Government Urged to Rethink Single-Word Ratings for Adult Social Care

Care Giver

The Local Government Association (LGA) has called for the abandonment of the government’s plans to introduce a single-word rating system for adult social care services, citing concerns about the ability of councils to fulfil their legal duties. The LGA argues that years of underfunding have hampered councils’ capacity to meet the expected standards against which they will be judged.

Commencing in the Autumn, following a series of live pilots, the Care Quality Commission (CQC) regulator will implement a new assessment regime, assigning councils an overall rating of either ‘inadequate,’ ‘requires improvement,’ ‘good,’ or ‘outstanding.’ This system is part of the government’s new adult social care assurance framework.

Councils, ahead of the LGA’s Annual Conference in Bournemouth next week, assert that the allocation of single-word ratings to such a complex service struggling with the repercussions of long-term underfunding is unhelpful and counterproductive.

The most recent survey by the Association of Directors of Adult Social Services (ADASS) revealed that three-quarters of directors in this sector lack confidence in meeting their legal obligations under the Care Act, which will serve as the basis for assessment under the new CQC assurance system.

Representing 350 councils across England, the LGA proposes that narrative reports, rather than solitary word ratings, would provide a more comprehensive and equitable evaluation of the quality of services.

Adult social care has endured over a decade of insufficient funding, resulting in an increase in unmet and under-met needs. Although additional funding was announced in last year’s Autumn Statement, it is anticipated that the majority of it will be allocated to address demographic changes, wage increases, inflationary pressures, and will fall significantly short of what is necessary for councils to fulfil their Care Act duties, given the broader pressures within the workforce and care market.

In addition to the funding for adult social care outlined in the Autumn Statement, the LGA continues to question the adequacy of earmarked funds for broader care and support reforms. Their analysis indicates that £250 million invested in measures supporting the social care workforce translates to a mere £78 per worker per year. Similarly, £102 million designated for home adaptations, aimed at aiding individuals in remaining in their homes or facilitating a quicker return after hospital stays, amounts to less than £27 per household per year for those with health conditions requiring such adaptations. Lastly, the allocation of £25 million for unpaid carers amounts to just £5 per carer.

The LGA emphasises that the government must maintain realistic expectations regarding the achievable outcomes, even with this funding. Councils are diligently working to safeguard crucial adult social care services and fulfil their statutory obligations, despite having redirected billions of pounds from other council services in recent years to keep them afloat.

Regrettably, these efforts have not been sufficient to avert service cuts. The ADASS survey highlights that social care directors are currently required to identify savings amounting to £806 million this year, an increase from £597 million in 2022/23, in order to balance their budgets.

According to the LGA, immediate government investment is necessary to resolve this crisis, address unmet and under-met needs, and urgently establish a long-term funding and reform plan that ensures equitable access to necessary care services for all individuals.

Councillor David Fothergill, Chairman of the LGA’s Community Wellbeing Board, commented, “It is clear that most councils are struggling to meet all of their legal duties under the Care Act. Given that, it seems absurd to push ahead with single-word ratings for adult social care departments, which would oversimplify what are very complex services to deliver. As it stands, councils are being set up to fail.”

Fothergill added, “The Government must ensure that the assurance process is, and remains, productive and supportive for councils. Sufficient time must be given to learn the lessons from the pilot sites. Councils want to give full transparency to their residents on how their adult social care services are performing, but a single-word rating does not do justice to the complex and parlous state that adult social care is in.”

In collaboration with care providers, councils, and individuals utilising care and support services, the government must urgently develop and implement a fully costed, long-term, and sustainable plan to fund social care, Fothergill emphasised.

© 2023 Adult Social Care