State of Care

Care England, the largest and most diverse representative body for independent providers of adult social care in England, has today welcomed the publication of the Care Quality Commission’s annual assessment of health care and social care in England and called for action to address the findings.

Professor Martin Green OBE, Chief Executive of Care England, says: “The ‘gridlock’ which characterised the health and social care system last year has been aggravated by new pressures for care, including inflation, the cost of living and ongoing challenges with the workforce. Despite 70,000 new international workers in the care sector across 2022 – 2023, resulting in a net reduction of 13,000 vacancies, we have lost 57,000 domestic workers. This is not sustainable. Without central Government intervention, we may not be looking at gridlock next year, but a total impasse.”

The State of Care 2022/23, published today, 20 October, is the CQC Quality Commission’s annual assessment of health care and social care in England. The report is available here.

Insufficient capacity in adult social care is continuing to contribute to delays in discharging people from hospital. Ongoing staffing and financial pressures (such as increased running costs and insufficient Local Authority fee uplifts) are having an impact on the quality of people’s care, with some at greater risk of not receiving the care they need.

Local authority budgets have failed to keep pace with rising costs and the increase in the number of people needing care. The ADASS Spring Survey published earlier this year indicated that Local Authorities in England are starting from a £400m deficit, before they even look to address staffing, inflation and wider cost pressures across the adult social care sector. The sector’s own analysis indicates an average gap between the Fair Cost of Care and the Local Authority fee rate of £144 per week for residential care and £101 per week for nursing care in England.

To combat the funding and workforce issues that are so prominent in the State of Care report, Care England has called for a number of solutions in Care For Our Future, including a fully-funded minimum £15 wage for care staff, and a £1,500 hospital discharge tariff.

Other key findings include:

  • While occupancy rates have increased, the CQC’s register of adult social care services shows the number of registered beds has decreased by 0.6% between July 2022 and July 2023.
  • In 2022/23, the number of applications to deprive a person of their liberty increased to over 300,000, with only 19% of standard applications completed within the statutory 21-day timeframe.
  • Data shows that the proportion of care home residents who receive state-funded care increases as the levels of deprivation increase. In areas with the lowest levels of deprivation, just over 2 in 5 care home residents are state-funded (43%) whereas in areas with highest deprivation, 4 in 5 residents (80%) receive state-funded care.
  • This correlates with the ‘Fair Cost of Care Report for Older People and Dementia’, published by LaingBuisson, which indicates that the North and Midlands have a lower proportion of self-funders contributing towards inequalities in the hours of care provided than the South.
  • The numbers of autistic people and people with a learning disability in hospitals are still high – at the end of June 2023, there were 2,035 inpatients, over half of whom have been there for over 2 years.
Martin Green continues: “With a general election on the horizon, these concerns must not be lost. Social care must be seen as an essential part of national infrastructure. The social care sector is brimming with talent and provides essential support for our citizens. We need a government that understands the importance of social care and sets about creating an environment where it flourishes, rather than struggles.”