The Bill introduces a new duty for the Care Quality Commission to: conduct reviews of councils’ regulated adult social care functions (functions under Part One of the 2014 Care Act); assess the performance of councils following each review; and publish a report of its assessment. In addition, the Bill sets out the roles and responsibilities of the CQC and the Secretary of State. The latter will set objectives and priorities for the CQC in relation to the assessment process, and the former will determine the indicators of quality for the assessment process (which the Secretary of State needs to approve and can direct the CQC to revise). Wherever possible, this framework should use existing data sets and reporting rather than creating new ones. Similarly, the CQC must prepare a statement setting out the frequency with which the reviews are conducted, the period they relate to and the methodology to be used. This must be approved by the Secretary of State, who can also direct the CQC to revise the statement.
LGA view
We understand Government’s desire for greater transparency in social care. Councils need to continue to be an equal partner in the ongoing design of national oversight, which must build on existing sector led improvement work, recognise local democratic accountability and give a meaningful voice to people who draw on and work in social care.
Any new processes or structures for assurance and oversight need to be accompanied by a New Burdens assessment to fairly capture the capacity and resource implications for councils in meeting new regulatory approaches.
Any assurance process has the potential to highlight shortfalls in services and delivery of the intentions of the Care Act due to resource constraints. Any assessment of a council’s adult social care services would need to be contextualised in terms of available resources.
The assurance process must continue to be developed in partnership with local government and the CQC; we favour an approach looking at whole systems, based on a shared agreement of what good looks like (– in particular, the importance of person-centred and locally flexible care and support), based on councils’ own self assessments and improvement plans, and where targeted local reviews are needed, building on the successful model of Local Area Reviews which took place in 2017 and 2018.
An important aspect of the assurance process will be intervention in cases where, following CQC assessment, a council is considered to be persistently failing in its duties. The criteria for such intervention, and what is considered “failure”, is under current discussion with DHSC civil servants. They indicate that the policy intention is for this to be very rare, but – as with many aspects of this section of the Bill – much will depend on the drafting of the policy and any further guidance or secondary legislation.