This year’s State of Care shows that, thanks to the efforts of staff and leaders, the quality of health and social care has been maintained despite very real challenges and the majority of people are getting good, safe care. But future quality is precarious as the system struggles with complex new types of demand, access and cost.
The Care Quality Commission’s (CQC) annual assessment of the quality of health and social care in England contains much that is encouraging. As at 31 July 2017, 78% of adult social care services were rated good (71% were rated good at 31 July 2016) as were 55% of NHS acute hospital core services (2016: 51%); 68% of NHS mental health core services (2016: 61%) and 89% of GP practices (2016: 83%).
Commenting Professor Martin Green OBE, Chief Executive of Care England, a representative body for independent providers of adult social care said:
“This is the second year in a row that the Chief Inspector at CQC has had to outline the precarious state of social care to Parliament. Parliament can ill afford to ignore the warnings from CQC; there is an urgent need for a long term funding settlement that will reach the frontline and support sustainable quality services”.
CQC published its state of health and adult social care report in England 2016/17 on 10 October. This report is CQC’s annual assessment of health and social care in England and looks at the trends, highlights examples of good and outstanding care, and identifies factors that maintain high quality care www.cqc.org.uk
Care England is leading on high profile policy and strategy developments on behalf of providers. It has been triangulating a range of publically available intelligence to consider how well local systems are working and we welcome this updated narrative and data from CQC across all sectors.
Professor Martin Green continued:
“There is a lot of uncertainty in the sector and by dragging its heels on the social care Green Paper; Government simply cannot abdicate responsibility for those in need of care, especially those funded by local authorities.
Margaret Willcox, President of the Association of Directors of Adult Social Services (ADASS), said:
“The fact that nearly four in five adult social care services were rated ‘good’ and many others have improved is testament to the dedication of care staff working under significant and continuing pressures, although we recognise that more needs to be done.
“However, with councils overspend on adult social care budgets, contracts being handed back, providers closing, councils being fined for delayed transfers of care and potentially facing crippling back-pay costs for sleep-in shifts, and the sector struggling to recruit and retain staff, the future is bleak for adult social care.
“While the extra £2 billion funding for adult social care is welcome, this is only short-term. Without a long-term, sustainable solution for adult social care, there will be worrying consequences for the fragile care market, the NHS and, most importantly, for older and disabled people, their families and carers who need and deserve good, reliable and personal care.
“The Government should bring forward its forthcoming consultation process on the future of adult social care, which ADASS stands ready to engage in, to help establish a better social care system that is fit for the 21st century.”
New evidence about the state of England’s adult health and social care services must be the driver for better quality support, says VODG (Voluntary Organisations Disability Group), the national body representing leading not-for-profit disability support providers.
This is the VODG verdict on today’s report from national regulator Care Quality Commission, The state of health care and adult social care in England, which shows that most health and adult social care services in England are providing people with safe, high quality and compassionate care. However, it also serious raises concerns that the health and care system is ‘straining at the seams’, making future quality precarious.
Commenting on today’s publication, VODG (Voluntary Organisations Disability Group) chief executive, Dr Rhidian Hughes said:
“This report is vital, authoritative evidence about what kind of health and social care support is available across England. CQC’s analysis of the quality of support comes as such services face unprecedented challenges in a climate of austerity. Social care providers, in particular, are experiencing increasing demands for support, rising costs and recruitment and retention worries.”
Nuffield Trust Director of Research Professor John Appleby said:
“Today’s report shows that although most NHS patients still receive good and safe care, the system as a whole is struggling to cope. The CQC’s warnings must be seen in the context of the unsustainable financial squeeze. The NHS ended last year with an underlying deficit of £3.7bn and faces an even greater challenge this year.
“If the response to this problem is to try to exert more grip and push harder from Whitehall, it will fail: at this stage staff and leaders can’t work much harder. We need supportive leadership which puts the emphasis on working together to tackle difficult changes.
“Perhaps the most worrying parts of this report touch on social care for older people. One in eight are not receiving the care that they need in the community, and costs have already been pushed so low that companies are giving up contracts. The future funding and organisation of social care is becoming one of the greatest unresolved policy issues of our time, and action on this is now an important priority.”
Cllr Izzi Seccombe, Chairman of the Local Government Association’s Community Wellbeing Board, said:
“It is encouraging that the vast majority of adult social care services were rated good, and that services have improved on last year, which is a massive achievement given the unprecedented pressures across the system.
“Social care faces a perfect storm, and the CQC report is yet another timely warning from a key part of the sector, of the need to resolve the short and long-term future of care as an urgent priority.
“It was pleasing to see that social care was such a prominent issue during the election campaign, and that the vast majority of MPs agree there needs to be a cross-party solution.
“The pre-election momentum must be maintained, and it is imperative that the Government urgently brings forward its consultation on how it will tackle the social care funding crisis.
“Everything must be on the table when it comes to discussing how we pay for the care people need, and who contributes.
“We have warned that despite the helpful one-off funding of £2 billion announced in the Spring Budget, social care faces an annual funding gap of £2.3 billion by 2020. Government must use the forthcoming Autumn Budget to set out how it plans to address this.”
Jeremy Hughes, CEO of Alzheimer’s Society, says: “This year’s State of Care is not much to be celebrated. It is indeed a sad state of affairs when all we have to be thankful for is that performance in the health and care system hasn’t dramatically deteriorated.
“Last year the CQC delivered the stark warning that social care was approaching “tipping point”. This went unheeded and we are in the midst of a crisis where one in eight older people are not receiving the help they need, the number of beds in nursing homes are decreasing and a lack of funding is seeing home care providers exit the market in droves. It is only down to the dedication and hard work of health and care staff that the whole service hasn’t buckled under the strain.
“With continued political inertia, the care system is at real risk of collapsing. Vulnerable people with dementia deserve far better. For all those affected by dementia, the Government must act now to produce a long-term, sustainable plan to fix the broken social care system. We cannot wait another year and then see more people with dementia struggle or die under this failing system.”
Caroline Abrahams, Charity Director at Age UK and co-Chair of the Care Support Alliance said
“According to this report people have only a one in fifty chance of receiving great care, compared to a one in five chance of that care not being good enough. What’s worse, these odds are not evenly distributed so if you’re unlucky you may find yourself living in an area where mediocre care is as good as it gets. “
“Really this tells you everything you need to know about the state of care today: it’s like a rubber band that’s been stretched as far as it will go and can’t stretch any further. Meanwhile the demand for care keeps ratcheting up.
“In the report the inspectorate effectively puts the Government on notice that our country’s current approach to care is in the last chance saloon, and that increased investment and reform can’t be put off any more. We strongly agree and we call on the Government to put paid to today’s press rumours suggesting they may be preparing to kick the issue into the long grass. This report shows that any such move would be reckless in the extreme.”
Colin Angel, Policy Director at the United Kingdom Homecare Association (UKHCA), said:
“It is right that CQC recognises the significant contribution of the workforce and leaders in making services resilient, but it is clear that the ‘tipping point’ referred to in last year’s report is still a reality in many parts of the country.
“The ability of front-line workers and their managers to keep quality services functional will not last, unless there is a proper solution from Government on the long-term funding of care.”
UKHCA welcomes the initial work that CQC has undertaken in reporting on the overall picture of social care and health services across local areas. This will help hold local authorities and the NHS to account for the way they commission services and how councils shape their local care markets.
Colin Angel continued:
“As well as being able to report on the quality of services delivered by providers, CQC also need statutory powers from government to have oversight of how care services are commissioned and supported by the state in line with councils’ responsibilities under the Care Act 2014.”