What Else do we Need to Know About the State of Home Care?
The CQC recently published the annual State of Care Report 2017 looking at the status, progress and ongoing challenges for Health & Social Care provision. Across Adult Social Care CQC noted the continuing risk of a ‘tipping point’. This is where service deterioration outpaces the capacity for service improvement in the face of an inexorable increase in the number of people with complex care needs.
The State of Care report notes how some areas have moved further away from this tipping point while some are at increased risk. There’s little analysis of why some areas have been able to improve and others not, which is a shame.
Insights into factors and trends that fuel improvements would have been welcome. Could there be a link to better commissioning processes, improving data sharing with health services, or are there other factors at play?
Overall, there are few surprises in the report but it does raise a couple of questions in my mind.
The whole picture?
First and foremost there’s a question about whether a focus on individual providers reveals the whole story. At the extreme, every provider in the land could be delivering good or outstanding care and we might still have a broken care system.
For example, 43 councils reported domiciliary care contracts being handed back, representing over 3000 care users. The report also notes that there are 1.2m older people with unmet care needs and over 90,000 unfilled vacancies for care staff. There is a big picture beyond the performance of individual care providers.
Can quality be managed sooner and more actively?
There’s also an argument for saying that by the time CQC has rated a care provider as needing improvement or inadequate it’s too late. Certainly for service users who may not have been receiving the care they needed.
Should commissioners be doing more to proactively manage the quality of the provision they fund? Perhaps this is a tough ask when many are labouring under the burden of manual brokerage models rather than embracing technology.
Consistency and availability of performance data are additional limiting factors that could prevent some commissioners from seeing a detailed picture of performance. But this can be fixed. We have the technology to deliver data insights that allow commissioners to step in sooner if there are concerns.
Part of the issue is the remit that CQC has. We would wholeheartedly endorse the views of Colin Angel, Policy Director at the United Kingdom Homecare Association, who said:
“As well as being able to report on the quality of services delivered by providers, CQC also need statutory powers from government to have oversight of how care services are commissioned and supported by the state in line with councils’ responsibilities under the Care Act 2014.”
Such a remit would shine a light on the effectiveness of the whole care system, from assessing local needs, to commissioning care from high performing providers. It might not take away all of the problems but it would certainly help us understand where we really are.
In order to break away from the tipping point, We are offering local authorities 3 months’ free use of CareForIT eBrokerage. This allows care packages to be broadcast to care providers and will allow authorities to evaluate for themselves how much time can be released for activities that more directly support excellent front line care delivery.