Social care is past “tipping point”

Social care has reached a tipping point, with some people not getting the good quality care they need, the Care Quality Commission has warned in a new report.

CQC chair Peter Wyman said: “Two years ago, we warned that social care was ‘approaching a tipping point’ – as unmet need continues to rise, this tipping point has already been reached for some people who are not getting the good quality care they need.”

He also said that continued fragility of the adult social care market poses a threat to effective collaboration between health and social care. “Without a long-term funding settlement for adult social care, the additional funding for the NHS will be spent treating people with complex conditions for whom care in the community would have been more effective both in terms of their health and wellbeing and use of public money.”

The new report from the CQC, the 2017-18 report into the State of Health and Adult Social Care in England, concludes that the capacity of adult social care provision continues to be very constrained, with very stark regional variations:

  •  changes in nursing home bed numbers ranging from a 44 per cent rise to a 58 per cent reduction 
  • almost a third of adult social care directors (32 per cent) said they had seen home care providers close or cease trading in the previous six months.

Calling for a sustainable financial plan for adult social care in the forthcoming social care Green Paper and the wider Spending Review, Wyman said: “Providers face the challenge of finding the right capacity to meet people’s needs. Services need to plan – together – to meet the predicted needs of their local populations, as well as planning for extremes of demand, such as sickness during winter and the impact this has on the system.”

According to the CQC, specific challenges facing social care, include:

Funding and commissioning: Good funding and commissioning structures and decision-making is needed to end rising levels of unmet need: Age UK estimates that 1.4 million older people do not have access to the care and support they need – a rise of almost 20 per cent in two years

Vacancy rates: In adult social care, the highest vacancy rates in all regions in 2017/18 were for the regulated professions that include registered nurses, allied health professionals and social workers. Vacancies reached 16 per cent in the East of England and 15 per cent in London.

Commenting on the report, Professor Martin Green OBE, Care England chief executive, said: “If health and social care really are hand in glove it is important to offer the same opportunities in terms of recruitment, retention and training to all staff whether in health or social care.  Otherwise we are in danger of an integration lottery.”  

Neil Tester, deputy director of Healthwatch England, added: ““Politicians and policy makers need to hear CQC’s words today and address the capacity issues in social care, but this alone will not create an environment that enables people to get the best out of life. We need to build a system that encourages earlier planning… creating a culture where accessing care and support becomes a normal part of the ageing process.

“Councils are facing growing demand for social care services, and are struggling to cope. By developing better information and advice services they can help people plan earlier and therefore reduce the urgent, ‘crisis point’ needs they currently have to deal with.”   

In the report, the CQC congratulates providers for improvements in quality. Wyman said: “The efforts of staff and leaders to ensure that people continue to receive good safe care… must be recognised and applauded.”

Social care quality on the up
According to the CQC 2017-18 annual state of care report:

  • 3 per cent of adult social care services rated outstanding (2017: 2 per cent)
  • 79 per cent of adult social care services rated good (2017:78 per cent)
  • 17 per cent of adult social care services rated requires improvement (2017:19 per cent)
  • 1 per cent of adult social care services were rated inadequate (2017: 1 per cent)  



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