SERVICE INSPECTION
OF
INDEPENDENCE, WELLBEING AND CHOICE
HERTFORDSHIRE COUNTY COUNCIL
Presentation of Report
5 March 2009
Focus of the Inspection
For all vulnerable adults:
• Safeguarding From Abuse
For adults with learning disabilities only:
• Delivering Personalised Services
The Inspection Team
Lead Inspector: Jan Clark
Team Inspector: Tim Willis
Support Inspector: Rachel Cheney
Expert by Experience: Darren Cunningham
Support Worker: Tracy Ward
Delivery of Adults’ Safeguarding Arrangements
We concluded that the council’s overall performance in
safeguarding adults was adequate.
Key Strengths
• Responses to alerts were timely and appropriate to protect
vulnerable adults
• There were examples of good practice
• The Serious Concerns Process was driving improvements in
provider services
• The multi-agency arrangements had been strengthened
• The Adults Safeguarding Committee was leading developments
• Preventative services were being developed
Delivery of Adults’ Safeguarding Arrangements
Key Areas for Improvement
• Council reporting, scrutiny and governance
• Managerial decision-making, oversight of practice and
outcomes
• The approach to protection planning
• Performance management and quality assurance
• Data collection and analysis of activity and trends
• Recording practice
Delivery of Adults’ Safeguarding Arrangements
Key Areas for Improvement (cont)
• Development of competency-based training
• Ensuring partners comply with procedures and expected
investigative standards
• Involvement of experts by experience in developing
arrangements
• Development of a Serious Case Review process
Delivering Personalised Services
We concluded that the delivery of personalised services for
adults with learning disabilities was good.
Key Strengths
•
Referral and initial responses were sound and person-centred.
•
Eligibility criteria were clear.
•
Accessible information for people with learning disabilities was being
developed: DVDs were being increasingly used
•
The implementation of Self-Directed support was progressing positively:
the NAQ and the dedicated PCP and SDS teams were playing a key role.
•
Imaginative actions were being taken to promote some people’s
independence.
•
The Health Facilitation Service was highly effective in working across
health and social care to promote responsiveness to vulnerable people
resulting in improved outcomes.
Delivering Personalised Services
Key Strengths (cont)
• There was a strong overall approach to independent and selfadvocacy, although take-up was inconsistent.
• Carers’ Contingency Plans were being introduced and were
proving helpful when invoked.
• Day service modernisation was successfully enabling people with
learning disabilities to participate increasingly in community life.
• Community services such as libraries and bus transport were
becoming increasingly responsive to people needing extra
support.
• People who used services were becoming increasingly involved in
developing the range and quality of services that were available.
• The Single Assessment Process was well established.
Delivering Personalised Services
Key Areas for Improvement
• Capacity issues had resulted in delays in assessment work.
• Work was in hand to improve the experience of young people in
transition from children’s to adult services.
• There was more to do to improve access to information about
services and community opportunities.
• The approach to medium and longer-term planning for people
with lower levels of need could be strengthened.
• There was more to do to secure good health outcomes for
people more consistently.
• A stronger approach was needed to case reviews, recording
practice and the assurance of quality in care management.
• Support to carers was not yet strong enough.
Capacity to Improve
We concluded that the council’s capacity to improve was
promising.
Key Findings
•
There was a strong vision in the council to develop modernised, selfdirected community services: this was supported by strong leadership
in ACS.
•
Councillors were supportive of the ACS leadership and agenda:they
could play a stronger role in governance and quality assurance,
particularly for safeguarding.
•
Staff were well engaged and enthusiastic about the direction of ACS:
creativity was being encouraged.
•
Business planning processes could be further developed: performance
management and quality assurance were developing with some good
initiatives but quite a lot more to do.
•
A refreshed learning disability strategy was planned to reflect Valuing
People Now. This would sit above the existing suite of commissioning
plans.
Capacity to Improve
Key Findings (cont)
•
Partnerships with all stakeholders were developing well and people
using services and their carers felt they had real influence.
•
The learning disability service had been successfully reshaped and was
integrated.
•
The Workforce Strategy lacked detail and workforce planning was
underdeveloped.
•
There had been a high investment in training and a good range of
training and development opportunities were in place. Further work was
needed to develop a competency-based approach linked to workforce
planning; this was particularly true for safeguarding and had been
identified by the SAC as a priority.
•
The SAC had identified and prioritised most key areas needing
development to strengthen safeguarding and was driving
improvements.
Capacity to Improve
Key Findings (cont)
•
Joint commissioning was well established.
•
There was more to do to ensure services were developed to reflect the
participation and meet the needs of people from minority ethnic
communities.
•
More detailed work was underway on identifying the needs of people
with learning disabilities. This would inform the new learning disability
overarching strategy.
•
The county had been awarded pathfinder status for its work on
improving two-tier local government.
•
Increasingly close arrangements between ACS and HPFT were evident.
•
Contracting and performance monitoring of contracted services were
being developed. Contracting was becoming more closely engaged with
safeguarding work.
Next Steps
• The Business Relationship Manager would
normally monitor the delivery of the council’s
action plan through established reporting
systems.
• The judgements from the inspection contribute
to the Annual Performance Assessment.
• Monitoring arrangements will be determined by
the Care Quality Commission (CQC).