Adult social care provided by the Royal Borough of Windsor and Maidenhead requires improvement, according to the health watchdog, which has found shortfalls in safeguarding and some people facing long waits for support. 

The rating is against 'a backdrop of increasing demand and severe financial constraints', according to the council's cabinet member for adult services, Councillor Catherine del Campo. 

The report from the Care Quality Commission follows an inspection at the start of the year, which reviewed the council's £48 million adult social care system, supporting more than 2,000 people. 

Inspectors found 'shortfalls' in work around safeguarding, management, partnerships, and care provision, as well as some people waiting 'too long' for occupational therapy. 

The council had demonstrated 'good standards' around assessing people's needs, supporting people to lead healthier lives, and safe transitions. 

The overall CQC grade was just one point away from a rating of 'Good'. 

But the report said that those in need were waiting 'too long for a full assessment of their occupational therapy needs', with some waiting up to six months.

At the time of the assessment, there were almost 200 people waiting for a full occupational therapy assessment. 

Staff also weren’t always able to deliver timely annual reviews of people’s care and support need, according to the report. 

Among other issues highlighted was a lack of personal payments, which can be spent on care and support services  for people needing adult social care.

Just 12 percent of supported individuals were receiving direct payments - lagging behind the national average of 26 percent across England, 

People who 'lack mental capacity' also had 'limited' access to advocates, including family or friends, to support them when accessing care and support. 

Just 58 percent of people lacking capacity were supported by advocates -  'significantly lower' than the national average of 83 percent. 

People who lacked mental capacity to make particular decisions faced a risk of not having their voices heard in decision-making that affected their lives, according to the report. 

The council is working to improve its rating with a range of measures, including replacing its 'ageing' case management system with a new system due to go live in January 2025, according to Councillor Del Campo.

The councillor said: “Our rating reflects the fact that we are working hard to deliver a good service against the backdrop of increasing demand and severe financial constraints.

“Whilst the CQC report shows that we have missed out on a good rating by one point, the report sends the clear message is that our improvement plan is the right one and as transformation work becomes embedded in everyday practice, we strengthen our position going forwards.”

The local authority estimated that it would spend £41,596.000 of its total budget on adult social care last year, while its actual spend was £48,862,000. This was 24 per cent of its total budget. 

James Bullion, CQC’s chief inspector of adult social care and integrated care, said inspectors had seen 'positive' steps to address the concerns in the report. 

The chief inspector said: "The Royal Borough of Windsor & Maidenhead has a great foundation in place on which to build their future plans and make improvements with local people at the heart of it. 

"We look forward to returning to see how they’ve done this and how their current plans mature.”