Thought Piece on Quality Matters


For such a fanfared document, I'm afraid that when I read "Quality Matters" I didn't learn a lot.  As someone who advises providers of care, it gave me nothing new that I could pin anything on when supporting a provider in understanding and implementing the obligations and standards already in existence.  What it did tell me was that the state is in a mess.  You could say: at least it is talking about the problem – but to a limited degree, and what effect?

The organisations who are responsible for overseeing the sustainable delivery of adult social care are talking about coming together to work in a joined up way, as if it was a novel idea!  Now, it doesn't serve to be overly critical; and some outcomes of the exercise may be helpful, but is it the best way to go about raising the quality of care to people who need it now and in the future?

It is a basic requirement that providers of care should be able to deliver a safe environment with staff who can meet the needs of people in a person-centred way.  It's a given.  So what do good care providers actually want and need to support that?  They want a fair playing surface where they are kept informed of changes in best practice, understand what commissioners expect, to receive payment of a fair price, and they need to be working as part of a system where the state has a plan for delivering funded care in which they are an integral and valued part.

As I write this I know that I am not saying anything new either! Nor am I blind to the fact that there is a need for quality improvement in many cases.  I don't think that the mess the state is in is just the fault of the regulator.  QCC has made strides in informing the public of the state of the sector.  But the answer is not to keep punishing providers for things out of their control, especially if they have not compromised safety.  Many providers are powerless to find and keep high quality managers or to have a full complement of nurses when there are national shortages, or to keep good carers when they are so poorly paid because of the lack of funding.

Dare I say it, Quality Matters is an easy way for the state agents who are signed up to it to pat themselves on the back and take a breather.  When you read it you may, like me, see it as a talking shop document which will deliver action points but not decisive action.  I hate to pour scorn where there are no-doubt good intentions, but will Quality Matters lead to a step-change in the state of care in this country?  I fear not.

Give the sector clarity on best practice, on sustainability by all means. Tell us how providers are expected to provide less for less, more for less or something different.  And if it's fair, then expect and enforce that.

Yesterday I read the Local Government Ombudsman's report on "The Right to Decide: Towards a greater understanding of mental capacity and deprivation of liberty" which found that vulnerable adults are being let down by poor social work practice and care provider understanding.  Now that's a much more practical and helpful document; we can learn from that.

Am I being too cynical?  I'd like to hear your views.  Email me at

You can read Quality Matters at

You can see the LGO report at 


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