28 September 2007
The government's move towards 'lighter-touch' regulation in adult social care creates new concerns, a senior inspector told delegates at the CIPFA social care finance conference on September 24.
Peter West, head of performance and information management at the Commission for Social Care Inspection, told the conference that a new heath and social care performance framework, due to be announced in October, would slash the number of indicators in adult care from 20 to 'eight or nine'.
'Instead of councils having to earn autonomy they will have presumed autonomy… Our reservation about that is that social care can easily get overlooked,' West said.
Referring to the CSCI's discovery of 'widespread institutional abuse' of people with learning disabilities in Cornwall last year, he added: 'In the past 12 months we have had to look into some very serious issues… and some of the worst conditions we have seen for a very long time, which were very much systemic, whole-systems failure…
'So in that context you can understand that the CSCI is nervous about people with learning disabilities having the same voice as someone who is worried about their library closing.'
The revised adult social care performance indicators will sit within 200 other amended PIs for local government and will be scrutinised by the planned new health and social care inspectorate, Ofcare, which is expected by 2009.
Although West admitted that the reduction in the evidence base for adult social care inspection was 'worrying' – particularly as such services were becoming increasingly complex and 'personalised' – he said that the current performance framework was 'no longer fit for purpose'.
It needed to become more outcome-focused and take into account a service's use of resources, he said. Performance indicators were also open to perversion and were merely indicators, not proof, which was why the CSCI remained committed to its 'gold standard' evidence in the shape of service inspections.
West's comments came as Unison, the Royal College of Nursing, Prospect and Unite wrote to social care minister Ivan Lewis expressing concern that the CSCI's recent change in its inspections policy from twice a year for all to once every three years for good providers was putting vulnerable people at risk.
Ring-fenced funding to end
The last remaining ring fences around adult social services funding will be removed in 2008, leaving social service departments concerned that their funds will be hived off to other council budgets.
Paul Carey-Kent, financial controller for social care at the Department of Health, told the CIPFA conference that ring fences around all but the £16m AIDS support revenue grant were likely to disappear over the Comprehensive Spending Review period of 2008 to 2011.
Instead, the funds allocated for adult social services such as disabled facilities and Supporting People will be consolidated within an overall area-based grant, paid to support Local Area Agreements.
That raised concerns among delegates from across council social services departments that funds could easily be diverted for other, non-care spending purposes.
'It's true there won't be anything to stop that, but the pressures on social care will mean it will be very difficult to do,' said Carey-Kent.
'The money will still be visible as the element of the grant which originated from social care, thus enabling the case to be made for spending that amount on social care.'
He added that the government would still publish guidance on what services should be offered.
PFsep2007
