Adult social care 'near tipping point', warns CQC

The sustainability of adult social care is approaching a "tipping point" as growing pressure caused by rising demand and limited resources mean more people are not getting the help they need, putting pressure on other parts of the health and care system, the Care Quality Commission has warned.

In its annual State of Care report, the regulator said providers are starting to hand back contracts because they are "undeliverable" - and local authorities expect more to come. This is because of pressures on fees funders of care are willing to pay and cost pressures arising from the introduction of the National Living Wage in April.

The CQC said the fragility of the adult social care market, combined with a growing and ageing population, more people living with long-term conditions and a challenging economic climate, is creating more problems for those who need to access care. In turn, this is translating to increased A&E attendances, emergency admissions and delays in being discharged from hospital.

Councils said inadequate funding means social care is "already in crisis".  

The CQC report shows most health and adult social services in England provide safe, high quality and compassionate care - 71 per cent of adult social care services it inspected were rated as Good, with one per cent judged Outstanding.

However, some providers are failing to improve even after being given clear information on where they need to act. Two per cent of services were rated as Inadequate by the CQC and nearly a quarter failed to improve on re-inspection. In addition, half of services rated as Requires Improvement - 904 out of 1,850 - had no change in their rating on re-inspection and in 53 cases, the quality of care slipped to Inadequate.

CQC data shows that after the number of nursing home beds increased from 205,000 in 2009 to 224,000 in March 2015, the figures have been static ever since.

Furthermore, 81 per cent of local authorities have reduced real-terms spending on social care for older people over the last five years.

The CQC report comes after research by the King's Trust and the Nuffield Trust showed the number of people receiving local authority-funded social care has fallen by more than a quarter - 26 per cent - from 1.1m in 2009 to 850,000 in 2013-14.

Elsewhere, the International Longevity Centre-UK has warned adult social care faces a "bleak" outlook and increasing polarisation, with private formal care for those that can afford it and rising reliance on informal care and increasing unmet needs for those who can't.

"The good news is that, despite challenging circumstances, most people are still getting high quality care and there are encouraging levels of improvement taking place. This is something to celebrate. However, there continues to be wide variation in quality, some providers are struggling to improve and there is emerging evidence of deterioration in quality," said David Behan, chief executive of the CQC.

"While there are no easy answers or quick fixes, 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 meet, less improvement and more deterioration."

Cllr Izzi Seccombe, chair of the Local Government Association's Community Wellbeing Board, said: "The scale of underfunding means that social care is already at crisis point and the CQC is right to highlight this.

"There is a real danger that more providers either pull out of the publicly-funded care market, or go bust, placing vulnerable people at risk.

"Councils, care providers, charities and the NHS are all united around the need for central government to fully fund pressures facing the provider market and the longer term funding gap for local authorities to pay for social care.

"Properly funding social care is essential if we are to move away from just trying to meet people's basic needs to ensuring they and their carers can live independent, fulfilling lives in safety and in control of their care, as well as alleviating the pressure on the NHS."