Long waiting times and inconsistencies has resulted in a local authority’s adult social care services being rated as “require improvement”.
Medway Council narrowly missed out on a “good” rating from the Care Quality Commission (CQC), but officers and councillors say they have a plan to tackle problems.
Medway Council has faced recruitment issues for some time and has been reliant on expensive agency staff
Nine areas were ranked by the health and social care watchdog, with three being rated as showing a good standard, but six as showing some shortfalls – totalling a rating of 59%.
A “good” rating is above 63%, but problems with inconsistency of service and waiting lists caused by recruitment problems held the authority’s service back.
Difficulties filling roles in the service, as well as retaining staff and losing them to higher paying authorities or agency roles, had caused backlogs in assessments.
While some people who received care said their experience with the authority’s service was positive, praising kind and compassionate staff, others said they did not always feel valued or considered.
One example was given by James Bullion, CQC’s chief inspector of adult social care and integrated care, who said: “Some people gave us positive feedback of being supported and listened to during the assessment and the ease of direct contact with their allocated social worker.
James Bullion, CQC’s chief inspector of adult social care and integrated care. Photo: CQC
“However, we were also told of an example where staff weren’t knowledgeable about the specific disabilities of a person and their family members felt staff had been reluctant to help or support.”
Waiting times for equipment were also inconsistent, with the report saying the council delivered basic home equipment quickly, but waiting times for complex items were up to 98 days.
Voluntary sector partners also told inspectors about “unacceptable” waiting times for home modifications, one of which had seen a resident unable to leave their home for 15 months because adaptation works had not been made.
The maximum wait time for equipment assessment in the last 12 months was 356 days.
Similarly, the council struggled with its target of completing financial assessments within 56 days, averaging 181 days, due to a shortage of staff, delays in information being provided by people, and responses to information requests from social workers.
Adult social care has been rated as “requires improvement” in Medway. Photo: iStock
The authority said new staff were being trained to undertake financial assessments to address this.
Waiting times for carer assessments – which determine whether someone needs support or assistance as an unpaid carer – were an average of 29 days in the last 12 months – with a target of 28 days – but inspectors found some carers had waited up to 530 days as cases were not reassigned if the staff member responsible was off sick.
However, the report says Medway Council said 86% of carer assessments were completed within the 28-day target and only nine people had experienced a wait for an assessment.
Care Act assessments – which assess a person’s care needs – saw an average wait for an annual review of145 days.
Medway Council said they aimed to get 80% of annual reviews completed within the month they were due, but recruitment plus an increase in demand from people aged over 65 had led to backlogs.
However, the authority’s Waiting Well programme ensured those who wait longer than 28 days for any assessment received a letter with details of other support services they could access for self-help whilst waiting for local authority intervention.
Data provided by Medway Council showed the average waiting time for an initial Care Act assessment in the last 12 months was 15 days.
The report said the authority’s leadership had recognised many of the issues found and were making efforts to address the recruitment problems.
Mr Bullion said the root of most of the issues facing Medway’s adult social care services were related to recruitment.
He continued: “At this assessment we found staff who were proud to work at Medway Council and were passionate about serving local people.
“However, the council faced challenges with staffing and recruitment, particularly with adult social care staff, which was having an impact on how long people were waiting for assessments and the effectiveness of their services.”
Responding to the report, Medway Council’s deputy leader and portfolio holder for adult social care, Teresa Murray (Lab) said the issues raised were not a surprise and the feedback from the report would be fed into the authority’s improvement plans.
She said: “I would always want our services to be good or outstanding, but this report, only four percentage points away from good, shows us where we are, shows us that we know what we need to do, and endorses our cause for an improvement journey that we were already on for this important service.
Medway Council’s deputy leader Teresa Murray (Lab) said the authority had been aware of the issues raised by the report and would continue on its action plan to improve the service.
“I would like to say that in two years’ time we’ll be where we want to be. Now, that’s a big promise, but I think if we continue to make investments, if we continue to work in the way that we’re doing, only four percentage points away from good now, we’ve got a really encouraging chance of being in that place.”
She added the council was reinstating an allocated service – meaning a specific practitioner handles a case rather than a number of staff serving needs depending on who is available – which was changed under the previous administration.
Cllr Murray added: “If somebody has got a specific disability, in the very near future, we’ll be able to guarantee they can work with somebody who understands that and has got access to specialist information.
“The report told us things that we needed to know and has helped us to really focus the direction we were already going on to improve the services.”
The report praised the council’s willingness to reconsider its processes, listening to staff through a variety of routes for feedback.
Other issues raised were the limited accessibility of the council’s website, which prevented some people from understanding all the options available to them, and some limitations in serving specific communities in Medway – such as the deaf.
Shadow cabinet member for health and adult social care, councillor David Wildey (Con) said: “It was positive to see that there are some areas where the CQC have said that Medway are performing well.
“I would like to congratulate all the staff involved and I look forward to holding the administration to account, particularly through the health and adult social care overview and scrutiny committee so the council can achieve better outcomes in its journey at the next report.”
Medway Council spent £97,640,000 on adult social care in the 2023/24 financial year – 24% of the authority’s total budget.