CQC ratings may return to ensure weaker social services improve, says minister

Care Quality Commission assessments of council adult services may return to help ensure weaker authorities improve, care services minister Norman Lamb has said.

Speaking yesterday at an event on improving care in the wake of Winterbourne View, Lamb became the second leading figure to question whether the “sector-led improvement” regime, set up to replace CQC assessments, was dealing with issues in weaker authorities.

This follows similar comments from CQC chief executive David Behan, who said in April that failing adult social services departments were unlikely to be open to scrutiny from fellow councils, as should be the case under sector-led improvement.

Return of star ratings under consideration

Lamb said this concern was one of the reasons he was considering reintroducing CQC assessments of council adult social services, which were scrapped by the coalition in 2010.

“Sector-led improvement is a very good initiative that I’m very supportive of,” said the minister. “There’s a difficulty that the good authorities will tend to engage with that more than the weaker authorities, where problems are likely to lie.”

“This is an area of work that we are developing but I’m clear that local people need to know how well their local authorities are doing in their commissioning.”

What is sector-led improvement?

Sector-led improvement encompasses several different processes: peer challenge inspections of council adult social services by managers from other authorities; mutual support to help councils improve, delivered regionally; and local accounts, published by councils, to help local communities understand how well they are doing in adults’ services.

It is overseen by a sector partnership board – Towards Excellence in Adult Social Care (TEASC) – led by the Association of Directors of Adult Social Services and Local Government Association, but also including representation from the CQC and the Department of Health. The DH is funding TEASC to the tune of £800,000 this year to support its work.

TEASC published a protocol on managing the risk of under-performance last year. This places an expectation on directors of adult social services that they will be self-aware about their authority’s level of performance and consider seeking challenge and support from peers.

Where an Adass regional branch identifies under-performance in a member it should arrange offers of support, subject to available resources. Where failings continue or are significant this will be reported to regional LGA regional advisers, who would be expected to assess the prospects for improvement and identify further support needs.

Councils must be ‘self-aware’ about performance

TEASC chair Sandie Keene, who is also this year’s Adass president, acknowledged that making this work was a key challenge for sector-led improvement, particularly engaging with authorities who were less self-aware about their performance.

“Most councils who are self-aware will [seek support]. The areas that David [Behan] is most concerned about are those that are not self-aware and how we can shine a light on those areas. The key thing for TEASC is that we make sure we can identify those authorities and work together to help them improve.”

Besides peer challenge inspections, she said regional Adass networks were organising buddying schemes, under which top-performing authorities work with under-performing ones.

She said TEASC planned to collate and publish the number of authorities receiving the various types of improvement support on offer to improve transparency. However, she said it would not be identifying which authorities were receiving support.

No ‘naming and shaming’

“If you’re talking about naming and shaming, that’s not our role,” she said. “We are the sector supporting the sector, not an independent body like CQC doing that.”

She warned against the government reintroducing CQC assessments of council adult services in a similar form to the system that existed before 2010, “which was exceptionally time-consuming and a very blunt instrument”.

“In a world where commissioners are struggling because of a lack of resources, we don’t want to construct a system that takes resources away from commissioners.”

However, she said Adass was prepared to enter discussions on the subject.

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