Kate Terroni’s blog

Monthly column for providers and professionals working in adult social care from Kate Terroni, Chief Inspector of Adult Social Care.

Welcome back to my column. This month saw the publication of our annual State of Care report about Health and Care across England.

The key message from our report is that when people access care, the majority of them receive good quality services, however people are waiting too long to get the care they require and as a result of this, there are more people with unmet care and support needs — Age UK reports this includes approximately 1.4 million older people and we know there are a growing number of adults caring for other adults, with Carers UK reporting this as 1 in 8 people. We particularly highlighted poor outcomes that can be experienced by adults with learning disabilities, autism and mental health needs who in a crisis are not consistently able to get the support they require in their home and as a result of this some of them end up being cared for a long way from home, without the constant focus on supporting them to return to their community.

For Adult Social care, we see a similar picture of people waiting too long for assessments, and when their care needs have been identified, they wait too long to receive a service. People told us about having to chase professionals to make progress with accessing care and this was particularly concerning for those people less able to speak for themselves.

We particularly highlighted poor outcomes that can be experienced by adults with learning disabilities, autism and mental health needs.

Capacity within the social care market continues to be challenging; care home provision has reduced across the country at a differing rate between regions and despite seeing the number of domiciliary care agencies increase by 23% in the last five years, we do not have confidence that this increase in the number of care agencies has equated to sufficient additional care capacity being available to support people in their own home. When people do get social care, four out of five services are rated as good and compared to last year an additional 282 services are rated outstanding. In community social care services the quality of care is especially high, in particular Shared Lives and specialist colleges. Unfortunately though, we have rated 22% of nursing homes as requires improvement.

As we all know, funding pressures are still one of the biggest challenges our sector faces and in 2018 we twice were required to exercise our legal duty to notify local authorities that there was a credible risk of service disruption because of provider business failure, and the second of these referred to one of the largest domiciliary care providers in England. We have been running our Market Oversight scheme for four years and these were the first notifications of this type that we have had to issue.

When people do get social care, four out of five services are rated as good and compared to last year an additional 282 services are rated outstanding.

On top of funding pressures, the report highlighted the challenges we face with workforce in adult social care. Skills for Care report that there are 122,000 vacancies in our sector. We have seen examples of values-based recruitment campaigns that have been successful at recruiting the right people into the right jobs. Having access to recruitment tools and resources can be more difficult for smaller organisations, so it’s important to be sighted on opportunities with the national recruitment campaign. October saw the launch of the second year of this campaign for adult social care led by the Department of Health and Social Care — Every Day is Different. If you haven’t already I would encourage you to look at the resources they have available, which may aid you in any recruitment you need to do.

The State of Care report shows that there are significant barriers to the improvement of the adult social care sector, which is not surprising to those of us working within it, but it also shows that improvement is happening and provides examples of excellent, person-centred care done in new and different ways. I encourage you to read the report and discuss it with colleagues, share it with your staff and talk about what’s good about the care you deliver and what could improve.

I look forward to writing next month’s blog and updating you on what I’ve seen and learnt as I continue to make the role of Chief Inspector my own.