Councils need more funding to manage CQC adult services performance checks, leaders warn

Local authority assurance process sapping time and energy when teams are already under significant pressure, say ADASS and LGA, with rollout of assessments due to start imminently

Person putting jigsaw piece with word 'quality' written on it on to space with 'assurance' written on it
Photo: fotomaximum/Adobe Stock

Councils need more funding to manage the impact of Care Quality Commission (CQC) performance checks of adults’ services, sector leaders have warned.

The Local Government Association (LGA) and Association of Directors of Adult Social Services (ADASS) issued the call with the rollout of assessments of England’s 153 authorities due to start imminently.

This follows pilots of the system in five areas, which resulted in the CQC giving four authorities (Birmingham, Lincolnshire, North Lincolnshire and Suffolk) an indicative rating of good and one (Nottingham) a grade of requires improvement.

But despite the positive performance, the process added significantly to pilot authorities’ workloads at a time of severe pressures on adult social care, said ADASS joint chief executive Cathie Williams.

Process taking ‘huge amount of time and energy’

“The pilots have shown the assurance process takes up a huge amount of time and energy within local authorities, at a time when social care teams are already under pressure with growing numbers of people needing care and support, budgets under severe strain and high levels of vacancies,” she said.

The process involves three phases: evidence gathering, an on-site visit and follow-up.

During the first phase, the CQC gave pilot councils three weeks to submit documents under 48 categories, some of which required multiple submissions, found LGA research with the authorities.

Councils also had to provide the regulator with 50 cases for it to track retrospectively, and submit reflective logs for 10 of them, the LGA said.

‘Immense workload’

Based on its research with the pilot councils, the association advised other authorities that the workload for assurance was “immense”, and they needed a full-time, dedicated team to co-ordinate the work.

The Department for Health and Social Care handed each council a £27,000 flat-rate payment to prepare for their first assessment.

However, the LGA and ADASS said authorities needed more to deal with the additional burdens the process was imposing on them.

‘More funding needed’

“To ensure assurance doesn’t take away from support going to people who need social care, the government must provide local authorities with additional funding and resource to carry this out,” Williams added.

“The added workload these assessments are causing for councils must be addressed and councils should be given appropriate additional funding and support in order to participate in them effectively,” said the chair of the LGA’s community wellbeing board, David Fothergill.

Speaking yesterday at the National Children and Adult Services Conference (NCASC), CQC chief inspector of adult social care and integrated care James Bullion said the regulator had been made aware of the concerns.

James Bullion of the Care Quality Commission

James Bullion, chief inspector of adult social care and integrated care, CQC

“It’s not our role in CQC to solve that problem but we will be helpful in seeing what we are seeing,” he said. “Some of the messages we’ve heard is that pilots have had to invest in teams. I know there’s been some compensation but I understand it’s not been enough.”

Councils ‘must be forewarned about CQC checks’

Bullion told the conference that the CQC was expecting to start assessments this month, pending official sign-off from care minister Helen Whately.

In the light of that, the LGA said councils in the first tranche to be assessed needed to be informed of this fact as soon as possible “given the significant amount of preparatory work required in advance of assessment team on-site visit”.

About the CQC’s local authority assurance system

  • All 153 councils will be assessed once during a two-year period.
  • Councils 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. These scores will inform the single-word rating.
  • 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; 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.

Speaking at NCASC on the same day as Bullion, Whately said she recognised the concerns but did not pledge any more funding.

Minister for care Helen Whately (Credit: Department of Health and Social Care)

Minister for care Helen Whately (Credit: Department of Health and Social Care)

“I know some local authorities have been concerned about this and I know about the wider financial pressure you are facing. But this assurance is really important and I genuinely believe it is a good thing for social care teams in local councils.

Assurance ‘will boost transparency’

“Right now, if you are doing a great job in social care, do people really know that? I actually don’t think so. If you ask around, people will tell you all about the problems in social care, but they won’t tell you about the councils who are doing a great job investing in social care, helping their care market, supporting people to live at home.

“And on the other hand, if there is unmet or under-met need or carers are not being supported and the care market isn’t being supported, that needs to be known about. Too much of what we know about social care is anecdote.”

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6 Responses to Councils need more funding to manage CQC adult services performance checks, leaders warn

  1. Carol December 4, 2023 at 10:21 pm #

    If Councils are operating effectively and efficiently, then they should not need any prior warning or additional funding to meet the requirements of CQC. If they do its because they need to cover up for poor practices and pull the wool over CQC’s eyes which is fairly easy!

    No more funding, work within your budget! Stop employing expensive consultants and people who can’t do their job!

