Government overhauls adult care ratings system

Councils will assess each other on adult social care and determine their own standards, while providers will no longer receive quality ratings, as part of an overhaul of the performance assessment system announced today.

Service users will be expected to play a bigger role in assessing performance, while providers could be paid according to results, under a proposed performance framework issued for consultation.

Health secretary Andrew Lansley and care services minister Paul Burstow said improving outcomes in the future could not be achieved by “top-down programmes and performance management” but by allowing “local government and citizens to take control”.

The biggest shift is in the way local authorities are judged on their commissioning of adult care. As previously announced, the annual performance assessment of councils’ commissioning will be scrapped next year. In its place, councils will be expected to produce local accounts of their performance, the content of which they would determine themselves.

These could be signed off by local service user groups and then be peer reviewed by other councils, which would “challenge poor practice and share expertise”. These could also be used by the Care Quality Commission to identify any areas where safety and quality are at risk, triggering an inspection.

Council performance against a set of outcome measures will still be published annually, alongside a Quality and Outcomes Data Set capturing raw data on service quality. However, unlike the current system, where performance indicators and data requirements are specified by government, these will be “co-produced” and agreed by councils.

There will also changes in the assessment of providers which will no longer be graded on their performance but will be invited to apply for a new “excellence rating”. This is intended to identify best practice for commissioners and service users, and would be awarded by the CQC in partnership with user groups and sector bodies.

As now, all providers will be reviewed on their compliance with registration standards by the CQC, including through periodic inspections.

Providers could also be paid by councils according to the results they achieve for service users, in a similar fashion to payment-by-results systems in the NHS and welfare-to-work.

As previously announced, the National Institute for Health and Clinical Excellence will extend its role from health to social care and begin producing quality standards for the sector from 2012-13. These will lay out what constitutes best practice, based on existing evidence, and help commissioners and individuals in assessing the quality of providers.

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