Ministers and the Care Quality Commission are coming under pressure to ditch the planned “excellence award” scheme for adult care providers after the idea was universally condemned by sector bodies in a consultation.
Council and provider leaders raised fundamental objections to the scheme in their responses to the CQC consultation, which closed this week.
The excellence award would be introduced next year to replace the quality ratings for providers abolished last year. Unlike its predecessor, it would be voluntary, have no grades below the level of excellent and would be paid for by providers who apply, not the CQC. Sector leaders slammed the proposal on all three grounds.
In its response, the Association of Directors of Adult Social Services said there was no evidence that providers would apply for the award. It feared the emergence of a “two-tier system” because there would be no marker of quality to distinguish providers that did not apply.
This was echoed by the United Kingdom Homecare Association (UKHCA). “We do not believe that the proposed scheme will meet the requirements of the majority of interested parties, particularly as there is no gradation between providers that are achieving legal compliance and those that are achieving ‘excellence’,” it said.
“In practice, we believe that take-up of the award on a fee-paying basis will be unattractive to many organisations and may leave service users either unable to source care from an ‘excellent’ care provider in their local area or to distinguish between providers that would meet their preference for quality and cost.”
A voluntary system would not “provide consistency or certainty for people seeking information on the quality of care services”, said the English Community Care Association. It added: “ECCA believes there should be more, not fewer, gradations of scale. The Scottish system has intermediate stages that recognise services that fell short of ‘excellent’ but inform people which services are good or very good. These gradations challenge providers and encourage improvement.”
Adass warned that requiring providers to pay to apply would push up the costs of services while the ECCA said the cost should be funded by the CQC.
Plans to outsource the delivery of the scheme to accreditation organisations were also attacked, as was the fact that this issue was not part of the consultation, but decided in advance.
“Multiple licensed assessment bodies, responsible for developing their own approach to assessment, might increase the risk of inconsistent assessments and judgements,” warned John Adams, general secretary of the Voluntary Organisations Disability Group, which represents voluntary providers.
Adams, who called for the CQC to deliver any new award, added: “It is astonishing that the concept of licensing other organisations to deliver the award is not part of this consultation.”
The multiplicity of providers was also attacked by the National Care Forum, which represents not-for-profit providers. In the conclusion to its consultation response, it said: “We are unable to think of a set of consultation proposals so ill-conceived and problematic as those contained within this paper.”
Social Care Association chief executive Nick Johnson said delivering any award should be the responsibility of CQC as part of its regulatory role. “It’s CQC’s job to define the poorest and to define the best.”
The UKHCA has also said that the proposed definition of ‘excellence’, which includes ensuring that service users have control over day-to-day activities and could spend time purposefully, was not suitable for home care.
The association called for the development of a “quality recognition” to identify gradations of quality, with an excellence award – delivered by the CQC – introduced as an interim measure.
A Department of Health spokesperson said: “CQC’s consultation on recognising excellence in adult social care has only just closed and CQC now needs time to analyse the responses to the consultation and consider whether changes to the proposals are needed in light of the views expressed.
“We are committed to the development of a scheme that helps people choose between providers and recognises quality beyond the essential safety and quality requirements. Responses to the consultation will now be carefully considered to ensure that the new scheme meets these objectives and has the support of the sector.”
A CQC spokesperson said: “The Care Quality Commission (CQC) consultation on the excellence scheme has now closed. Once the Commission has had an opportunity to carefully evaluate the response it will be reporting back on the finial scheme before its launch next April.”
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