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Inspection of Older Adults Services: Monmouthshire County Council

Our findings and recommendations for Older Adult Services.

We undertook an inspection jointly with Healthcare Inspectorate Wales (HIW) (External link), and explored how well Monmouthshire County Council is promoting independence and preventing escalating needs for older adults. 

Key Findings


Well-being – the local authority demonstrates a collaborative, outcomes based approach, in which people are pro-actively involved in their ‘what matters’ conversations and subsequent decision-making.

People – voice and choice – we identified good quality, strength-based assessments are outcome – focused, and reflect people’s choices and wishes. They are used proportionately and in a timely way to inform decision-making. 

Partnerships, integration and co-production – the local authority has developed and maintained a particularly good approach to integration, with health and social care professionals working in ways focused on promoting and maintaining people’s independence.

Prevention and early intervention – Monmouthshire County Council has developed a range of innovative and creative ways to work with people in finding their own solutions in preventing or delaying their need for statutory care and support. The resources invested in an extensive range of community-based services support early intervention and good outcomes for people. 

Areas for improvement 

Wellbeing – Improve the recording of ‘what matters’ conversations so that specific personal outcomes are more fully reflected and subsequently acted upon. 

People voice and choice – more work is required to ensure people’s voice, or that of their advocate or representative is always heard and effectively represented during safeguarding processes. 

Partnerships, integration and co-production – the work of the integrated teams and other aspects of partnership working would benefit from being underpinned by a framework of agreed protocols or other means of supporting this approach. 

Prevention and early intervention – the local authority should implement an effective quality assurance mechanism which enables them to review the effectiveness of their interventions, and inform how these can be improved. 

Next steps

CIW and HIW expect the local authority and local health board to give attention to areas for improvement in the report. CIW will monitor progress through its on-going performance evaluation activity with Monmouthshire County Council. To view all our findings and recommendations read the full report below.