“The health and care system is in gridlock and this is clearly having a huge negative impact on people’s experiences of care.”
That is how the health and care regulator for England, the Care Quality Commission, describes the state of care in its 2022 report.
In a workforce pressures survey, the CQC finds that over one in three (36 per cent) of care home providers agreed that workforce challenges have had a negative impact on their service. Almost nine in ten (87 per cent) of these care home providers spoke of recruitment challenges. Over a quarter of care homes with workforce pressures said they were actively not admitting any new residents.
Overall, the regulator has seen a small increase in the number of ratings of requires improvement and inadequate across residential and nursing homes and homecare.
Inspectors found problems with leadership, management and oversight of the service, driven by staffing challenges.
These challenges included the availability of experienced managers, staffing levels and staff burnout. They manifested themselves in poor person-centred care, and not meeting basic care needs (for example pressure area care, oral care and nutrition and hydration). Exhausted staff responded inappropriately to challenges and there was increased use of unauthorised or overly restrictive restraint.
The regulator also found ongoing problems with the Deprivation of Liberty Safeguards resulting in unlawful deprivation.
Overall, 83 per cent of adult social care services were rated as good or outstanding.
In addition, the regulator highlighted large numbers of delayed discharges due to recruitment and retention problems and social care capacity constraints.
There were also inequalities in care access, particularly for people with a learning disability and autism.
In the report, the regulator made the following recommendations:
- Understanding the health and care needs of local people is paramount for integrated care systems, and each one faces a different challenge in meeting those needs
- Good leadership will be vital for local systems as they become established during challenging times for all services
- Local partnerships are starting to make a positive difference – they must be focused on outcomes for people
- System-level planning should include all health and care services to address population needs and health and care inequalities, and do their best to keep people well.