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Cordis Briefing
January 2015
Follow live #briefing
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%
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