Risks to human rights identified as watchdog hands council first “inadequate” rating for adult care

In the report, published earlier this month (6 August), investigators cited “risks to human rights” which left people’s needs not being met, and negatively impacted on people accessing and being supported by the local authority.

To carry out the investigation, the CQC looked at nine areas spread across four themes, to assess how well the authority was meeting its responsibilities.

The regulator gave the areas a score out of four, with one representing “significant shortfalls”, and four showing an “exceptional standard”. The scores were as follows:

1. Assessing people’s needs: 1
2. Supporting people to lead healthier lives: 1
3. Equity in experience and outcomes: 1
4. Care provision, integration and continuity of care: 2
5. Partnership and communities: 2
6. Safe pathways, systems and transitions: 2
7. Safeguarding: 1
8. Governance, management and sustainability: 1
9. Learning, improvement and innovation: 1

The report warned that adult social care staff did not effectively recognise young carers of adults with care and support needs, and that unpaid carers spoke negatively about a “lack of effective working” between adult social care staff and drug and alcohol services.

It noted: “They stated there was a lack of understanding of unpaid carers roles and lack of adult social care staff working alongside services to support the cared for person.”

There was mixed feedback from people and their unpaid carers who had been involved in safeguarding enquiries.

The CQC noted that for example, people had felt listened to and involved in safeguarding processes. However, opinions were not always considered, and they had not had regular involvement in meetings.

The report said: “Some people did not feel heard or had not been actively involved, referring to poor communication, lack of empathy, and inconsistent approaches as barriers to effective participation.”

Investigators observed that people accessing care and support were mostly responded to in a timely way.

However, they warned that senior leaders did not have a “clear picture” of who could be signposted away from adult social care, and whether this decision making was “appropriate and effective”.

Meanwhile, the report cited concerns about staff confidence in carrying out safeguarding work. It noted: “There was no specific induction or specialist training for staff to be deemed competent to undertake any areas of safeguarding work.”

The regulator’s assessment gave the quality of Blackpool Council an overall rating of “inadequate”.

As a result of this, the CQC has sent a notification letter to the Secretary of State for Health and Social Care, outlining the areas where improvements are needed.

James Bullion, CQC’s chief inspector of adult social care and integrated care, said: “When we carried out our assessment of Blackpool Council, we found stronger leadership was needed to drive rapid improvements in how people were able to access adult social care services across the borough.

“Strong leadership is especially important given the authority needs to make these improvements against a challenging backdrop. Blackpool is the most deprived local authority in England, and five areas in the borough have NHS priority ward status due to the level of deprivation and health inequalities. Leaders weren’t working well with partner organisations to provide person centred care and tackle these inequalities. This meant the authority weren’t able to ensure people had access to the care or support they needed, which was having a negative impact on their health and wellbeing.

“There was a culture where the authority made decisions for people regarding what care and support they needed, rather than allowing them to make their own decisions. This posed a risk to people’s wellbeing and in some cases didn’t respect their human rights.”

He added: “Across the authority, we also heard mixed feedback on people’s experiences about the uptake of direct payments. Some unpaid carers told us they’d heard of them but felt they didn’t qualify or wouldn’t be able to manage them. However, others received them and spoke positively about the invaluable support they gave them. Data showed the percentage of people receiving direct payments was worse than the national average at 17.70% compared to 25.48% for England.

“We have told leaders at Blackpool Council where they need to improve, and we expect to see rapid and widespread improvements when we return.”

Cllr Neal Brookes, Deputy Leader of Blackpool Council and Cabinet Member for Adult Social Care, said: “This report is a difficult read and we take the findings exceptionally seriously. Adults in Blackpool deserve the highest quality of care when they need it and I am committed to putting the processes in place to make sure that happens.

“There are areas of good work highlighted in the report, including the care and passion of our staff. In fact, Blackpool Council performs well and above average in most of the government’s surveys looking at adult social care performance, including people’s satisfaction of care. But there are also areas where we need to improve and do better. We won’t shy away from the work we need to do. Our independently chaired improvement board is already meeting and we will be assessing each risk that has been raised by the CQC and addressing it.

“It is very important to note that the inspectors found no evidence to suggest adults were unsafe. Our staff have focused on keeping people safe and solving their immediate problems, but we need to do more to work with people to create care packages that are tailored to them.

“Care users will be at the heart of our improvement journey and their lived experience as recipients of our care will shape our future actions and processes. Blackpool has an above average number of adults requiring care, but below average funding to deliver that support. While the funding deficit is not an excuse for having the right processes in place, the demand for adult social care services will continue to grow in the near future as our population gets older. With that aging population brings even more pressure on our processes and staff.”

Lottie Winson