Agenda item

Report to follow.

Chris Atherton, Principal Social Worker and Head of Quality Assurance & Development for Adult Social Services, introduced the report for this item beginning with social care reform. Proposed measures on liberty protection safeguards and the social care cap had been pushed to the next Parliament. Changes to the Mental Health Act had been pushed back by a Parliamentary Committee which stated that it did not do enough to tackle inequalities and rising detention rates.

The new inspection regime for adult social services by the Care Quality Commission (CQC) was being slowly implemented with pilot work ongoing with five local authorities until September 2023 and then another 20 local authorities from then until March 2024. The aim was for all local authorities to be inspected and rated in the two years after that. The CQC had identified four themes for local authority assurance:

• How local authorities work with people – including assessment of needs, supporting people to live healthier lives and equity in experience and outcomes.
• How local authorities provide support – including market shaping, commissioning, workforce capacity/capability, integration and partnership working.
• How local authorities ensure safety within the system – including safeguarding processes/frameworks, reviews, safe systems and continuity of care.
• Leadership – Governance, management and sustainability. Learning, improvement and innovation. 

Chris Atherton said that, from their work with ADASS and the LGA, it was clear that the CQC would have a particular focus on recruitment, retention and development of staff. The redevelopment of the Council’s workforce strategy had therefore aimed to identify the key drivers that relate to its workforce, Haringey as a borough and its connection with the wider system. From this, workforce priorities had been developed including staff welfare and wellbeing, leadership and management traineeship, apprenticeships and career pathways.

He added that it was often difficult to get the workforce supply that was needed and so consideration had been given to developing capacity moving forward. Low vacancy rates improved outcomes for residents, improved service delivery and improved new models of practice. The Council’s new social work and occupational therapy officer roles would provide stability to the workforce and future proof services by ensuring a steady flow of social workers and occupational therapists into the service each year by providing clear pathways into professional qualifications.

Chris Atherton, Vicky Murphy and Beverley Tarka then responded to questions from the Panel:

• Helena Kania expressed concern about the extensive staff time taken up by preparing and responding to inspections. Vicky Murphy agreed that this was an issue and said that preparation was key, including the work that had already been done with the commissioning review and the workforce review. They had also joined the ADASS group for peer review and would obtain experience from contact and collaboration with other local authorities. Beverley Tarka added that ADASS had worked closely with DHSC (Department for Health and Social Care) over the development of the inspection framework and were pleased that these focused on people’s experience of care and support and the outcomes that people identify for themselves. There would be more learning after the first five pilots had been completed and there was also significant support available from ADASS and the LGA for all local authorities.
• Beverley Tarka also spoke about the recent ADASS spring seminar report which had highlighted the significant pressure that Directors of Adult Social Services were under across the country in terms of demand and responded to need. The government had provided some short-term funding which had seen some improvements, but more sustainable funding was needed for social care in the longer term.
• Asked by Cllr Mason about the reasons for staff leaving, Chris Atherton said that exit interviews were carried out and there were various reasons for people leaving which were not specific to Haringey. Chris Atherton explained that there was currently a challenging picture with a 30% vacancy rate which was being filled with the agency quota. A lot of agency workers moved outside of London as they could get better rates. However, it was not good to be reliant on agency workers because of the inconsistency in care and support to residents. Other issues raised by people leaving included Covid fatigue, work-life balance and the requirements of commuting. Staff surveys had recently been carried out to ascertain what additional support they felt they needed and this information was being used to improve the staff offer. Audits had been carried out on support and supervision for practitioners which would help to develop the role. Cllr Mason commented that a 30% vacancy rate represented a high risk for the Council and that it would be useful to continue to monitor staff turnover rates in future. (ACTION) Vicky Murphy added that the Council was currently in the process of transferring six qualified social workers to permanent posts which represented around 15%.
• Cllr O’Donovan asked about progress towards recruitment in the new social work and occupational therapy officer roles. Chris Atherton explained that this was currently in the pilot stage and that there were 10 practitioner roles altogether in areas such as mental health, learning disabilities and adult services. The practitioners were passionate about the opportunities that these roles provided and were involved with assessment, reviews, support and planning. This provided the mould of, for example, a social worker without the level of complexity or risk that a qualified social worker would hold but with the opportunity to follow a career path that could lead to full qualifications. This was developing a completely new model for the workforce to drive forward the outcomes that they wanted to achieve for residents. Vicky Murphy added that this approach would enable more employment opportunities for people with lived experience and draw in these strengths to local communities. Partnership and co-production would also be key elements of this work and this would be included in the CQC inspection.
• Cllr Iyngkaran asked about the cost pressure of agency work on the budget as it was more expensive. Chris Atherton acknowledged that the cost of agency staff was higher than permanent staff and that specific details of the cost could be provided to the Panel in writing. (ACTION) However, from a workforce perspective, he felt that Haringey had an excellent offer for permanent staff with the workforce strategy and opportunities for practitioners to do post-qualifying. In the last six years, every application made by internal staff to develop their career pathways and the budget for training and development had remained intact during the previous budget cuts. There was also the general training and learning development offer for staff, some of which was run through commissioned organisations or individuals with particular expertise.
• Cllr Iyngkaran requested further details about staff training, noting that this required a full training plan and funding to support this.
• Cllr Brennan asked about the workforce age graph provided in the agenda papers and expressed concern about the high proportion of older social workers and the impact on the workforce when they retired. Chris Atherton acknowledged that the age profile was an issue, but pointed out that social work tended to be something that people came to later in life and may have experience of working in the care sector before becoming a social worker. However, the current aim was to ensure that there was a more robust offer of bringing students into placements and developing pathways that could lead to the point of qualification including the apprenticeship and social work practitioner roles that had been discussed. This would help to negate some of the age differences.
• Asked by Helena Kania about the involvement of the CQC with carer agencies, Vicky Murphy said that a key line of enquiry for the CQC was on partners and co-production so partners, including agencies, would be engaging with the CQC as part of the inspection process.
• Referring to page 105 of the supplementary agenda pack, Cllr Peacock highlighted that “communication across the piece” had been identified as an issue under ‘workforce’ and observed that for many people in the community, the ideas that had been discussed needed to be communicated in easy-to-understand language. Vicky Murphy responded that there had been work with the communications team, and on the redevelopment of the Council website to improve the information that was available. The new locality approach was also based on communicating with people directly in local communities.

Summarising the key issues that had been raised, Cllr Connor said that the Panel appreciated the challenges involved with the workforce issues but queried whether there were sufficient resources in place to support the new roles and apprenticeships. She added that the new roles of social work officer and occupational therapy officers needed to be explained to residents so that they were aware of who they were interacting with. She also highlighted the risks associated with the high vacancy rate. Cllr Connor suggested that a further update on progress with workforce issues should be scheduled for a later date. (ACTION)

On communication and co-production with residents, Cllr Connor observed that there would be a challenge involved with helping residents to understand how they were going to be asked to be engaged in this process. Vicky Murphy said that plans were in place to start that co-production work, starting with a series of workshops and she was keen to continue working with the Panel on the outcomes that they needed to achieve and to obtain feedback.