PLMR's On The Pulse Newsletter | 30th August 2024

Mayday, mayday: sector regulation 'like a ship taking on water' according to new homecare association report

This week, the sector has been given further reason to reflect on the lack of oversight for homecare provision that has come as a result of critical failures in the Care Quality Commission (CQC).

A new report from the Homecare Association suggests that the ongoing challenges in England’s homecare sector have reached a critical juncture: with 60% of homecare providers never having been inspected, or operating with severely outdated ratings. The CQC’s regulatory performance, particularly in the homecare sector, is under intense scrutiny, with significant implications for the safety and quality of care services.

This comes just weeks after Wes Streeting condemned the CQC as “not fit for purpose” following an interim report in July from Dr Penny Dash which identified “significant failings” in the organisation, and noted the inevitable impact that this continues to have on the ability of services to “deliver much-needed improvements in care” .

Why is the CQC failing to meet its own inspection targets?

Perhaps the most pressing issue is the CQC's inability to keep pace with the rapid expansion of home care services. The number of registered community social care locations has increased more than fivefold over the last decade, while the resources allocated to the CQC have remained largely static.

As a result, the CQC is struggling to fulfill its core responsibilities. This gap in oversight has profound implications for the quality and safety of care, and public confidence in services. It is notable that this period coincides with the introduction of the CQC’s new Single Assessment Framework, the biggest change to care regulation practices in years, when the organisation’s need for sector buy-in is arguably more crucial than ever.

The Homecare Association’s report also points to broader systemic issues, including flaws in the CQC’s funding model, and the ineffective implementation of IT systems despite significant investment. The report attributes these factors to a regulatory environment that is increasingly unable to protect the public or maintain high standards of care.

Dr Jane Townson, Chief Executive of the Homecare Association, has compared the nation’s current state of home care regulation to “a ship taking on water, with a crew using buckets instead of pumps to bail it out” , while Emma Williams of Care Rights UK has suggested that the CQC’s failings have left people “baffled” and “despairing” when it comes to finding good care or approaching the regulator with serious concerns.

In anticipation of Dr Dash’s full report, due to be published in Autumn, the Homecare Association has called for a comprehensive review of the CQC’s resourcing needs, an overhaul of its funding model, and improvements in transparency and efficiency. The sector will now be waiting with bated breath to see if this latest research prompts serious action from the CQC and new Government to move forward positively and reaffirm confidence in the sector regulators.

Here are the highlights from this week’s news:

The Economist : Funding social care: an international comparison ?

Reforming social care in the UK is challenging, but other countries offer valuable lessons.

Social insurance, used in Germany and Japan, involves mandatory contributions but still requires tax support, while Nordic countries offer more generous care but face financial sustainability issues.

Key lessons for the UK: clearly communicate the need for reform and consider social insurance as a transparent alternative to higher taxes.

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The Guardian : Alarm at failure to inspect 60% of England homecare providers in four years or longer ?

A survey shows 60% of homecare providers in England haven’t been inspected in over four years or ever. The Homecare Association have launched a report warning that this lack of oversight threatens care quality and safety.?

An independent review is expected to address these issues, while the CQC pledges to boost inspections and improve regulation.

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FT Advertiser : Social care: learning from the past and looking to the future ?

The current means-test thresholds for care costs have been frozen since 2010, leading to more people having to self-fund, often by selling their homes. Previous attempts at reform, such as the 2014 Care Act, have brought some improvements, but funding remains a central unresolved issue.

Labour's government has announced ambitions to address staffing issues and is considering a royal commission to review social care, though past commissions have not always led to action. Potential solutions include voluntary or compulsory funding sources, clearer distinctions between state support and individual responsibility, and better planning incentives for later life.

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Care Home Professional : Survey shows 93% of care providers want hospital discharge reform ?

A survey by Autumna, a later-life care directory, reveals that 93% of care providers want reform in the hospital discharge process. Despite positive relationships with local discharge teams, 85% still believe reform is necessary. Delays are common, with nearly a quarter of patients waiting over a week to be discharged after being deemed fit.?

The report highlights poor communication as a key issue, with nearly half of care providers feeling that hospital teams don’t understand their services.?

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BBC News : Care staff deserve better recognition, boss says ?

Antur Waunfawr, a Gwynedd-based care organisation, bucks the national trend of high staff turnover with just 5%, thanks to strong employee support and well-being initiatives. They advocate for better pay and recognition for care workers.?

The Welsh government has increased funding to help care workers, but challenges in recruitment and retention persist.

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