Inspection and regulation

The quality of social care is assessed in two distinct ways. Local authorities are judged on their success in implementing government policy, managing public resources and responding to the needs of their communities. And social care providers, from public, private and voluntary sectors, must register with inspectorates and then face regular assessment and inspection.

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England

Inspectorates:

Since 1 April 2009, the Care Quality Commission has been responsible for the regulation and inspection of adult social care and health in England, and monitoring the welfare of detained mental health patients. Previously these responsibilities were held by the Commission for Social Care Inspection, Healthcare Commission and Mental Health Act Commission respectively.

In April 2007, Ofsted took responsibility for inspecting and regulating children’s social services from CSCI.

Assessments of local authorities

Children’s services

Ofsted’s annual assessment of children’s services is scored on a four-point scale and based on a performance profile of local authorities, which itself is informed by performance against the national indicators and inspections.

Inspections are triggered by service concerns, however Ofsted is also carrying out three-yearly inspections of the performance of council and their partners in relation to child protection and looked-after children’s services. The only other periodic inspections of any service are of youth offending teams, which are carried out every three years by the probation inspectorate.

The looked-after children and safeguarding inspections take place at the same time, though there are separate scores for each on Ofsted’s four-point scale:- outstanding; good; satisfactory and inadequate.

Ofsted is also carrying out unannounced site visits of councils’ contact, assessment and referral centres for children’s social care to evaluate their impact on minimising child abuse and neglect. These do not take place in years where councils receive their three-yearly inspections.

Adults’ services

The CQC conducted its final annual performance assessment of local authorities in 2010, while periodic inspections of councils’ adult social care functions have also ceased.

This is part of government moves to make councils accountable to their populations for performace in adult social care, not to government. Councils will now be expected to produce annual reports on the quality of adult social care in their areas for local scrutiny.

To supplement this, the Local Government Group and the Association of Directors of Adult Social Services will arrange for councils’ performance to be reviewed by other authorities to drive improvement. Where performance is particuarly weak and a council fails to improve with help from the sector, there will be scope for inspections to be carried out by the CQC but a methodology has not been designed for triggering these probes.

Provider regulation:

Adults:

All providers of home care, residential and nursing home care must be registered with the Care Quality Commission under the Health and Social Care 2008 and are required to meet essential standards of safety and quality.

CQC enforces these standards by imposing conditions on a provider’s registration and, if necessary, through sanctions including warning notices, penalty notices, prosecution or suspending or cancelling registration.

Providers are inspected a minimum of once every two years, with additional inspectors based on a CQC assessment of the level of risk posed by the service; this is based on all the information that the CQC holds on the provider, including complaints or changes in management.

In July 2011, the CQC announced plans to carry out annual inspections of all care services, though this is contingent on extra money from government.

Children

A similar system of registration applies to children’s services, managed by Ofsted.  

Under this system, independent fostering, adoption and adoption support agencies, children’s homes, both open and secure, residential special schools and residential family centres must register with the inspectorate, and then face regular inspection.

Children’s homes are inspected at least twice a year, residential special schools at least once a year and adoption and fostering agencies at least once every three years.

Workforce

Unison represents staff at Ofsted and the CQC, whilc regulatory staff have professional representation through the Social Care Association, which in January 2007 absorbed the former Care Regulators Association.

Scotland

In Scotland, a unified inspectorate and regulator, Social Care and Social Work Improvement Scotland to monitor local authorities and regulate care services for adults and children. It replaced the Social Work Inspection Agency and the Scottish Commission for the Regulation of Care.

The Mental Welfare Commission for Scotland monitors the welfare of patients receiving treatment under mental health legislation.

Wales

As of April 2007, Wales has had a joint regulator and inspectorate for social services for children’s and adults. The Care and Social Services Inspectorate Wales replaced the Social Services Inspectorate for Wales, which previously assessed councils, and the Care Standards Inspectorate for Wales, which previously regulated care services.