Adult social work teams are racking up backlogs of care package reviews due to staff shortages and increased demand, Community Care has learned.
Service users in parts of England are waiting up to 18 months to be seen, despite statutory Care Act guidance placing an expectation on councils to review care plans “no later than every 12 months”.
With local authorities facing thousands of cases behind schedule – in some areas more than 40% of reviews are delayed – councils are drafting in full teams from social work recruitment agencies or getting care providers to carry out reviews, in order to boost capacity. One council with both measures in place still did not expect to clear its backlog for another six months.
The issues were flagged in the latest set of performance reports from a series of local authorities.
Councils affected attributed the delays to a shortage of social work staff, stretched resources, and increasing demand for social care resulting from the Care Act.
The British Association of Social Workers said the picture varied across the country but some teams simply did not have the capacity to keep up with demand.
The Association of Directors of Adult Social Services said that where backlogs existed local authorities were prioritising reviews of cases where there were safeguarding concerns.
In Nottinghamshire, for example, 6439 service users have not had their care package reviewed in the last 12 months. The reviews are overdue by a maximum of six months.
Reviewing care plans under the Care Act 2014
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Paul McKay, service director for adult social care in the South Nottinghamshire region, told Community Care the council’s social work teams were understaffed to meet new demands.
“There are more people eligible for social care, increasing numbers going through hospitals, and people are obviously becoming older and perhaps have higher expectations, he said.
“That, connected with the fact that we’ve had staff shortages, has been a bit of a perfect storm.”
The council’s adult social care and health committee approved an additional £300,000 to assist with clearing the number of outstanding assessments and reviews.
This has been used to employ agency social workers on a ‘per assessment’ basis.
McKay said: “We’ve got agency social workers in our social work teams who are backfilling certain posts but we’re paying on a per assessment basis, so it’s a very different model.”
“We’ll get rid of our backlog in approximately six months and we’re hoping after that – with all the things we’ve put in place – we won’t need to use the agencies. That would be our aim.”
The council has also recently appointed 15 community care officers and 10 social workers on a permanent basis, some of whom have joined its two dedicated reviewing teams but significant vacancy levels remain in other services.
A significant number of the outstanding reviews in Nottinghamshire relate to service users who have been placed within residential or nursing homes as part of their care package.
The council has proposed that these individuals will now be reviewed by their care provider.
“The care home manager or senior nurse would undertake a provider review and that would then come to us to check if there are any concerns,” McKay said.
“We’re writing to relatives and residents to inform them of this change and that they can contact us with any concerns, and then we’ll need to look at a process for taking it forward.”
McKay added that ‘no unmet need’ had been detected as a result of the backlog, but in some cases people’s needs had reduced because of the support being provided.
“To a certain extent we’ve been over-providing because they haven’t had a review,” he said.
“Obviously there’s a cost implication to that and that’s why we’re looking now to review people in a timely fashion to ensure they remain as independent as possible.”
Cumbria Council has also brought in a social work agency to address its backlog. A recent cabinet report said there had been a ‘significant decline’ in the number of reviews being completed, with 41% of service users not reviewed or reassessed within the last 12 months.
A spokesperson for Cumbria Council said the recording process for reviews had been affected by the number of care packages being changed due to increased complexity of need.
He added: “Due to social workers leaving (due to relocation or promotions), we have agreed to contract with an independent social work provider to prevent backlogs, pending the recruitment to these vacant posts.
“Taking into account guidance under the Care Act around proportionality, we are also looking at new ways to undertake reviews, rather than the ‘one-size-fits-all’ approach.
“Where existing people in receipt of services are outstanding, these reviews will be prioritised against other priorities such as safeguarding or hospital discharges.”
‘Care management pressures’
There was a similar picture in Devon. Cabinet papers revealed that issues in the recruitment and retention of qualified social workers had affected the performance of the council’s care management service. The frequency of reviews had declined, with 3,000 currently overdue.
A spokesperson for Devon Council said a number of measures were being implemented to improve the service.
He added: “The responsiveness of our care management service, including the proportion of people receiving services who have been reviewed at least annually, is one of our three top priorities for improvement in adult social care in 2016-17.
“Pressures on the service include challenges in workforce recruitment and retention, increases in the demand for assessment and review, and increases in the complexity of people’s needs and the necessity of deploying care management capacity to enable safe changes to service provision.”