Adult care providers face less scrutiny, warns Adass

Adult care directors are seeking “urgent” talks with the Care Quality Commission over concerns that a new ratings system for providers will reduce scrutiny of services, to the detriment of users.

The government has proposed replacing the quality ratings system, under which the CQC graded all registered providers as poor, adequate, good or outstanding, with a voluntary “excellence standard” for the best providers, in consultative plans to overhaul the adult care performance system.

However, the Association of Directors of Adult Social Services warned that the proposed system failed to provide the same degree of “assurance” and transparency as quality ratings.

In its response to the government consultation, Adass said: “[This] could be particularly disadvantageous to self-funders and people using personal budgets to arrange their own support, particularly as this new system does not distinguish between ‘adequate’ and ‘better than adequate’ service or between ‘good’ and ‘excellent’ service.”

It warned that the system may also favour larger providers that had the financial muscle to apply for an excellence rating, and may lead councils to increase their own monitoring processes, increasing costs.

Quality ratings were scrapped last August, but Adass warned: “Further we are concerned that there is no timeline, implementation plan or agreement about how this system will operate.”

It called for urgent talks with CQC on the issue.

A CQC spokesperson said: “CQC will be consulting in the first half of 2011 on how to define excellence in adult social care, as part of the development of the information scheme which is referred to in the consultation document.

“CQC will also be producing a public facing provider profile for each registered provider which will provide up to date information about standards of care.”

The government’s proposed performance framework is also designed to cut bureaucracy on councils by scrapping annual assessments and routine inspections of councils by the CQC.

Instead, councils would produce “local accounts” on the standard of services, which would be reviewed by other councils or user-led groups, and authorities would be inspected by CQC only when risks are identified.

However, Adass said local accounts would fail to cut the bureaucratic workload significantly, nor was such a system costed, while the CQC’s triggers for inspections of councils needed to be urgently developed.

The government has also mooted introducing payment by results, under which councils would pay providers on the basis of what they achieved for service users, however Adass warned against introducing this on a national basis.

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