CQC State of Care 2025/26: What the Findings Mean for Care Home Owners and Providers

CQC has published its State of Care 2025/26 report, highlighting continued financial pressures, workforce challenges and changes across the adult social care sector.

For care home owners and providers, the findings raise practical questions about how services are managed, how leaders are supported and whether governance systems provide a clear picture of care quality.

The report recognises good care across many of the services assessed, while identifying areas for improvement in leadership, accountability and staff development.

What does the report tell us about care home quality?

Among the 3,783 care homes assessed under CQC’s current assessment framework, 67% were rated good and 3% outstanding overall. A further 27% were rated requires improvement and 3% inadequate.

There were particular strengths in caring and responsive support, with around nine in ten homes assessed rated good or outstanding for these key questions.

However, these figures need context. CQC explains that assessments under its current framework have been largely risk based. The services assessed may therefore not represent all care homes across England.

For providers, the findings offer areas to consider within their own services rather than a benchmark that describes the entire sector.

Leadership and governance remain priorities

Leadership was a recurring area of concern. Among the care homes assessed, 31% were rated requires improvement and 3% inadequate for the well-led key question.

CQC also identified shortfalls in more than half of care home assessments that examined the governance, management and sustainability quality statement. This covers clear responsibilities, accountability and effective governance.

Feedback from inspectors and specialists highlighted leaders lacking the time and support needed to maintain oversight and drive improvement. Concerns also included leaders not listening to staff or acting on their feedback.

For owners and senior teams, this raises practical questions about management capacity. A registered manager may understand what needs to change but struggle to make progress while managing staffing gaps, incidents and daily operational demands.

Providers should consider whether managers have sufficient support, whether responsibilities are clear and whether unresolved concerns receive timely attention at the right level.

Workforce pressures extend beyond filling vacancies

The report notes that staff vacancy and turnover figures continue to fall, although both remain high. It also highlights concerns about workforce stability as international recruitment reduces.

In services rated inadequate for safe, CQC identified problems with recruitment processes and ensuring sufficient, safe staffing. These affected care delivery and staff wellbeing.

The findings reinforce the need to look beyond whether a shift has been covered. Providers also need to understand whether the team has the right experience, skills and support to meet the needs of the people receiving care.

Reviewing recruitment and retention together can help identify recurring pressures. Frequent departures, persistent vacancies or continued reliance on temporary cover may warrant closer examination of induction, supervision, working arrangements and management support.

Staff training needs to translate into competence

Staff training and qualifications are another concern within the report. CQC found that services rated inadequate for safe did not always ensure staff had the skills, knowledge or competence needed to meet people’s needs safely.

The report also recognises the barriers employers face when developing their workforce, including the cost of training and the time required.

For providers, a training record is one part of the picture. Oversight should also consider whether staff can apply their learning in practice, whether supervision identifies gaps and whether development keeps pace with residents’ changing needs.

This makes regular observation, competency checks and meaningful supervision valuable parts of quality assurance.

Financial sustainability remains uncertain

Despite recent increases in funding and provision, CQC describes the long-term sustainability of local authority-funded social care as uncertain.

The report also identifies a growing focus among providers on people funding their own care, potentially driven by financial pressures.

For care home owners, financial planning needs to remain closely connected to operational decisions. Staffing, occupancy, maintenance and investment in training all influence a service’s ability to deliver consistent care.

Considering these areas together can help leaders understand emerging pressures and assess the consequences of proposed changes.

A changing market brings new oversight demands

CQC describes consolidation within the care home market, with more available beds located in larger homes and increasing acquisition activity by institutional investors.

As portfolios grow, providers need management arrangements that maintain visibility across individual services.

Consistent reporting can help senior leaders compare performance, identify concerns and direct support. However, group-level information also needs to reflect what is happening within each home, including feedback from residents, relatives and staff.

Expansion creates a clear reason to review whether leadership capacity, governance and quality oversight are keeping pace.

What should providers take from the report?

The findings give providers a useful basis for reviewing their own arrangements:

• Do managers have enough time and support to lead improvements?
• Are concerns assigned to a responsible person and followed through?
• Does reporting show whether actions are improving care?
• Are recruitment, retention and staff competence reviewed together?
• Can owners see how financial and operational pressures affect each service?

Fulcrum Care supports providers with governance reviews, quality assurance, improvement planning and practical management support. An independent review can help identify where existing arrangements are working and where additional support would be useful.

If the report raises questions about your service, speak to Fulcrum about strengthening oversight and supporting your leadership team.