Plymouth health and social care staff numbers stagnant as demand rises

More support to be offered "at the front door"

Staffing levels at a company providing health and adult social care for Plymouth have been stagnant since 2019 despite the demand for services increasing.

A performance report from Livewell Southwest has revealed that some people are waiting 18 months for a Care Act assessment and others waiting a similar amount of time for an assessment to be completed.

Chair of Plymouth City Council’s health and adult social care scrutiny panel Cllr Pauline Murphy (Lab, Efford and Lipson) said it was “not acceptable”.

The meeting heard that there were people with “low level needs” who were “perpetually queue jumped” as more urgent cases came in.

Livewell said it is changing its priority system from ‘red, amber and green’ to one of ‘urgent and routine’ and expected the waiting list to reduce as more cases could be dealt with “at the front door” with targeted support and advice.

The company said it is being honest and transparent about the figures which it admitted are not good enough but it is trying to work with the resources it has.

This included all staff becoming competent in offering advice around the Care Act and sharing skills and responding faster to cases less urgent cases.

Chief operating officer for Livewell Ian Lightley told the panel there is clearly a gap with what the service can manage and what is coming through the door.

Recruitment and retention of staff is good but the funding isn’t there to provide more staff, he said.

He told the panel that the longest waits of more than 500 days are not the average and overall waiting times were dropping from earlier in the year.

Once a case is in the hands of a social worker or community care worker, it takes roughly 30 days to complete, he said.

“Once people are seen, turning around the work is not too bad but what we are also seeing is people with more complex needs than prior to 2019.”

Currently there are nearly 3,000 people with overdue reviews and almost 500 unallocated assessments.

Livewell’s workforce in adult social care includes advanced practitioners, mental health practitioners, social workers, occupational therapists and community care workers. It has around 500 staffing, which hasn’t changed much for five years.

Mr Lightley said more people under 65 are being seen than in the past with issues around self-neglect and mental health.

Cllr Will Noble (Lab, Moor View) said some people who were ‘green’ on the waiting list could be “waiting forever” and would eventually give up.

Cllr Carol Ney (Lab, Southway) said NHS waiting times are capped and people move up the list from green to amber if they wait more than 48 hours.

“We can’t just send them off with leaflets on diabetes. We have a duty of care,” she added.

Mr Lightley said there were different rules in social care, but it should be on a first come first served basis. “If we only have resource for a certain amount of people in a certain amount of time, we must have a clear offer for people who fall outside of that window,” he said.

Cllr Murphy said: “These figures are not acceptable – people waiting 18 months to be assessed when their health could be deteriorating.”

She asked that Livewell return to the panel soon to inform members of how it is progressing on targets.