Agenda item

The Strategic Director of Social Care and Education regarding early learning and reflections of the Care Quality Commission (CQC) assessment of Adult Social Care.

The Strategic Director for Social Care and Education introduced the item highlighting the CQC have recently been tasked with undertaking assessments of Local Authorities and whilst there had been inconsistencies in reporting and processes so far, the external view of quality of service provision is welcomed.

The Director for Adult Social Care & Safeguarding presented the item in which it was noted that:

·       The report pulls together learning of Local Authorities that have been through the CQC assessment process and includes statements and reflections. A self-assessment process started in Leicester in March 2023 and refreshed in August 2023 to draw on experiences of service users and evidence with data.

·       The self-assessment identified various strengths in the service, including areas such as co-production; high feedback rates from individuals (70% responses last month); good availability of care with individuals not enduring long waits once needs identified; efficient discharge processes from hospital; quality of commissioned care in the city is generally good; safeguarding arrangements, leadership and governance; and a willingness to learn and undertake peer reviews. The pride, passion and commitment of the workforce is vital, and compliments are often received illustrating this.

·       Areas have been identified to improve and improvement plans are in place. This includes overdue reviews and waiting lists for assessment and occupational therapy where additional resource has been allocated; the volume of audits has not been sufficient but was relaunched in July to see improvement; carers are not as satisfied as the service would like, generally due to lacking own wellbeing, support and access to information; feedback suggests Leicester residents do not feel connected generally and work is required to draw on the knowledge of communities; and the quality of provision for self-funders is not of the quality as national comparators.

·       The financial position of the Local Authority is a challenge with increasing cost to support individuals in the city but a corporate approach to preventative services is underway.

·       The service continues to engage with individuals and improve services to ensure residents of Leicester have the best possible care across the city and that the Authority is prepared as much as possible to be ready for when an assessment is announced.

The Strategic Director for Social Care and Education highlighted that peer review activity is underway across the East Midlands to help develop improvement plans. The Deputy City Mayor for Social Care, Health and Community Safety further highlighted that lead professionals and directors undertake peer reviews whereas the CQC assessment is undertaken by individuals who may not have held leadership positions and an unwillingness by CQC to adopt learning from best practice of assessments in children’s services had been frustrating.

In response to questions and comments from Members, it was noted that: 

·       Local Authorities who have undergone the CQC assessment and their results published were contained within Appendix 2 of the report. Regional conversations and analysis had taken place and direct conversations had occurred with those authorities in the East Midlands, including Nottingham, Derby and Derbyshire.

·       The CQC appear to be undertaking assessments in areas that share health services so it is likely that Leicester would be considered alongside Leicestershire.

·       The CQC request 50 practice examples (‘cases’) where they will identify 10 and then review 6. Direct details are not examined, instead a description of the individual circumstances, support and reflections will be provided to inspectors. The CQC will also speak directly to the individual or family to triangulate the information provided and their direct experience. Feedback from other authorities illustrates a difficulty to identify individuals willing to speak to the CQC due to their busy lives or complexity of needs.

The Strategic Director for Social Care and Education highlighted that feedback had varied about the assessment process and there was no easy way to benchmark against ratings. It was recognised that service had strengths including an outstanding leadership that have identified and recognise issues, but the Local Authority might expect a good rating overall when inspected based on our current self-assessment.

The Chair thanked officers for the report and noted that the Commission would welcome an update on the results when assessed.

AGREED:  

·       The Commission noted the report.