Agenda item

Report of the Cabinet Member for Adult Care, Health and Public Service Reform is attached.

The Chair invited Councillor Tariq, Cabinet Member for Adult Care, Health and Public Service Reform, to present the report.

Councillor Tariq advised that it was not often that an item followed two such positive inspection outcomes. He reported that Falcon and Griffin services had received a rating of Good from the Care Quality Commission (CQC), whilst Killalea had been rated Outstanding. Introducing the report, he explained that it outlined the outcome of Bury's Local Authority Adult Social Care CQC Assessment, which had resulted in an overall judgement of Good.

Members were advised that the assessment recognised a number of strengths across the partnership, including strong integration with NHS partners, effective co-production with residents and stakeholders, Bury's positive organisational culture, strengths-based approaches to practice, timely support for carers and a clear understanding of workforce challenges through existing workforce planning arrangements.

Councillor Tariq took the opportunity to thank staff, partners and colleagues for their contribution to the assessment outcome. He recognised the efforts of all those involved in driving improvement over recent years and paid particular tribute to Adrian Crook and Sue Massel for their leadership. He stated that significant improvements had been made across adult social care services and that Bury had successfully recruited and retained high-quality staff, which continued to be a major strength for the Council.

Councillor FitzGerald commented that Adrian Crook had consistently been open and transparent with members regarding areas for improvement and acknowledged the work that had been undertaken.

Councillor Martin thanked officers for the report and referred to the section relating to support during periods of crisis, particularly outside normal working hours. He asked how awareness of these services could be improved to ensure that residents and carers were aware of the support available.

In response, Councillor Tariq emphasised the importance of partnership working, particularly with Pennine Care and Integrated Neighbourhood Teams. He explained that services benefit from local knowledge and a detailed understanding of individual circumstances, which helps ensure appropriate support is provided. He described this joined-up approach as one of the strengths identified through the assessment process.

Adrian Crook added that feedback received during the assessment process included comments regarding the responsive and personalised support provided by teams, including the availability of in-house overnight sitting services where required.

Councillor Southworth congratulated officers on the assessment outcome. Drawing on experience of working with older people and intermediate care services, he commented that a great deal of good work was taking place that residents were often unaware of. He suggested that more should be done to communicate the positive support available. He also asked how residents could access information about digital services and support.

Councillor Tariq acknowledged the point and agreed that further work was required to improve awareness of adult social care services and support available to residents and carers. He noted the importance of communication, particularly for individuals who may feel isolated or disconnected from services. He advised that this issue would be considered further through ongoing work around the Carers Strategy and wider equality and diversity considerations.

Adrian Crook added that, in relation to intermediate care services, residents not being aware of a service often reflected the fact that they had not required it. He assured members that residents would receive support when needed. He also highlighted work with Bury Blind Society and acknowledged that there remained opportunities to improve information, advice and guidance services through the implementation of the Sensory Improvement Strategy.

Councillor Southworth commented positively on the quality of the presentations and information provided during the assessment process.

Councillor Green congratulated officers on the outcome and shared a personal experience of support received from social workers, praising their professionalism and commitment. He asked about support available for unpaid carers and whether there was a need for greater engagement and communication with carers.

Councillor Tariq advised that the assessment and previous peer review activity had both emphasised the importance of co-production. He explained that the current carers support contract was delivered through Compass and that a decision regarding future arrangements would shortly be finalised. The intention was to ensure future commissioning arrangements would support delivery of key priorities and align with the Council's strategic objectives. He stated that further consideration would be given to ensuring support was accessible to carers from different communities and demographic groups through an Equality Impact Assessment approach.

He also welcomed the positive comments regarding social workers, describing them as often being the "silent workforce" behind the delivery of care packages and support. He noted that maintaining effective recruitment and retention remained an important priority.

Councillor Green welcomed the response and highlighted the risk of carers becoming isolated, particularly where they may be waiting extended periods for support or carrying significant caring responsibilities. He stressed the importance of keeping carers' needs at the forefront of future planning.

