This relates to strategic planning, learning, improvement, innovation, governance, management, and sustainability.

Strengths

• Bexley has a strong and coordinated system approach which is evident at all levels of the organisation. The matrix management approach across the Place is well established and the capacity has been strengthened by the introduction of two roles following the retirement of the Executive Director earlier this year.

Considerations

• Whilst the partnership working is undoubtedly strong the peer team did identify some gaps within the internal Council practice model and leadership and the associated supporting policies and procedures.
• The Council and its partners have established overarching joined up visions and structures in place but the operational delivery scaffolding for front line practice was less well defined. Consequently, the peer team struggled to see demonstrable evidence of how practice was translating into improved outcomes for the most complex people. The Council may want to focus on strengthening this narrative.

Quality Statement Eight: Governance, Management, and Sustainability

The Council has a strong and connected leader who understands system working. Other elected members showed a good awareness of, and interest in adult social care, including being able to give examples of service response and delivery. Front line staff were used to service visits by members and the Mayor and appeared fairly relaxed regarding councillor engagement.

Leadership is both system and internally focused which is a strength with a range of governance and strategies in place at a strategic level. On a tactical and operational level there appeared to be some gaps in operating polices that scaffold and support practice which is likely to impact on ability to describe outcomes in a strengths-based way. There is a need to assure sufficient focus on Care Act duties, particularly the practice model across staff and partners. To support this the Council may wish to strengthen its professional leadership capacity in social work and occupational therapy.

Staff mostly reported that they feel supported by their front-line managers and that they have good working relationships, there were some exceptions to this which were highlighted to leaders within the review.

The Council and the ICB are both financially challenged. Bexley is a relatively low funded authority and is also a relatively low spender. This does create risks given the integration with the NHS and the peer team heard reports of decisions taken at ICB level that reversed previously agreed Place arrangements. This is a significant risk for all partners.

A lack of affordable and available housing is recognised as a national problem and something that all local authorities are dealing with. The market position statement makes a reference to a need for increased Extra Care and there was a clear narrative across the board that a lack of appropriate housing was a significant challenge. Whilst this was acknowledged within the review and there is a combined strategy the priority of the Council in this area is not as high as would be given that Bexley has both social care and housing functions.

Quality Statement Nine: Learning, Improvement, and Innovation

Bexley has significant innovation and learning in relation to the operating model and integration. There is a clear leadership narrative around innovation rather than making savings. The OneBexley model is expanding. The level of trust and cohesiveness across the system is evident from all angles and some of the work, such as the safeguarding adult board agenda is exemplary.

The voice of front-line staff and people with lived experience in supporting and developing service change did not come through as strongly as would have been expected given this level of integration. There is a risk that the positive working model is seen as the overall achievement rather than the enabler to improving outcomes for individuals with care and support needs.

There is an open offer of training to the entire system for Council delivered training and safeguarding adult board training and this offer is clearly articulated within the Councils Professional Standards Framework.

There was evidence through the review of an increasing amount of resource that has been invested in quality assurance processes, for example; an increase from four to seven quality assurance officers, practice forums, implementation of electronic market management software (PAMS) and utilising lessons learned from safeguarding. Staff working in this area were clearly able to describe the quality assurance governance. This would benefit from linking to a formal practice model to ensure it is an effective use of resources.