5 Provision of information to the
Information on adult social care
79. The CQC also plays a role in helping the
public to choose between providers by giving them access to the
information it holds on providers and, specifically, the results
of its reviews and inspections. Following our pre-appointment
hearing with Dame Jo Williams the Committee noted its concerns
regarding the quality and accessibility of this information, in
particular that regarding adult social care providers. In September
2010, Dame Jo had told us that:
One of the most important things that we can contribute
is information on our findings that is understandable so that
people can use it to make really informed choices. Translating
some of the mechanisms that we are buildingsuch as our
quality and risk profileinto a usable set of messages for
individuals in a local community is one of the things that we
are looking at very carefully. You will know that our predecessor
organisation had a star rating for providers of social care.
We are currently consulting on what might be the most appropriate
system for the future and anticipate that that will be concluded
this year, with the new system probably starting next May.
80. This has not been the case. The promised
successor to the star rating system (see 'The Excellence Award',
below) is currently being consulted upon and is not intended to
be in place until April 2012, while the 'user-friendly provider
profiles' setting out more of the data CQC holds on each provider
have been put back from January 2011,
to summer, and
then again to autumn 2011.
81. The CQC website now offers a searchable 'Care
Directory', with information on each provider, but the information
that is available is limited and often out of date. The CQC acknowledged
these limitations in its annual report.
Entries for typical adult social care providers currently show
their last star rating (in line with legislation, the CQC stopped
awarding star ratings in July 2010, so even the most recent star
ratings are over a year old) and past inspectors' reports (which
may also be several years old). The only information relating
to the CQC's current system is a statement that the provider has
been registered and licensed against CQC standards of quality
and service. The charity Action on Elder Abuse noted that this
could be misleading:
The new system of registering social care providers
[...] did not test compliance other than by self declaration.
The process therefore gave a false sense of reassurance as it
could only confirm a provider's assertion of compliance.
82. Amanda Sherlock, Director of Operations Deliver
at the CQC, told us that as of 5 July a statement would appear
on a provider's entry if they were under review by the CQC.
83. The paucity of information and, in particular,
the delay in developing a successor to the system of star ratings,
has been subject to criticism. The English Community Care Association
accused the CQC of a 'singular lack of urgency',
while Adass noted that the 'considerable time-lag restricts the
public from making informed choices about providers at a time
when national policy supports choice as a core value'.
84. The information currently
provided by the CQC on adult social care providers is unhelpful
and often out of date. We welcome the introduction of an 'under
review' label where the CQC is investigating a provider, but we
find it surprising that it has taken so long to provide the public
with such essential information. The delay in developing provider
profiles is particularly frustrating as they could have been a
useful interim guide for the public until a successor is developed
for the star rating system. The constant slippage in the planned
roll-out of the profiles is further evidence of a lack of control
within the organisation.
THE EXCELLENCE AWARD
85. The Adult Social Care Excellence Award is
the proposed successor to the star rating system that operated
under the Care Standards Act 2000, and which came to a close with
the expiry of that Act in 2010. CQC is developing the scheme at
the invitation of the Department of Health. The award is intended
to demonstrate where providers meet a standard of 'excellence'
above and beyond the CQC's essential standards. The CQC is currently
consulting on the principles behind the award, the definition
of excellence, and suggested assessment procedures. It intends
to launch the new award in April 2012. Under the consultation
proposals (and as set out in the Government's own consultation
on social care services)
assessment for the award would be voluntary. Assessment would
be carried out by a third party organisation on behalf of the
CQC, and the provider would pay an additional charge for assessment
towards the award.
86. Evidence to the Committee was widely critical
of the proposals. The Relatives and Residents' Association told
has that they 'totally reject' the concept 'on grounds of cost,
equity and total inappropriateness',
while Adass cautioned that the voluntary nature of the system
would 'not help the public with easy to access and understandable
ratings of all care providers'.
The English Community Care Association, Action on Elder Abuse,
and the National Care Association also opposed the scheme.
The imposition of an additional charge for the assessment raised
concerns that smaller providers could be financially excluded
from the award.
There are also questions over the suitability of using a
third party to carry out the assessment: 'surely when inspecting
providers of care CQC is best placed to identify which provider
is delivering an excellent service'.
87. The proposed Adult Social
Care Excellence Award has been roundly rejected in evidence submitted
to us. We share these concerns and recommend that the project
106 These standards were awarded under the Care Standards
Act 2000, which expired in September 2010. The CQC stopped awarding
star ratings in July 2010. Back
See Health Committee, Appointment of the Care Quality Commission,
HC (2010-12) HC461, Q 31. The transcript of the session can be
found on the Committee's website (http://www.publications.parliament.uk/pa/cm201011/cmselect/cmhealth/uc461-ii/uc46102.htm) Back
The CQC state that the provider profile will 'tell people at a
glance whether each service is meeting the essential standards.
If they are not, it will state what improvements we require to
make sure they do meet the standards involved. People will also
be able to see when we have carried out a formal check of a service,
whether it was directly in response to concerns or a routine check.
Most importantly, each profile will include information about
what people told us during our last formal check'. Care Quality
Commission, Annual Report and Accounts 2010-11, p17. Back
Care Quality Commission, Business Plan 2010-11, p9. Back
Care Quality Commission news story, New excellence scheme for
Adult Social Care, 28 February 2011 http://www.cqc.org.uk/newsandevents/newsstories.cfm?widCall1=customWidgets.content_view_1&cit_id=37165 Back
Q 236 Back
Care Quality Commission, Annual Report and Accounts 2010-11,
13 July 2011, HC 1212, p17 Back
Ev 44 Back
Q 213 Back
Ev 28 Back
Ev 62 Back
Department of Health, Transparency in outcomes: a framework
for adult social care, November 2010 Back
Ev 74 Back
Ev 62 Back
Ev 28 (English Community Care Association), Ev 38 (National Care
Association), Ev 45 (Action on Elder Abuse) Back
Ev 45 (Action on Elder Abuse), Ev 38 (National Care Association). Back
Ev 38 (National Care Association) Back