Read more about standards of care and good working practice.
'The state of social care'
In January 2008, the forerunner of the current Care Quality Commission, The Commission for Social Care Inspection (CSCI), reported on ‘The state of social care', an annual report which highlighted the significant differences in the quality of support received between people who do and who don't qualify for social care services.
In response, care services minister Ivan Lewis ordered a review into eligibility criteria for government-funded adult social care. Published in October 2008, the report recommended that the current eligibility criteria should be removed with immediate effect and replaced with criteria that take into account the urgency of each situation. It also states that eligibility criteria should be applied consistently across the country.
- Find out more about 'The state of social care' on the CQC website.
Across England, Wales and Northern Ireland there are a number of regulatory bodies: CQC, OFSTED, CSSIW (Wales) and RQIA (Northern Ireland). In April 2009 the new Care Quality Commission came into effect in England, joining the work of the Health Care Commission and the Commission for Social Care Inspection into one health and social care regulatory body.
CQC inspects the majority of services to ensure they meet the requirements of the Care Standards Act 2000. Each type of service must comply with minimum standards that are used to monitor how well service providers are performing. Currently CQC are consulting on a new set of standards, covering both health and social care services, that it is proposed will take effect from April 2010.
In 2007 the regulation of children's services moved from CSCI to OFSTED (Office for Standards in Education, Children's Services and Skills).
The provision of children's services is supported in legislation by the Children Act 2004. Services are also informed by Every Child Matters: Change for Children, the government's national framework for ensuring the well-being of children and young people from birth to age 19 by building services around the needs of children and young people.
The aim is for every child to have the support they need to:
- be healthy
- stay safe
- enjoy and achieve
- make a positive contribution
- achieve economic well-being.
To do this effectively there needs to be real partnership working between all those involved in working with young people, sharing information and working together, to ensure their well-being and supporting them to achieve the things they want and need.
In December 2007 the government published its Children's Plan, which gave a fresh impetus to Every Child Matters. It places an expectation on local authorities and their partners in Children's trusts to champion and take responsibility for measuring improvements in children's lives. Children's trusts bring together the services for children and young people in an area to improve partnership working. Their creation was outlined in duties set out under the Children Act 2004.
Other Quality Assurance Bodies and Contractual Arrangements
Services that are not regulated by CQC may be subject to visits from non-regulatory quality assurance bodies. These include Supporting People, now part of the Department for Communities and Local Government.
As Supporting People has both a quality assurance role and that of commissioner of services, its approach is locally led. However, there is a national Quality Assurance Framework, aligned to the outcomes set out in Every Child Matters, that all providers who access Supporting People funding need to work within. In April 2009, following a period of review and consultation, this framework has been amended and now has five core areas that all services need to be able to demonstrate they are delivering and working towards improvements in. These are:
- assessment and support planning
- security, health and safety
- safeguarding and protection from abuse
- fair access, diversity and inclusion
- client involvement and empowerment
Service providers may have other contractual and commissioning arrangements that they will be required to meet. These can often be assessed through formal contract reviews.
Other legislation impacting on the delivery of services to people with a learning disability includes the Mental Capacity Act 2005 (MCA), which came fully into force in October 2007. This governs how and when others can make decisions on behalf of someone who lacks mental capacity.
Consultations: Following the publication of its green paper on the future of health and social care, ‘Shaping the Future of Care Together', the government ran a consultation to gather public responses. The consultation looked at what could be expected from a National Care System, how to ensure a joined up service and the different options for payment. The consultation closed on 13 November 2009 and the results will be published in 2010.
Read about Mencap's own consultation and response to the social care green paper.
Outcomes focus: In recent years there has been a change in the way that service delivery is seen. This has moved from a model based upon delivery of ‘services' for groups of people, to one where the standards and tools for commissioning services are more closely aligned with the outcomes for the individuals who use the services.
This approach is seen in a number of Department of Health documents including ‘Our health, Our care, Our say - A new direction for community services' and ‘Putting People First - A shared vision and commitment to the transformation of Adult Social Care'
- Visit the Department of Health website to view current publications.
The Independent Safeguarding Authority has been created to work alongside the CRB to prevent vulnerable children and adults being supported by unsuitable people, this authority is due to go live from October 12 2009.
- Visit the Independent Safeguarding authority website.
Research into improving care standards is carried out by several groups, and forms part of ongoing consultations by the Department of Health.
In 2001 the government established an organisation, The Social Care Institute for Excellence (SCIE), to improve social care services for adults and children in the United Kingdom. SCIE shares knowledge-based good practice and guidance, and looks to involve service users, carers, practitioners, providers and policy makers in advancing and promoting good practice in social care.
The Care Services Improvement Partnership (CSIP) was created in 2005 with the integration of a number of initiatives supporting the development of services to help improve people's lives. Commissioned by the Department of Health and other agencies, CSIP aims to work with local communities, as well as the systems and organisations that are engaged in health and social care work. Their aim is to ensure the implementation of national policies.
Current good practice in delivering services that meet, and exceed, the standards defined by the Care Standards Act focuses on the importance of person centred planning in developing and delivering services.
As a regulator of health and social care services, CQC has developed several good practice guides for professionals working in health and social care.
Find out more about the good practice guides on the CQC website.
In December 2007 the Department for Children, Schools and Families launched a process for identifying the organisation (or consortium) that will run the Centre for Excellence and Outcomes for Children and Young People's Services (C4EO).
Find out more on the C4EO website.
As a large service provider in England, a number of the services we deliver are regulated by CQC. This includes registered homes (adults and older people), domiciliary services and adult placement services.
Each year we receive a national report from the care regulator. Our last full years report from September 2008 shows that we were above the rating of the national comparator in all of the regulated service types. Nationally our registered services are rated at: 90% (adults) and 98% (older people), adult placement 90% and our domiciliary services are at 88%.
Our standards, developing high quality support
Mencap operates its own quality review systems and has this year launched a set of best practice standards for direct support services, ‘What Matters to me'. This set of standards has been developed from an understanding of what has worked well for the people we support and has included consultation with people to ensure they reflect the things that people want and need from a service.
These standards have been written to both quality assure the services we deliver and raise the expectations of people who use our services. Using ‘What matters to me' we can review the quality of services people receive, and plan how to further personalise and improve the services for the people we support.
To make sure that we are learning from current research and to continue the development of service delivery we review current strategies and carry out research that supports the delivery of good quality services and the development of best practice.
How we work with others
As both a campaigning and provider organisation we are continually seeking to improve the services people receive through Mencap. We welcome the opportunity to work with other groups and organisations to develop good practice. Please visit our how we learn from others page for more information.