The care regulator has welcomed improvements in the quality of adult social care, but has raised a number of concerns about areas such as personalisation and eligibility for services.
In its first report on adult social care since its launch in April as the regulator for adult social care and health services in England, the Care Quality Commission (CQC) found 140 of 148 councils (95 per cent) were performing well or excellently in commissioning adult social care.
The report says 27 councils have improved since last year, while 11 have deteriorated.
And for the sixth year running, no councils have been assessed as performing poorly overall.
But the number of councils performing excellently at increasing choice and control for adults using social care fell to 26 (from 32 in 2008), with nearly a quarter only performing adequately.
Although the CQC said this may partly be because its assessment in this area had “sharpened up”, it highlighted this as a “priority” for improvement.
The CQC also said that nearly two in five councils needed improvement to increase the number of adults using self-directed support and individual budgets.
And about a third of councils are only performing adequately in maintaining the dignity and respect of service-users, about the same level as last year.
Three councils restrict eligibility for care-managed services to those with “critical” needs, while 103 set their threshold at “substantial” needs, 39 at moderate and three low. Three have raised their criteria and three have lowered them since 2008.
The CQC said it was “encouraged” that eligibility thresholds remained “largely unchanged” since last year, despite the recession, but it said it was still “concerned” that some councils could have to raise eligibility criteria further as public spending is squeezed in future years.
The quality of care homes and domiciliary services has also improved – over the year, the proportion of services rated as good or excellent increased from just over two-thirds (69 per cent) to just over three-quarters (77 per cent).
The CQC highlighted eight councils where improvements in adult social care were a priority, with a further 16 selected for in-depth inspections.
Cynthia Bower, the CQC’s chief executive, welcomed the “steady improvements” but said she was concerned that many care homes and agencies “have more to do to deliver the quality of care expected of them”.
She added: “There are also serious issues for councils to address in areas such as giving people more control over their care, treating people with dignity, and ensuring commissioning is as effective as possible.”
3 December 2009