CQC checks of council adults’ services: pilots selected to test system

Three authorities will trial regulator's scheme for assessing how well councils are performing their Care Act 2014 duties, amid concerns that lack of funding will set them up to fail

Dial pointing at the word 'performance'
Photo: Coloures-pic/Adobe Stock

The Care Quality Commission’s (CQC) new system for assessing council adults’ services’ performance of their Care Act 2014 duties will be piloted by three councils over the coming months.

The regulator’s work in Birmingham, Lincolnshire and Nottingham councils, which starts this month, will inform its rollout of its local authority assurance system this autumn.

Inspectors will assess the authorities using its draft local authority assessment framework  and will also study a sample of people’s cases. This will result in a report including scores against nine quality statements and an overall rating ranging from ‘inadequate’ to ‘outstanding’.

The CQC stressed the pilots’ ratings would just be indicative, with formal scoring starting from the rollout of the system later this year.

Alongside the pilots, the regulator will carry out desk-top reviews of performance information for all 153 councils in relation to two areas: assessing needs and care provision, integration and continuity.

How CQC assessments will work

  • All 153 councils will be assessed once during a two-year period due to start in September 2023.
  • They will each receive an overall rating on the same four-point scale Ofsted uses for children’s services and the CQC uses for care providers: ‘outstanding’, ‘good’, ‘requires improvement’ and ‘inadequate’.
  • Councils will also receive a score of 1-4 for each of nine quality statements on: assessing needs; supporting people to live healthier lives; equity in experiences and outcomes; care provision, integration and continuity; partnerships and communities; safe systems, pathways and transitions; safeguarding, and governance, management and sustainability.
  • The CQC’s assessments will involve a combination of desk-based checks and visits to the council concerned.
  • Sources of evidence will include: feedback from people who receive care and support, including self-funders, carers, voluntary and community groups and staff, including the principal social worker, director of adult social services and social workers; analysis of performance data on, and surveys of staff, carers and people accessing care and support, and studies of a sample of cases.
  • There will be no observation of practice by social workers or other professionals, such as occupational therapists.

The pilots come amid longstanding concerns from council leaders that the system risks setting councils up to fail because of what they see as inadequate levels of funding. These have intensified since the Department of Health and Social Care told the CQC to produce single-word ratings of authorities.

Councils’ concerns about performance checks

The concerns were raised with Michelle Dyson, the DHSC’s director general, adult social care, at a meeting last week of the Local Government Association’s community wellbeing board, which comprises 23 councillors from around the country and focuses on adult social care and health-related issues.

“Money flowing into the system being less than expected alongside a new assurance system does risk CQC finding local authorities are not meeting their statutory duties,” said the LGA’s director of policy (people), Sally Burlington.

“Having a framework saying you’re not doing well without the resource to improve it is challenging to say the least, said one member of the community wellbeing board, while another added that single-word ratings “could make things a lot worse than they already are”.

In response, Dyson said: “I know there are a lot of local authorities who are really worried about [the assurance system]. I was in Solihull the other day and, while they were worried, they saw it as an opportunity.”

Pilot councils welcome CQC checks

All three pilot areas said they welcomed the chance to have their performance assessed by the CQC.

“We see the CQC assurance process as something that will add value to our existing ambitions of continuous improvement in generating even better outcomes for the people who need our advice and support,” said Lincolnshire’s executive director for adult care and community wellbeing, Glen Garrod. “As well as reviewing our own work in this area, people’s experience of care and feedback from our partners will also help CQC to inform their independent assessment of local authorities.”

Nottingham’s director of adult health and social care, Sara Storey, said she hoped the process would “identify areas for further development and provide important feedback on things we can start to do differently to support our residents”.

And Birmingham’s cabinet member for health and social care, Mariam Khan, added: “There have been really positive changes in adult social care in the city over recent years but we know there is still more to do and we are open to learning from others as we all work together to ensure people get the support they need and deserve.”

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3 Responses to CQC checks of council adults’ services: pilots selected to test system

  1. Carol May 25, 2023 at 2:22 pm #

    The CQC checks are a farce. I rang CQC to ask about when they would be coming to Lancashire as I have a lot I want them to know. CQC response we won’t be telling anyone but the LA when we are going and we definitely won’t be asking members of the public anything as its none of their business! No change there then but covering up for their own poor performance and that of LA. Waste of time and money pilot or no pilots

  2. Beth May 27, 2023 at 6:11 am #

    It will be another nail in the coffin for some social workers if the stress of inspection is passed down from managers (it is happening now piling work on to get stats up).
    Poorly rated LA’s might find it difficult to recruit.
    Scrutiny is good but am not convinced about CQC

  3. Daniel Powner May 29, 2023 at 5:31 am #

    I welcome the assurance visits. It will be interesting to know how CQC interpret Care Act guidance, as this is often subjective. For example, it can be a matter of debate for when the duty to assess is triggered, or whether the duty to complete an annual of a care and support plans applies where no service is provided.

    I hope this will highlights the investment needed in social care.