Posted by Mei-Ling Huang, Partner
CQC’s annual State of Care report for 2017/18 has been published
CQC have focused on five factors that affect the sustainability of care:
- Access: CQC found that although most people are still receiving good care, access to care varies throughout the country. Some people cannot get the care they need or only have reasonable access, disjointed care or poor services.
- Quality: The overall quality of care has improved with 79% of adult social care services rated good, up from 78% in 2016/17. There are now 605 services rated outstanding which is 250 more than this time last year. An emphasis is placed on providers having an effective and stable manager who embraces learning and working externally with local partners. In addition, providers are encouraged to utilise new technology to increase the quality of care they deliver.
- Workforce: Recruitment, staff retention and development are still problematic for providers. This, in turn, impacts on their ability to meet the needs of service users. The vacancy rate for jobs across the sector has gone up from 6.6% to 8%, with the most vacant posts being nurses, with 12% of posts currently unfilled.
- Capacity and Demand: The demand for social care services is increasing relentlessly due to the ageing population and the increasing number of people living with complex, chronic or multiple conditions, such as diabetes, cancer, heart disease and dementia. The report finds that there will be twice as many people needing 24-hour care in England by 2035. The capacity of adult social care provision continues to be very constrained. Overall, the number of beds has dropped slightly. There is a challenge in finding the right provision to meet people’s needs. Collectively, services need to plan to meet the predicted needs of their local populations, as well as planning for extreme periods of demand, such as during the winter months.
- Funding and Commissioning: Funding continues to be the greatest challenge in the care sector. 78% of directors are concerned about their ability to meet the statutory duty to ensure the market sustainability of their business within existing budgets whilst councils are grappling with the tension between prioritising those with the greatest needs and investing in services that will prevent and reduce future needs. The Local Government Association estimates that adult social care services will be confronted by a funding gap of £3.5 billion by 2025. The government have announced an extra £20.5 billion funding for the NHS by 2023/24 but there is still no long-term funding solution for adult social care. This is due to feature in both the forthcoming social care Green Paper and the wider Spending Review.
Other Key Findings
- Services perform the best in the caring domain with 91% of services rated as good and 4% rated as outstanding. Conversely, 2% of services were rated as inadequate and 21% as requires improvement for well-led, emphasising the need for strong management and a focus on the well-led domain in inspections.
- Of the 396 services that were originally rated as inadequate and have been re-inspected since 1 August 2017, 89% improved their rating.
- However, improvement is still challenging for many services. Of the 3,031 services that were originally rated as requires improvement, 42% of services that were re-inspected failed to improve and have retained a rating of requires improvement. A further 7% dropped to a rating of inadequate.
- CQC has been exercising its enforcement powers. Of the 141 services closed by the regulator, 73% of those were adult social care services.
- CQC’s message for adult social care providers is that a poor rating should be taken “as a wake-up call”. Those who improved their rating used the issues identified in their inspection report to create an action plan and demonstrated increased staff training and appraisals.
- The resounding message is that the hallmarks of providing good quality care are good leadership and governance with a strong organisational culture and collaborative relationships with partners and other healthcare organisations.
- The urgent challenge for Parliament and commissioners is to change the way services are funded.
- Providers must recognise the needs of their local populations and find sustainable, person-centred solutions to the issues they face. Regrettably, the alternative is a future in which inequality in care will continue to grow.
You can read a full copy of the report here.
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