Councils need to open up about adult social care weaknesses and cuts

A recent review into key plank of 'post CQC' regime has found that many local annual reports to the public omit evidence of under-performance and reduced service levels.

The review, commissioned by Towards Excellence in Adult Social Care (TEASC), the coalition of sector bodies that oversees sector-led improvement, and carried out by former Manchester adults' services director Caroline Marsh and social care consultant Rachel Ayling, was based on a stock-take of all accounts published so far (since 2011), an analysis of 25 of these and interviews with 11 councils.

It found that many councils were using local accounts as an "annual report on their achievements rather than a balanced assessment of progress". These accounts often did not compare budget levels or the numbers of people receiving services year-on-year, despite national evidence that the numbers of people supported by councils and real-terms spending are both going down.

Local accounts are designed to provide residents and service users with information on their council's adult social care performance, activity and objectives and are a central plank of "sector-led improvement", the system under which councils support each other to improve, which replaced annual assessments (APAs) by the Care Quality Commission in 2010.

While not compulsory, 93% of councils had published one since 2011 and 89% are due to publish one this year reflecting on their performance in 2012-13. Despite this, the review has raised concerns that 19 councils had not updated their initial local account from 2010-11, a problem linked to cuts in the number of staff in performance monitoring roles.

Compounding the problem, it was discovered that it was not unusual for local accounts to be difficult to find on council websites - going against the purpose of the accounts to inform the public.

A major issue, the review found, is the "cultural challenge" for councils to report on their weaknesses as well as their strengths, "with only a minority of councils doing this well".

Another issue is the lack of involvement of local involvement networks (Links), the statutory service user representative organisation, in the development of local accounts. Links were replaced by local Healthwatch branches in April 2013 and the review said councils were at an early stage of engaging them in local accounts.

Good practice must be shared

The review concludes with a list of good practice features and things to avoid in relation to local accounts. It said that councils should:

  • Be transparent and honest rather than edit out bad news;
  • Invite independent challenge of the local account, for example from the local Healthwatch or through peer review;
  • Include or attach hard data to enable comparison with previous years' performance, rather than use statistics randomly without making clear whether they are indicative of good or bad performance;
  • Ensure that the local account process is widely publicised and documents are accessible, rather than buried within the council's website;
  • Address the need to prioritise the use of resources in their local accounts rather than duck this and other difficult issues.

TEASC published guidance on local accounts in May, containing similar recommendations. The review authors said it would be counter-productive to produce fresh guidance in the light of the review, but they called on TEASC to be clear about where improvements needed to be made and also to disseminate best practice.

It said these messages should be reinforced through regional Adass networks, and through peer reviews of councils carried out in the coming year. These involve councils being scrutinised on their performance by managers and practitioners from other authorities, and are another key plank of sector-led improvement.

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Last Updated : 27 November 2013. Page Author: marijke.hirst.