Author Archives: Stephen Lowe

Roundup – National Children’s and Adults Services Conference

This year’s ‘National Children’s and Adults Services’ (social care) conference, saw contrasting perspectives on the changing role of local authorities. Peter Hay, the current President  of the Association of Directors of Adult social Services, speaking at the morning session, welcomed the new leadership role of local authorities with regard to public health.

In the afternoon, by contrast, Andy Burnham, the new shadow Secretary of State was concerned that current reforms would result in a loss of local authority powers and of local accountability. Concentrating on the NHS and on education, his view was that reforms were dominated by provider interests. They hand huge power to GP’s and Head Teachers and take it away from service users. ‘In a world with no PCT’s,’ asked Burnham ‘how can patients challenge decisions by GP commissioners?’. He concluded that Parliament has not yet woken up to the full implications of these reforms.

The current Localism bill includes proposals for independent social work practices to take over local authority social work functions, so this raises the question of whether Burnham’s concerns will be an issue for adult social care. Independent practices are already being piloted, and in August the Secretary of State for Health issued the Contracting Out (England) order 2011 to ensure that the delegation of local authority functions to these practices is lawful. The order can be found here.

Whether this order was strictly necessary depends on what independent social work practices will be expected to do. Older people for the most part do not receive extended social work interventions. Their contact with social work is more likely to be through assessment, arranging services, and if they are lucky, subsequent reviews of their care and support arrangements. Continue reading

Caring for our future; shared ambitions for care and support

Last month the Department of Health announced that it intended to ‘co-produce’ the proposed social care reform white paper. This month, on the 15th of September it has launched an ‘engagement’, entitled ‘Caring for our future; shared ambitions for care and support’ which is intended as the first step toward making good on this commitment.

The content of the engagement reveals that the scope of reform is meant to go well beyond responding to the proposals of the Dilnot Commission on long term care funding or the Law Commission review of adult social care law.  However the government does ask for people’s views on the recommendations of the Law Commission and the Dilnot Commission ‘and on ‘how we should assess these proposals, including in relation to other potential priorities for improvement’.  So the DH is still thinking about the extent to which they intend to implement the proposals of the two commissions.

The engagement focuses on six key areas. These are;

  • quality – including improving quality and developing the future workforce;
  • personalisation – giving people more choice and control and helping them to make informed decisions;
  • shaping local care services in order to ensure a wide range of innovative and responsive services;
  • prevention and early intervention;
  • integration, in particular better connections between the NHS and local services; and
  • the role of financial services.

The engagement runs for three months. There will be a series of events and meetings which will be attended by six ‘discussion leaders’ drawn from the ‘care and support community’ – one for each of the six key areas. The discussion leaders come from a variety of backgrounds representing service providers, local authorities and the NHS. Jeremy Hughes from the Alzheimer’s Society and Imelda Redmond from Carers UK represent service users and carers. There will also be a web based feedback form that people can use to respond directly. This can be found at Written comments must be sent to the Department of Health by December 2nd.

Find out more about our Care in Crisis campaign

Care Quality Commission Annual Report

The Care Quality Commission has published its annual report on the state of health and adult social care in England. This report is different in format from it’s two predecessors as a result of being  produced under the  new regulatory system brought in by the 2008 Health and Social Care Act.

It therefore looks at whether services comply with the essential standards of safety and quality bought in by the act, rather than the old minimum standards.  Introduction of the new system means that CQC has only been compiling data on compliance by social care providers for 6 months.

Also, as the Health Select Committee report published yesterday points out, there has been a dramatic drop in the number of inspections of social care services carried out.

Some of CQC’s findings are alarming and show low rates of compliance with the essential standards, particularly by nursing homes and by NHS hospitals. Under outcome 4 – which requires that people experience ‘effective, safe and appropriate care, treatment and support that meets their needs and protects their rights’, only 51% of nursing homes an NHS hospitals are compliant.

They  also lag behind  on outcome 9, management of medicines,  where they both achieve just over 60% compliance, on outcome 16, management of risks to health, welfare and safety, and outcome 7, safeguarding.

The CQC is also planning to launch a new website which will make it easy for people who are looking for a service to see why services have been rated as non compliant.

Find out more about care on the Age UK website



Care Quality Commission under-resourced

The publication of the Health Select Committee report today backs up our belief that that Care Quality Commission needs more resources to undertake inspections. The committee reported that the focus on registering providers had taken away resources from its core function of inspection. This led to a huge 70% fall in the number of inspections in the second half of 2010-2011. MPs stated that the priorities and objectives of the health and social care regulator were not clear and the system for registering new providers was not thoroughly tested before being rolled out.

The role of the Care Quality Commission is to support the most vulnerable; the significant drop in inspections is therefore of grave concern. In 2010/11 just 3,805 inspections took place in adult care homes comparison to 10,856 in 2009/10. MPs highlighted that these failings were not adequately brought to the attention of ministers.

The only way the health regulator can provide better monitoring and regulation is to have more resources, yet their budget has been reduced by 30%. We are calling for yearly inspections to safeguard the quality of care for of older people in hospitals and care homes across the country. The challenge now for the Government and the Care Quality Commission is to work together to ensure this takes place and that they have the funding to do so.

Find out more about our Care in Crisis campaign