The Care Quality Commission’s annual State of Care Report has concluded that most services inspected over the past year have been providing good quality care despite challenging circumstances facing providers, particularly in adult social care.
David Behan, chief executive of the CQC, says staff should be commended for going above and beyond to look after people in their care, but warns that over the coming five years, the financial strain on the sector will force radical changes. “What is clear is that, across health and social care, innovation and transformation of services will be vital. Incremental cuts and efficiency savings will no longer be sufficient to meet the challenges ahead,” he adds in a foreword to the report.
According to the National Audit Office, local authority budgets have been reduced by 37% in real terms and on a like for like basis over the last five years. Local authorities have attempted to protect social care budgets from these reductions, but statutory funding for social care has still decreased by £4.6 billion in this period, which is a 31% real-term reduction in net budgets.
Local authorities have managed reduced funding partly through greater efficiency and prioritising spending on social care. This now accounts for 35% of their spending, compared with 30% in 2010. At the same time they have made cost savings by reducing fees to providers – contributing to low pay for the care workforce and a knock-on effect on investment in skills.
The CQC report does not distinguish between adult social care providers – community care, home care and care homes (with and without nursing) are all included. The regulator admits that in the research period, it managed to visit only 18% of the country’s 17,000 residential care homes. This makes it difficult to analyse the effect of rising levels of self-funding in the care home market, and to what extent this private finance is helping to maintain quality services across the whole adult social care market.
Within residential care across the UK, private sector providers make up 75% of beds, according to LaingBuisson research. This shift to private funding might explain why the CQC found that almost 60% of operators were providing good or outstanding care, despite dwindling financial support from the state or local authorities.
The CQC’s advice for providers trying to maintain quality services in a cash-strapped market is to focus on the quality of staff. “Services must have a registered manager consistently in post, as this has a crucial influence on the quality of a service. We take action when services that require a registered manager do not have one,” the report concludes.