Care Quality Commission
Printable version E-mail this to a friend

Adult social care services have improved but the market must respond to meet future needs, says CQC

The overview report has been compiled using data on council commissioning patterns, national minimum standards and registration data.

CQC’s analysis is restricted to the regulated adult social care market. This includes care homes, home care (domiciliary) care services, nursing agencies and shared lives schemes. These are schemes that pay a family to accomodate an isolated or under-supported older or disabled person. Shared lives schemes are also used as day support and respite care.

Adult social care services have improved significantly since 2008 but further growth in the market is required to meet future needs, according to a Care Quality Commission (CQC) report published today.

The national analysis of the adult social care market examines capacity, quality and commissioning and has been developed using technical data and discussions with leaders within the sector.

An assessment of the market since 2004, the report is based on the CQC’s responsibilities under the now defunct Care Standards Act (2000), giving a final definitive report on evidence gathered under this legislation.

This data shows that this year, 83 percent of care homes, home care services, nursing agencies and shared lives schemes were rated good or excellent compared to 69 percent in 2008.

Other findings include:

There is stability in provision in the adult social care market but further growth will be needed to meet future needs. Overall, the number of services has increased. Residential care home numbers have fallen but nursing home numbers and home care services have increased. The rise in nursing home provision reflects an increase in the number of people who may have been cared for in hospital but are now living in nursing homes.

It also reflects that people with complex needs are living longer. Demographic forces mean an increase in the number of services will be required if future demand is to be met. For example, according to research, the number of older disabled people is expected to rise by 108 percent by 2041. The challenge is for providers and commissioners to work together to further develop the market to anticipate future long term care needs.

People are increasingly being supported to live in their homes. Home care services are increasing. In some parts of the country, such as London, significantly more services are geared towards providing care to people in their homes rather than in residential care. Self-directed support, such as direct payments, is enabling people to design their own home care in new ways. To make sure people can continue to be supported to live independently and in their own homes in the future, NHS and council commissioners need to be able to develop local markets.

Year-on-year councils are commissioning better care homes and home care services. Comparisons with the quality of care arranged by councils from 2008 and 2009 shows a growing improvement in the numbers of services rated good or excellent. However, there remain considerable regional variations within commissioning.

Data contained in the briefing are reported on the cusp of significant economic change and local markets may experience turbulence in the future, the report adds. For example, fewer publicly funded care home places may put pressure on services. However, the national picture of stability in terms of numbers and quality may disguise significant local and regional variations. For example, in London there are fewer care home places available for the over-65s, including places for those with dementia. However, London also has the highest percentage of people living in homes rated good or excellent.

CQC chief executive Cynthia Bower said: ‘We’re greatly encouraged to see the improvement in quality of adult social care and the growth in levels of provision.

‘However, we acknowledge there remain pockets of poor practice. Where we have concerns about quality we will not hesitate to act swiftly, using our tougher enforcement powers.

‘The pressures of the current economic climate mean it is particularly important for providers and councils to work together to develop local care markets and anticipate future long-term care needs.

‘Policy makers should also ensure future social care strategies encourage capacity building for commissioners to develop markets, which will require innovation in the light of economic and budgetary constraints.’

CQC has introduced a new tougher system of regulation based on registration under the Health and Social Care Act 2008. This brings together all the sections of the health and adult social care sector, which are required to meet the essential standards of safety and quality to be registered. Adult social care providers were registered under this system on 1 October.

Note to editors:


For further information please contact the CQC press office on 0207 448 9401 or out of hours on 07917 232 143.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of all health and adult social care in England. Our aim is to make sure that better care is provided for everyone, whether it is in hospital, in care homes, in people’s own homes, or anywhere else that care is provided. We also seek to protect the interests of people whose rights are restricted under the Mental Health Act. We promote the rights and interests of people who use services and we have a wide range of enforcement powers to take action on their behalf if services are unacceptably poor.

We are introducing a new registration system that brings the NHS, independent healthcare and adult social care under a single set of essential standards of quality and safety for the first time. Registration is a legal license to operate. We register health and adult social care services if they meet essential standards and we continuously monitor them to make sure they continue to do so as part of a dynamic system of regulation which places the views and experiences of people who use services at its centre.