English councils would face a tougher assessment of performance but no overall rating in 2010-11, if consultative plans issued by the Care Quality Commission yesterday come to fruition.
Pointing to the fact that 95% of councils had been assessed as performing excellently or well in 2008-9, the CQC said it would “set clear and stretching expectations for councils” through a comprehensive review of the current outcomes framework and the scoring rules for determining ratings.
It said there would be a keener focus on how councils were delivering against the Putting People First agenda and on holding authorities to account for the quality of care they commissioned.
It added: “We expect that sharpening up our approach will make the 2010-11 assessment more challenging – and also more streamlined and efficient.”
However, councils would not receive an overall rating under the plans; as now, they would receive separate ratings for their performance against seven outcomes:- health and wellbeing; quality of life; freedom from discrimination and harassment; dignity and respect; economic well-being; making a positive contribution, and choice and control.
While the CQC said it would continue to assess primary care trusts and councils separately, it proposed carrying out joint service inspections of authorities and PCTs on safeguarding adults and securing more joined-up care. It also wants to develop a common outcomes framework for assessing PCTs and councils with the Department of Health.
The CQC proposed to retain the quality ratings system for assessing care providers but asked for views on whether the four-point scale (nought to three stars) should be revised.
Three-yearly inspections to stay
While the CQC will no longer be under a legal duty to inspect providers once every three years when the new registration comes into force for adult care services in October 2010, it proposed to retain this as a minimum frequency for site visits, with providers receiving a revised quality rating each time.
The regulator also proposed a range of topics for “special reviews”, through which it assesses the quality of particular types of care or other specific issues across the country, including:-
- Unmet needs in social care.
- Domiciliary care.
- Long-term neurological conditions.
- Hospital discharge and its impact on carers.
- Nutrition and hydration in care settings.
- The care programme approach for people with mental health problems.
- The use of restraint.
- Health and social care for offenders.
It is seeking views on which of its proposed topics should be taken forward.
Call to examine neurological conditions
The Neurological Alliance – a coalition of charities supporting people with neurological conditions – urged the CQC to examine care for the client groups they represent, given “significant inequalities in quality and access”.
Alliance chief executive Clare Moonan said: ““We hope a special review of neurology services will act as a powerful signal to service providers and commissioners to ensure that neurological conditions are given greater priority. There is a great deal of innovation and good practice in some areas of the country but unacceptably poor care in others. We need the CQC to use all its power and influence to look at why these gaps in service exist and ensure things improve across the board.”
In 2007, the Healthcare Commission announced plans to scrutinise NHS performance in implementing the 2005 National Service Framework for Long-term (Neurological) Conditions – but this was not taken forward before its merger into the CQC in April 2009.