Regulator calls for longstanding adult social care issues to be addressed

Ian Trenholm, chief executive, CQC

A deal for the care workforce that develops clear career progression and better recognises staff needs to be urgently addressed, the regulator’s State of Care report has concluded.

The Care Quality Commission (CQC)’s annual assessment said the pandemic not only exposed but exacerbated existing problems and that the long-standing need for reform, investment and workforce planning in adult social care had been ‘thrown into stark relief’.

Pre-Covid, concern remained over the fragility of the sector, the watchdog said.

The report, which covers the state of health and social care in England, said: ‘The legacy of Covid-19 must be the recognition that issues around funding, staffing and operational support need to be tackled now – not at some point in the future.

‘The pandemic has powerfully underlined the essential value of social care in helping people to live the lives they want to lead. To ensure the very best care and support for people in the future, there needs to be a new deal for the care workforce – one that develops clear career progression, secures the right skills for the sector, better recognises and values staff, invests in their training and supports appropriate professionalisation.’

As of 31 July, 80% of adult social care services were rated ‘good’ and 5% as ‘outstanding’ (2019: 80%, 4%). However, inspectors continued to find poor care in inpatient wards for individuals with a learning disability or autistic people. The overall proportion of services rated as ‘inadequate’ rose from 4% to 13% – almost entirely based on deterioration in independent, rather than NHS services.

Care England said this emphasised the need to deliver on the Transforming Care target to reduce the total number of patients with a learning disability or autism within inpatient units by 35%.

Over the summer, CQC reviewed the way health, social care and other local services worked together in 11 parts of the country. The report said there was evidence that the places with established working relationships and an understanding of need in their local areas were better able to care for their population during a crisis.

Prof Martin Green, Care England chief executive, was critical of the report. He said: ‘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.’

Rhidian Hughes, chief executive of Voluntary Organisations Disability Group, said: ‘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 document is based on inspections and ratings data, along with other information, including from people who use services, their families and carers. This includes quantitative analysis of inspection ratings of 31,000 services and providers, drawing on other monitoring information including staff and public surveys.

Ian Trenholm, CQC chief executive, said: ‘There is an opportunity now for government, parliament and health and care leaders to agree and lay out a vision for the future at both a national and local level. Key to this will be tackling longstanding issues in adult social care around funding and operational support, underpinned by a new deal for the care workforce. This needs to happen now – not at some point in the future.’