While the majority of services are safe and of a high quality, too many people across England are living in care homes and receiving care and support in their own homes that is not good enough.
In a national report, the Care Quality Commission (CQC) has found that over three-quarters of adult social care services are currently rated as Good or Outstanding.
CQC has found that strong leaders – both at provider and registered manager levels – play a pivotal role in high-performing services, where a strong vision and person-centred values inspire staff, encouraging a culture of openness and transparency.
However, CQC has also found considerable variation with nearly a fifth of services being rated as Requires Improvement or Inadequate.
This is the first time that such focused analysis on a national scale has been possible following the formal introduction of CQC’s new regulatory regime for adult social care in October 2014, with expert-led, specialist inspections that focus on what matters most to people using services – are they safe, caring, effective, responsive and well-led? CQC then rates services as Outstanding, Good, Requires Improvement or Inadequate so that the public and providers are clear about its judgements.
Since then, CQC has carried out over 33,000 inspections of around 24,000 different services – many more than once. These include residential homes, nursing homes, care in people’s own homes, Shared Lives schemes and supported living services.
CQC found the adult social care sector performed best in how ‘caring’ its services were. In these services, CQC found staff building meaningful relationships with the people who they care for over time and treating them with compassion, kindness, dignity and respect.
Safety is where CQC has found its greatest concerns, with 23% of services being rated as Requires Improvement. Issues uncovered by CQC include ineffective systems and processes for managing medicines or determining staffing levels, which can result in people not getting their prescribed medicines, call bells not being answered, and home visits being rushed or missed.
CQC has used its inspections and ratings to help providers of adult social care understand the specific areas where improvements are needed, to hold them to account to make these necessary changes, to celebrate best practice and to help people to make informed choices about their care.
Already, CQC’s actions are driving improvements in care for people but worryingly, 26% of the services that were first rated as Good and have been re-inspected have deteriorated.
Andrea Sutcliffe, Chief Inspector of Adult Social Care at the Care Quality Commission, said:
Having carried out over 33,000 inspections of around 24,000 different services, most of the adult social care sector is meeting the Mum Test, providing safe and high quality care that we would be happy for anyone we love, or ourselves, to receive.
However, there is still too much poor care, some providers are failing to improve, and there is even some deterioration.
Last October, CQC gave a stark warning that adult social care was approaching a tipping point. This was driven by more people with increasingly complex conditions needing care but in a challenging economic climate, facing greater difficulties in accessing the care they need.
The announcement in the Chancellor’s budget statement of £2 billion additional funding over the next three years is welcome but even more welcome is the promise of a Government consultation this year, which hopefully will lead to a long-term solution to support good quality, person-centered adult social care, both now and into the future.