Governing the delivery of care and support services

6 June 2018

Nottingham Community Housing Association (NCHA) has a large Care and Support team delivering a range of services to communities across the East Midlands. Our Care and Support team comprise two thirds of our staff and at around £27m turnover, over a third of our income.

We provide adult social care services and make properties available for other providers to support people in. Of our directly provided services, about 50% of our work is with adults with learning disabilities. The majority of the rest of our portfolio involves supporting individuals with their mental health needs and providing services for older people. A small but significant amount of our work provides homelessness support and services for those experiencing domestic abuse.

Working across such a broad spectrum of services provides its challenges. Not least, having two regulators: the Regulator of Social Housing and the Care Quality Commission (CQC). Over 80% of our work is monitored by up to three external bodies, usually annually, as CQC, local authority commissioning teams and NHS monitoring teams all step up to give us their views.

Not that I’m against regulation and quality assurance – far from it. For 20 years NCHA have developed a robust internal quality assurance system and all our schemes hold the BSI ISO 9001:2008 Quality Standard. Our rigorous approach to quality management means our staff have a framework within which they are supported to deliver the highest possible quality for our customers. For our managers and board members it’s an early warning system through which we are alerted to services that are not achieving our high standards, for whatever reason, before we are informed by customers, commissioners or regulators. It gives us an opportunity for the early identification and rectification of problems.

I’m also very much in favour of customer and stakeholder feedback to get a sense of how it feels to be a customer of NCHA Care and Support. Like most providers, we invest in surveys and quality of life assessments to really try and get good qualitative and quantitative data to help us plan the development of our services.

In response to Grenfell it is understandable and proper that the Government considers a regulatory response. However, I make a plea to the policy makers: let’s try and join up some of this regulation.

Surely, it can’t be good value for money to have so many agencies involved in the regulation of housing and adult social care? Of course, different agencies will argue they have different agendas, but in our experience so much of what we are inspected on by CQC forms the basis of inspections from both the NHS and local authority commissioning teams, despite efforts from CQC to set a protocol with local councils to stop this from happening.

Of course we should have good quality services which protect and enhance the lives of vulnerable adults in receipt of housing and social care services. But in a world of decreasing resources, let’s divert some of the resources away from excessive monitoring to where it makes the most impact.


Join Holly Dagnall at her session on governing the delivery of care and support services at Housing Governance 2018.

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