Councils face stricter assessment of commissioning practice, says Behan

Councils could be measured on the quality of the services they commission under performance assessments being piloted by the Commission for Social Care Inspection.

David Behan, chief inspector at the CSCI, told delegates at the Association of Directors of Social Services spring seminar last week that a “cultural shift” in commissioning was needed to deliver the health and social care white paper’s policy ambitions.

Commissioning would be made “more important” in performance assessment, he said.

Services were “weighted too far towards the traditional” and he questioned whether councils were commissioning “for the whole community”.

Behan unveiled the initial findings of the CSCI pilot in six councils that indicated many supported older residents were placed in poor quality registered care homes in 2004-5.

More than half the residents were placed in homes where four or more key national minimum standards were not met.

The councils taking part in the pilot were asked to use CSCI information on regulated care homes to measure the quality of their commissioning.

Behan said the pilot, known as Capturing Information at the Local Level, could be rolled out from July to allow all councils to assess the quality of their commissioning.

He said that councils needed to commission “to improve outcomes for people using services” and said it was a “key challenge” for councils and the CSCI to collect evidence about the quality of care being provided.

He also pointed out that two-thirds of councils’ gross spend – amounting to 6.5bn – on older people went on residential care in 2004-5 and said that better commissioning would help councils overcome spending pressures.

In response, delegates said joint commissioning with primary care trusts was being “threatened” by the financial crisis in the NHS, forcing some councils to “go backwards” after funding arrangements had broken down.

Others expressed concern that money ring-fenced for community services for people who had been in long-stay hospitals had not been transferred by PCTs in every area.

Delegates also said the impact of budgetary pressures, including Supporting People cuts, made good commissioning difficult.

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