Gateshead Council: Peer review and challenge The context ‘Towards excellence in councils’ adult social care’ (TEASC) is a national programme helping councils to improve performance in adult social care. It is a sector-led initiative building on the self-assessment and improvement work already carried out by councils. The core focus of TEASC is on promoting innovation, excellence and collective ownership of improvement. The programme has been working with local authorities rated as ‘adequate’ for adult social care by the Care Quality Commission (CQC) in its last round of assessments. TEASC has provided funding for the improvement plans of these councils, based on the principles of sector-led improvement. Gateshead Council was rated ‘adequate’ for adult social care in 2010, when the issues raised included the quality of nursing care, delayed discharges, and the number and spread of assessments. This followed a service inspection in 2009 which had given a ‘poor’ rating for adult safeguarding. Since then, Gateshead has been on an intensive and ongoing journey of improvement.
Developing an improvement plan David Bunce, Gateshead’s Group Director of Community Based Services, says that once the disappointment of these findings had been absorbed there was a real determination to improve services. The whole authority was keen to offer support to adult social care as it embarked on developing an improvement plan.
With support from the TEASC programme, Gateshead was determined to use all the sector-led improvement tools available, including peer review and peer challenge to provide an independent focus. A clear improvement and development action plan was developed, with a focus on four key areas: safeguarding; partnerships with health; vision, strategy and leadership; and performance management. David Bunce says the improvement plan was a “root and branch” approach which set out to create a new professional standards and practice competency framework; refine systems, policies and procedures to support safeguarding (including more joined-up and partnership working); and with elements of mentoring, coaching and improving supervision/performance management. The plan also brought clarity around what success would look like and how it could be measured, evaluated and acted upon. The team decided to take every opportunity to bring in external challenge and support to validate and enhance its progress. This included two peer reviews and a final peer challenge as part of the TEASC programme.
New ways of working All this was against a backdrop of severe pressures on spending and demand which placed a focus on reallocating resources. As a result, Gateshead has introduced some new ways of working. For example, rather than having a safeguarding team within adult social care, there is a new community safety team which works across the authority to reinforce the message that ‘safeguarding is everybody’s business’. Within two years of the improvement work beginning, Gateshead’s safeguarding practices went from being highlighted as a significant concern to the point where the peer challenge team said they could be considered to be a “national exemplar”. The peer challenge also found that there was clear political support for adult social care, a clear vision for safeguarding, good corporate links and partnerships across Gateshead, improvement and development plans with clear milestones, and that person-centred planning was integral to the work of the directorate. The peer challenge team said they were impressed with the scale of progress made.
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While there is an element of frustration that the changing assessment landscape means Gateshead’s progress cannot be assessed through comparative measures, David Bunce is satisfied that the external validation provided through peer review is evidence of the significant progress made.
Sustainable improvement When Gateshead’s work was presented to the TEASC board, members also noted that the council had developed vigorous plans to sustain and develop the improvement agenda. These took account of future budgetary challenges and the need for continuous improvement with an outward focus to learn from others, as well as contributing to best practice. The board said: “It was noted that you intend to build on workforce planning, develop more effective commissioning and extend personalisation, as well as continuing to develop safeguarding in terms of user involvement and improved performance management.” As for the residents of Gateshead, they can be confident that adult social care services are improving and are in an excellent position to tackle any future challenges. “The peer reviewers had no agenda other than to help us improve,” says David Bunce. “The way the reviews and challenge were conducted was extremely helpful. All parties went into it with a clear sense of the scope and with the outcomes clearly identified. The whole process was well received by staff, who were wary at first of what they perceived as more inspection and assessment. It was as supportive as possible while being hugely challenging at the same time.” For further information please contact David Bunce, Group Director of Community Based Services, Gateshead Council: davidbunce@gateshead.gov.uk.
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© Local Government Association June 2011
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