CQC have received a complaint from Equal Lives, a service user group, urging them to investigate Norfolk County Council ("the Council") for allegedly disregarding its statutory obligations under the Care Act 2014. The complaint focuses on the fact that eligibility thresholds are being raised and care package reviews are increasingly being used as a tool to withdraw or reduce support for people in need. A number of case studies have been appended claiming to show the devastating effect the removal of wellbeing payments have had on service users' lives.
Section one of the Care Act establishes a general duty on a local authority to promote an individual's wellbeing. The concept of "wellbeing" is broadly defined in s.1(2) and includes personal dignity, both physical and mental health, emotional wellbeing, personal control, participation in work/training/education and social wellbeing. The supporting statutory guidance also states that care package reviews must not be used to arbitrarily reduce a care and support package. It is universally recognised that councils have had to make significant savings, however in the cases advanced by Equal Lives, the concern is "they've cut too fast and too deep and people have been left without the care they need".
Under s.91 of the Care Act, the CQC can only inspect councils when systemic failures are identified and they are instructed to do so by government. This power has not been used since the Act came into force and the CQC has not inspected a local authority since 2010. The political mind-set appears to be that where there is evidence of poor practice, councils should be given the opportunity to improve performance themselves with regulatory intervention as a last resort. Any alleged breach is disputed by the Council; however, it has indicated that it takes the complaint extremely seriously and will carry out a review of its decision-making on the specific cases as well as commissioning external scrutiny of their processes and decision making. The CQC have publicly acknowledged receipt of the complaint and have indicated that they will respond in due course. It will be interesting to see how this plays out. The structure under the Care Act did not envisage an active role for CQC in examining the conduct of local councils; however, as significant funding cuts bite service users and pressure groups may look for more inventive ways to challenge decisions that they perceive to be unsatisfactory.