Councils need more funding to manage CQC adult services per

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, 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)

“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."