Care Inspectorate Wales and Healthcare Inspectorate Wales conclude assurance check of Torfaen learning disability services

We have recently completed an assurance check with Healthcare Inspectorate Wales of Torfaen County Borough Council's Community Learning Disability (CLDT) service and the Learning Disabilities Directorate within Aneurin Bevan University Health Board.

Key improvements identified

Our inspection found that the co-located model of the health board and social care is a significant strength and represents effective practice in integrated service delivery.

The co-location enhances access to services, reduces delays, and ensures care is better aligned to people's needs. All staff report that the partnership between health and social services works well or very well. Strategic and operational relationships are characterised by collaborative communication and a stable workforce.

Nearly all people rate their care as good or very good, with staff consistently described as kind, caring, supportive, and good at listening. Most people experience strength-based and person-centred planning.

The local authority has taken a sustainable approach to strategic improvements, including developing services for Information, Advice & Assistance and Integrated Reablement.

The local authority has implemented innovative decision-making forums, including the 'fishbowls' approach, which has received recognition from the Equality and Human Rights Commission.

People experience a joined-up approach to eligibility and care planning. Wellbeing workers support people to explore what matters to them, and the use of reablement services enables people to move towards more independent lifestyles. Few people experience waiting lists for domiciliary care, reablement, and care homes.

Staff manage safeguarding concerns in line with the All Wales Safeguarding procedures with appropriate managerial oversight, and staff complete best interest decision paperwork thoroughly.

Areas requiring further development

Whilst recognising these strengths, our inspection identified some areas where further progress is needed.

The local authority must ensure people are consistently offered direct payments in line with legislation.

The health board must ensure people consistently receive their annual health check and should promote a named GP for people with a learning disability, with improved pathways to primary care and physical disability teams.

The local authority must ensure sufficient staff are trained to complete Best Interest Assessments and that all people deprived of their liberty in community settings have timely applications made to the Court of Protection in line with legal requirements.

The voice of people with learning disabilities should be strengthened in plans and safeguarding records, and the active offer of formal advocacy should be consistently provided.

The local authority should urgently consider research recommendations to improve employment opportunities for people with a learning disability, with both the local authority and health board developing opportunities for inclusive and supported employment.

Support for carers requires improvement, with variable information sharing and mixed experiences highlighting the need for better communication, consultation, and follow-up.

Next steps

We expect the local authority and health board to consider the areas identified for improvement and take appropriate action to address them.

CIW will monitor progress through our ongoing performance review activity. Where relevant we expect the local authority to share the positive practice identified with other local authorities to help drive continuous improvement in statutory services throughout Wales.

HIW will monitor progress against the health-related improvements via completion of an Improvement Plan, which will detail the findings and agreed improvement actions with responsible officers and timescales.