01 December 2006
NHS budget cuts, tight eligibility criteria and foot-dragging on personalised services have created 'pockets of poor performance' in adult social care, England's inspectorate has found.
In its November 30 report, the Commission for Social Care Inspection found a net increase of just one council in the 'excellent' three-star rating for adult services in 2005/06.
Overall, 44 councils (29%) received an 'excellent' rating, 73 (49%) received a two-star 'good' rating and 33 (22%) received a one-star 'adequate' rating.
Although no adult service department was rated zero or 'inadequate', the report Performance ratings for adults' social services in England warned that departments' 'capacity to improve has remained fairly static'.
The report referred to several 'pockets of poor performance'. Slow progress on the use of direct payments to enable service users to buy personalised care packages and 'tensions' between the health and social care system, created when indebted NHS primary care trusts adjusted spending plans, were highlighted.
Chief inspector Paul Snell said: 'Health and social care budgets are under pressure, and where those two things happen coterminously we then see rising levels of eligibility criteria, where councils are having to make decisions about who receives services and who doesn't.'
Budget pressures meant that two-thirds of councils set their eligibility criteria for adult care services at 'substantial' in 2005/06, and more were expecting to raise their criteria this year.
Where that happened, the cost and burden of providing care services fell on their unpaid carers, said Snell.
In 1992, 528,000 adults received home care services from their council but by 2005 that had dropped by a third to just 354,000.
Care services minister Ivan Lewis said there had been real improvements but that he was concerned about the 21 councils that had not improved their services since 2001. 'Adults and their carers deserve better,' he said.
That comment was not well received by social care leaders, who said the sector should be congratulated for managing to improve amid funding cuts.
'We cannot ignore the fact that these improvements have been made in the teeth of one of the most severe financial squeezes social care has experienced,' said John Coughlan, president of the Association of Directors of Social Services.
'In that light, authorities who have added a star to their total, or maintained services at the same level as last year, deserve an extra round of applause.'
PFdec2006
