Local government should act with audacity and in a way that is “borderline illegal” to create its own solutions to the social care crisis, according to the chief executive of the Care Quality Commission.
Ian Trenholm, the former chief executive of Windsor & Maidenhead RBC who took over from David Behan this year, said local government should follow the NHS in devising its own solutions to the problems it faces.
Addressing the Association of Directors of Adult Social Service today, Mr Trenholm said “very little” of the NHS Long Term Plan is not a “collection of prototypes” reflecting what is “already going on” to form a strategy.
He added: “We may need to reflect in local government, and as a former local government chief executive I am just as culpable of this, that we look to government for guidance and instruction probably more so than the NHS does.
“There is something about audacity within this room, within local government more broadly, to say can we create some prototypes? Can we create some new ways of doing things which are borderline illegal perhaps?
Mr Trenholm said councils should not be too bothered about “the nuance” to create new approaches “and then go to government with what the answer is rather than the other way around”.
He added the delayed social care green paper would not address system problems in the short term and called on councils to be “pragmatic”.
Mr Trenholm was speaking the day after Four Seasons, one of the country’s largest care home providers, announced it was calling in administrators. The CQC has said it does not expect services to close as a result of the move.
He advocated the formation of an “improvement alliance” for social care similar to arrangements in the NHS which drive productivity and effectiveness across the social care system.
Mr Trenholm added this would help councils fulfil provider “market shaping” responsibilities under the Care Act 2014 and understand “financial and quality drivers” among local providers.
He said these alliances could operate on a local, sub-regional or regional level and enable councils to commission “a good quality forensic accountant” to help manage care providers in their areas.
Councils should work with providers in the same way franchisers work with franchisees to “drive down their costs which in turn drive down our costs”, Mr Trenholm added.