Scrutiny, CQC and ADASS

Yesterday, I read on the Community Care website that ADASS (Association of Directors of Adult Social Services.. and Housing Departments or whatever else they direct these days) are seeking a meeting with the CQC (Care Quality Commission) about

‘a new ratings system for providers will reduce scrutiny of services, to the detriment of users.’

I see a problem.

This is Adass’ (I’m not sure where you put apostrophes on acronyms.. ) response to the government’s consultation document ‘Transparency in Outcomes – A Framework for Adult Social Care’. I’m glad I came across this article because the consultation had completely passed me by.

This is a part of the government’s push from measuring targets to measuring outcomes. I remain more than a little sceptical regarding the measurements used in these systems and neither seem to devote much credit to quality over quantity and cost of support.

According to Community Care

The government has proposed replacing the quality ratings system, under which the CQC graded all registered providers as poor, adequate, good or outstanding, with a voluntary “excellence standard” for the best providers, in consultative plans to overhaul the adult care performance system.

The article goes on to quote Adass saying that this

‘”could be particularly disadvantageous to self-funders and people using personal budgets to arrange their own support, particularly as this new system does not distinguish between ‘adequate’ and ‘better than adequate’ service or between ‘good’ and ‘excellent’ service.”

It warned that the system may also favour larger providers that had the financial muscle to apply for an excellence rating, and may lead councils to increase their own monitoring processes, increasing costs.

Quality ratings were scrapped last August, but Adass warned: “Further we are concerned that there is no timeline, implementation plan or agreement about how this system will operate.”

So we are currently in a period where ratings have been scrapped and they have not been replaced – meaning that there is no quick, easy and current way to check the standards are being met or exceeded by care services. The system intended to replace the previous one is reliant on voluntary standards which will be easier for large companies to achieve to the detriment of smaller providers.

More costs are being pushed from the CQC and the ‘central pot’ towards local government and quality assurance teams which are being cut (certainly in my own borough) due to central government cuts.

You know those ‘back office staff’, and ‘non frontline staff’, Mr Pickles? Those were the people who were checking on the quality of the services provided to your proverbial grandmother.  Why did they need to check so much? Because the CQC is a shadow of what it should be and has had all funding removed and is no longer fit for purpose and reliant on voluntary systems of regulation.

Would OFSTED be allowed to operate in this manner and haphazardly decide that they only wanted to check children’s services when they felt like it or when they fail? Or you know, that school should be ok because it hasn’t been so bad as to be reported to us? No, we demand more for our children so why don’t we demand as much for our older and disabled citizens who need  more regulation not less.

The government pushes direct payments and personal budgets but washes her hands of any regulatory support to promote quality. They are gearing up a system that will be heavily favouring large companies like Care UK – you know, the organisation that funded Lansley’s private office and is geared up towards taking over whole swathes of the NHS.

Even if you think you have no interest in adult care, you would be wise to listen and learn to the Cassandras like myself who constantly shout while the regulatory body is being stripped away.

This is exactly the way the government want to take the entire NHS.

We must learn from these lessons and not be fooled by the language of choice. Choice has to be a choice of quality rather than solely cost. Often the two are not the same. That has been the lesson of the deregulation of care services.