A ‘growing care injustice’ could take shape unless access and quality improves in the country, the Care Quality Commission (CQC) has warned.

Its annual state of care report said there were signs of improved performance in the health and care sectors compared to last year, despite funding pressures and workforce recruitment problems intensifying. However, the watchdog raised concerns that people’s experiences varied too much, with some receiving disjointed care.

Access to preventative support, doctors and extra GP help in care homes varied in urban areas, the report said, and people living in rural places still faced travelling long distances to get to services and poor transport links.

Funders, commissioners and regulators focused too much on individual organisational performance rather than ensuring services provide joined-up care, the report suggested.

It said the continued ‘fragility’ of the adult social care market – which is seeing the closure of care providers who cannot afford to keep services running and contracts being handed back to councils –  is a threat to services being more integrated.

Variations in quality persist, the commission said, with 100 adult social care services rated Inadequate at the end of July and around one in six services – and one in five NHS mental health services – in need of improvement.

Improvement is challenging for some. Of 3,031 adult social care services that required improving, 42% failed to do so after being re-inspected.

However, more than four-fifths of services were rated Outstanding (3%) or Good (79%), whereas 17% of services were rated as Requires Improvement and 1% as Inadequate. There are now 605 services rated Outstanding – nearly 250 more than last year.

While the £240m cash injection for adult social care announced by the Department of Health and Social Care last week has been welcomed by the regulator, it said there was need for a long-term funding solution. The department has also provided local authorities access to £9.4bn in dedicated social care money over the past three years and is due to publish its green paper due later this year setting out plans to reform the social care system.

Ian Trenholm, CQC chief executive, said: ‘The challenge for parliament, national and local leaders and providers is to change the way services are funded, the way they work together and how and where people are cared for and supported. The alternative is a future in which care injustice will increase and where some people will be failed by the services that are meant to support them.’

George McNamara, director of policy and influencing at Independent Age, the older people’s charity, said: ‘It’s completely unacceptable that the care you get is dependent on where you live, and on how closely the health and social care services work together in your area.’

Professor Martin Green, Care England chief executive added: ‘CQC’s report makes it clear that there is no room for complacency. It recognises that tipping point has been reached for some people who are not getting the care that they need; however the fortunes for next year are ominous.’

Care England’s analysis has identified that over a third of councils (56 in total) will lose access to £739m ring fenced funding for adult social care due to the end of their precept and the scrapping of the adult social care support grant.