London Borough of Hounslow: local authority assessment
Learning, improvement and innovation
Score 3
3 - Evidence shows a good standard
The local authority commitment
We focus on continuous learning, innovation and improvement across our organisation and the local system. We encourage creative ways of delivering equality of experience, outcome and quality of life for people. We actively contribute to safe, effective practice and research.
Key findings for this quality statement
Most staff we spoke with emphasised the opportunities for learning and development. There was a particular focus on supporting experienced unqualified staff in social work and Occupational Therapy teams, to gain professional qualifications. There was an inclusive and positive culture of continuous learning and improvement, limited only by workers ability to manage workload and find time. Local authority staff had ongoing access to learning and support so Care Act duties could be delivered safely and effectively.
The Senior Leadership focused on improving practice and told us they wanted to increase opportunities for reflection on practice and consideration of the theoretical models being used to inform decision making. The Principal Social Worker led on the Annual Social Work Healthcheck, on work with the Social Care Institute for Excellence which focused on Practice with Impact, and on the creation of the Practice framework. They were also responsible for delivery of the Training and Development plan agreed with the Director of Adult Social Care and the Executive Director (Statutory DASS).
Senior leaders told us they would adopt a Reflective Practice Model called Schwarz Rounds so that staff could have peer group discussions outside of their own teams. The local authority worked collaboratively with people and partners to actively promote and support innovative and new ways of working to improve people's social care experiences and outcomes.
The local authority shared learning, best practice and innovation with peers and system partners to influence and improve how care and support is provided. For example, mental health commissioners had shared their innovative commissioning practice of providing accommodation and support to people with complex needs, with neighbouring London boroughs, as it had reduced acute hospital bed usage. They were hoping to encourage a cohesive mental health approach across the Integrated Care Board and were being used as an example for how it can be done.
We were also told about efforts to use a more collaborative and joined up approach to work around frailty, through use of joint commissioning and shared resources delivered under the Integrated Care Partnership Board.
Co-production was acknowledged to be at an early stage in the local authority’s work. There was consultation but they were seeking to transform the way they co-produced with people. This was described as a ‘Radical Overhaul of Consultation and Engagement’. In their recently developed Improvement Plan (November 2023) they had actions set to develop and carry out a co-production plan, setting out how co-production will be progressed across the themes of working with people, providing support, ensuring safety and leadership.
The local authority had actively sought peer review and developed an Improvement Plan in response to its findings. Hounslow actively participated in Peer Review and sector-led improvement activity. Hounslow engaged with partners in London ADASS for professional network support/best practice and tackling inequality in London workforce for Adult Social Care. The local authority had the ability to draw on external support to improve when necessary.
The local authority learned from people’s feedback about their experiences of care and support, and feedback from staff and partners. This feedback informed strategy, improvement activity and decision making at all levels. A partner told us having collaboration enabled engagement in various projects, such as ‘health in the park’, which informed discussions on what to prioritise. Internally, the Adult Social Care Quality Assurance Process report provided insight into areas for improvement such as better recording of steps taken during an assessment and of what people considered important for their wellbeing. The council responded to feedback from the ‘Our Voice Our Say’ group which noted the inaccessibility of local authority forms, by commissioning them to address this communication barrier using easy read documents.
There were processes to ensure learning was gained from when things go wrong, and from examples of good practice. Leaders encouraged reflection and collective problem-solving and 7-minute briefings were circulated after Safeguarding Adult Reviews. Hounslow had 5 investigations by the Local Government Social Care Ombudsman (LGSCO) in 2022/23 and had a slightly higher uphold rate at 80% than other comparable local authorities. This meant that the Ombudsman agreed with the complainant in 4 out of the 5 cases and in 2 cases the authority was slow to respond but did so without any further action from the Ombudsman. 26 complaints were sent directly to the authority in 2023 about adult services. A senior leader told us they looked at reviews of all complaints and authorised responses to all LGSCO complaints, to see what they need to learn. This could lead to practice development or service improvement which could reduce the likelihood of future complaints. They told us there was always more to be done. Some staff we spoke with talked of a ‘no blame’ culture, where learning, and collective problem solving was normal practice.