When recently asked about key future work priorities for the European Social Network (ESN), our members almost unanimously agreed that quality in social services should be one. While agencies agree that we need to ensure quality across the sector, it is more difficult to agree on what quality means and how it can be ensured and measured. In this context, ESN recently launched a new working group, which held its first meeting on 8-9 November 2022. The group will gather evidence on existing quality assurance mechanisms, common principles of quality, and possible ways forward on cross-European quality standards in social care and social services.
Aligning quality assurance with key trends in social services
During the meeting, working group members discussed recent key developments impacting quality assurance in social services. The discussions covered the shift of focus from assessing quality of care to quality of life, from process-oriented inspection to outcome-based quality measurement, from sanction-based quality control to a culture of learning and continuous improvement, from institutional care provision to home, family and community-based services, and from addressing health and social needs separately to an integrated provision and evaluation.
National quality assurance systems are adapting to new trends
Dave James, Head of Adult Social Care Policy at the Care Quality Commission (CQC), reported current reforms in England aiming at making CQC a single assessment quality agency for health and social care. To take on this task CQC has developed a single assessment framework that looks at quality based on five key questions: is it safe, effective, caring, responsive, and well-led? Mr. James explained: “These questions will be analysed based on statements from people with care experience, care providers, relatives, staff, and management, as well as based on the outcomes achieved for the person.”
Carol Grogan, Chief Inspector at the Health Information and Quality Agency (HIQA) Ireland presented the results of a recent international review they have undertaken, to prepare the development of national standards for quality in home care. But she highlighted that “from the seven national frameworks analysed, only in Northern Ireland home care was regulated by dedicated mandatory standards.” Rosa Martín Niubó, Director at Barcelona Municipal Institute of Social Services shed light on possibilities to ensure quality beyond regulation: “When procuring home care services, we define in our contracts key quality outcomes that need to be achieved by providers such as requiring that people with care needs are supported to stay longer in their own homes, enhanced quality of life, and early detection of risks.”
European initiatives to ensure access to quality social services
The European Union has made several attempts in the past decade to set up and align social care and social services quality assurance with these new trends and align them across EU national governments. In 2010 the Social Protection Committee developed a voluntary quality framework for social services, which unfortunately remained unknown, especially at regional and local levels. In 2019, the European Commission, put forward key quality principles for early childhood education and care and in 2022 proposed quality principles for long-term care. ESN Chief Executive Officer Alfonso Lara Montero pointed out the need to revamp European quality assurance policies: “Our quality assurance mechanisms at EU, national and local level need to adapt to the new trends we have seen in recent years.”
Common quality principles and how to put them in practice
During the working group meeting, participants representing quality assurance agencies, national and local public social services, providers, and applied research institutes, discussed the ongoing EU initiatives, made proposals for key quality principles, and discussed how they potentially could be translated into comparable cross-European standards and indicators. The outcomes of those discussions will be documented in an upcoming policy briefing. The working group will continue its work until 2025, when it will present its recommendations.