Moaning about your job at times is par for the course, but bosses at the Commission for Social Care Inspection must be shaking their heads in despair at the recent criticism they have received from their workforce.
Last month CSCI’s annual staff survey for 2007 – which just over half its 2,200 workforce answered – revealed that 67% felt the body did not value employees 68% thought it had not managed change well and 54% believed staff were not consulted about changes affecting them.
More criticism came in another survey conducted jointly by Unison, Unite, Prospect and the Royal College of Nursing among 11% of CSCI staff. It found 76% of the staff were not confident that new methods of inspecting care provided a robust assessment of the risk to service users. Just under one-third had felt bullied to meet performance targets, while 81% wanted more frequent inspections. It is this latter point – the decision to change from twice-yearly inspections to proportional inspections depending on each service’s rating – that is troubling some inspectors.
Services rated as excellent (three-star) will have one key inspection at least once every three years good services (two-star) will have a key inspection at least once every two years adequate services (one-star) will be inspected at least once a year and those with no stars will have two key inspections a year.
Linda*, who has been an inspector for 10 years, says this goes against the spirit of regular inspection. “What I and other inspectors are concerned about is services yo-yoing between adequate and good. We’re worried about them not functioning as good services consistently between inspections.”
Feedback from Unison members within CSCI suggests this is resulting in inspectors complaining that they are no longer having enough contact with service users. If so, this will compromise the authenticity of inspections as service users are often the ones to divulge information to inspectors. To do this, says Linda, “they need to trust you, which they won’t if it’s someone they’ve never seen before”.
When Community Care approached CSCI it would say only that care providers were receiving “the same principle” of proportional inspection as councils. It also highlighted the speech chief inspector Paul Snell gave to the Association of Directors of Adult Services’ spring seminar this year. In it he defended CSCI’s position saying: “The biggest myth is that service providers are now being ‘left alone’ for three years between inspections. This is not true. While the frequency of inspections for good providers will be reduced, there will not be zero contact between one inspection and the next, or less rigour in the way we scrutinise services.”
Presumably he was referring to random inspections which are carried out in addition to key inspections. These are used to follow up a complaint or allegation, or may occur if there is a change in the manager or service. However, CSCI’s website says “sometimes we may visit a ‘good service’ as part of random checks”, from which you could surmise that it’s fairly unlikely that an “excellent” service would be on the receiving end of one.
Another gripe from inspectors is the issue of providers completing self-assessment questionnaires on their services. The fear is that, despite having to incorporate the views of services users in the assessment, providers will not be forthcoming about the problems they are encountering.
Helga Pile, Unison’s national officer for social care, questions this: “How robust is the self-assessment process in terms of providers filling it in realistically? The care sector is a highly competitive market and to what extent all providers are doing a good job is questionable, as is how open they will be about it.”
A further complication lies on ensuring providers return their paperwork to CSCI in time. According to the union survey, this is a routine failing and 74% of inspectors knew of inspections conducted without the provider having completed the required self-assessment exercise. One reason behind this is a reduction in the number of support staff who chase the paperwork on inspectors’ behalf, says Linda.
However, CSCI head of communications Robin Banerji says that completing self-inspection is a legal requirement for providers which they comply with. Service users asked by providers to share their views about the service shouldn’t feel pressure to paint a rosy picture, he adds.
Some inspectors are also worried about CSCI’s decision to take a more hands-off role to adult protection inquiries complaints are referred back to the provider who then investigates rather than CSCI. This approach is fine if the provider is a large organisation, says Linda, but she and her colleagues are worried when it is a sole trader. “Small providers may not have the skills or impartiality to investigate complaints effectively and it can make those who complain quite vulnerable.”
Local Government Association programme lead Anne MacDonald has heard anecdotal evidence from councils who are unhappy with this situation. Their inspection role ended when the National Care Standards Commission was created in 2000 to conduct inspection, but now they are being forced to take it on through the back door, she says. “Local authorities are saying ‘the NCSC took all our inspection staff and now we’re having to reinvent something similar’,” she adds.
Banerji disputes that local authorities should feel they have to inspect social care services, saying this still remains the duty of CSCI. “Yes, local authorities have to make sure if they are contracting services for people they are getting what they pay for, but CSCI has a statutory responsibility to inspect quality,” he says.
CSCI has clearly lost the confidence of some of its inspectors, and more needs to be done to support staff through change.
* Not her real name
THE CHANGES TO INSPECTION
● Periodic inspections replace twice-yearly inspections of all services.
● Frequency of service inspections based on the risk to service users with more unannounced inspections.
● Service providers legally required to complete a paper-based self-assessment questionnaire, which includes service users’ views, to be returned to CSCI. The CSCI decides how often to inspect a service based on these results.
● Quality ratings are being developed based on outcomes to score each social care service, with services rated as excellent receiving fewer inspections.