The debate on whether the Care Quality Commission should routinely inspect councils is not over despite the government’s decision to remove its power to do so.
That was the message from CQC chief executive David Behan ahead of an expected vote today on a government amendment to the Care Bill to remove its power to inspect councils. Though this power has not been enforced since 2010 – when annual performance assessments were scrapped – its removal from the statute book would prevent regular assessments from being reinstituted.
However, Behan told the National Children and Adult Services Conference last Friday that adult care providers were not happy with the government’s decision.
“I haven’t spoken to any national provider association who doesn’t think councils should be inspected,” he told delegates. “The removal of that power from CQC was seen as a retrograde step by them.”
‘Still a debate to be had’ on inspecting councils
He added: “I think there’s still a debate to be had about this.”
Behan also said the CQC would comment on the quality of council commissioning when it reports on its investigations into the use of 15-minute visits in the home care sector, from next year. Last week, care services minister Norman Lamb said that, from next year, the CQC would question home care providers on whether visits were long enough to ensure dignified care.
Behan said he had been complimented by a delegate who had said that the CQC was not as “prickly” as Ofsted, which is responsible for inspecting councils and was accused last week by children’s services leaders of damaging staff morale through ‘inappropriate judgements’. This followed Ofsted’s annual report on social care, which found some councils were failing to meet basic child protection standards.
However, rejecting the idea that the CQC was soft by comprison, Behan added: “I’m prickly about 15-minute visits.”
The abolition of annual performance assessments led to the establishment of a system of “sector-led improvement” under which councils support each other to improve, mainly through regional partnerships.
Effectiveness of sector-led improvement questioned
Behan – and Lamb – have both raised concerns in the past about whether sector-led improvement can successfully identify and address failures in a local authority’s adults’ services. Under the Care Bill, the CQC would retain a power to inspect a local authority – with government approval – in the wake of significant failings in adults’ services.
Regional sector-led improvement leads met with Department of Health officials at the conference to discuss progress with the programme, which is overseen by the national Towards Excellence in Adult Social Care board.
London sector-led improvement lead Ray James said DH officials had sought assurance at the meeting about whether sector-led improvement had “teeth” in tackling under-performance.
James, who is head of health and social care at Enfield Council, said there had been a significant increase in sector-led improvement activity in the past two years. For example, in London all 33 councils have agreed to submit themselves to a three-day ‘peer review’ – under which their performance is examined by officers and councillors form neighbouring authorities, and service users.
Councils urged to be transparent about performance
Unlike inspection reports by the CQC, which were always made public, councils are under no obligation to publish the report of a peer review. However, James said all five councils who have been peer reviewed so far in London have published the results.
He also stressed that such transparency was important in driving improvement. “All of the evidence shows that transparency increases the likelihood of improvement because individuals feel greater accountability if results are published.”