Councils maintain high standards of adult social care in final year of CQC assessment

Councils have kept up the high quality of their social care services for adults in the past year, the Care Quality Commission said today (25 November).

Outcomes for local people who use services continued to improve in 2009-10 in key areas such as choice and control, dignity and respect, and health and emotional well-being.

Of the 152 councils responsible for adult social care services in England, 95% (145) were assessed as performing well or excellently – the same proportion as the previous year (when there were 148 councils). However, the number performing excellently has increased by five to 37.

Seven authorities were assessed as “adequate”, and CQC said they needed to improve their performance in all outcome areas. For the seventh year running, no councils were rated “poor”.

CQC chief executive Cynthia Bower said: “About 1.75 million people across England rely on the care arranged for them by their council. The large majority of councils provide good standards of care, whether they run the services themselves or commission them from the private or voluntary sectors. But a few need to improve considerably before they can say they are providing good services for local people.

“Our experience is that good performance is the result of strong leadership and commitment by elected councillors and service managers, working together with a skilled and dedicated workforce.

“They encourage people to be actively involved in shaping their own care packages, and they develop and commission the services that meet people’s individual needs.

“The best-performing councils work closely with health agencies to deliver joined-up care, with joint commissioning and monitoring of services becoming more common. This year partnership working was found to be a key strength in half of councils and an area for improvement in a third.”

The system of performance assessment that has operated since 2002 is changing. From the current year, 2010-11, the councils themselves will take more responsibility for driving and monitoring improvement locally, in line with the Government’s vision for the future of social care.

CQC is assisting in the design of a new system with the Department of Health, the Local Government Group and the Association of Directors of Adult Social Services (ADASS).

Ms Bower said: “Councils have achieved improvement year-on-year since 2002. Now the challenge for them, as we move to a new approach, is to continue to perform at this level and to strive to improve even further. The new system will include ways of focusing on the few councils that were assessed as ‘adequate’. We anticipate this will involve an element of peer assessment by other councils.”

Each council sets the level of need that makes a person eligible to receive funding towards their care. There are four levels of eligibility criteria: ‘critical’, ‘substantial’, ‘moderate’ and ‘low’. In 2009-10 one council raised its eligibility criteria and two lowered theirs. Of the 152 councils, three (2%) set their criteria at critical, 107 (70%) at substantial, 37 (24%) at moderate and five (3%) at low.

Key areas of the 2009-10 (April 2009 to March 2010) assessment were:

Choice and control. Councils should help people to take control of their care support by providing clear information and advice on the care options and funding available, helping them to assess their needs, and providing a broad range of support services. Two more councils are performing excellently in this respect, taking the total to 28, and the number judged to be performing well has gone up from 88 to 102. One council was assessed as poor.

Dignity and respect. Councils should have effective “safeguarding” procedures to co-ordinate the response to cases of abuse or people being at risk of abuse, and they should ensure that people’s dignity and privacy are respected in care services. The number of councils judged to be adequate decreased from 45 to 24, while the number performing well or excellently increased from 101 to 125. But the number of councils performing poorly in this area increased from two to three. Concerns reported to councils under the adult safeguarding system increased by nearly a third, to a total of 103,000 referrals. CQC said this rise was largely the result of an increasing awareness of safeguarding through public information campaigns and closer working between councils and health agencies.

Health and emotional well-being. Councils should provide people with personalised advice, information and support to improve their health and well-being and help them to live independently, with the option of individual budgets and local services that meet a range of needs. The number of councils performing well or excellently in this area increased from 136 in 2008-09 to 148 in 2009-10.

CQC’s report, Performance judgements for adult social services, can be found on its website (from Thursday 25 November) at: /guidanceforprofessionals/councils/annualassessments/annualperformanceassessment2009/10.cfm