"As governments, businesses and charities seek to improve social care provision, we should remember to also strengthen the data infrastructure that supports it. A society that cares needs data that cares." Jeni Tennison, CEO – Open Data Institute
Future Care Capital’s latest report highlights structural changes to the residential care home market in England and gaps in our understanding about the quality of provision.
We have produced a detailed and data-rich analysis to illustrate what we are able to say with confidence about the structure and stability of residential social care markets as well as the quality of care provision in England. There are, however, significant barriers to accessing and linking publicly available as well as open datasets if the aim is to derive meaningful insights from them. We have only a partial understanding of an increasingly important facet of modern society and, in some important respects, lack the information needed to make informed policy decisions and judgments about care – despite this issue being of critical importance to families the length and breadth of the country.
We urgently need to overcome these barriers if we are to understand, for example, whether changes in the number of care home beds is, in and of itself, ‘good’ or ‘bad’; what the relationship between supply and demand for residential social care looks like at an area level; why older people’s provision does not clearly track changes in population; why not-for-profit care home providers tend to be rated as higher quality than their private-sector counterparts; which areas benefit from better quality provision as compared with others; and how both state-funded and self-funded service users rate the care they receive. Crucially, we cannot track the amounts of money that are currently being spent by individual local authorities with the range of care providers upon whom so many state-funded service users depend. How, then, are we to make sense of calls to significantly increase funding for social care and ensure that any additional monies promised are spent wisely?
How might we also help Directors of Adult Social Care Services who report that their top concern at present is market fragility? We undertook in-depth work with Spend Network integral to our research to explore the extent to which automated analysis of publicly available data could help identify residential care providers that may be ‘at risk’ of failing from a financial perspective. This looks viable – subject to further work to see what best predicts a provider’s financial risk and, by extension, their risk of eventual failure without any intervention. But, the data published by the CQC does not yet meet the standards required for full integration with Companies House and other entity registers, which would allow us to monitor changes in, often, complex ownership structures and better explain the reasons why providers leave the market. The data being generated by the CQC is critical data infrastructure and needs to be recognised as such.
It is clear that the CQC is doing its utmost to create and maintain this data with limited resources, but investment and, potentially, greater powers to demand access to – ideally, timely – data are needed to create reliable infrastructure from which meaningful financial insights may be derived. This can be fixed and we make a number of practical recommendations that would resolve these issues and provide, for the first time, a comprehensive picture of social care provision. We recommend that the Government introduces a Digital Duty of Care applicable to all public bodies that are responsible for the commissioning, provision, monitoring and/or regulation of social care services with this in mind.