The
morning after yet another Panorama expose on appallingly bad care the media
response is, as usual, distinctly underwhelming. No loudly broadcast calls for
the resignation of senior civil servants, no demands for inquiries into the
care system, in fact, nothing.
One
particularly difficult issue with social care is that it is far too easy to
spread the blame and for nobody to take responsibility.
Commissioners,
Regulators and providers can all blame each other and the Government can blame
all three! Yet, ultimately, the responsibility for regulating social care lies
in Westminster and it is the responsibility of politicians to ensure safe,
quality care is available to all.
Yes
appallingly bad care exists but good quality care also exists. The quality of
care is solely dependent on the care provider and good care providers have to
struggle in a system that treats both good and bad care equally. Both are
allowed to thrive in a system that is, currently, more focused on money rather
than quality and the needs of individuals.
Of course
bad care providers are to blame for the care they provide and such providers
need to be shut down and banned from providing care services again yet the
system allows them to carry on. Regulators can be blamed for not spotting the
bad care being provided yet they are constrained by the regulations they
regulate and inspections can only provide a snapshot of care provision and
inspecting home care in particular is challenging. Commissioners can be blamed
for buying services based on price rather than quality and, perhaps, they rely
on information provided rather than going out and inspecting the care services
they are commissioning services from.
But all of
this can only happen because of the framework in which everyone operates.
Contrast
this to the NHS and the calls for action following the Mid-Staffs enquiry.
Those who stoutly defend the NHS and campaign for better quality do so because
the NHS is a single, national, entity yet few of those people so stoutly
campaign the fragmented social care system.
The
ultimate responsibility for social care lies with Westminster, it is no use
politicians blaming other elements within the system because it is the system
itself that is broken and urgently needs to be reformed. There increasingly
needs to be a system that promotes and rewards good care providers whilst
ensuring those who provide bad care are eradicated.
We are
promised a new care rating system soon, which is welcome, but it must,
obviously, be one that can be trusted, one that will influence commissioning
and one that reflects the care individuals need rather than what bureaucrats
believe is essential in terms of paperwork!
Yet beyond
this we also need a system that has real accountability. The ability of all
parties to pass blame on others MUST STOP NOW. Ministers must admit their
responsibility for social care services, commissioners must accept they have a
responsibility to ensure the services they are commissioning are quality
services, regulators must accept their responsibility to rigorously act and
eliminate poor care and care providers must be held fully accountable for any
failures in their duty to care.
The time
to end poor care is now and this has to start with ending the blame game and
all those responsible for social care to stand up and shoulder that burden.
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