Public Health
(1991), 105, 89
© The Society of Public Health, 1991
Editorial Caring for People Under the provision of the National Health Service and Community Care Act 1990, local authorities are required to effect a separation between providers of care and the control and regulation of residential care. This particular part of the Act comes into force in April 1991 and requires local authorities to set up independent inspection units. Such units will register and inspect all private and voluntary residential care homes, and, in addition, inspect local authority residential homes. The accountability of the Director o f such a Unit is uncertain: it appears that it is to the Director o f Social Services. If this is the case, then the position is rather an artificial one and, perhaps, no different from the situation as it is, at present, in a number o f local authorities. The position also seems obscure as regards the possibility of using another agency for this purpose. Can a statutory body contract out this sort o f responsibility without somehow retaining direct day-to-day control? If they cannot, without abrogating their legal obligations, then there can be no true agency arrangement. There are obvious similarities between registered nursing homes and private residential homes. Would it be fruitful to somehow amalgamate the inspection arrangements? Such a step has obvious attractions, especially as the local authority will be responsible for Social Security funding for residents in both sorts of establishment after the 1st April 1993. Unfortunately, unless the status of such a unit is clarified, it is unlikely that a joint approach could be made to work. One can conceive horrific scenarios with difficult and protracted clashes of various interested people, all acting for the best, as they see it, and all with a different view. Add to this self interest or even malice and the problems are further compounded. The establishment of truly independent agencies would be the only way in which a generic approach could have any hope of succeeding. It is understandable that the Government views an innovation such as this as spawning unnecessary bureaucracies and they would possibly be right. Such an arrangement would be cumbersome and could attract staff with a narrow and rigid approach . . . perhaps! Unfortunately what we are getting is a half solution. It doesn't really alter matters. It does mean that if anything goes wrong, the blame can be shuffled off to some distant head of the so-called Independent Inspection Unit. It doesn't encourage a genuine comprehensive approach to producing integrated community programmes. This piece of legislation seems doomed by circumstances to being reduced to ineffectiveness. Shouldn't we be taking a deep breath and starting again?
(1991), 105, 89
© The Society of Public Health, 1991
Editorial Caring for People Under the provision of the National Health Service and Community Care Act 1990, local authorities are required to effect a separation between providers of care and the control and regulation of residential care. This particular part of the Act comes into force in April 1991 and requires local authorities to set up independent inspection units. Such units will register and inspect all private and voluntary residential care homes, and, in addition, inspect local authority residential homes. The accountability of the Director o f such a Unit is uncertain: it appears that it is to the Director o f Social Services. If this is the case, then the position is rather an artificial one and, perhaps, no different from the situation as it is, at present, in a number o f local authorities. The position also seems obscure as regards the possibility of using another agency for this purpose. Can a statutory body contract out this sort o f responsibility without somehow retaining direct day-to-day control? If they cannot, without abrogating their legal obligations, then there can be no true agency arrangement. There are obvious similarities between registered nursing homes and private residential homes. Would it be fruitful to somehow amalgamate the inspection arrangements? Such a step has obvious attractions, especially as the local authority will be responsible for Social Security funding for residents in both sorts of establishment after the 1st April 1993. Unfortunately, unless the status of such a unit is clarified, it is unlikely that a joint approach could be made to work. One can conceive horrific scenarios with difficult and protracted clashes of various interested people, all acting for the best, as they see it, and all with a different view. Add to this self interest or even malice and the problems are further compounded. The establishment of truly independent agencies would be the only way in which a generic approach could have any hope of succeeding. It is understandable that the Government views an innovation such as this as spawning unnecessary bureaucracies and they would possibly be right. Such an arrangement would be cumbersome and could attract staff with a narrow and rigid approach . . . perhaps! Unfortunately what we are getting is a half solution. It doesn't really alter matters. It does mean that if anything goes wrong, the blame can be shuffled off to some distant head of the so-called Independent Inspection Unit. It doesn't encourage a genuine comprehensive approach to producing integrated community programmes. This piece of legislation seems doomed by circumstances to being reduced to ineffectiveness. Shouldn't we be taking a deep breath and starting again?
