The State of Care – Professional bodies comment on CQC’s annual assessment on health and social care

State of Care
Care England, a representative body for independent providers of adult social care, has welcomed the publication of the Care Quality Commission’s annual assessment of health care and social care in England.Professor Martin Green, Chief Executive of Care England, says:  

“Although this year’s State of Care report makes a raft of important recommendations including a new deal for the adult social care workforce, it is disappointing to note that the report is predominantly a narrative of events which spanned the Covid-19 pandemic, as opposed to a critical reflection of what must change. This is underscored by the lack of internal reflection from CQC as to its handling of the crisis.”  

The annual State of Care report, examines trends, shares examples of good and outstanding care and highlights where care needs to improve. This year’s State of Care starts by considering the quality of care prior to Covid-19 before subsequently examining the impact of the pandemic and the response of the system.

The report highlights the fantastic work of the adult social care sector with 80% of adult social care services were rated as good and 5% as outstanding (31 July 2019: 80%, 4%). However, it is concerning that among mental health services that the level of poor care in inpatient wards for people with a learning disability and/or autistic people continues to rise; the overall proportion of services rated as inadequate rose from 4% to 13%. This emphasises the need to deliver on the Transforming Care target to reduce the total number of patients with a learning disability and/or autism within inpatient units by 35%.

Professor Green continues: 

The Covid-19 pandemic has demonstrated the interdependence of the health and social care system and the organisations that operate across the system. The regulator must now reflect upon its own role and look to facilitate the delivery of safe, quality and sustainable Covid-19 proof care in the future.”

The Independent Care Group (ICG) says the Care Quality Commission’s report on the state of health and social care makes damning reading for the Government.

The findings of the care watchdog have confirmed the need for an urgent “root and branch” reform of the way we care for older and vulnerable people, providers said today.

ICG Chair Mike Padgham said: “Here we have damning evidence that the crisis in social care has hampered its response to the Covid-19 pandemic and made it ever more vital that we have reform of the sector straight away.

“The dire state of social care – with providers struggling, 100,0000 staff vacancies a day, thousands going without care and poor staff morale – was not good preparation for the arrival of a pandemic.

“Covid-19 found social care exposed and the toll has been terrible: 15,646 people died from coronavirus in care and nursing homes between 28th December and 2nd October, a number that is rising by the day. We must never forget, these are people’s loved ones – a wife, a husband, a mother, a father, an aunt, an uncle, a brother, or a sister.

“”Under-funded and neglected by government after government, coronavirus exposed a social care system that was already in crisis and plunged it into further despair.”

The CQC says: “In social care, COVID-19 has not only exposed but exacerbated existing problems. The sector, already fragile, faced significant challenges around access to PPE, testing and staffing – and coordinated support was less readily available than for the NHS. The long-standing need for reform, investment and workforce planning in adult social care has been thrown into stark relief by the pandemic.


“Today’s report makes clear that these issues need to be urgently addressed – underpinned by a new deal for the care workforce, which develops clear career progression, secures the right skills for the sector, better recognises and values staff, invests in their training and supports appropriate professionalisation.”


Mr Padgham added: “Reform is long overdue; the Prime Minister has repeatedly promised it and it is time to deliver. Unless we get more funding into the sector to support care, ease the staffing shortages and improve the terms and conditions of the staff providing amazing care, the sector will continue to be extremely fragile.”


The ICG wants to see:


•A root and branch overhaul of the way social care is planned and funded

•NHS care and social care to be merged and managed either locally or nationally

•Extra funding for social care, funded by taxation or National Insurance

•A guarantee that people receiving publicly funded care can receive it in their own home or close to where they live

•A commissioner for older people and those with Learning Disabilities in England

•A properly costed national rate for care fees linked to a national career pathway and salary framework for care staff

Dementia treated like other high priority illnesses, like cancer and heart disease

•A fixed percentage of GDP to be spent on social care

•A cap on social care costs, including ‘hotel’ charges

•Local Enterprise Partnerships to prioritise social care

•A national scheme to ensure people save for their own care, as they do for a pension

•A new model of social care delivery based on catchment areas – like GPs

•Social care businesses to be zero-rated for VAT

•CQC to have much greater powers to oversee all commissioning practises such as per minute billing and 15-minute visits

•Less duplication of inspection between CQC and local authorities/CCGs

•Greater recognition of the role of the independent sector and utilisation of its expertise in the commissioning and delivery of social care

•Guaranteed equal partnership working through seats on Health and Well Being Boards, CCGs, and NHS

•Giving providers and CQC greater flexibility in delivering services

•Providing telemedicine incentives

•Allowing nurses and social care staff from overseas to work in the U.K. including lowering the salary cap

•Training and bursaries to encourage recruitment/end the shortage of nurses

•Long term measures to integrate older and younger people in care settings and change the perception of the generations

•Investment in research and development into new models of social care delivery

•Funding to help upgrade older care homes to maintain a range of choice for the public and investment in domiciliary care

•Funding for leadership training.

The Voluntary Organisations Disability Group (VODG), the national infrastructure body representing organisations within the voluntary sector who work alongside disabled people, welcomes this comprehensive picture. There is an encouraging focus on how COVID-19 has had a disproportionate effect on some people with protected characteristics, including how disabled people have been among those hit hardest by the pandemic and its knock-on effects.


Since the outbreak of the pandemic in March, VODG has raised concerns about how the government’s response has overlooked the rights and entitlements of disabled people and of the workforce supporting them. This has been alongside a continued call for the government to put social care on a strong and sustainable footing – instead of dishing out quick-fix solutions.


VODG hopes that today’s publication will encourage the government to finally address the historic and sustained political failure to fully recognise, understand and fund equitable care and support services.


Dr Rhidian Hughes, chief executive of VODG, said:


“We welcome CQC’s continued spotlight on the most pressing issues within the sector as well as its unique perspective, which gives us a broad view across health and social care at a time of particular concern.


“The pandemic has exacerbated the need for reform, investment, and sensible workforce planning for the social care sector. It has also highlighted the government’s lack of recognition for working age adult social care services and the inequities that exist for many people with protected characteristics –  as CQC rightly reports, the pandemic has exacerbated the challenges already faced by the UK’s 14.1 million disabled people and the social care sector that supports them.


“COVID-19 has also shone a spotlight on the significant role voluntary sector disability organisations play in supporting people and their families and of the local community services that play such an important role in people’s lives.


“While it is reassuring that CQC’s State of care report had identified and acknowledged these issues, we can only hope that the government finally takes notice and addresses these issues as a matter of urgency.


“For many years, the annual State of care report has highlighted the precarious financial state of the social care sector and the growing demands placed on it. “Today’s report provides yet another reminder of the impact this sustained lack of funding is having on the sector, only now, it has been truly magnified and worsened by the pandemic.


“The government must now seize the chance to ensure its ongoing response to the pandemic, and future planning for the social care sector, is fully inclusive and responsive to the needs of all the people it serves.”




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