Cordis Briefing

January 2015

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These are extracts from January 2015’s Cordis Briefing. Full versions of the slides are available for subscribers by

emailing lucyasquith@cordisbright.co.uk. Please contact Lucy if you would like to receive further information about

subscribing.

Today’s Briefing

• Updates : Minimum wage, election and CQC

• Access to social care

• Burstow Commission on Home Care

BREAK

• Planned cuts to local authority social care budgets

• Mapping the cuts by client group

• Adult social care outcome framework

• Better Care Fund Review

Update: CQC Activities

Annual report 2013-2014

• A report on CQC itself – understanding how your regulator thinks and

behaves.

• Looked at this in 2013, thought it would be interesting to see what’s

happened since.

Activity

Activity 2013/14 2012/13 2011/12 Variance

Total inspections carried out 39,567 35,371 12,407 +219%

Inspections that included

Experts by Experience

4,481 1,408 506 +785%

Whistleblowing contacts

received

9,473 8,634 4,100 +131%

Warning notices to

providers

1,456 910 638 +128%

Activity

Activity 2013/14 2012/13 2011/12 Variance

Total inspections carried out 39,567 35,371 12,407 +219%

Inspections that included

Experts by Experience

4,481 1,408 506 +785%

Whistleblowing contacts

received

9,473 8,634 4,100 +131%

Warning notices to

providers

1,456 910 638 +128%

Activity

Activity 2013/14 2012/13 2011/12 Variance

Total inspections carried out 39,567 35,371 12,407 +219%

Inspections that included

Experts by Experience

4,481 1,408 506 +785%

Whistleblowing contacts

received

9,473 8,634 4,100 +131%

Warning notices to

providers

1,456 910 638 +128%

Internal goals for 2014-2016

• An increased focus on qualitative factors.

• “Improve how we listen to people who use services, the public, and

staff providing care.”

• “Build a new, open, transparent culture and managing resources more

efficiently.”

– Includes a “just” culture (historic concerns about bullying and harassment).

– CQC academy to train all staff, starting with Inspectors.

Internal goals for 2014-2016

• “Introducing the new approach to how we monitor, inspect, regulate

and take enforcement action, and work with other regulators and

partner organisations”

– Re-organised inspections into 3 departments: recognising the need for a

focus on specialisms and expertise, rather than generic approach.

– Monitoring the finances of some larger adult social care providers, as part of

DH’s wider focus on market sustainability and provider failure in social care

markets.

– 263 new roles (11.8% increase in workforce).

What it costs

Year Expenditure

Change

from

previous

year

No.

registered

services

2013/14 £189m 15% 46,054

2012/13 £165m 11% 30,200

2011/12 £149m 7% 22,300

2010/11 £139m -27% 21,500

2009/10 £189m 12,378

CQC – some conclusions

• In 2013, we concluded that CQC had:

– Significantly ramped up their level of activity

– Become more efficient (unit costs reducing).

• Expected by now that this increased activity might be tapering off

• But no sign of that yet.

• One of the few areas of public expenditure which is consistently

attracting more resources.

• Likely to experience significant pressure to demonstrate value for

money and return on investment.

Access to social care

Access to social care

• RAP data – Referrals, Assessments and Packages of Care

• The nuts and bolts of state funded social care for adults

• Programme has been running for around eight years;

much of the data is no longer available from government

sites

• We are looking back over the past five years

Who gets a service?

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000

2010 2011 2012 2013 2014

Aged 18 - 64 Aged 65+

Who gets a service?

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000

2010 2011 2012 2013 2014

Aged 18 - 64 Aged 65+

Is this the new

normal?

Who gets a service?

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000

2010 2011 2012 2013 2014

Aged 18 - 64 Aged 65+

32%32% 32%

33% 33%

68%68%

68%

67% 67%

The future

0

50,000

100,000

150,000

200,000

250,000

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Physical disability Mental Health Learning Disability

Substance Misuse Other vulnerable people

Impact of ILF transfer

The future

0

50,000

100,000

150,000

200,000

250,000

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Physical disability Mental Health Learning Disability

Substance Misuse Other vulnerable people

The future

• 10 years from now if current trends are maintained the

picture of who is funded by the state will have changed.

• The numbers of people with mental health needs, people

with substance misuse issues and vulnerable people will

have halved.

• There will be around 35% fewer people with a physical

disability

• Around 7% more people with a learning disability.

• Population growth in England for the same 10 years is

around 7%

Homecare

• Not looked at homecare for some time

• Less data available than in the past

• General trends continue:

• Slow overall decline in numbers

• More marked decline for older people

• Intensification of service

Homecare

2010 2011 2012 2013 20145 year change

Physical disability, frailty and/or temporary illness

371,210 375,325 353,010 311290 309,605 -17%

Physical disability other 58,210 37,280 38,295 33,590 38,505 -34%

Mental health 56,525 59,695 58,415 51,355 53,890 -5%

Learning disability 37,870 40,320 40,205 37,325 43,025 14%

Dementia 20,495 23,840 24,205 25,130 25,160 23%

Visual impairment 11,480 11,230 10,195 9,430 8,870 -23%

Hearing impairment 7,515 7,325 6,350 6,025 5,600 -25%

Dual sensory loss 2,040 2,105 1,900 1,845 1,670 -18%

Homecare intensification

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

2010 2011 2012 2013 2014

2 hours or less

Over 2 hours, up to and including 5 hours

Over 5 hours, up to and including 10 hours

More than 10 hours, with overnight/live-in/24hr services

-50%

-34%

-15%

+5%