Agenda item

Cllr Tim Bearder, Cabinet Member for Adults, Karen Fuller, Director of Adult Social Services, Victoria Baran, Deputy Director of Adult Social Care, and Ramone Samuda, Adult Social care Assurance Lead, have been invited to present the CQC Feedback and Outcomes Report.

The Committee is asked to consider the report and raise any questions, and to AGREE any recommendations it wishes to make to Cabinet arising therefrom.

Cllr Tim Bearder, Cabinet Member for Adults, Karen Fuller, Director of Adult Social Services, Victoria Baran, Deputy Director of Adult Social Care, and Ramone Samuda, Adult Social Care Assurance Lead, attended to present the Care Quality Commission (CQC) Feedback and Outcomes Report.

Two corrections should be NOTED to the report. Firstly, in the Recommendation section, the LGA report should be updated to reflect a change to March 2024. Secondly, in Table 1, it should read West Oxfordshire instead of South Oxfordshire, in row 5.

The Cabinet Member introduced Oxfordshire’s first CQC assessment under the new assessment regime, noting a “good” overall rating that matched regional performance. He credited strong leadership, a clear strategic vision, effective partnerships, workforce dedication, and innovation, and emphasised the inspection’s focus on improvement. He confirmed a continuous improvement plan was already underway to address four key areas identified for progress.

The Assurance Lead summarised the CQC report, noting Oxfordshire’s “good” rating after a January inspection and data submission from July 2024. The CQC praised strong partnerships, person-centred care, reduced waiting times, and stable leadership, but highlighted the need for more consistent rural support, improved communication, and better services for complex needs. The Director added that management and oversight remain robust, with further improvements made since the data submission.

The Committee discussed the following questions and concerns with the Cabinet member and Officers:

·       Members sought to understand ongoing concerns beyond the CQC report. The Director cited challenges in managing increasingly complex cases within tight budgets, improving data use, and keeping assessment waiting times low without sacrificing quality. There was also an ongoing need to demonstrate continuous improvement. The Cabinet member expressed worries about delays in adult social care reform, the care market’s sustainability, rising complexity and costs, and reliance on external (CQC) quality assurance. Financial pressures and changing demographics were highlighted. The Deputy Director noted growing demand, particularly for safeguarding, the pace of technological change, risks of digital exclusion, and the challenge of balancing innovation with local community expectations and needs.

·       Members queried how reducing inappropriate safeguarding referrals would not risk missing genuine cases. The Director stated that all referrals were carefully reviewed, with inappropriate ones filtered out for not meeting statutory thresholds. The countywide safeguarding team reallocates resources as needed, and ongoing collaboration with other services aims to improve referral quality. The Deputy Director explained that partners were educated on statutory criteria, encouraging reporting to avoid missing serious cases. Both highlighted exploring digital and AI tools to better manage and triage increasing referral volumes.

·       Members queried the number of people with complex needs placed outside Oxfordshire, whether this has decreased, and the impact on families and support services. The Deputy Director explained that some out-of-county placements were due to personal choice or cultural reasons, while others result from limited local specialist provision. The Council maintained close oversight, working with host authorities and health services to ensure quality and continuity of care, with regular reviews by the quality improvement team. The Director noted that historic gaps in local provision were being addressed through new investments, especially in mental health and autism services, reducing the need for such placements, though some will always remain necessary for individual reasons.

·       Members raised concerns about communication and advocate delays during hospital discharge, as highlighted in the CQC report. The Deputy Director explained that assessments now occur at home, which improves outcomes but reduces family involvement time. Actions to address communication included collaborating with Healthwatch on patient information leaflets, improving communication at admission, and implementing daily reviews of complex cases. These measures had reduced the average discharge wait by four days, with current targets of 4.5 days for general discharge and nine days for nursing home placements. Weekly discharges had increased from 120 to 150–170, and complaints had fallen due to better informal resolution.

·       Members enquired about care home provision in Oxfordshire, particularly in South Oxfordshire, and how planning for new homes was managed. The Director clarified that there was no shortage, as vacancies existed in the private sector, and the Council’s strategy prioritised supporting people to live independently at home rather than expanding care home capacity. For planning applications, the Council advised against new developments unless there was proven local demand, with demographic and geographic factors taken into account. The Cabinet Member noted that regular strategic assessments were carried out, and providers themselves did not seek to expand due to competition. He also mentioned the financial risk of overprovision, as surplus beds could eventually increase the Council’s funding responsibilities.

·       Members asked whether care provider contracts addressed uncertainties from Local Government Reorganisation (LGR) and its effect on suppliers. The Cabinet Member said contracts existed with both large and small providers, who recognised ongoing demand for care. While LGR might require new contract arrangements, there was little concern among providers. The Director highlighted that managing the market at scale supported financial stability and favourable terms, with any LGR changes handled to protect effective practices. The main provider request was for financial certainty and long-term sustainability, which scale management helps deliver.

·       Members enquired about the role of voluntary services in co-production within the Oxfordshire Way and the potential to adopt best practices, especially in advice and hospital discharge support. The Director confirmed early and ongoing involvement of organisations like Citizens Advice Bureau, with numerous contracts and collaborative networks in place. She recognised further integration of voluntary sector expertise was possible and suggested Local Government Reorganisation (LGR) could facilitate expanded partnerships. Initiatives such as the inequalities network and Marmot Place were highlighted as opportunities to enhance co-production and share best practice with voluntary services.

The Committee AGREED that the Committee Clerk and Director would consult to determine the most effective method for incorporating a detailed rural access plan, the report from the Rural Inequalities working group, and information on neighbourhood-level work into the committee’s forward work programme.