The Care Quality Commission have said that escalating pressure on demand, access and costs mean the adult care sector in England is becoming unsustainable.

The health watchdog the Care Quality Commission (CQC) have warned in a report today that the adult social care sector has become so fragile that it’s reached a tipping point, with many services struggling to make improvements after receiving a poor rating from them.

The Care Quality Commission (CQC) is the independent regulator for health and social care in England. It makes sure services such as hospitals, care homes, dentists and GP surgeries provide people with safe, effective, compassionate and high-quality care, and encourages these services to improve.

In its annual assessment of adult social care services, it found 71% of the adult social care services inspected by the CQC were rated ‘good’ and 1% were outstanding. However, 2% were rated as ‘inadequate’.

More worryingly, many are struggling to make improvements (often due to a lack of funding and resources). Nearly half (47%) of those that were re-inspected after a rating of ‘requires improvement’ were unable to improve their rating. In fact, 8% of those declined further, going from ‘requires improvement’ to ‘inadequate’.

It’s led the CQC to raise concerns that the adult social care sector has become unsustainable. They highlighted the following problems:

- The number of available nursing home beds has stalled, despite rising demand, with no new beds in a year and a half.
- Adult social care providers are having to hand back undeliverable contracts due to unmet fees and the impact of the national living wage.
- Squeezed local authority budgets mean 81% of councils are spending less on adult social care in the past five years.

David Behan, chief executive of the Care Quality Commission, said:

‘The good news is that, despite challenging circumstances, most people are still getting high quality care and there are encouraging levels of improvement taking place. This is something to celebrate. However, there continues to be wide variation in quality, some providers are struggling to improve and there is emerging evidence of deterioration in quality.

‘We are becoming concerned about the fragility of the adult social care market, with evidence suggesting that it might be approaching a tipping point. The combination of a growing, ageing population, more people with long-term conditions and a challenging financial climate means increased need but reduced access. The result is that some people are not getting the help they need - which in turn creates problems in other parts of the health and care system, such as overstretched A&E departments or delays in people leaving hospital.

‘While there are no easy answers or quick fixes, what distinguishes many of the good and outstanding services is the way they work with others – hospitals working with GPs; GPs working with social care and all providers working with people who use services. Unless the health and social care system finds a better way to work together, I have no doubt that next year there will be more people whose needs aren’t meet, less improvement and more deterioration.’

Jeremy Hughes, Chief Executive of the Alzheimer’s Society responded to the report saying:

‘This is the second warning in less than a month that social care is in dire straits. The CQC highlights a system unable to sustain itself, consequently failing many of the people with dementia it serves.

‘Each successive report echoes what we hear from people with dementia and their families – from the devoted husband who must choose between having a hot meal and paying his wife’s care home top-up fees, to the 94-year old grandmother in hospital with infections due to poor personal care.

‘With the NHS rising to the top of voters’ priorities, the knock-on effect from an underfunded social care system is clear. The NHS and social care go hand-in-hand – we cannot fix one if the other remains broken. Social care urgently needs a solid financial grounding before this entire house of cards falls.’

Sources: cqc.org.uk & alzheimers.org.uk