Regulation under pressure: tensions in regulating care in England-Australia

8.00-9.30 (UK time), 18.00-19.30 (Australian time)

The regulation of care for older people and disabled people is often seen as a key component of high quality and safe care services. However, regulators have been criticised for failing to provide timely, proportionate and helpful oversight.

The latest in a series of webinars from Monash University and the University of Birmingham will explore current insights from practice and research about the challenges of regulating care and how it can be improved.

We are delighted to present three speakers who will share their research in this area, followed by opportunities for discussion and questions:

Closing a care home: the uneasy mix of national and local regulation in England

Professor Catherine Needham, University of Birmingham, UK

Residential care homes close for a number of reasons. Closure can be triggered by the care provider who is exiting the system or relocating elsewhere. Where there are quality concerns, closure can be mandated by the national regulator (the Care Quality Commission (CQC)). Often such quality concerns have been evident for a long time with national regulators (CQC) and local government quality assurance teams helping to support the home to improve. Care home closures are by their nature hard to study – either because they take place in an emergency or because there are issues of confidentiality and commercial sensitivities. Getting access to homes that are closing is difficult in terms of making sure residents, families and staff are not caused additional distress. This presentation focuses on what happened during an emergency home closure – a topic which would have been very hard to research unless part of a broader programme, given events typically unfold at very short notice, and are potentially traumatic for everyone involved. By concentrating on the contested relationship between local authority commissioners, providers and national regulators at the moment of closure, we contribute new insights about how key players within social care systems work together.

Catherine Needham is Professor of Public Policy and Public Management at the University of Birmingham. She researches social care systems and markets, and her most recent book is Social Care in the UK’s Four Nations: Between Two Paradigms. She also researches the public service workforce, with a range of studies under the theme of the 21st Century Public Servant.

'Take the pressure down': The challenges of regulating provider markets whilst enabling participant choice and control in Australia's National Disability Insurance Scheme

Associate Professor Libby Callaway, Monash University, Australia

Australia's National Disability Insurance Scheme (NDIS) is a once-in-a-lifetime social care reform, offering no-fault disability insurance to Australians with significant and permanent disability. The NDIS achieved national implementation in 2020, now costing over AUD$54 billion per annum and providing services to over 700,000 Australians with disability. The NDIS has required significant market stewardship to ensure a quality direct support and therapy workforce is available to meet the goals and needs of Scheme participants. In its first five years of national NDIS roll out, a tension is arising linked to the challenge of regulating the growing provider market, whilst enabling choice and control of services received by NDIS participants and their families. This presentation will use Scheme data, research and policy instrumentation to point to challenges in the regulatory environment and ways to 'take the pressure down' to ensure Australians with disability can achieve the social and economic participation outcomes the NDIS was originally designed to enable.

Associate Professor Libby Callaway is a registered occupational therapist who has worked in policy and practice for over thirty years in Australia and the USA. Libby currently works across the Rehabilitation, Ageing and Independent Living (RAIL) Research Centre and Occupational Therapy Department at Monash University, as well as clinically in her community-based private practice, Neuroskills. Libby has just completed a six-year role as the voluntary President of the Australian Rehabilitation and Assistive Technology Association (ARATA) – the national non-profit peak body for assistive technology stakeholders in Australia – and then augural strategic executive advisor to ARATA. Libby sits on various government advisories, including the National Disability Insurance Scheme (NDIS) Industry Chief Executive Advisory Group and the NDIS Home and Living Policy Steering Committee.

Governmental assurance of social care in practice: a senior leader's perspective

Professor Graeme Betts CBE

Regulation of social care in England has historically focussed on provision of direct services including residential and home care, but from 2023 a new process of assurance was introduced for local authorities as the strategic planners and commissioners (funders) of adult social care. This involves the Care Quality Commission considering performance against four key themes - Working with people, Providing support, Safety within the system and Leadership - through engaging with people with lived experience of care, social care staff, partner organisations, assessing local processes of care and analysing national data sets. In this presentation, Graeme will reflect on the realities of such a process and how it can contribute or detract from improving outcomes for people and families.

Graeme has over 20 years’ experience at Chief Officer and Chief Executive level leading organisations across care and health and implementing national and local policies, most recently as the Corporate Director for Adult Social Care in Birmingham City Council. Since retiring from practice, Graeme has been appointed as an Honorary Professor in the School of Social Policy & Society at the University of Birmingham where he is involved in research and teaching alongside roles with national bodies including the Care Quality Commission and the Local Government Association.

We look forward to seeing you at the Webinar