A reminder that accountability can't be contracted out
A recent Local Government Ombudsman decision should give pause to cash strapped councils who are hoping that contracting out as many social care functions as possible to third parties will outsource their responsibilities. An elderly woman with dementia lost a third of her body weight whilst living in the Care Home she had been placed in by her local council. Administrative errors and a lack of co-ordinated oversight on the part of the council meant that they had failed to react and address the quality of care in the home, despite complaints from the woman's family and a CQC inspection report which had criticised poor record keeping at the home. The Ombudsman upheld the family's complaint against the council.
The case highlights that, despite the appalling financial situation facing most councils, the monitoring of council contracts with third parties to whom they outsource functions must go beyond a "race to the bottom" focus on fees, fees, fees. The LGO's decision recommends that future Contract Monitoring visits to the Care Home should look into:
- nutrition care plans, food and fluid charts and weight charts;
- falls monitoring, falls risk assessments and falls/mobility care plans; and
- care plans for activities and records of activities on offer.
That shouldn't be news to any council. Good practice in contract monitoring must include awareness of early indicators of institutional 'early warning' signs which should trigger safeguarding procedures. What is needed to achieve that effectively is good communication between Commissioning and front line Social Care. Those councils whose Commissioners still sit secure in an ivory tower with their calculators and bottom line focus, remote from the reality of the social care front line, must start to listen.