Agenda item

This report outlines the outcome of the CQC Local Authority Assessment, and the subsequent actions being taken.

The Corporate Director of Adult Social Care presented the report outlining the Care Quality Commission (CQC) Local Authority Assessment, and the subsequent actions being taken.

The Informal Improvement Advisor reported that he had been appointed by the Department of Health and Social Care (DHSC) to support CYC in its improvement journey, address challenges identified within the assessment, and report to the Secretary of State for Health and Social Care on improvements made.

It was reported that the method used for the assessment was following a new assessment process and there was a need to work with departments such as housing to ensure further quality care. CYC had a ‘requires improvement’ score overall and a notification had been sent to the Department of Health and Social Care highlighting that CYC had not met some requirements. Meeting had been held with staff to outline the recommendations made within the assessment outcome in order to ensure understanding.

The Director of Adults Safeguarding reported that in response to the assessment CYC had developed a consistent approach to deal with the risks people faced while waiting for Council services which was now consistent and overseen. He discussed the approach to transitional safeguarding to ensure people have support they need in transition to adulthood and noted work ongoing with the Safeguarding Adults Board to develop a new framework measuring the actions being taken.

The Executive Member for Health, Wellbeing and Adult Social Care expressed that safeguarding was the responsibility of all Council areas.

In response to questions from members, the Corporate Director of Adult Social Care, the Director of Adults Safeguarding, the Informal Improvement Advisor, and the Executive Member for Health, Wellbeing and Adult Social Care confirmed that:

·      There was a need to ensure that there was appropriate housing and supported living options for people; the recruitment of Occupational Therapists would help with this as well as joint working with the Director of Communities.

·      Local Area Coordinators worked with Social Care teams and now had powers to directly pick people up early in their journey into care.

·      A joint frailty Hub facility with Nimbuscare had helped reduce admissions to hospital.

·      In the short term, agency staff and secondments would be used to focus on specific areas, in the medium to long term however there would be a focus on engaging with the Occupational Therapy partner to increase the number of Occupational Therapists to help people access more adaptations and support.

·      People on waiting lists were seen on a risk level and so people with greater needs tend to get seen first while others wait – as such, many people’s needs then develop further as they wait; work was ongoing with staff at the first point of call to help get support early to prevent people’s lower level needs developing without support, and reduce demand. There was a great amount of unmet demand within York and needs were expected to go up in the short term because of this, but plans presented within the report was expected to make us more resilient in the long term. A 12% reduction in waiting lists was a significant improvement that had been achieved.

·      CYC co-produced a learning leadership board giving a valuable opportunity to see peoples’ experiences.

·      Some types of placements out of York were less expensive than in York. York care home costs were higher than elsewhere and there was a lot of demand. CYC funded 27% of care home costs in York with the other 73% being self-funders or other Local Authorities.

·      Although CYC had run care homes in previous years, it wouldn’t work to run care homes today as the strategic balance in York is different to larger Local Authorities.

·      Examples of progress made included: Joint ongoing working and improved working relationships with York Hospital and with health colleagues, and the reduction in delays and an increase in people going home from hospital rather than care home first.

·      CYC’s ongoing priorities were to meet the statutory duties outlined in the Section 50 letter notification shared with the Secretary of State. The Corporate Director of Adult Social Care was accountable for achieving these and was advised by the Informal Improvement Advisor.

·      Individual circumstances were considered when out of area accommodation was required.

·      CYC’s Market Position Statement had lapsed and was due for renewal; this could be shared with members to highlight and develop how CYC manages its market responsibilities.

·      National standards for pay were being investigated by the Government, and the outcome would feed into how Local Governments support the external care market. The Market Position Statement would help shape CYC’s position on this.

·      Work on a development plan was ongoing and could be brought back to the Committee for further scrutiny; Learning from Safeguarding Adult Reviews (SARs) would be shared with members.

Resolved: That the People Scrutiny Committee supported the action plan and approach outlined.

Reason: So that members were aware of the outcome of the CQC Local Authority Assessment and supported the subsequent actions being taken.