The CQC’s State of Care report has arrived and there’s been a lot of commentary on it. I don’t think any of us are surprised by any of it, so I won’t be making any general observations as we’re all glum enough! Looking for something different, for me one figure jumped out. Over a quarter – 28% – of homecare agencies in England are very small providers, supporting four or fewer people.
Very small providers often get talked about as fragile or risky, and the CQC is rightfully concerned about market fragility, but that is only part of the story. Sure, some are fragile fly-by-nights, but I know from experience that many others are the opposite and are small because they are specialised or simply growing carefully instead of rushing.
We know the sector has grown faster than the CQC can keep up with. This means many small agencies are working hard without recognition or a current rating to show commissioners what they do well.
The Homecare Association’s recent report (Care Quality Commission: regulatory performance in homecare one year on) backs that up. They found that more than 70% of homecare services either have not been inspected yet or have out-of-date ratings. The old standard “back in my day” where a provider requiring improvement would have the inspectors back within a year at most is long gone and many providers, even in areas with high demand, are saddled with a rating that is keeping them small.
Many of these services have great potential and are the seed of a much larger service. But being small may be the long term intent, enabling a highly skilled service to do very well at something complex, specialised, hyper-local or otherwise niche. What matters is not size but structure. The providers who keep clear records, train their teams properly, and have systems that make sense are the ones who thrive when the inspector finally arrives.
The strongest indicator of a good service is the quality of its leadership, not the size of it. However, smaller services do come with their own risks, particularly where one very busy person is the provider, manager and nominated individual – and that’s where I and my app can help. 😊 I bring an expert external opinion, and the Z Cares App brings together many useful tools for busy providers including policy creation and management, auditing and service improvement, a training matrix and induction tracker, recruitment and referencing, and many more.
Please do get in touch for a free consultation and quote.
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