Care Assessment Survey: with Sheltered Scheme and Care Home Managers

Healthwatch Lambeth surveyed care home, supported living, sheltered housing and extra care scheme managers during 2016 to understand experiences of social care assessments, reviews and care package delivery. The work formed part of a wider national Healthwatch project examining delays in adult social care processes. Responses were received from 29 services representing 22 provider organisations. Overall, findings suggested that major delays were not a widespread issue for most residents living in supported accommodation, although a notable minority of managers reported problems affecting some individuals. 

Data provided by Lambeth Council showed that the number of social care assessments had fallen slightly between 2013/14 and 2015/16, while requests and referrals for support increased substantially following the introduction of the Care Act 2014. The Council reported aims to respond to referrals within 48 hours where possible and generally complete assessments within four to six weeks, depending on complexity. However, Healthwatch noted that the Council did not routinely collect data on assessment waiting times, making it difficult to monitor performance against these targets.

Most managers did not report significant problems, but around a third had witnessed delays in assessments or reviews during the previous year. Individual examples included poor coordination between brokerage and social work teams, lengthy waits for reassessments after changes in need, uncertainty about which service was responsible for assessment, and difficulties identifying or contacting relevant social workers. Some managers felt that residents’ deteriorating needs were not always recognised promptly, particularly in sheltered housing where some residents appeared to require a higher level of support than their current accommodation could provide.

Managers also raised concerns about the quality and appropriateness of some assessments. Examples included disagreements about care needs, concerns that some residents were not receiving sufficiently holistic assessments, and requests for scheme staff to be consulted more routinely because of their detailed knowledge of residents’ circumstances. Feedback from Age UK Lambeth suggested that some older people experienced difficulties obtaining reviews and locating social workers, although much of that feedback related to people living outside supported care settings. 

Similar issues were reported regarding care packages. Around a quarter of respondents had witnessed delays in implementing agreed packages of care. Examples included waits of several weeks or months, disputes between organisations over funding responsibilities, delays in equipment adaptations, and uncertainty about which agency should provide support in complex cases. In several instances, existing care providers temporarily filled gaps to ensure residents remained supported while arrangements were resolved.

Healthwatch concluded that while widespread delays were not evident among residents living in supported accommodation, there were examples of individuals falling through gaps in the system. The report recommended improving awareness of assessment and review processes, helping scheme managers identify changing care needs, improving understanding of referral pathways, and exploring ways to monitor assessment waiting times more systematically. It also suggested further investigation into whether people living in unsupported accommodation experience greater difficulties accessing assessments, reviews and care packages.