What do care providers want from regulation? Less of it might be a glib answer, and in the past there might have been some truth in this. However the new Care Provider Alliance ‘vision’ of social care regulation is in many respects a plea for more and better Regulation.
Inspectors should look, say the Alliance, not just at whether services are fit to be registered, but at quality, and should grade services on the basis of quality and of the outcomes they achieve. Regulation should be sufficiently rigorous to stop local authorities feeling the need to carry out their own inspections of services that they contract with. Regulators should take time to talk to service users and their families, whose views should form the basis of inspection reports.
Inspectors should be prepared to consider individual complaints from service users and their families. There should be a national framework of regulation in order to prevent local inconsistency in regulation. Local links between providers and inspectors, fractured by reform of the system should be repaired. Poor performing providers should pay more towards the regulatory system.
All of this is strikingly at odds with the views of the current government (and in it’s latter years, the previous one) that providers simply want reduced ‘regulatory burdens’, that the market will drive quality, and that inspection and regulation is a prime area for making cuts. As a result of successive cuts in funding the current regulator, the Care Quality Commission, operates on a much reduced budget of £164.4 million in 2009-10 compared to the £240 million spent by its predecessor organisations in 2005.
The Health Select Committee report on the CQC concluded that the CQC should have been more vocal in pointing out that it did not have the resources to carry out its statutory duties.
CQC has asked for 10% additional funding to carry out it’s duties and seems to be gaining allies in unexpected quarters. However supporters do want improved performance in return for more resources – the Care Provider Alliance wants the CQC to take some of it’s own medicine and to publish evidence that it is meeting it’s own quality standards.