This year’s State of Care report shows that most health and adult social care services in England are providing people with safe, high quality and compassionate care, but it also raises concerns about the sustainability of this position in the future.
The report provides the most comprehensive view yet of our inspection findings to date and is based on inspections and ratings of more than 21,000 services.
This the first time we have been able to report on what happens after our inspections when we return to re-inspect. Despite increasingly challenging circumstances, many services have managed to either improve or maintain quality. However, there is also evidence of deterioration in quality, and some providers that are struggling to improve, despite being given clear information on where improvement is needed.
We continue to see good care and improvement
Around three-quarters (76%) of NHS services, care homes, general practices and other services that were rated as ‘inadequate’ were able to improve their ratings following re-inspection. 23% went from ‘inadequate’ to ‘good’ and 53% went from ‘inadequate’ to ‘requires improvement’.
Some services are failing to improve or have deteriorated in quality
47% of providers that were re-inspected following a rating of ‘requires improvement’ were not able to improve their rating. Most worryingly, in 8% of cases, the quality of care had deteriorated so much that the rating was downgraded to ‘inadequate’.
The report raises concerns that the fragility of the adult social care market is now beginning to impact both on the people who rely on these services and on the performance of NHS care. The combination of a growing and ageing population, more people with long-term conditions, and a challenging economic climate means greater demand on services and more problems for people in accessing care.
Commenting on the report, David Behan, chief executive of the Care Quality Commission, said:
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 met, less improvement and more deterioration.”