The care regulator has called for a “fundamental cultural shift” away from a “one-size-fits-all approach” and towards the personalisation of services.
The call from the Care Quality Commission came in its first annual report to parliament on the state of health and adult social care in England.
The report says there have been steady improvements in social care and health, despite “pockets of poor practice”.
But the CQC is concerned that disabled people’s needs in many areas have to be “substantial” before they can receive social care support from the council.
The proportion of adult social care services rated as good or excellent rose from 69 per cent in 2008 to 77 per cent in 2009, but there was still “unacceptable variation”, with a small number of providers failing to meet minimum standards of safety and quality.
And although spending on direct payments in 2008/09 increased by nearly a third on the previous year, this was still only four per cent of councils’ overall spending on adult care.
The report also calls for a “real acceleration in joining up health and social care and centring it on people’s needs”.
And it points to three particular areas of concern, with performance on safety, safeguarding and staff training varying widely across both social care and health care, “despite overall improvement in recent years”.
Dame Jo Williams, CQC’s acting chair, warned that “trends such as increasing demand and rising expectations will be exacerbated by pressure on finances”.
This meant a need for “radical changes” in organisation and delivery of services, “shifting the culture away from a one-size-fits-all approach to care that puts the needs of individuals and carers at the centre of everything”.
Care services minister Phil Hope said the report “recognises the major improvements that have been made across health and social care services”.
He pointed to government plans to bring in new laws on safeguarding adults, and he said the government would “shortly” publish its care and support white paper, with plans for a “simple, fair and more affordable” National Care Service, while its personal care at home bill will help those with the highest needs.
The CQC has also released a new five-year strategy.
Its five priorities will be: ensuring care is centred on people’s needs and protects their rights; “championing” joined up care; “acting swiftly” to help eliminate poor quality care; promoting high quality care; and effective regulation.
10 February 2010