  2. Pauline December 5, 2023 at 11:14 am #

    Give us the questions as well as the answers before we sit the exam so you can score us accurately isn’t the confidence boost Mr Bullion might have thought it would be. Admitting basic information is either not available or is so poorly gathered and stored that it can’t be retrieved without significant notice is the admission that lays bare that for all of the endless reorganisations, big fees paid to private consultants, layers of managers and ‘data analysts’, the bureaucracy that blights the lives of social workers is the nonsense we keep going on about. Mr Bullion might have spared us the embarrassment by just asking the CQC to let us appraise ourselves.

  3. Chris Sterry December 5, 2023 at 6:17 pm #

    This should come as no surprise to anyone for any audits need to be prepared for while undertaking the required necessary day-to-day work and LAs are already overburdened with work due to austerity cuts from 2010 while demands in all areas of council work are increasing and even more so in both children’s and adults social care, both of which are extremely underfunded and with immense workloads.

    Due to reduced funding, staffing will have been reduced so the work burdens are ever-increasing, so releasing staff for these audits is going to be extremely intense.

    So, the provision of £27000 was always going to be so insufficient and after the pilot Nottingham council as declared bankrupt, was this due to the increased pressure of the pilot? It may have been coming but the pilot wouldn’t have helped.

    More councils will do so eventually, perhaps everyone in time.

    Pity there isn’t a CQC investigating the government for they would have a field day and then who could the government call upon?

    But none of this is helping councils so they will go under for I can’t see this government helping more nor the next one, hinder, yes, but helping, no.

    Governments who would have them for is there one government in any country that is any good, perhaps not.

  4. Roger December 6, 2023 at 9:49 am #

    What preparation does a competently run LA need to answer questions about it’s workforce numbers, vacancy rates, documentary evidence of policies and implementation strategies, acces to electronic notes, providing staff to be interviewed, access to users of services, training offered? Asking for it is an admission that all of the self promoting, self congratulating teams of ‘policy and support staff’ are a pointless drain on morale and scare resources when faced with having to evidence all that they claim. Running away and hiding should be exposed not rewarded by more funding. It’s time CQC actually listened to practicioners and not the ‘leaders’ who have next to nothing to say about he realities of our work. Promoting mates does tend to do that mind.

  5. Alec Fraher December 18, 2023 at 9:48 pm #

    how is the CQC methodology team handling the evaluatulatory and methodological issues aring from an assumption of extreme commensurability ie that orange’s and apples are the same, and in the face of increasing indeterminacy in addressing unmet need is a strengths approach merely ideological.

    the CQC having courted choice must, as happened in 2010, set out its evaluation methodology for consultation ~ are they for example assuming that complexity arises not from a denial of simplicity and common sense but rather from how such ‘common sense’ simplicity is being organised?

    the above definition shaped the 2010 consultation and was written not by the in-house CQC methodology team, rather it was commissioned from PA Consulting including help from the, then, outgoing former SofS for Communities and Local Government.

    Brexit hearelds the demise of postmodernist thought and Continental Philosophy, and the rise of the machine model of AI, the creation of LLM as a replacement for social worker judgement, and Analytical Philosophy ~ where’s the consultation on this and how it will show up?

    For cpd see Navigating Indeterminacy by Xin Wei Sha ~ it’s a 30min video setting out the narratives on the use of data and how it evolution.

    Remember that at the BASW AGM in 2007 members, by show of hands, held a vote of no confidence in the use of the then in use information technology ~ the jargon is to ask whether the Enterprise Architecture designed for social work follows TOGAF and if it has been tested against either the Zachman Model or the Carnegie Mellon Model.

    Xin Wei Sha examines the relationship between frequentist, bayesian and set-theory statistical information and urges caution ⚠️

    Crucially, social workers are empowered under the provisions of the DPA to make sure any data held on their clients as data subjects is actually accurate.

    The recent coverage of adult adhd/autism/disassociative conditions, given the diagnostic overlap between the conditions, must show up as they, the data subject, see it.

    The misuse of the mental disorder codes may increase the spend allocated between primary and tertiary care ~ it may also cast individuals as being personality disordered when they are not. Serious, no?

    • Alec Fraher December 20, 2023 at 3:19 pm #

      For cpd checkout Anthony Doerr’s treatment of ‘The Birds’, by Aristophanes ~ the-book-within-the-book ~ a tale of being in nephelokokkuyia (I just love saying this word out loud) or cloud-cockoo-land.

      The bread and butter of antidiscriminatory and antioppressive practice is on trial ~ a product, in part, of the SWE silence and blind adherence to the Right Touch, Light Touch of a totally cloud-cockoo land abstracted reality of sectoral governance.

      Is it, as Apuleius wrote, an era of ‘The Golden Ass’ in Social Work?