Community and Social Services for Adults and Older Adults – Follow-up

Background

In 2015, the C&AG reviewed Community and Social Services operated by the (then) Health and Social Services Department (HSSD). Her report identified significant issues and made a series of recommendations.

At that time, the Community and Social Services Division (C&SSD) of HSSD provided a range of health and social care services to three groups – children, adults and older adults. Since then:

• there has been extensive further scrutiny of Children’s Services including by the Independent Jersey Care Inquiry (2017) and the Office for Standards in Education, Children’s Services and Skills for England (2018)
• Children’s Services have moved to the newly formed Department for Children, Young People, Education and Skills; and
• Adult Services and Older Adult Services have formed the Community Services element of the reorganised Health and Community Services Department (HCS).

Scope

This follow-up review focusses on the implementation of recommendations made in the C&AG’s 2015 report in so far as they relate to Adult Services and Older Adult Services. Given the scrutiny of and structural change relating to Children’s Services, this review does not extend to those services.

Conclusions

The services covered by this review are provided to some of the most vulnerable people in Jersey. The C&AG’s concerns about the way in which those services were managed were significant.

Progress in implementation of agreed action has been poor. Perhaps most concerning is that there were no effective arrangements for monitoring implementation of agreed actions or their impact. The former Health and Social Services Department did not display a learning culture: it did not take on board my recommendations or those from other external reviews (including those of children’s services) to drive improvement. As a result, risk has not been effectively managed, which may have contributed to the repeated Health and Safety failures and the findings of the recent quality and safeguarding review.

Over the last 12 months arrangements have improved. However, more work is required to embed a robust approach to responding to external reviews and agreeing, implementing, monitoring and reporting on change.

Until the States focus on implementation of agreed actions and the outcomes of implementation, opportunities to drive improvements in the services provided and to mitigate the very substantial risk to vulnerable people will not be secured.