'Serious concerns' over adult social care provision

An authority's adult care provision is not meeting its responsibilities to ensure people have access and support, a report has found.

The Care Quality Commission (CQC) rated Southampton City Council as "requires improvement" and also raised "serious concerns" around safeguarding processes.

Chris Badger, CQC's chief inspector of adult social care and integrated care, said the inspection team found an authority in which "significant and prolonged leadership instability had affected its ability to deliver consistently good access to adult social care".

Southampton City Council has been approached for comment.

The assessment team found that leaders had not provided "adequate respite support for unpaid carers, with far fewer carers able to access emergency breaks or short breaks than the national average, contributing to burnout".

Inspectors said the authority had not appointed a strategic safeguarding lead for a significant period, leaving adult social care "without proper direction" or someone "able to consistently have a grip of the issues to manage risks, leaving people at risk of coming to harm".

The council had also not carried out timely reviews of care packages, leaving many people on outdated support plans that no longer reflected their changing needs, the CQC said.

Badger said the authority had been through 11 adult social services directors in 12 years, and that management and quality assurance arrangements "were still being rebuilt following organisational restructuring" at the time of the assessment.

"This meant leaders didn't yet have a grip on the areas of concern in order to address them quickly," he said.

"These included delays in assessing safeguarding and risks to people's safety that came from concerns not being addressed in a timely way," he added.

"We saw recommendations from a safeguarding review from March 2024 still hadn't been implemented by the time of the assessment."

He said the authority needed to do more to "ensure there is equity in outcomes across different communities".

The CQC also described a "recurring unaddressed theme" across several reviews that "unconscious bias and poor cultural inclusivity was having an impact on people's ability to access adult social care and their experience".

Badger said: "This is particularly important in such a diverse area as Southampton where more than a third of people don't describe themselves as White British, one in seven don't speak English and more than half of residents live in some of the most deprived areas in England."

However, the report said leaders "responded effectively" when a company providing equipment to help people remain independent at home ceased trading at short notice.

They worked quickly to partner with another authority to "maintain supply without critical shortages and continuing to meet people's same-day and next-day equipment and support needs," the regulator said.

The council also "acted quickly on complaints about disability-related expenses" by reviewing and changing its processes, resulting in no further complaints.

The report also singled out the council's strengthened commissioning of home care services in a positive light.

It said by making quality a significant factor in provider selection - 30% of the overall scoring process - it resulted in 81% of providers being rated good or excellent, and that the overall performance improved by 26%.