The government will produce a national strategy for quality in adult social care after a review found there had been a lack of attention paid to what constitutes good services in the sector.
In a parliamentary statement, health and social care secretary Wes Streeting said that the government had accepted in full all the recommendations from a review into patient safety across health and care by NHS England chair Dr Penny Dash, published yesterday.
Though focused on healthcare, one of Dash's nine recommendations was that a national strategy for quality in adult social care, "underpinned by clear evidence", should be developed.
'No clear strategy to drive improvements in quality'
Dash, who previously carried out a highly critical review of the Care Quality Commission, said she had been "surprised to find no clear strategy or plans to drive improvements in quality".She found far more organisations were involved in considering the quality of healthcare than adult social care, a role which fell predominantly to regulator the Care Quality Commission (CQC) and improvement agency the Social Care Institute for Excellence (SCIE).
While patient watchdog Healthwatch England's role covers both health and social care, it was primarily focused on the former, Dash concluded.
Dash also said that significantly less data was collected about the quality of social care, as opposed to healthcare.
'Data on adult social care lacking'
The adult social care outcomes framework (ASCOF), for which data is collected annually from local authorities on metrics including self-reported quality of life and satisfaction with services among people receiving care and support and carers, care home admission rates and the take-up of self-directed support, is the main performance dataset for the sector.However, Dash concluded it was limited, saying that it was "only published at a local authority level on an annual basis".
Several ASCOF indicators are based on the results of the personal social services adult social care survey, which polls people receiving long-term care and support on their satisfaction with services and quality of life.
Dash said that this provided key performance indicators of user experience, but that it only covered people funded by local authorities, not self-funders, and its results were not mapped to an individual provider level.
She also highlighted that councils were not required to submit data on complaints or feedback they received, with only a fraction of complaints being considered by the Local Government and Social Care Ombudsman.
In addition, no data was collected nationally from providers, including on key issues such as missed home care visits, falls, urinary tract infections and bed sores.
Call for national quality strategy
Recommending the development of a national quality strategy to set out what "good looks like" in adult social care, Dash suggested this include:- an agreed set of metrics to assess quality of care, focused on outputs and outcomes rather than inputs;
- agreement on how to disseminate best practice;
- work to ensure appropriate governance structures, systems and processes are in place across all providers;
- action on improving commissioning of adult social care.
SCIE welcomed the recommendation, with its chief executive, Kathryn Marsden (formerly Kathryn Smith), saying: "If we want better outcomes, we need better data, clearer standards, and a shared language for quality. But most of all, we need the will and the leadership to make that vision real. This review is a timely reminder of what’s at stake, and what’s possible.”
