Care England Responds to the CQC’s State of Care Report 2023/24

Care England, the leading voice of adult social care providers, has responded to the Care Quality Commission’s (CQC) State of Care 2023/24 report, released earlier today. This report sheds light on critical issues facing adult social care across England, from rising demand and delayed hospital discharges to staffing challenges and inequalities in care access.

Professor Martin Green OBE, Chief Executive of Care England, commented:

“This report confirms the deeply entrenched issues we have been highlighting within social care. Despite ongoing efforts, there remain persistent gaps in care access, leading to heightened pressures on both the NHS and adult social care providers. This lack of alignment between demand and provision is resulting in vulnerable people not receiving the timely support they desperately need. Now, more than ever, urgent action is required to address these critical shortfalls.”

Key Findings Highlighted by Care England Include:

• Rising Demand and Service Gaps: Demand for local authority adult social care has surged, with a marked 27% increase in unmet requests since 2017/18. This stark trend reflects a lack of alignment between increasing needs and available support.
• Delayed Discharges from Hospitals: The report reveals that in April 2024, delays for care home beds and home-based care contributed to 45% of patient discharge delays after 14 days in an acute hospital. These delays reflect a strained system in which pressures on the care sector often prevent it from accommodating individuals ready to transition out of hospital settings.
• Regional Disparities in Care Provision: Pronounced regional disparities persist, with the North East reporting the highest rates of delayed discharges due to insufficient home-based care, while London leads in delays driven by limited availability of care home placements.
• Staffing Pressures and Recruitment Challenges: Although care home vacancies are at a three-year low, international recruitment has sharply declined, with an 81% decrease in overseas worker visa applications between 2023 and 2024. This trend poses serious risks to workforce stability and care continuity.

Professor Green continued:

“The CQC’s report underscores the urgent need for targeted funding and support. Without sustainable solutions to recruitment challenges, service gaps, and regional inequalities, the system will continue to struggle because of increasing need, which is not matched by supply. We cannot afford to overlook the well-being of those relying on our services. It is imperative that the Government, in partnership with the sector, steps up to provide the resources and support needed to strengthen the foundations of adult social care.”

The report underscores the financial strain on providers, with inflation and workforce challenges eroding resilience which are set to worsen given the changes to international recruitment numbers as reported in the recent Skills for Care report. Although care homes show promising occupancy returning to pre-pandemic levels, they face reduced reserves, operational uncertainties and financial surplus at its lowest levels ever. Meanwhile, a 34% rise in registered homecare services since 2020 contrasts with a slight decline in care homes and beds, revealing a shrinking residential care market not aiding hospital discharges. This shift highlights an urgent need for balanced capacity and equal access to services across regions to ensure sector sustainability through essential reforms and investment.

Professor Green added:

“Providers are operating under immense financial strain. Recent unfunded inflation, coupled with escalating workforce costs, has left many organisations vulnerable. The resilience of adult social care must not be taken for granted. We need proactive, equitable funding to ensure that our sector remains stable and capable of supporting both our communities and the broader health system.

This reduction in care home availability poses a serious challenge for a sector already under pressure. While expanding homecare services is beneficial, we must not overlook the need for residential care, especially as our population ages. A balanced system requires both home-based and residential care options, accessible in every region. It is essential for the Government to work with us to ensure that everyone who requires residential support can receive it, wherever they are and wherever they choose to call home.”

Finally, the report highlights Care England’s research as a model of pioneering innovation, citing initiatives like the decaffeination study reducing toileting related falls developed in partnership with organisations across the sector to enhance quality of care, and its work in partnership on the Vivaldi social care project.

Professor Martin Green OBE, Chief Executive of Care England, commented:

“We are proud of the work highlighted in this report that Care England has undertaken to drive meaningful, evidence-based change across the sector. By collaborating on initiatives that enhance infection monitoring and reduce falls, we are reinforcing our dedication to improving the lives of those receiving care, while also aiming to reduce systemic pressures and healthcare costs. These partnerships demonstrate the impact that focused, innovative care strategies can have on improving safety and quality within adult social care.”