Paul Snell has a difficult job on his hands as the new chief of the Commission for Social Care Inspection.
Snell, who took over from David Behan in early September, already knows the organisation will not exist in its current format within two years, with the inspection of children’s social care moving to Ofsted next year and CSCI’s adults’ services functions due to merge with the Healthcare Commission in 2008.
But he is determined that CSCI’s operations will be fit and healthy when the time comes for them to move.
Indeed, Snell says the name of the organisation does not matter so much as the job that’s being done.
“People out there don’t care what organisation does this stuff,” he says. “It’s not the organisational form that’s important, it’s the primacy social care has in these new organisations.”
But that, of course, is a worry for many in social care, given the huge clout of the education and health sectors.
Snell is adamant, though, that social care will occupy a central role in the new inspectorates.
“Issues around safeguarding children will never go away,” he says. “They will have a primacy in Ofsted. I think social care will always hold its own.”
Although CSCI has known for some time that its days are numbered, that hasn’t stopped it making and planning big changes to the regulatory regime for social care providers, while its public pronouncements on services have become more forthright, even critical, in recent months.
Here, Paul Snell talks about some of the major developments.
The “light touch” inspection regime for adults’ services
Introduced in April, this is designed to allow CSCI to focus on poor performers while good providers could face only one inspection every three years.
However, this has been criticised by some campaigners, including Action on Elder Abuse chief executive Gary FitzGerald, as well as members of the public who responded to a consultation on the plans, who said the quality of care could change as often as staff and management changed.
But Snell is convinced of the new regime’s merits, saying it has allowed CSCI to inspect all poor providers in the first quarter of 2006-7, and a “significant number” of those are already showing improvement.
He is adamant that the new system is not a cost-cutting exercise, and says it will give CSCI “a better bang for our buck”.
He adds: “Rather than a sledgehammer, we think this is more of a scalpel. We were not convinced the previous way of inspecting services was the best way.”
And he also says CSCI will take action “with a hard edge” against providers that fail to respond to its recommendations for improvement.
The report into the abuse of people with learning difficulties in Cornwall made for frightening reading. CSCI and the Healthcare Commission said there was evidence of staff hitting people, withholding food and an over-reliance on medication to control behaviour.
Much of the criticism was reserved for Cornwall Partnership NHS Trust, which ran the services, but the report also identified problems at Cornwall Council, particularly in adult protection and in assessing people and commissioning services.
This, however, brings into question the record of CSCI and its predecessor, the Social Services Inspectorate.
Cornwall was awarded three stars in 2003 by SSI, followed by two stars in 2004 from CSCI and two stars again in 2005, but abuse was taking place during this period.
Snell, though, views the Cornwall case as an example of the “importance of regulation and inspection” because much of the abuse occurred in unregistered care homes.
“The NHS trust didn’t register those services with us,” he says. “Had they been registered and had we inspected them, I don’t think Cornwall would have happened as it did.”
He says, though, that CSCI is inspecting councils to see if they are taking the lessons of Cornwall on board.
CSCI has been taking councils to task for months over poor commissioning practice, most recently with criticism from chair Dame Denise Platt.
Snell says councils need to think more about commissioning services for their whole population, not just those they are immediately responsible for, and must also give people more choice about the services they receive.
He uses the example of a restaurant he visited on his summer holiday to Italy.
“The menu said they had two lots of pasta – one with scampi and cream, the other with lobster, tomato and basil. I’m not keen on lobster but I would be keen on tomato and basil. But they said that’s not the way it comes.
“In this case the chef is the professional, he decides how the meal comes, and you can buy it or not buy it.
“But it’s not just about what’s on the menu, it’s if people have choice about what goes on it.”
Snell says councils also need to cut the costs of transacting with providers. Contracts are often “overspecified”, but he says councils should instead start from an outcomes-based framework that allows providers more flexibility to design services.
Consistency of inspections:
A Community Care study of CSCI’s proposed star ratings for care providers highlighted ongoing concerns over the consistency of inspections, and Snell acknowledges this is an issue raised “at every conference we speak at”.
However, he is also sure that the commission is addressing any problems that exist.
“We are mindful of it and one of the things we have done is to developing training for staff. Our programme director is also doing training with key managers and all staff will be trained in January and February next year.”
Snell also says the nature of social care, with services in many cases designed to meet specific needs, means there will be variations in approach.
“Services aren’t consistent because they respond to different situations,” he says. “It’s very difficult to compare like with like.”
In August, CSCI launched a special email address, firstname.lastname@example.org, for providers to comment on the consistency of its inspections and judgments.
Snell says there has only been a small number of responses so far, although they have raised “interesting” issues. The address will stay live until November.
Age 51, lives in London
After taking a degree in sociology at Warwick University, Snell joined Coventry Council as a social worker in 1979 and became a manager before leaving in 1988.
“When I started it was very much about empowering communities and consulting them. Thirty years on we are now talking about similar things in relation to individuals.”
1988-95: Birmingham Council, area manager, then assistant director, leading on mental health and child protection.
1995-97: Bexley Council, chief officer for social services within a combined social services and housing directorate.
1997-2004: Nottingham Council, director of social services, also acting chief executive
2004-2006: Commission for Social Care Inspection, business director for inspection, regulation and review, then chief inspector.
Outside of work, Snell is a keen supporter of Norwich City Football Club, which has been in and out of England’s top flight in the past 15 years. “This is snakes and ladders where there are more snakes than ladders,” he says.
However, he admits he’s not entirely literate with new technology.
“I had an iPod bought for my birthday, which cost £160. But I didn’t realise you had to have a computer [to download the music] and it ended up costing me another £350 to buy a laptop to service it.”
The future of CSCI: “We are entering a different phase of our life. If this was the life cycle of a human being this organisation would probably be about 42 or 43. In some ways we are an organisation coming into maturity.”
CSCI’s mission: “We are about putting people who use services at the heart of everything we do, and in doing that we celebrate good practice but also are intolerant of poor practice and poor services.”
High standards: “You can’t be a chief inspector without being impatient for improvement. I am passionate about performance.”