Mixed report for Plymouth adult social care

Some cases closed too early

Plymouth City Council’s adult social care provision has been rated ‘good’ by the Care Quality Commission (CQC) but a report recognises that improvements still need to be made.

The CQC looked at nine areas across the four themes of how the authority works with people, provides supports, ensures safety in the system and leadership and gave it a 67 per cent rating overall.

The authority’s strongest area was in ensuring everyone, regardless of background, receives fair and personalised support and achieves similar positive results.

This which was found to be of an “exceptional standard” whilst supporting people to lead healthier lives, partnership and communities and leadership aspects including governance and learning and innovation were all considered good.

However shortfalls were identified in assessing people’s needs, care provision, continuity of care, safe pathways and transitions and safeguarding.

Chris Badger, CQC’s chief inspector of adult social care and integrated care, said the city council had demonstrated “a strong commitment to collaborative working and continuous improvement” and “an impressive culture of working with partners” but he said “advocacy support wasn’t always offered when required”.

The CQC began a new program to assess local authorities on their delivery of adult social care in 2023 and this was Plymouth ‘s first inspection under this framework.

CQC inspectors met with adult social care staff and sought views from adults who receive support in the city, and their families in June.

The report found that joined-up teams in adult social care were supportive and worked well together to understand and reduce barriers to care and support and address inequalities. 

Mr Badger continued: “People who use service, and their families, also have a real say in how things are run, from helping choose which organisations should deliver care, to shaping future plans for unpaid carers.

Wellbeing hubs had been especially successful, offering friendly places where people could get advice, meet others, and receive health support all in one location.

“However, significant challenges remain, we saw advocacy support wasn’t always offered when required,” he added. “The authority has begun to make progress in reducing backlogs. We saw actions they were taking including creating an improvement plan focused on key priorities and introducing a digital financial assessment tool to speed up processes.”

“Overall, Plymouth City Council know what work they need to do to implement improvements and should be pleased with the positive areas identified in this report. The challenge now is to ensure the improvements are carried out, sustained, and embedded across all service areas so that every person in Plymouth receives equal and timely support. We look forward to returning to see how their plans mature.”

The reports reveals that in 2023/24 nearly 27 per of the total Plymouth City Council budget of £400 million was spent on adult social care and there was a £5.6 million overspend.

Three quarters of the council’s revenue is on social care including children’s social care and homelessness.

Approximately 4330 people were accessing long-term adult social care support in 2023/24, and around 1000 people in short-term support.

The assessment team found that staff had effective systems to protect people from abuse and neglect, with the correct knowledge and skills to carry out their work; the authority worked in an integrated way with 70% of people discharged from hospital using a home first approach; people could easily access equipment and minor home adaptations to maintain their independence in their own homes.

Community wellbeing hubs were concentrated in more deprived areas, offering facilities and programmes to connect communities together and an online directory provided help, advice and information about accessing services for non-eligible care needs.

However it raised concerns over reviews no longer taking place consistently and tended to be reactive, with partners not always aware of them taking place despite being involved in the care.

Pathways and processes did not always ensure that staff planned and coordinated people’s support across different agencies and services. Some partners said staff closed cases too soon, which caused people to wait to be seen again.

And some providers felt there was less preventative work taking place around safeguarding and were not always sure where to go for support if people did not meet thresholds, especially where people had mental capacity to make their own decisions.

Gary Walbridge, strategic director for adults, health and communities at Plymouth City Council, said: “We’re really proud to have received a good outcome from our assessment, which has highlighted areas where our work across the city is really strong, particularly our relationship with partner organisations and our commitment to ensuring that residents who may experience inequality receive the tailored care and support that they need.

 “However, we acknowledge there are areas that require further improvement and the report has also helped highlight where we need to do more to ensure that everyone gets the same standard of care.

“We will, with our partners, be focusing on addressing these to ensure that all our residents receive a good level of care.” 

Cllr Mary Aspinall, cabinet member for health and adult social care, said the report was testament to the strength of the council’s partnership working and dedicated staff, Livewell Southwest, all commissioned providers and the local voluntary sector, “who work incredibly hard every day to support our residents”.

“Our ambition is for Plymouth to be a great place to grow up and to grow old, and adult social care has a hugely important role to play in this by ensuring that all adults are safe, cared for and well supported.”

Livewell Southwest is commissioned to deliver adult social care assessments in Plymouth. Its chief executive Michelle Thomas, said: “Livewell became one of the first integrated community health and social care providers back in 2015. This was a forward-thinking move at the time to bring together physical, mental health and social care, so that a person’s whole health and care need can be considered.

“For that reason, we were particularly pleased to see the CQC acknowledge ‘a strong inclusive and positive culture of continuous learning and improvement’. Our staff work hard collectively to never stand still when it comes to developing the best possible service for the city.”