Andrea Sutcliffe, Chief Inspector of Adult Social Care at the Care Quality Commission.

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Today we are waking up to the media headlines about the launch of our 2015/16 State of Care report.

Eagerly awaited by many, State of Care is our statutory obligation to present to Parliament each year our inspection findings of the country’s adult social care, hospitals and primary medical services. This second report since we started our new approach of monitoring, inspecting and rating services in 2014 is based on the most comprehensive evidence base of the quality of care we have ever assembled. It is a compelling, fascinating read. Okay, I know I am biased, but you can judge for yourself by reading the full report or taking a look at the infographic story.

The good news

So let’s start with the good news. Our latest ratings show over 70% of adult social care services are providing good or outstanding care — a positive increase on last year — and three quarters of those services originally rated as inadequate are getting better following re-inspection.

That is great and I am pleased the vast majority of people, their families and carers, are experiencing services that meet the Mum Test — care that we would wish anyone we love to receive. Congratulations and thanks are due to all the staff who work in these services for their dedication and commitment.

The worrying news

Despite the good and outstanding services we see, State of Care highlights the stark reality that great care is not the norm for everyone, with around a quarter of adult social care services not consistently providing safe, high quality and compassionate care — and we are seeing too many services struggle to improve.

The latest trends show that nursing provision has stalled, increasing numbers of people are not having their care needs met and growing numbers of providers are handing back local council contracts because they are worried that good quality care isn’t possible on the money available.‎ We also know the sector has difficulties recruiting and retaining the capable, confident staff we need.

These are not abstract, academic points. These challenges are happening at a time when we need good quality adult social care more than ever. People are living longer with individual needs becoming more complex.‎ And if adult social care isn’t there or isn’t good enough, the pressure shifts to other parts of the health and care system. We are undoubtedly seeing this happen in the NHS with increases in A&E attendances, emergency admissions and delayed discharges.

We mustn’t forget that the impact of these problems on people using services, their families and carers can be devastating and distressing. In many ways the system as a whole is failing the Mum Test — with too many people facing a situation we wouldn’t want anyone we love to experience.


It is fantastic that despite all these challenges, there are still so many services providing good and outstanding care. But our analysis of the pressures and the fragility of the adult social care sector causes concern for the future. Are we confident that the good quality care we see now can be sustained and the improvements necessary delivered? Hand on heart, I am not as confident as I would like to be or indeed need to be.

Given the pressures highlighted in State of Care,the worry is that people’s individual needs are not always prioritised, providers may be tempted to cut corners when it comes to quality and services are now at greater risk of deteriorating.

The message from State of Care is clear. Unless the system finds a better way of working together then we are likely to see more poor care, less improvement — and the impact this all has on people’s lives, their families and carers, is my number one concern.

We have got to make adult social care the priority it deserves to be.

Originally published at

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

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