ITEM CA8
CABINET – 20 JANUARY 2009
ADULT SOCIAL CARE STAR RATING
Report by Director for Social & Community Services
Introduction
1. Each year the Commission for Social Care Inspection (CSCI) provides an annual report on how each council serves the people in their area who use adult social care. The 2007/8 report for Oxfordshire is attached as Annex 1 (download as .doc file). The report is summarised into a single star rating, based on a four-point scale from zero to four stars, with additional comments on current service outcomes and future prospects. Current service outcomes are an aggregation of seven individual outcomes which are improved health and emotional well–being; improved quality of life; making a positive contribution; increased choice and control; freedom from discrimination or harassment; economic well-being and maintaining personal dignity and respect. Two further criteria are used to assess the future prospects for the council, these are an assessment of the leadership within the council and the way it commissions services and uses resources.
2. From April 2009 CSCI will merge with the Commission for Health Care to form the Care Quality Commission. This therefore is the last annual review of Oxfordshire from CSCI. The Care Quality Commission will provide a report on 2008/9. It will not include a star rating, but will still include judgements on current outcomes for people and future prospects.
Current Rating
3. Oxfordshire is rated a 2 star ‘good’ authority, delivering good outcomes and with promising prospects. Of the 150 authorities, 56 have been awarded 3 stars, 75 two stars and 19 one star. The rating is based on evidence from any inspections in the year, a self-assessment provided by the authority and performance against a set of statistical measures - the Performance Assessment Framework (PAF). On the set of statistical measures Oxfordshire's ranking is joint 46th. Of the 56 three star authorities, 31 have a higher rating than Oxfordshire, 6 have the same score and 19 have a lower score.
4. Oxfordshire’s rating is the same overall rating as last year however there were changes in the individual outcomes. These are shown in table 1 below:
5. The process is such that an inspector rates each individual authority; this rating is then moderated at regional level and at national level. The inspector awarded Oxfordshire 3 stars, this was upheld at regional moderation, but was downgraded to promising at national moderation and consequently two stars were awarded. The reasons for this were · The need to ‘continue to work with independent sector providers to further promote and increase the quality of care available and purchased’ · The need to further improve performance on Delayed Transfers of Care.
6. The council does not agree with the conclusions of the appeal. CSCI launched a new star rating for providers in 2007/8, where providers were rated on a scale from zero to 3 stars. The council has included this rating within its own internal contract monitoring systems, its adult safeguarding procedures, the information it provides to the public and is including it within the information provided for self-directed support. We have undertaken analysis of the costs of placements for different star ratings, the results of which were reported to Scrutiny last year.
7. The council accepts that it needs to further improve performance on delayed transfers of care and has included this as a priority within the Local Area Agreement. The year to date performance of delayed transfers of care is better than the stretched target agreed with the Government Office of South East Current performance on delayed transfer of care. The Annual Review letter notes improvements were made in the final quarter of 2007/8 and these have demonstrably continued in 2008/9.
8. For the individual outcomes, one of the good service scores, ‘Increased Choice and Control’ has improved to Excellent. For two other outcomes “Making a Positive Contribution” and “Economic Well being” the report provides no areas for development. This is the second year that the report has identified no areas for development and we are pursing with CSCI, what further work is required for excellence in these areas.
9. One Service outcome score has deteriorated from Good to Adequate namely “Improved health and emotional well–being”. This reflects three issues. Firstly, whilst we made progress last year on delayed transfers of care, CSCI wish to see that progress maintained. There is clear evidence that this is happening this year. Secondly, they referred to the fact that the percentage of service users whose needs were reviewed during the year fell from 72% to 69%. This reflects the fact that some service reviews were delayed towards the year due to ensure that teams had sufficient time to cope with the successful implementation of electronic social care records. The actual number of reviews increased in the year (the CSCI report is incorrect on that point). The percentage fell because the number of service users increased even more. It is important to note that reviews are prioritised on the basis of need: those who have the greatest needs are always reviewed first. We expected to achieve more than 80% of service users being reviewed this year, which is well above the threshold for good performance laid down by CSCI. Finally CSCI described the performance of the Drugs and Alcohol services as ‘adequate’. This contradicts the health care commission view and we are again working with CSCI to understand this issue.
10. The directorate is committed to raising performance health and emotional well-being to good in 2007/8. It is also committed to increasing the number of outcomes described as excellent. The medium term goal is for four outcomes to be described as excellent, which will deliver a judgement of ‘excellent’ service outcomes.
11. Within the report the Commission identify key strengths and areas for development. The report identifies 48 distinct key strengths. The areas of strength not only cover comments on individual service areas, but also describe examples of strong leadership and management which are delivering modern and innovative services in partnership with other agencies. Service planning is based on strong commissioning strategies, with good user and carer involvement that focus on developing independence. Financial management is excellent. There are appropriate standards and guidance in place, performance management is effective and people know how to comment or complain about services.
12. The report highlights 10 areas for developments. The council meets routinely with the Commission for Social Care Inspection throughout the year. For each area of development an action plan will be drawn up and shared with the Commission. The Commission will monitor these plans through their routine meetings with the council. The key areas for development will be picked up in the directorate plan for 2009/10 and will be included within the directorate balanced scorecard.
RECOMMENDATION
13. The Cabinet is RECOMMENDED to
(a) receive the report; and
(b) review progress on the areas for development through the quarterly monitoring of the directorate balanced scorecard.
JOHN JACKSON Director for Social & Community Services
Attachments: Performance Summary Report Of 2007/08 Annual Performance Assessment Of Social Services For Adult Services For Oxfordshire County Council
Background papers: Nil
Contact Officer: Steve Thomas, Performance Information Manager Tel (01865) 323609
January 2009
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