A series of scandals have exposed a lack of understanding of social care in the ranks of both Ofsted and the Care Quality Commission. The watchdogs need to learn from the wisdom of those delivering the service
How the mighty are fallen! There used to be tremendous respect for bankers. Then they got too greedy. There used to be prestige in being a national politician. Then a surprising number were found to be on the make with their expenses. And the press were celebrated for being free and fearless. Now much of the press is exposed as exploitative and grubby. And within public services it was the national inspectorates and inspectors who, while not always loved, were largely recognised as having integrity, expertise and wisdom. Oh dear, we now have another fall from grace. The two inspectorates for the largest chunk of local council services and responsibilities, the social care of children and adults, have themselves become tarnished.
There are lessons here for public services, and for local authorities, more generally. What is needed in all services and sectors is experience and expertise, a willingness and openness to be reflective and to learn, adapt and improve, and an honesty and humility about weaknesses to be tackled.
In the mid 2000s the then chancellor of the exchequer, Mr Brown, announced with no warning that in the interest of economy and efficiency the Commission for Social Care Inspection was to be abolished. The CSCI had had demonstrable success in improving the standards of the social care services it was responsible for inspecting and registering. It knew the territory in which it was operating and had a considerable commitment to service improvement.
It was not a hit-and-run inspectorate, as was Ofsted with schools, turning up, issuing a report and then galloping away over the horizon unseen until the next inspection. The CSCI took a developmental responsibility for services, staying independent but close enough to services to be well informed and to be a continuing and consistent critical commentator to prompt change and improvement.
The CSCI was also not like the Healthcare Commission. The Healthcare Commission was responsible for inspecting health services, but it came to rely heavily on self-reports and self-completed questionnaires from, for example, hospitals. It was too distant to get under the skin of services and was left scratching the surface rather than exposing the failings which should have been identified and tackled. It got caught up, along with the health service managers, in relying too much on performance data focussed on hitting national targets.
So when the CSCI was abolished and its children’s social care (including child protection) inspection responsibilities were transferred to Ofsted, and its adult social care (including for care homes and home care services) inspection responsibilities were transferred to the new Care Quality Commission, based largely on the Healthcare Commission, there were warnings at the time of dire consequences ahead. The warnings proved to be only too true.
Neither Ofsted nor the CQC adequately understood the dynamics and nature of social care services. Both were arrogant enough to think that top management teams exclusively or heavily weighted with backgrounds in education or health services could by a process of osmosis learn how to lead inspectorates with major national responsibilities for crucial, life-defining, high-risk and high-exposure social care services. Both, in essence, just bolted their new social care responsibilities on to the inspection styles, processes and cultures they already had for schools and hospitals. The considerable learning, experience and expertise which had been held within the CSCI was ignored and discarded.
It should, therefore, have been no surprise when, following the terrible death of Baby Peter Connelly in Haringey and the inspection and re-inspection of child protection services in the borough, Ofsted found itself ducking and weaving in the media and political spotlight, showing itself to be inconsistent in its judgements. The hospital scandal in Staffordshire and the private hospital abuse of people with learning disabilities in South Gloucestershire also made apparent the weaknesses within the CQC. Both inspectorates have now been the subject of negative and critical House of Commons reports. Both have lost much of the respect of the bodies they inspect.
So what lessons here? First, no matter what the service, do remember there is an experience, expertise and wisdom built up over time within the services. Discard and destroy this expertise and wisdom at your peril. Secondly, there are different requirements for different services and functions. Inspecting schools is, or at least should be, different from inspecting child protection services. One size does not fit all. And thirdly, have humility by acknowledging what you do not know rather than just bluffing and bulldozering ahead.
As councils talk about ‘one council’, introducing generic call-centres with corporate leadership teams which may not be grounded in service delivery, there may be more dangers ahead. Gordon Brown and the last government ploughed ahead in the interest of economy and efficiency despite the warnings in 2005. Let’s hope it is not a lesson to be repeated.
Ray Jones is professor of social work at Kingston University and St George’s, University of London. From 1992 to 2006 he was director of social services in Wiltshire.
