London Borough of Camden: local authority assessment

Staff, leaders and partners consistently told us there was an inclusive and positive culture of continuous learning and improvement. Local authority staff had ongoing access to learning and support towards care activity duties which was very effective. The staff team were well trained, motivated and worked collaboratively with people and partners to actively promote innovative and new ways of working on an on-going basis. Proactive joint working was undertaken with partners to influence and improve how care and support was provided. The documentation around co-production demonstrated a clear approach and staff and leaders gave examples of sharing power with people. Some feedback was mixed around the effectiveness of co-production activities from people. Staff consistently reported they had regular supervisions and the training and opportunities to advance in their career was available to everyone equally. Training opportunities were offered in a variety of settings and ways and training was available on specific issues if they were requested. For example, one social worker had accessed special training about continence care in care homes following a request. The induction process for all adult social care staff included a ‘What Matters’ induction where information on the direct payment offer was included. Partners described examples of research and surveys carried out by the VCSE sector providing feedback to the local authority was used as a source of informative data on the needs of communities.

Building on place partnerships and work done within the 5 local authority areas, we saw evidence of collaborative work to commission services across local authority areas, which had improved efficiencies and economies of scale. Examples of impact included, finding partnership savings on new care home placements; the implementation of digital care records in 65 care services; securing over £1,000,000 from a government initiative to adopt innovative practices and build capacity in health and social care. They had secured funding to pilot a digital service which involved technology support placed in people's homes to monitor the every-day activity of people, by observing patterns and trends and spotting potential signs of need or difficulty. The intention was to enhance people's independence and reduce care home or hospital admissions.

The local authority had used citizens assemblies and panels as part of their co-production approach to get people involved in designing services and making policy. There was a co-production plan created with 38 residents including seldom heard groups, which detailed their aim to constantly learn and improve. The framework for co-production had incorporated learning from resident feedback, staff experiences and partners views. Diverse groups had been involved and a carers action plan had been developed using it. It showed they had used feedback to drive continuous improvement. An Autistic-led reflective workshops programme had shared the findings from research autistic people had undertaken. Other lived experience perspectives were also incorporated in the reflective space attended by autistic people and service representatives. This demonstrated another example of the local authority’s relational approach to sharing power and making informed decisions. These reflective sessions had led to a creative project in partnership with the British Association of Social Workers (BASW) to create a film based on this local autistic-led participatory research. There was also a network of autism champions in development, with plans to develop ‘autism informed walkthroughs’ of services by autistic people to inform and improve service delivery. There was a co-production framework which showed the mental health day service had been co-designed and there was a co-production service for adults with learning disabilities supporting creative solutions and equality of experience. A number of autistic people had completed a leadership programme and a new role of ‘Autistic peer consultant’ had been developed at a local disability charity with the local authority’s support, they provided training with a focus on inclusive employment. Mechanisms to track progress of co-production in the local authority area included setting up a resident advisory board and using monitoring and evaluation. The specific needs of seldom heard groups were embedded in the vision for co-production, for example the Skills for Care LGBTQ+ learning framework demonstrated a commitment to inclusive practices.

Staff consistently described having the required training to assess and support people in a person centred way and included any specialist fields. They also described using multidisciplinary teams and partnership environments to support. Managers reported having access to funding to hold away days with their teams. Leaders had undertaken ‘courageous leadership’ training, and this was led from the top of the organisation. It had focused on creating spaces to have early conversations and giving people agency to deliver. It covered the local authority’s ‘missions’, which were clear statements of partnership delivery. Leaders allocated resources to the work and encouraged staff to think cross-sector. For example, private sector buildings had been used as assets in delivery of the local authority missions and a community wealth fund had been set up. We heard examples from the transitions team of young people utilising local private sector resources and buildings, with support.

There was a range of methods of listening to and involving staff, there was an inclusive innovation network, where people were given space and a place to pause and reflect and all staff ‘atriums’ where staff came together to tell their story. Staff said they were managed and supported in a way which fostered innovation.

There was a lived experience advisor strategy which demonstrated an inclusive learning orientated environment and a practical approach to managing conflict where open discussion and learning from different viewpoints were valued. There were specific measures evaluating the impact of lived experience advisors and demonstrated ongoing adaptation and learning from people’s experiences. We saw a reward and recognition draft guidance for co-production which involved financial incentives for participation in co-production activities. People told us the lack of financial reward for the time involved in co-production had been a barrier to them and through this plan the local authority were responding to that feedback. Co-production principles and vision were excellent and staff and leaders were fully committed to involvement and co-production. They had recognised and sought to address the barriers faced by people to involvement, some of which had yet to be fully implemented. We found co-production guidance was trauma informed and provided tools, resources and a framework focused on reflection and well-being. There had been positive feedback from a government department on the culture of mutual respect and collaboration between people and the local authority.

Service innovation such as the integrated neighbourhood team pilot had been influenced by an innovative use of data. We heard staff working with data had time for learning and creative exploration. They worked closely with commissioners and had the capacity and freedom to look for themes and trends and use their professional and technical skills. There were apprenticeship opportunities in data analysis. In partnership with a local higher education institution, staff had looked at pathways and prevention and drivers within a person's journey. Public health staff described an effective and innovative partnership on this work and how staff enjoyed working with data and making tangible changes in neighbourhoods and service delivery.

The local authority listened to people and learned from feedback about peoples experiences of care and support and experiences of co-production and effectiveness of involvement. People were informed and involved in strategy, improvement activity and decision making. Staff said the local authority took action when concerns were raised and staff said they were proud they were able to maintain a high standard in their work. The quality assurance framework showed complaints and compliments were incorporated and the audit process included weekly reviews of section 42's enquiries. There was use of external auditors and an annual audit programme. People and partners said communication with the local authority worked well and we heard an example of the local authority listening and acting on feedback from people about direct payments contracts and the wording of the contract following the feedback. There were many examples where feedback from staff had been sought and acted upon through focus groups, listening events, surveys and staff forums. There was evidence of feedback being given to staff following a listening event. Leaders spoke consistently about their commitment to listening to people and demonstrated a commitment to identity and people’s stories. There was a virtual listening box where contributions from staff could be given via a dedicated e-mail inbox or an online form. The exercise, for example, had gleaned suggestions about improvements to supervision which allowed leaders to take action. Elected members had been involved in developing frameworks to measure, for example, co-production challenges and then the resulting plan had funding allocated. Partners were very positive in their feedback around how the local authority listened to them and involved them. We found the learning and feedback culture was consistent across all teams and disciplines.