Government tells CQC to rate councils on adult social care performance

Regulator will provide overall judgment, ranging from 'inadequate' to 'outstanding', on each authority's performance when it starts assessing authorities later this year

Dial pointing at the word 'performance'
Photo: Coloures-pic/Adobe Stock

The government has told the Care Quality Commission to rate local authorities on their performance in adult social care under its new assessment system, launching later this year.

The regulator will give each council an overall score – ‘inadequate’, ‘requires improvement’, ‘good’ or ‘outstanding’ – underpinned by scores of 1-4 against each of nine quality statements authorities will be judged on.

This will also generate an overall score that will indicate where the authority stands within its performance band, for example, whether it is ‘good’ bordering on ‘outstanding’, or ‘requires improvement’ tending towards’ inadequate’.

Ratings approach similar to children’s services

The ratings approach is similar to that taken by the CQC in relation to adult social care providers, and Ofsted in relation to council children’s services. However, many directors of adult social services favoured the regulator providing them with a “narrative” judgment, without an overall rating.

The decision to rate was taken by the Department of Health and Social Care (DHSC) which, under the relevant legislation (section 46A of the Health and Social Care Act 2008), must approve the CQC’s approach to assessing councils.

The regulator set out its approach to assessments in interim guidance published this week.

As Community Care reported last month, the CQC’s system for assuring the performance of local authorities will be rolled out from next month, but it said this week it would only start formally assessing councils from September.

How assessment of councils will be rolled out

From April until then, it will review data and published performance evidence across England’s 152 councils, with a particular focus on two of the nine quality statements: assessing needs and care provision, integration and continuity. It will also look at issues relating to the workforce, personalisation, access to services, market shaping and commissioning.

The regulator will publish information from this nationally, not at a local authority level, though will also do up to five pilot assessments of authorities during this first phase.

From September to December, the CQC plans to fully assess 20 councils, and will continue to so in 2024, working with councils and the DHSC on how to publish its findings.

ADASS welcome for staged introduction

The Association of Directors of Adult Social Services (ADASS) welcomed the approach set out by the CQC.

Joint chief executive Sheila Norris said: “We called for a delay to introducing the assessments this year so that adult social care services could focus their resources on supporting people during the winter crisis rather than preparing for assessments in these first few critical months of the year.

“The staged approach with five pilots this summer and a first group of 20 assessments in the autumn should help with this and enable the CQC to test and learn from their approach.”

However, while she welcomed the regulator’s commitment to work with authorities on the best way to publish findings, she raised concerns about the prospect of single-word ratings for each council.

Warnings over single-word ratings

“Directors of adult social services indicated in our reform report last summer that they think narrative reports would provide the most useful and balanced picture of the quality of services,” she added.

“Though the government wants individual ratings for each council, it’s important that any single word rating is presented very clearly alongside narrative and potentially sub-ratings across the seven theme areas that the CQC will be assessing, like care provision, access and personalisation.

“A single-word rating alone wouldn’t show the public how good different parts of the service are, and experience from Ofsted’s inspections of children’s social care shows the detrimental impact a negative single judgement can have on retaining vital staff.”

For the Local Government Association, community wellbeing board chair David Fothergill also raised concerns about the prospect of single-word ratings. He said the LGA did not think they could “adequately reflect how a council is performing across the wide spectrum of services that comprise adult social care or adequately reflect the local context”.

‘Extremely challenging context’

He also said the assessment process needed to take into account the “extremely challenging context councils are operating in”.

“The introduction of assurance of adult social care comes at a time when both councils and social care providers face significant financial and capacity challenges with rising costs and demand and significant levels of unmet and undermet need,” he said.

“Councils will want to work with CQC and government to make the most of the opportunities that assurance will bring including improving the experience of care and support for people who draw on it and further evidencing the scale of the challenges facing the sector. In order to do so it will be crucial that councils have the time and space necessary to learn from the initial pilot assessments.”

“We’re also keen to work with the Department of Health and Social Care on what support will be available for councils following assessments, as that will be vital in maximising the impact of this new assessment programme.”

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One Response to Government tells CQC to rate councils on adult social care performance

  1. Anonymous March 7, 2023 at 7:10 am #

    I don’t think this can come soon enough. Yes, it will be hard and I hope front line staff don’t take the brunt of the blame. This will drive positive change in the sector and expose what decisions council leaders have been making while no-one was watching. I anticipate big changes at senior levels across the country over the next 12 months.