Council chiefs urged to assess level of risk to local adult care services

Tool launched to help adults' directors identify risks to quality or financing of adult care in local areas

By Mithran Samuel on October 19, 2015 in Adults, Social care leaders

Directors of adults’ services have been urged to use a new tool designed to assess the level of risks to the quality and sustainability of local adult social care services.

The risk awareness tool was launched last week by Towards Excellence in Adult Social Care (TEASC), the sector-led improvement coalition set up to promote improvement in local authority adults’ social services in an era without independent inspection.

The tool asks council senior managers a series of questions across areas including performance against key indicators, resource levels, workforce issues, the quality of locally commissioned services and meeting national policy priorities.

What councils should ask themselves

These are among the questions the tool suggests that directors ask themselves:

How would you summarise the impact of budget reductions undertaken so far?
Are there any particular areas of adults’ services where there are high rates of sickness, vacancies or use of agency staff?
Has adult social care recently been subject to judicial review or are there any ongoing judicial reviews?
How are you handling the challenges posed by recent Deprivation of Liberty Safeguards legal judgements?
Have you specified target response times for particular activities, such as assessments, and are these targets being achieved?
Are you or the Care Quality Commission taking action in relation to quality concerns or serious incidents within one or more local service?
Have you had any recent instances of business failure or providers unexpectedly withdrawing from the market?

Directors, or people working under them, should assess risks in these areas and then act on them, for example by identifying the biggest risks and mitigating actions for them, or drawing up an action plan.

The tool was developed for TEASC by consultants Rachel Ayling and David Walden. Launching the tool at last week’s National Children and Adult Services Conference, Ayling said that TEASC was strongly encouraging all councils to use it or a similar tool, though its use is entirely voluntary.

As well as use by individual councils, the tool is designed to be used by the nine Association of Directors of Adult Social Services regional networks, who are responsible for sector-led improvement in their areas.

Critical friends

TEASC said that every director of adults’ social services should engage a colleague from the region as a “critical friend” to provide external challenge on their self-assessment and action plan. The Adass region should then identify which authorities are in need of support to mitigate risks to services.

Walden said that such “friendly external challenge” was a critical success factor for improving risk management and that such challenge needed to be routine, not infrequent.

Eighteen areas have piloted the tool and Ayling and Walden said the response from directors had been largely positive, on the grounds that it was not onerous and encouraged self-reflection on the part of directors.

Key risks identified by directors during the pilot process were:

Future budget pressures.
Gaps in the supply of care in the market and worries about the quality and sustainability of services.
Recruitment and retention of staff.
Pressures on councils’ frontline services, including in relation to the Deprivation of Liberty Safeguards and Care Act.
Relations with the NHS, with pressures building up where local health services are under financial strain.
Organisational capacity within the council.

No easy answers

“Some of these risks are very difficult to mitigate and if you are a council running out of money there are no easy answers.”

However, he said councils were successfully sharing ideas to mitigate pressures including in relation to managing demand for care, improving hospital discharge processes and changing the way service users journeyed through the care system to alleviate pressures on frontline practitioners.