Empowering consumers where it matters most
by Claudia Wood
When the Good Care Guide launched this past weekend, I had expected a warm welcome - from users of childcare and older people's care, who are often cast adrift to make significant decisions with little more than a regulator's inspection report to go by; from professionals in both sectors who often feel ill-judged by inspection reports and whose clients are usually their best advert; from local authorities, who have a responsibility to provide information about care but who often struggle to fulfil this function; and from policy experts, who recognise the value of accessible information in older people's care, which remains opaque and confusing for those trying to navigate it for the first time.
Linking up children's and older people's care was a stroke of genius by United for All Ages - one of the organisations behind the website who recognise the growing number of people who are now purchasing both childcare for their children, and older care for their parents or grandparents. Putting the two together also helps bring older people's care out of the shadows and reinforces the idea of preparing for later life as a normal family task.
So I was perplexed when coverage of the launch focused on the criticisms it was attracting. There are concerns that the Guide could open the door for poor reviews of older people’s care, forcing some providers out of business and leaving clients at risk. When I say poor reviews, I don't mean malicious and inaccurate ones written by competitors - the Good Care Guide has a review verification process to weed these out. I mean poor reviews written by people using the service, or their families.
But, and I don't mean to sound flippant, isn't this the point? The entire premise of choice in care services is to enable people to choose or not choose a provider. Personal budgets in care have given people the purchasing power to do just that, but this power is meaningless if they are not also armed with the information they need to choose wisely. To suggest we ought to limit this information protects the provider and disempowers the consumer.
I believe that the Good Care Guide is excellent news for providers. Having spent years relying on council block contracts, many are now faced with an alien concept of having to market their services to individuals. Winning business is no longer about fulfilling the demands of a procurement document - it's about convincing people of the quality, reliability and flexibility of services on offer. And we are asking this of a sector where many providers don't even have an ad in the Yellow Pages, let alone a website. The Good Care Guide is a boon - it disseminates more effectively what many providers already rely on - word of mouth. It doesn't require a fancy marketing strategy, just good service. For smaller providers - who often excel in quality, personalised care and solid relationships with their clients, but who don't have a BUPA sized budget to achieve brand recognition - this could save their businesses during the rocky transition from block contacting to personal budgets.
The controversy of the Good Care Guide presents an interesting question regarding consumerism in public services more generally. Even after complaints from hoteliers that comments on Trip Advisor from malicious guests had led some hotels to go out of business, no one ever questioned the user-review model for the private sector. It is phenomenally successful, and has spread from holidays, hotels and restaurants to other industries like tradesmen.
But when it comes to public services, we are on virgin territory and remain cautious. Of course we can't pretend that selecting a nursing home is like selecting a B&B. And we must consider what does happen when a home goes out of business and the residents need to find somewhere else to live. But the avoidance of disruption cannot be used to justify poor quality support - and that goes for care and nursing homes, children's care, schools, and hospitals. We cannot escape the fact that in almost all public services, supply is becoming more diverse to include private and third sector organisations, and individuals are being given more purchasing power. A consumerist relationship - and a subsequent thirst for consumer style information - is almost inevitable.
The critical question is how providers respond to this challenge. Calling for protection from public scrutiny, whilst doing nothing to change current practices that might generate poor reviews, clearly isn't the answer. Public services must ensure they listen to current clients and their families and responding to their concerns and requests. They must be delivering good quality, flexible, personalised services. The risk of receiving a poor review then suddenly becomes much smaller. And when you do receive a poor review, you scrutinise your service and respond accordingly, making sure the negative reviews are just a tiny proportion of the positives.
For those providers whose services justify poor reviews, the combination of better information and personal budgets does suggest the game is up without some swift remedial action. Local authorities and regulators should be on hand to assist with this, but must also help to minimise disruption if providers close. But what we cannot do is allow poor quality to exist in the system by denying people a voice.
The Good Care Guide finally links supply to demand with a flow of information, and completes the circle started by personal budgets. And just like the transition to personal budgets, the transition to an information rich care system may be rocky at first. But eventually everyone will benefit.