Response to CQC State of Care report

State of care

A statement from Julie Layton – Chief Executive of Advance Housing and Support

"Reading the CQC State of Care 2018/19 report and the responses to it can make the heart sing and sink in almost equal measure. While it is heartening to hear that most care is good quality and improving slightly. It is sad to yet again be reading about the challenges people face in accessing the right care and that often that care comes too late.

That lack of access to services is particularly challenging for people with a mental health condition and or learning disability – the customer groups that we at Advance focus on supporting. The CQC should be celebrated for highlighting the challenges this population face – along with so many other challenges in their lives – access to safe, great quality care remains patchy.

We are saddened but not surprised to hear of many people with a learning disability or autism being in a hospital setting due to the lack of local, intensive community services. It is even more concerning that the CQC reports concerns about the quality of inpatient wards where people with severe and complex problems are residing for long periods when they should instead be receiving specialist care tailored to their needs. We are proud to have played a part in successfully transferring several people out of these units into safe stable housing and support in the community.

It is disappointing that since October 2018, the CQC have rated as inadequate 14 independent mental health hospitals that admit people with a learning disability and or autism. Adding to the scandal at Whorlton Hall which served as yet another sobering reminder of just how bad it can be when the culture goes wrong, cruelty takes over and the meaning of ‘care’ is challenged beyond belief.

We totally agree with the CQC that the situation is letting people down. So what has to change, what will change, will it ever change and what can professionals in the sector do?

As a provider of support and housing for people with mental health conditions and learning disabilities we see day in day out the impact of silo working, of decisions made in isolation, of a lack of joined up thinking, funding and care.  We agree totally that everyone – Government, Parliament, commissioners, national organisations and providers need to work together to make sure the right services are commissioned.

This means working together in more innovative ways. This is something we have been doing wherever we can. All too often, we find ourselves in a position where funding challenges mean we have to reconfigure or amend a current support service – the drive, the main problem – a system being slowly starved of funding.

Where we see things work well – and it is working well in many parts of the country – at its heart is a clear, consistent and system wide approach to commissioning health and social care; an approach that looks at and understands the needs of the local population; an approach that has a focus on prevention; an approach that puts people and the community at the centre; an approach that tackles the urgent and the important and doesn’t leave anyone behind.

To make this happen we all need to look outside our individual remits and put the people at the heart of our work. It can be done. It is being done and we will keep pushing that approach with likeminded commissioners and providers wherever we can. This is too important to get wrong.

In the meantime, while we await a long term funded and sustainable approach to social care from Government, we will keep doing our bit to drive the sort of improvements the CQC identify. We will keep trying new and innovative ways to recruit new people to the sector – so we stop the recruitment merry go round and focus on keeping and growing great people who have rewarding and varied careers. 

We will continue with our work to make sure we enable our customers to access healthcare services and address the health inequalities people with mental health conditions and learning disabilities face by educating staff and informing customers.

We will also continue to develop our approach to using technology – driven by and for the individual, and will continue the conversation with commissioners and other providers to make sure we use technology to improve the quality of our services in the long-term."