The CQC has rated Lancashire County Council’s adult social care provision as “requires improvement” across all nine areas.
The Care Quality Commission (CQC) has rated Lancashire County Council as “requires improvement” in how well it is meeting its responsibilities to ensure people have access to adult social care and support.
The CQC looked at nine areas spread across four themes to assess how well the authority is meeting its responsibilities in order to create its “requires improvement” rating.
None of the categories – from assessing people’s needs to learning, improvement and innovation – had a score above two, indicating an urgent need for development.
“While people using services spoke positively with us about committed and compassionate staff, we had concerns about how quickly the authority was able to assess their needs,” said James Bullion, CQC’s chief inspector of adult social care and integrated care.
He went on to say that more than 2,000 people were still waiting for assessments, some up to 226 days. He was also concerned by the fact that more than 3,500 people were waiting for their annual reviews – some for many years – in which time their care needs could have changed dramatically.
A series of problems
In addition to delays in care assessments and reviews, the assessment team found long waits for occupational therapy (up to 262 days), Deprivation of Liberty Safeguards (DoLS – up to 405 days against a 21-day target), and advocacy services.
The CQC identified workforce pressures causing major challenges. Staff cited unsustainable workloads due to long-term vacancies, especially in occupational therapy. Morale was affected by leadership and system changes, rising demand, and change fatigue. Mental health was a leading cause of sickness absence. Staff felt senior managers ignored frontline impact and their concerns about new processes, fuelling low confidence and retention issues.
At the same time, lack of staff continuity was affecting people’s experience and safety. Frequent practitioner changes meant people had to repeat themselves, couldn’t build relationships, and felt unsupported. Together with that, the communication systems did not help. The telephone system was hard to navigate, with confusing menus and delays of up to a week for urgent and three weeks for non-urgent call-backs. The website was also seen as inaccessible, with small text and hard-to-find information.
Partnership working was hindered by strained relationships, limiting collaboration. Some organisations had disengaged, and many felt success relied on individuals rather than structured systems. Historic tensions with health partners and funding disputes also blocked integration.
There were also stark inequalities between the most and least deprived areas, with higher unemployment, sickness, poor housing and caring responsibilities.
