and impact of the voices of people with lived experience.
79. The team were made to feel welcome, and many small details were planned for and delivered: staff were available to support access to the council offices and provide security lanyards each day; car parking access was made available; there were no access issues; refreshments and lunch were made available each day (and access provided to a shared kitchen area); and IT resources and wifi were made available whilst the team were on-site.
80. The council office where the team were situated is a recently renovated office space, which allowed plenty of room for the Peer Team, along with dedicated meeting rooms nearby for interviews and focus groups. Whilst the dedicated space was helpful, it did however restrict the Peer Team in their informal or situational interaction with wider council staff, which may have both pros and cons for a formal assurance team (and the council) in terms of building a sense of staff and culture.
81. The Challenge Team were aware that a thorough communications approach to the Peer Challenge was developed, including briefings and updates (for staff and more widely), and with a plan for communication following the Challenge itself. This resulted in a good level of engagement from those invited to attend the Challenge, with the very large majority of invitees arriving for both interviews and focus groups. All participants showed good engagement with and understanding of the interview and focus group process, as well as of the wider Challenge.
82. The Team noted that there was a process for debriefing staff following meetings on-site, and that feedback from this was used to inform a sense of how the Challenge was progressing and any issues arising. However, this was less “formalised” or in real time than e.g. for an OFSTED Inspection. There was therefore less rigorous oversight of the process as it developed than may be needed or desirable in a future CQC assurance visit.
83. There was generally positive feedback about the process / on-site team, but some sense that not all peers were as fully prepared for individual meetings or focus groups as participants might have expected. This might be a learning point in terms of an assumption of particular expertise carried by any given member of a peer (or inspection) team, and that some preparation of the key messages for communication to peers in any given session might be helpful to maximise the chances of an assurance team being able to find out about the outcomes or key points they may be looking to hear about (or that the council may wish them to hear about!). However, the engagement and positivity with which the Challenge was received was certainly evidence of the positive attitudes of staff towards the process, and indeed more generally within and around the council.
84. Whilst the initial presentation from the council was kept “in house”, the final presentation from the Peer Challenge Team was open to wider invitees (including partners and staff) who had been involved in the Challenge. This showed an openness and transparency in the process, and a desire to engage with stakeholders around assurance and improvement. We understand that there is a plan in place to swiftly disseminate key messages from the Peer Challenge and to take both the findings, and the resulting action plan, through formal Cabinet and then public council processes.
85. The council would benefit from quantifying the resources deployed in terms of staff time, and at all levels, both in preparation for the Challenge (e.g. in preparing the Position Statement and supporting evidence, development of timetable and diary management for invitations, etc), and whilst the team were on-site. Whether this may need to be built into CQC preparation either as a standing resource, or some kind of “on call” team with responsibility, experience, training, and allocated time as and when called on, could be something for future budgetary and role considerations. Those who were involved in preparing for and supporting the Challenge will have developed good knowledge both of the process, and of resources in the council which are required to prepare for and support it, and consideration might be given as to how to harvest and grow this knowledge in advance of any future assurance process.
Recommendations for next steps
The Peer Team appreciate that senior political and managerial leadership will want to reflect on these findings and suggestions in order to determine how the council wishes to take these forward. In due course the LGA will be pleased to work with the council to consider progress in line with wider Sector Led Improvement work, and there is an offer of further activity to support this, including through ongoing engagement with the South West Region Care and Health Improvement Advisor (CHIA), and the LGA Principal Advisor.
Specific recommendations are included in the detailed report above, but the summary below outlines those areas where the Peer Team believe effort could best be concentrated in order to address the issues that they have seen during visit:
86. Continuing work across the council and with partners to raise the profile of Adult Social Care, and its role within the wider work of the council and local communities, will be central over the coming months. Key messages from this report, updates on preparation for Adult Social Care assurance, as well as on progress against both savings and transformation plans, will all provide an important framework in which council and wider system leadership can understand and balance risks and opportunities for Adult Social Care, and notably the importance of work to mitigate the risk of receiving a less than good judgement from any future CQC assurance process. The quarterly cycle of review and refresh for the Adult Social Care Position Statement (mentioned as planned following the Challenge) along with regular internal council and wider presentation of this, might help to raise the profile and ambition of this work, as well as developing wider and fuller understanding of its purpose, impact, risks and mitigations.
87. There are a range of different plans across the Directorate, including around savings, transformation (in different service areas), assurance, improvement work (for instance around waiting lists or practice), etc. Bringing these plans into alignment will help not only to develop synergies and avoid duplication, but can also help to balance and manage risks and priorities, identify mitigations to key risks (where there are inter-dependencies), and where possible to identify initiatives or pilots that could be scaled up at pace, or accelerate where they are shown to work (in Devon or elsewhere).
88. Developing better and more varied ways to routinely create and collect evidence of outcomes for people will help to prepare for future assurance. This might include the aggregated out-turn from reviews, feedback from people and communities and partners, or formal coproduction. A clear focus on delivery of outcomes, through transformation and innovation, can also help to maintain quality and values in the service offer, with equal priority to the management of risk and financial out-turn.
89. Alongside this a renewed approach to regular case file audit, and other processes for peer learning at a practice level, should underpin a refreshed approach to quality assurance, wider practice and approach and efficacy, and safeguarding practice. This can also be used as a means to embed practice change, and to bring challenge to frontline teams in line with these changes, in particular relating to outcomes, savings and independence.
90. Building on existing work on coproduction will help to engage with wider communities, and to develop services (at both individual and macro-levels) that best meet their needs. It will allow staff and system leaders to learn from those who have lived experience of using adult social care and other public services, and to develop an offer in line with what works best for local people. And it can help to build capital with those who will continue to rely on local services in the coming years, and whose support will be needed when making difficult decisions, or managing significant transformation in how services are offered.
Contact details
For more information about this Adult Social Care Preparation for Assurance Peer Challenge in Devon County Council please contact:
Tandra Forster
Director of Integrated Adult Social Care and DASS
Email: [email protected]
The LGA Programme Manager for this programme of Adult Social Care Preparation for Assurance Peer Challenges is:
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.