Gary Walbridge (Strategic Director for Adults, Health and Communities), Julia Brown (Service Director for Adult Social Care) and Louise Ford (Service Director for Integrated Commissioning) presented the Adult Social Care CQC Outcome Update and discussed:

a)     The inspection outcome had been received following a significant assessment process which began in January of the previous year, during which the Council had submitted over 300 documents and 50 anonymised cases to the Care Quality Commission (CQC);

b)    The on?site inspection had taken place over three and a half days in June and had involved approximately 45 formal interviews with staff, partners and people receiving services, including around 180 individuals in total;

c)     The service had been awarded an overall rating of Good, and the presenters expressed strong pride in the outcome, noting the extensive work undertaken by staff, Livewell Southwest, wider Council teams, partner organisations and voluntary and community sector networks;

d)    Plymouth had achieved an Outstanding rating for the domain of ‘equity, experience and outcomes’, one of only a very small number of councils nationally to achieve Outstanding in this area;

e)     The Outstanding rating recognised Plymouth’s proactive approach to identifying and listening to people most likely to experience inequity in services and reflected extensive partnership work across directorates and sectors;

f)      The presenters emphasised the importance of acknowledging the success achieved while also recognising that not everyone experienced services positively, and the report identified clear areas for improvement which would form the basis of ongoing work with Scrutiny;

g)     Inspection documentation, including the full report, had been published on the CQC website and was available for partners and the public;

h)    Assessing People’s Needs had scored 50%, with strengths including person?centred assessments and 90% of callers having their situation resolved at first contact;

i)      Strong examples of joint working and positive feedback on carer assessments had been noted;

j)      Improvements were required in communication with people and carers and in strengthening strength?based practice, with the Principal Social Worker leading training to address this;

k)     Supporting People to Live Healthier Lives had scored 63%, with strong preventative work, effective reablement and strong partnership working across the council and the voluntary sector;

l)      Improvement areas included occupational therapy (OT) pressures and outcomes for those receiving short?term support, though some progress had already been made since the inspection period;

m)   Equity in Experience and Outcomes had scored 88%, reflecting embedded co?production and strong engagement with seldom?heard groups, with further work planned on cultural competency and data quality;

n)    Care Provision, Integration and Continuity, had scored 57%, with strong recognition of the Council’s use of the Joint Strategic Needs Assessment to shape commissioning and the strategic direction provided by the Plymouth Plan;

o)    Strong partnership working with the voluntary and community sector and commissioned providers had been noted, alongside positive examples of how people were offered choice in their care;

p)    Market?shaping work and the co?production commissioning toolkit had been well received, though further work was needed regarding younger adults, transition pathways with children’s services and the development of a dementia commissioning plan including technology?enabled care;

q)    Work on domiciliary care market development remained a priority;

r)     Integration and Partnership Working had scored 82%, reflecting strong strategic working across the Local Care Partnership, effective use of well?being hubs and community groups and strong integration between health and social care;

s)     Improvements were needed to strengthen engagement and feedback loops within partnership structures;

t)     Safe Systems, Pathways and Transitions had highlighted a strong Home First discharge model, with 70% of people returning home, strong crisis support responses and improvements in waiting?list oversight;

u)    Positive multidisciplinary practice in learning disability pathways had been noted, though mixed experiences remained for young people transitioning to adult services, with a joint plan in development and a joint Select Committee session scheduled;

v)     Safeguarding arrangements were strong, with people generally feeling safe, timely reporting and review systems, and high levels of Mental Capacity Act training, though significant pressures remained in Deprivation of Liberty Safeguards;

w)   Improvements were required in documenting how safeguarding was made personal to individuals, with work already underway;

x)    Governance, Management and Sustainability had shown stability in leadership roles, clear oversight and effective use of data to inform decision?making;

y)     Strong organisational culture, learning and improvement, staff development pathways and active partnership working were recognised;

z)     Improvements were required in standardising audit processes and addressing workforce capacity challenges in some areas, with work underway locally and regionally;

aa)  Learning, Improvement and Innovation had scored strongly, with well?regarded workforce development including the ASYE programme for new social workers, effective use of co?production and a strong culture of continuous improvement.

In response to questions, the Panel discussed:

bb)Clarification of how Deprivation of Liberty Safeguards (DoLS) protected people lacking mental capacity by ensuring any restrictions were in their best interests, proportionate and legally authorised through specialist assessment and medical advice;

cc)  The inspection visits had taken place primarily at Crown Hill Court, with additional visits to Mount Gould and to a well?being hub to meet voluntary?sector representatives;

dd)Members asked whether DoLS waiting?list data could be reported regularly, expressing concern about high numbers waiting in residential care. Officers reassured the Panel that people were safe and offered to provide focused reporting in future;

ee)  Discussion took place regarding Theme 1 scoring and whether sufficient budget allocation was available to support improvements, with officers advising that performance had progressed since the inspection and that proportional assessment of need was key for financial sustainability;

ff)    Members raised concerns relating to emergency respite care for unpaid carers, asking whether urgent placements were available when carers were struggling. Officers confirmed that residential respite could be accessed quickly when appropriate and emphasised the importance of ensuring the right support option was identified based on need;

gg)  Members offered congratulations for the achievement of a Good overall rating and acknowledged the intensity of the inspection interviews;

hh) Members suggested that the next inspection, which historically occurred on long cycles, might be less daunting given the strong current performance.

The Panel agreed:

1. To note the Adult Social Care CQC Outcome Update.