Hunt hints at ‘Ofsted-style ratings’ for adult social care services

Local authorities may be rated on the quality of their adult social care services to address variations in performance, Jeremy Hunt has suggested.

Speaking on World Social Work Day about the forthcoming social care green paper, the health and social care secretary stated that the country needed “a relentless and unswerving focus on providing the highest standards of care” and suggested that independent reviews could be brought back to improve services.

Local authority adults’ services departments have not been subject to independent assessments since 2010. Instead, local authorities have worked together, regionally and nationally, to improve without intervention.

Hunt said the CQC’s recent reviews of local health and social care systems had “highlighted variation in performance between local authorities across a range of measures, including how the local authority commissions care from local providers”.

“We now need to ask whether the time is right to expand that approach, and one of the questions the green paper will pose is whether we can build on the learning from the introduction of independent, Ofsted-style ratings for providers to spread best practice to commissioners as well,” he added.

Speaking about social care for the first time since the cabinet reshuffle, Hunt outlined the seven key principles that will guide this summer’s green paper on social care.

Integrated services

The health and social care secretary dedicated a large section of his speech to discussing his vision of an integrated health and social care system, which he said would centre around the needs of the individual.

Describing the current system as “confusing and fragmented”, Hunt said individuals should have just one plan covering all their needs based on a joint assessment by both systems in the future.

He announced new pilots for integrated services in Gloucestershire, Lincolnshire and Nottinghamshire where people accessing adult social care would be given a joint health and social care assessment and support plan. They would also be offered an integrated health and social care budget.

This would help people to “stay longer at home, healthier, more independent and needing fewer hospital services”, according to the health secretary.

Security for all

Hunt also confirmed the green paper would set out options to cap social care costs, addressing the “punitive consequences” faced by some when funding their care, particularly those with dementia.

Last year, the government scrapped plans to introduce a system for capping care costs that had been included in the Care Act. However, it is not clear at this stage what form any such proposal will take.

Other principles of the green paper included attempts to:

• Attract more people to work in the social care sector by offering alternative routes into the profession
• Make the needs of carers central to the new social care strategy by building an active and creative partnership between the state, individuals and wider civil society
• Create a sustainable funding model for social care supported by a diverse, vibrant and stable market.

Ruth Allen, chief executive of the British Association of Social Workers (BASW), questioned how Hunt would ensure social work skills were at the forefront of the reforms.

“We would want both social professionals and wider social care representatives to be at the heart of the integration of health and social care plans.

“There have been examples of integration in the past which have been somewhat unequal, so we are keen to ensure the distinctive offer of social workers – their ethics and values – isn’t lost going forward,” Allen said.

Chairman of the Local Government Association (LGA) Lord Porter said he was pleased to see how the government intends to “make adult social care fit for the future”, but highlighted Hunt’s unwillingness to tackle questions about funding.

“While integration is an essential agenda that local government is committed to in order to achieve better health and wellbeing outcomes for people, appropriate funding must be the overriding priority for the green paper and we hope its broad scope will not detract from this focus.

“Government should first make a down-payment on the green paper by injecting additional resources into the system to fund immediate funding pressures which are set to exceed £2 billion by 2020. This will enable the system to stay afloat until such time as the green paper reforms bring in new resources,” he added.