CQC warns without social care investment, patients in England at 'increased risk of harm'

With only two in five people able to leave hospital when they are ready, the CQC chief is warning there needs to be a “real step change” in attracting and retaining social care staff or “people will be at increased risk of harm”.

The Care Quality Commission's annual assessment of the state of health and social care in England over the past year, revealed 'the health and care system is gridlocked and unable to operate effectively'.

Its report found 'most people are still receiving good care when they can access it – too often, however, people are not able to access the care they need'.

In addition 'capacity in adult social care has reduced and unmet need has increased. Only 2 in 5 people are able to leave hospital when they are ready to do so, contributing to record-breaking waits in emergency departments following a decision to admit, and dangerous ambulance handover delays'.

'We are seeing the perfect storm'

Ms Terroni said: “The money announced by the government to help speed up the discharge of people from the hospital when they are medically fit to leave, as well as to retain and recruit more care workers is welcome – but there needs to be more focus on long-term planning and investment rather than short-term sticking plasters.”

With 165,000 vacancies in adult social care, there needs to be a “real step change in thinking” about how to attract and retain staff, with better pay, rewards and training linked to career progression.

"If this doesn’t happen, people will be at increased risk of harm."

The Parliamentary and Health Service ombudsman, Rob Behrens, commenting on the findings, saying: “We are seeing the perfect storm of a gridlocked system combining challenges in both access to care and in workforce provision. This is a breeding ground for mistakes in critical services.

“Failure in any part of the system can have catastrophic effects on patient care.”

’The can must not be kicked’

Social care leaders welcomed the report saying this is the latest in a long line of publications which “starkly” present “the need for immediate government action” to help “tackle” ongoing workforce pressures.

Martin Green, chief executive of Care England, says: “If this gridlock is to be overcome, there must be an appropriate level of investment to stabilise the immediate and systematic workforce pressures currently experienced in the social care sector.

“There must also be a strategic focus on true integration, shifting the current focus from organisations and processes to people and outcomes.

“The can must not be kicked down the road any further; we need something to change, and we need this change now.”

’Get rid of the gridlock’

The Independent Care Group (ICG) said the report is “not a surprise” but is a “damning indictment of the way the country continues to treat the care of our most vulnerable".

Mike Padgham, chair of the ICG said: "Capacity is shrinking but we can’t increase it because we don’t have enough staff. To recruit staff, we have to be able to pay them properly and at the moment there isn’t the funding in the sector to do that and get rid of the gridlock."

'People are losing confidence'

The report highlighted 83 per cent of adult social care services were rated as good or outstanding.

But it also highlighted 36 per cent of care home providers and 41 per cent of home care providers said workforce challenges have had a negative impact on the service they deliver.

Of the providers who reported workforce pressures having a negative impact, 87 per cent of care home providers and 88 per cent of home care providers said they were experiencing recruitment challenges while over 25 per cent of care homes that reported workforce pressures were actively not admitting any new residents.

The report also polled people aged 65 + who had recently used health or social care services. It shows more than a third who said they were on a health waiting list did not feel well supported while 41 per cent said their ability to carry out day-to-day activities had got worse while they were waiting.

Vic Rayner, chief executive of the National Care Forum said: “This report highlights starkly the real impact on people when social care is underfunded and under resourced."

She added: “It is imperative that any new PM guarantees the reforms contained within people at the heart of care, as well as bring forward the necessary funding.”

PJ Care said the report offers "nothing new" and provides "no answers" or "suggested solutions.

"It is clear that social care is not working and it has reached a point where just throwing money at it is not going to work any longer," warned Neil Russell, chairman of PJ Care.

"We need a root and branch review of the whole system. The inequities in the system are clear for all to see and without major change in how social care and health care is managed by the government, it will only get worse."

’Don’t turn your back’

In a survey of more than 4,000 older people who had used health and social care services in the last six months, it found that those living in the most deprived areas were more likely to report that they had a long-term condition, disability or illness, compared with those living in less deprived areas.

The report also highlighted care for people with a learning disability and autistic people is ‘still not good enough’. It stated that ‘despite multiple reviews and reports, people continue to face huge inequalities when accessing and receiving health and social care.’

Edel Harris, chief executive of the learning disability charity Mencap, said: “People with a learning disability should be actively involved in decisions affecting their own care but instead, they’re left waiting and as a result are at increased risk of harm and are experiencing poorer quality care.

“Our message to the next Prime Minister is simple; don’t turn your back on people with a learning disability.”

The Voluntary Organisations Disability Group VODG is calling on the government to provide £500million in financial support to enable social care services to overcome the difficult winter ahead.

Dr Rhidian Hughes, chief executive at VODG said: "Every day, charities make harsh decisions about the services they are able to offer to disabled people, whether the costs of services can be covered by commissioners and if they have the workforce available to meet people’s needs."

To read the report in full, click here