The appointment of Andrea Sutcliffe as Chief Inspector for Social
Care at the Care Quality Commission is a highly commendable one. Not only is
she knowledgeable about the care sector (see for example http://www.guardian.co.uk/social-care-network/2013/jul/15/what-good-homecare-looks-like)
but she also has her own personal experiences to draw upon (http://www.whentheygetolder.co.uk/finding-care-for-older-relatives/)
and that combination, along with her naturally open approach, bode well for the
future inspection of social care.
Yet that future is strewn with challenges that Andrea first needs
to tackle. The general perception of social care is not great and trust in the
Regulators has been severely dented over recent weeks. The first challenge will
be defining a model of inspection that will ensure poor provision is identified
and stamped out yet this model must also reflect the nature of the care sector
and the huge variations within it.
Yesterday, for example, the new Chief Inspector for Hospitals, Prof
Sir Mike Richards, outlined a model which he frequently referred to as ‘an
army’, 20 or more inspectors marching into a hospital to inspect all aspects of
care provision and ensure the meeting of standards. Unfortunately, in social
care that will not work as, in many instances that many inspectors would
outnumber both residents and staff!
The variation in social care is completely different from that of
hospitals. Social care covers care homes and home care, it covers care and
support for the elderly and care and support for those with learning
disabilities, it covers large care providers with 100’s of homes as well as
micro providers with just a few beds. Finding a model of social care inspection
that fully encompasses the variation while ensuring consistency is, in itself,
a challenge.
The Care Quality Commission has recently stated that it intends to
have more specialist inspectors and social care could really benefit from this
approach. For example recent reports have highlighted training and development
issues with Health and Social Care staff and having learning and development
specialists as part of the inspection process can help raise awareness of the
importance of staff development, encourage providers to focus on training and
development and help identify failings where providers fail to implement staff
training and development. Similarly specialists in infection control or
nutrition could have a significant impact.
One thing that would be good to see, and may well happen given
Andrea’s former job, is a focus on best practice information and its
application both by providers and inspectors. Resources, for example, from the
three main national bodies, Skills for Care, National Skills Academy for Social
Care and, of course, the Social Care Institute of Excellence should be
routinely be embedded in care practice and those who inspect should also be
fully familiar with this in order to ensure inspections are informed. One
challenge has always been getting best practice information through to all
providers, it is easy for providers to say they don’t have time to look at
these things or, in the worst cases, believe they know what they are doing and
don’t need any advice. If providers know their inspectors will look at
this then they are far more likely to make to time to look at and use this
information.
The regulatory framework has increasingly moved toward an outcome
based approach, if providers and inspectors do not access the knowledge of what
excellent outcomes look like then that system fails.
Undoubtedly, Andrea Sutcliffe has a challenge ahead, one that I am
sure she will meet head on, and, ultimately, social care can only benefit by
having such an effective leader at the helm.
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