The Care Quality Commission published three documents on 3 December 2009, with the focus of quality of adult social care.
The main points drawn from these documents were;
- Councils are improving their ratings overall, however the assessment highlights concerns that are real and affect people's lives. There has been steady improvement in ratings awarded to councils for their adult social care commissioning, with 95% of local authorities in one of the top two categories - performing either "excellently" or "well" - in the year to March 2009. This compares to 87% of councils in the previous year. However, looking at specific areas of the assessment, one quarter of councils are rated only "adequate" in terms of giving people choice and control over their care.
- Ratings for providers have also improved, however one in six providers are only "poor" or "adequate". The proportion of care homes, home care agencies, nursing agencies and shared lives schemes rated "excellent" or "good" rose from 69% in May 2008 to 77% in April 2009. However there are some 400 regulated adult social care services rated as "poor" and around 3,500 are only rated "adequate". CQC requires poor homes to produce an improvement plan and then subjects them to regular intensive inspection.
- Councils must help get rid of poor quality care by purchasing from providers more effectively, particularly in some areas. CQC's analysis shows that some councils have been purchasing a significant proportion of residential and nursing home care from providers that have been rated as "poor" or "adequate", while other councils have been commissioning a high proportion that are "good" or "excellent" (as at December 2008 - the latest data available). This raises important questions about whether commissioning is as effective as it could be. CQC acknowledges that some councils may be constrained in their purchasing and have limited availability of care provision of the right quality and price in the short term.
- CQC has identified councils where improvements in adult social care must be a priority. CQC has designated eight councils as 'Priority for Improvement' councils. They will receive greater scrutiny from CQC and will benefit from practical support from government. CQC has also selected 16 councils for in-depth service inspection on the basis of concerns about performance, gaps in its evidence or the length of time since the last service inspection.
- CQC will be vigilant about spotting the impact of the economic downturn on people's access to social care. CQC says it is encouraged to see that councils' eligibility thresholds for access to care services remain largely unchanged since last year. This follows two years in which the number of councils providing care to people with "moderate" or "low" needs fell markedly from more than 60 to only 42. But CQC stresses that there are already some areas where only people assessed as having critical needs receive any public help, with damaging consequences for individuals and carers.
- CQC is raising the bar on councils and providers. Council performance against the agreed rating system shows significant improvement and it is time to strive for a higher standard. Future assessments of councils will be tougher and they will be held to greater account for standards within the services they commission. Regulation will also be tougher for providers of services. From next year, CQC will introduce a new registration system covering adult social care providers, NHS providers and independent healthcare, underpinned by a single set of new essential standards on safety and quality. Adult social care providers will join this system in October 2010.
Cynthia Bower, CQC Chief Executive, said: "It's good to see the steady improvements and this should be recognised. However, I am concerned that many care homes and agencies have more to do to deliver the quality of care expected of them. Those affected should be absolutely clear that we will be very persistent in ensuring they take action in the run up to registration and afterwards, using all the new powers that will be at our disposal.
We have attached all four documents published by the CQC, also feel free to view the full article and findings on the CQC website.
- An assessment of 148 councils' social care services for adults, including performance against seven outcomes set by the government (pdf - 1.26Mb) (opens new window)
- An analysis of whether councils are commissioning the best possible care, whether this is from the private, voluntary or public sector (pdf - 61Kb) (opens new window)
- An update on the performance of 24,000 care homes, home care agencies, nursing agencies and shared lives schemes looking at whether quality is improving (pdf - 2.41Mb) (opens new window)
- CQC's formal response to the government's Green Paper on social care, called: (pdf - 198Kb) (opens new window)