Regulation of Health and Social Care

A proposal for 8 reforms to the regulation of social care.

The Centre for Welfare Reform believes that it is important that we constantly work to improve standards and protect human rights across the whole welfare state.

However this process breaks down if regulators become too bureaucratic and too distant from people's real experience. The Care Quality Commission (CQC) is an example of an organisation which has become too removed from reality and which is not accountable to the public.

We propose the following reforms to the regulation of social care:

  1. The purpose of regulating and inspecting Social Care is to check that the care is good enough and, if it isn’t, to require improvement. Or, if care is not improved, to enforce either the transfer of the service to a competent provider or the closure of the care service. 
  2. Social Care regulation and inspection is primarily accountable to the public and the people who depend on the care provided.
  3. Inspectors must be directly accessible and responsive to the public on whose behalf they are acting.
  4. Social Care is a local service, therefore the organisation of Social Care inspection must also be local.
  5. At its heart, Social Care is a relationship. While technology, record keeping, and all the “hard” and measurable aspects of care are important, the most important component of care is not measurable, and the best people to evaluate the quality of the caring relationship are first the people who are being cared for, and then their families, friends, and neighbours. Their experience and assessment should therefore be at the centre of any evaluation. Wherever possible, people who receive care should make a substantial contribution to inspection reports.
  6. Social Care inspection should be independent of national and local government, of all providers, charities, voluntary and professional organisations, and consultants. While inspectors may come from such backgrounds, they must be clear in their focus and their commitment to serve the public and especially those who receive care.
  7. Social Care inspection, while respecting the privacy and confidentiality of individuals, must communicate in plain language. Inspection reports should be written promptly and in a way that is understandable to non-professionals.
  8. Reports should be available to the public on line and in printed paper form. Inspectors must be free to respond quickly to complaints from the public (and should of course take note of all comments both positive and negative).

The Centre also believes a culture of bureaucratic management and regulatory control has also been harmful within the NHS and you can read more about this here.

Project | 04.01.17

health & healthcare, social care, England, Project

Bob Rhodes


Co-Director of LivesthroughFriends CIC

David Zigmond


A veteran NHS medical practitioner and author

John Burton


Author, consultant and campaigner