Councillor FitzGerald agreed that carers required additional focus and asked whether further information could be provided in relation to future commissioning arrangements and ongoing support for carers.

It was agreed that members would receive further information on the commissioning arrangements and future service developments, together with details of actions being taken to strengthen support for carers.

Councillor Zaman asked what measures and performance indicators were used to assess respite provision and identify unmet need amongst carers.

In response, officers advised that a specific piece of work was underway to review respite provision. Members were informed that existing block contract arrangements for respite care were currently under-utilised and that the commissioning team had been asked to undertake a broader review of respite services. Further information would be circulated to members once the review timetable had been established.

Councillor Boles asked whether feedback had been received from staff during the assessment process, particularly in relation to workload and stress levels.

Councillor Tariq explained that engagement with staff had been a key part of the preparation and assessment process. Staff had been involved through peer reviews, workforce events and social work conferences, helping them to understand the purpose and requirements of the assessment. During the CQC assessment itself, inspectors met directly with staff across a range of teams. He noted that the process had ultimately become a positive and collaborative experience, with teams working together and developing a strong sense of shared purpose.

Councillor Boles referred to discussions within the Local Government Association regarding the use of single-word judgements and asked whether these could have implications for staff wellbeing.

Councillor Tariq acknowledged the point and noted that this was the first formal adult social care assessment process undertaken for many years. He expressed the view that long gaps between inspections were not helpful, as they reduced opportunities for challenge and improvement. Referring to the wider debate regarding single-word judgements, he explained that the CQC was currently undertaking work to review aspects of its assessment approach and engage with stakeholders. He acknowledged concerns that negative judgements could have significant consequences, including challenges around recruitment and retention, given the importance attached to regulatory outcomes.

Adrian Crook commented that while the one-word judgement served as a simple measure for members of the public, achieving a Good or Outstanding rating was beneficial for workforce morale and helped staff feel recognised for their efforts.

Councillor Simpson advised that he had participated in interviews as part of the assessment process and paid tribute to Adrian Crook's support and leadership throughout the process.

The Chair congratulated officers on achieving the positive outcome and acknowledged the significant amount of work undertaken across the service.

The Chair advised members that a comparison table of known CQC assessment outcomes across Greater Manchester authorities would be circulated. It was noted that Wigan had achieved the highest score nationally, whilst Salford had received the lowest score within Greater Manchester. Members were also informed that a minor error had been identified within Bury's reported score relating to the "Supporting People to Lead Healthier Lives" assessment area.

The Committee was advised that a deeper review of Adult Social Care assessment outcomes across Greater Manchester would be undertaken through the Greater Manchester Combined Authority Health Scrutiny arrangements. This work would seek to identify opportunities for improvement and shared learning across authorities.

Councillor Tariq welcomed the proposed review and cautioned that direct comparisons between authorities should be treated carefully, as differing levels of funding, demand and local circumstances could have a significant impact on performance outcomes. Whilst there would be opportunities to learn from high-performing authorities such as Wigan, he noted that the challenges facing Bury were not always directly comparable.

It Was Agreed:

·       The update and report be noted

·       To express thanks to officers

Actions

• Officers to circulate further information regarding future carers' commissioning arrangements and service developments.
• Officers to provide members with information regarding the review of respite provision, including timescales and scope of the work.
• Comparative Greater Manchester CQC assessment outcome data to be circulated to members.
• Greater Manchester Health Scrutiny is viewing the below items and will be circulated to the committee and covered in the chairs report
  • Wigan as a case study to understand factors contributing to outstanding performance.
  • A review of Salford's improvement and action plan.
  • A deep dive into the assessment areas of Assessing Need, Supporting People to Lead Healthier Lives and Safeguarding.
  • Information on how Greater Manchester ADASS leads will work collaboratively to improve outcomes across the conurbation and the targets associated with that work.