My Lords, first, I welcome the amendments in relation to CQC independence. I would like assurance that it does what it says on the tin. I assume that the CQC will be regarded as
independent. Perhaps it will be making fewer visits to the Secretary of State than it does at the moment. If there are weekly meetings, as is suggested, between the Secretary of State, the CQC, Monitor and NHS England, it is very difficult to believe that it is going to be truly independent. The proof of the pudding will be in the eating; but it is very difficult to know why the Secretary of State needs to see the CQC on such a regular basis if it is really an independent organisation.
Like other noble Lords, I am puzzled why the periodic reviews of local authority performance in commissioning adult social services have been removed from the Bill. I am surprised at the current policy, which is that, as part of wider moves to devolve responsibility for improvement in the sector, local authority commissioning performance and assessment will be led by councils. Presumably that means that it is government policy that the performance of the commissioning function of local authorities in adult social care will be reviewed by local authorities.
With the greatest respect for the noble Earl, Lord Howe, he knows that I am a great admirer of local authorities; I have served on two. However, Like the noble Lord who spoke so eloquently earlier about solar decisions being called in by DCLG—to which, no doubt, the noble Earl will have a detailed response—I would not have thought that the commissioning performance of local authorities was thought to be so excellent that they can be left to themselves to police their performance in future.
5 pm
We debated the question of 15-minute visits and zero-hour contracts last week. I have no doubt that part of the problem is that it is local authorities that are commissioning the 15-minute visits, and that the amount of money they pay has an influence on the kind of contractual relationship that private-sector providers have with their staff. That is how zero-hour contracts come into being. Therefore, how on earth can we deal with the scandal of 15-minute visits unless we look at the way local authorities are commissioning?
I was interested that the Care and Support Minister, Norman Lamb, was reported last week as saying that the length of home care visits could be monitored by the Care Quality Commission. He said that, with the new independence of the CQC, from next April it proposes to look at whether home-care visits are long enough to respond to people’s needs. Some independence, my Lords.
The CQC will also consider how staff working commissions might impact on the care issues under consideration; whether the service is able to respond to people’s needs in the allocated time; whether care is delivered with compassion, dignity and respect; how many staff have zero-hour contracts; and the levels of staff turnover. This is all true; it is from Community Care. Apparently, the Minister said that the CQC will use the information to drive its regulatory activity so that it will know when, where and what to inspect, and will be alerted quickly to the risk of poor-quality care in home-care settings. I put it to the noble Earl that that is all fine, but, given that often it is local authority commissioners who are responsible for the poor quality
of provision, surely the CQC should review and inspect the performance of local authorities. Therefore, I very much support my noble friend Lord Warner and other noble Lords on this.