Comprehensive area assessment set to replace star ratings

The star rating system for assessing services is giving way to a flag-based system. The new comprehensive area assessment will focus on joined-up services but will inspections be made any simpler? Report by Anne Gulland

This year’s star ratings are the last that will be published for adult services. And inspections of children’s services are to be revamped too. From next April a new system of inspection and assessment will be under way that will include awarding red and green flags to provide “narrative judgement” (see Six key ways). The changes affect all council services.

While social workers may not mourn, or even notice, the passing of the current regime of inspections and assessment, the new system – the comprehensive area assessment (CAA) – is a big change for local authorities. It will focus on councils and their partner organisations, looking at how they improve quality of life for everyone, not just those they provide services to.

New regime

Andrew Cozens, strategic adviser for children, adults and health at the Improvement and Development Agency, says that one of the biggest changes under the new regime is the emphasis on joined-up services.

“The focus of the CAA will be on how public services are doing in improving quality of life. Councils cannot just be good on their own terms – they have to work with other organisations. That’s a big change and it feeds well into the responsibilities of directors of adult and children’s services,” he says.

Paul Najsarek, director of adult and housing services at the London Borough of Harrow since 2007, is looking forward to the new regime. For the past six years his department has received one star and this year is the first time that the ratings will acknowledge progress.

“The old framework [of assessment] focused on things like supporting people at home and reduction in the use of residential care. That made sense at the time but we are now focusing on Putting People First and introducing personal budgets – the inspections have to catch up,” he says. “For example, we had an older person whose priority in life was to carry on fishing and he’s used his budget to pay for an assistant to help him carry on with that.” The old regime of assessment would not capture this kind of practice, he says.

Better judgement

But the old system of inspections for both adult and children’s services had their merits, says Cozens. “There’s no doubt that star ratings and scoring for services have meant that chief executives and leaders have recognised the need for these to be a priority and focused a council’s mind,” he says. “But the CAA is a much better judgement of the contribution of a whole range of partners.”

For adult services in particular the changes are further complicated by the merger of the Commission for Social Care Inspection, the Mental Health Act Commission and the Healthcare Commission into the Care Quality Commission. Some of the finer details on how the CQC will dovetail into the CAA has yet to be announced. The Association of Directors of Adult Social Services has already expressed alarm at the timescale of the change.

John Goldup, director of adult services at Tower Hamlets, whose department has gone from one star to three stars is wary about the changes.

“My personal view is that the performance assessment regime developed by the CSCI has been a very powerful force for driving up performance,” he says. “The commission has developed a well respected methodology of arriving at its judgement, based on much more than simply counting percentages and looking at performance indicators. It’s based on a process of dialogue and discussion and weighing up the qualitative and quantitative evidence.”

While he agrees that looking at an area as a whole is the right way forward he is concerned that social care might get swamped by health in the new body.

Directors of children’s services are concerned at how the work of Ofsted will fit into the new assessment regime. In its response to the Audit Commission’s consultation on CAA, the Association of Directors of Children’s Services was particularly concerned that Ofsted ran a separate consultation.

Unfortunate message

Marion Davis, director of children’s services at Warwickshire Council and chair of the ADCS’s standards, performance and inspection policy committee, says: “The unfortunate message is that there have been two separate consultations that have not coincided. There is disquiet among children’s services directors about the way in which the two consultations don’t match.”

However, Mike Cladingbowl, CAA project director at Ofsted, refutes the idea it has gone out on a limb, saying that the inspectorate conducted a separate consultation because it had to consult on the inspections it will carry out every three years on safeguarding and looked-after children. He says the performance profile data will be collated by Ofsted and will be used to provide an annual performance rating for children’s services.

He says Ofsted is fully signed up to the joined-up approach promised by CAA and says: “We’ve had some mixed reactions to our proposals and we are taking comments very seriously. We will work with stakeholders over the coming months to make sure that we have a performance framework that will help improve the lives of children.”

Davis also says that some of the proposals don’t look so different to the current joint area reviews. Another cause for concern is that the CAA will not live up to its promise of a “lighter touch” inspection regime for high performing authorities.

“In Warwickshire this year we have had: a joint area review a youth offending service inspection and an annual fostering inspection on top of the annual performance assessment an annual standards meeting, to discuss school standards and two additional national challenge meetings, to discuss schools’ GCSE achievements. It doesn’t feel as though the promise of proportionate inspection has been lived up to,” she says.

She’s also sceptical that the government will limit itself to the 198 indicators it will use to measure performance and says that Ofsted’s quarterly publication of performance profile data – information on inspected services, Every Child Matters indicators and a service’s “direction of travel” – sounds like an increase in data collection.

Trial results

Torbay Council is one of 10 areas that has trialled the new approach and a spokesperson for the council said that the changes should reduce the burden of inspection if the “inspectorates deliver their promised joined-up approach to CAA”.

The CSCI acknowledges the scepticism among social care managers that the burden of inspection will be reduced, but says the abolition of star ratings will allow councils and the regulator to focus on local issues. The commission also estimates that councils will have to submit 50% less data centrally.

Sarah Pickup, director of adult care services at Hertfordshire Council, agrees that the CAA is going to require some work on the part of social services managers.

“But the bottom line is that we should carry on working hard to deliver good outcomes for the people we serve. Inspections shouldn’t detract from the delivery of our services,” she says.

Six key ways in which the flag system will work

  • At the moment council performance is assessed by the Audit Commission under the annual comprehensive performance assessment. This looks at the range of council services but operates separately from the adults’ and children’s services inspectorates.
  • The CAA, also under the auspices of the Audit Commission, will differ from the CPA in that it will look at the prospects for improvement, outcomes and at the local authority’s partners not just focus past performances.
  • The seven inspectorates (Audit Commission, CSCI, Healthcare Commission, Ofsted, Constabulary Inspectorate, Prisons Inspectorate, Probation Inspectorate) scrutinising an area will feed into the CAA.
  • The CAA has two components: an organisational assessment of councils based on use of resources and managing performance and an area assessment of councils and their partners. This assessment will be in the shape of a “narrative judgement” and red and green flags. A red flag indicates that a service is poor and needs attention and a green flag indicates “innovation and notable practice”. These flags will not be awarded as a matter of course and it could be that an area will receive no red or green flags.
  • Councils will receive a rating under the organisational assessment and children’s and adult services will receive a rating but there will be no separate publication and no stars.
  • The new Care Quality Commission and Ofsted will continue to carry out their inspections of providers such as care homes and schools and these will inform the CAA.

Audit Commission information on the comprehensive area assessment

Expert guide to performance and star ratings

Published in the 27 November 2008 edition of Community Care under the headline Prepare to be Flagged Up

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