Compliance and risk-management in social services is not a tick-box procedure however, it is the bottom line in service users care. The social service staff has as much responsibility as the organisation to maintain standards within budgets.
It is been well noted that social services is facing unprecedented change, focusing on four structures which are: planned; unplanned; safeguarding and procurements. This is certainly the case with the “Birmingham County Council” (May 2011) who was summon to the Court to determine the eligibility criteria matrix (DH 2002) for care needs assessment (within critical level of needs) and it lost the case on technicalities. The decision of the court was that Birmingham County Council did not consult its intentions widely to all the stakeholders.
The Court’s decision has halted drastic changes that most social services would have wished to pursue in recent times. However, the intended changes may have resulted in many challenges but, also opportunities for efficiency. One critical task is to standardise compliance to governance and risk-management requirements across the new structures and streamline the organisation’s activities. In health and social care, compliance is not just a process of ticking the right boxes and this is the difference between services to people who can make contibutions towards their well being and tragedy. Care giving has to be tailored to individual needs irrespective where the service is delivered (in the primary or secondary sector) while compliance is imperative.
Monitoring services has taken on even greater resonance with the “Care Quality Commission's” new authority to sanction and even close down services if concerns of significant risk to service users are identified. The Commission can and does turn up unannounced at any service within an NHS trust or a care home and question staff, patients and service users about key areas within the standards of quality and safety, as set out by the legislation (DH 2000, 2005). The task of ensuring our enlarged workforce and all the services provided within the NHS and social service organisations should complie with the standards. In the present time, the standards are further complicated by the reorganisations and restructuring around the departments while bridging operational and culture differences between services.
Nonetheless, developments in technology has enhanced as well as embedded a sophisticated but easy-to-use real-time quality monitoring tools; from allocation of cases, to self-assessments, inputting relevant activities in the system, and ensuring correct processes. Through the dashboard technology, managers have instant access to up-to-date information or are able to extract information and give advice to all concerned at any giving time about what assurance is available to them, gaps in services or budget constraints that exist, and what is being done about issues in question.
This level of visibility is an absolute prerequisite to running health and social care at this point of demographic change and budgetary control. Yet, it is not uncommon to work in an organisation such as social services that still relies on multiple spreadsheets with outdated information and a poor grasp of what their problem areas are. Not only are these organisations ill-equipped to cope with the changing demography, policies, budgets as well as staffing issues, transformation and redesigning of the systems, they are also impeded by an intellectual deficit to embrace business culture within the organisations. In reality, the health care and social care sectors should welcome the extra stringency being exercised by the “Care Quality Commission”. It is now empowered to help drive quality performance and safeguarding of service users care, a goal we should all strive to achieve. Equally, as long as good governance is implicit in everything we do, we need not fear its new powers.
For a long time, the NHS and social service organisations have exhausted their resources and attention by seeking to back up everything they do with documentary evidence of good practise rather than focusing on practicing budgetary management on a day-to-day basis, in the field, where it matters. To date only a few management teams have placed adequate emphasis on taking a bottom-up approach to service developments and delivery. Time has come to shift the emphasis from creating paper trails and searching for proof of protocol, to each member of staff taking personal responsibility for their actions. This approach requires a level of education for all front line staff, which will involve keeping standards in the front of their minds in everything they do.
Compliance in budgetary rules, quality assessment and care as well as risk management is paramount for the NHS and social care to survive in the current macro and micro financial challenges and increasing demand for care. Front line staff needs to be reminded that compliance is not about form filling or chasing evidence for abstract standards, it is in fact about practicing the basic standards of care every day.
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