Quality assurance of social services
How are social services monitored?
Social services include a wide range of services, such as home care assistance, institutional care of the elderly and disabled, foster care and supported living services for people with a substance misuse problem or a mental health illness.
Local authorities are responsible for providing these services to everyone living in their operating area. Local authorities conduct an assessment to determine a person’s need for services and make a decision on the provision of the services based on the assessment.
Local authorities may provide a service by providing it themselves or together with other local authorities, buying the service from a private service provider or by issuing a service voucher to the customer.
The purpose of self-regulation is to ensure that service providers identify the risks that may affect the content and quality of the services provided to customers. Both public and private service providers must draw up a self-regulation plan which must be accessible without an express request to see it. All members of staff must be involved in drawing up the self-regulation plan to ensure that self-regulation is integrated into routine practice and that the personnel learn to evaluate their own actions.
Local authorities are responsible for monitoring all private social service providers operating in their area regardless of if the local authority buys services from them or not. Where necessary, local authorities must direct and provide guidance to service providers on the measures to improve the quality and adequacy of their services. Local authorities must also ensure that the standard of the services provided by private service providers is on the same level with public services.
When a local authority buys services from a private service provider, the provision of the services is based on a contract. The contract must define the minimum requirements set for the service, and these requirements must be met throughout the contract period. In addition to being responsible for monitoring private service providers in their area, local authorities must also enforce the performance of the contract. Local authorities may add sanction clauses to the contract and impose a sanction if the service provider fails to provide services to the standard specified in the contract. A sanction can be a penalty or for example the refusal to buy services until the service provider has demonstrated that their services meet the requirements specified in the contract.
Services provided with service vouchers
Local authorities may provide services with service vouchers. The service voucher system gives the customer the freedom to choose the service provider of their choice. However, customers using a service voucher may have to pay a portion of the price of the service if it is not fully covered by the service voucher. Local authorities can determine the value of the service voucher independently, which is why the sum covered by the customer can vary between different municipalities.
Local municipalities determine the criteria for the service providers providing services against service vouchers. If the service provider meets the criteria, the local authority accepts the service provider as a ‘service voucher provider’ and adds them to their register of service voucher providers. Local authorities must monitor the quality and adequacy of the operations of service voucher providers.
A service voucher customer enters into a contract with the service provider independently. This contractual relationship between the customer and service provider is subject to the provisions and principles of consumer and contract laws.
Services bought by the customer
If a customer acquires and pays for their social services on their own, the customer and service provider enter into a contract subject to the provisions and principles of consumer and contract laws. Local authorities must ensure that the services provided by the service providers are adequate and of good quality even if the local authority was not involved in the purchase of the service and if there is no contract between the local authority and the service provider.
If a local authority detects any problems in the services provided by a service provider, the local authority must steer the service provider to operate in line with the legislation. If a service provider fails to improve its services after joint discussions and other steering measures, the local authority must report them to the Regional State Administrative Agency.
Local authorities bear the primary responsibility for monitoring social services, but Regional State Administrative Agencies, too, monitors public and private social care services provided in their operating areas. The steering and monitoring tasks of Regional State Administrative Agencies are divided into three categories.
Guidance and advice
Guidance and advice are the primary methods for improving the quality of operations. Regional State Administrative Agencies provide guidance and advice to both customers and service providers.
A private social service provider may only start providing a service once they have obtained a licence for their operations and registered with the local authority for the operating area. When the licence application and registration are being processed, a Regional State Administrative Agency can also evaluate the service provider’s capacity to provide services and, if necessary, provide guidance to the service provider. The evaluation of the capacity to provide a service is referred to as ‘proactive monitoring’.
Sometimes the guidance and advice provided or sanctions imposed by a local authority are not enough to improve the quality of a service. In a situation like this, the local authority, the customer themselves or the customer’s next of kin can report the problem to the us at the Regional State Administrative Agencies. We decide what measures need to be taken after reviewing the report. As a general rule, we ask the local authority to submit a statement on the problem and the service provider to provide a clarification. These statements and clarifications are then used as a basis for processing the suspected breach. If the nature of the breach gives reason to believe that the safety of customers has been compromised, we can investigate the quality of service and customer safety by paying an unscheduled inspection visit.