I’m delighted that the MJ’s publication of our list of the Top 10 councils for adult social care has started a lively debate.
We have had responses from across the sector including from Glen Garrod, President of the Association of Directors of Adult Social Services (ADASS). Glen is absolutely right to point out a limitation in our Top 10 ranking. He highlights the value of CQC system reviews that look at a whole health and care system, rather than just at social care. I wholeheartedly agree that the CQC reviews are a good thing – but my view is that Whitehall are being far too timid with them. DHSC had to be bullied into confirming next year’s miniscule funding for the reviews by CQC (who put their whole team on notice to make a point). CQC have also been too timid in only suggesting doing a handful more. It looks like we will still end up at the end of next year with almost 85% of the country not having been reviewed at all.
Having said that, I would also defend the relevance of having a clear understanding of what good adult social care is on its own terms. Social care is absolutely part of a wider system – but it is also important in its own right. Let’s face it, whenever you look at health and care together, it is far too common for social care to receive insufficient focus. For example, it is quite possible for local areas to fly through CQC’s assessment for overall health and care, but still provide poor adult social care services. That’s why our ranking looks at how well adult social care manages the interface with the health system, but doesn’t dilute the focus by looking at the whole health system.
However, as with any league table, ours has limitations. We absolutely welcome people pointing these out – as long as (like Glen) they are happy to engage in discussion about better definitions of good social care. Just saying “it’s more complicated than that”, without working through that complexity, doesn’t do anything to move the debate on and enable the sector to improve.
By publishing league tables, we have aimed to do three things. First, to move the sector towards developing its own definition of what good adult social care is. Second, to widen the debate beyond simply the amount of money available to local government to what is being achieved with it: the outcomes achieved per pound spent. And third, to encourage councils to engage with debate about variation, in order to strengthen their case for increased funding.