State of Care is the annual health and social care assessment in England, reporting on industry trends, examples of good and outstanding care, and where care needs improvement.

The comprehensive audit looks at everything from the workforce to the quality of care within the industry. 

In this blog, we’ll be looking at how you can use the findings to improve your wider care offering…

CQC State of Care Health and Social Care Assessment

The health and social care assessment covered many bases, including:

• Access to care;
• Quality of Care;
• Inequalities;
• The health and care workforce;
• Deprivation of Liberty Safeguards;
• Systems.

Below, we’ve summarised the key findings to give you an overview of the 2023 health and social care assessment.

Access to Care

Access to healthcare in England remains a critical challenge, particularly for individuals with protected equality characteristics. 

With over 7 million individuals on elective care waiting lists in June 2023, the actual number could be higher due to referral issues. 

Community struggles for GP and dental appointments lead some to rely on urgent and emergency care or delay seeking help. 

Hospitals witness prolonged delays in care delivery, with more than half of respondents (51%) reporting waiting over an hour for examination in 2022, up from 28% in 2020.

Insufficient capacity in adult social care contributes to hospital discharge delays, while staffing and financial pressures compromise the quality of care, putting some at risk of unmet healthcare needs.

Quality of Care

The quality of care is influenced by numerous factors. Mounting demand and staff pressures have adverse effects on their mental health and, consequently, care quality. 

Deep-seated inequalities affect individuals from ethnic minority groups, and mental health services face persistent difficulties in staff recruitment and retention. 

Artificial intelligence (AI) offers promising innovations, but should be deployed cautiously to prevent exacerbating existing disparities in healthcare.

Inequalities

The 2022 State of Care report highlighted the persistent prevalence of inequalities in healthcare. 

This year, it’s placed a spotlight on individuals who’re disproportionately affected by disparities in healthcare access and experiences. 

Systemic failures and insufficient funding often lead to budget prioritisation over genuine person-centred approaches in supported living services.

The Health and Care Workforce

Healthcare staff frequently report severe overwork, exhaustion, and stress, often to the point of illness, injury, or quitting their jobs, which subsequently hampers their capacity to deliver safe and effective care.

Only 26% of NHS employees expressed satisfaction with their pay, a 12% drop since the pre-pandemic period, with pay dissatisfaction linked to healthcare staff industrial actions in 2023. 

In adult social care, some providers struggle to offer salaries in line with inflation. 

Over half of survey respondents from adult social care providers in England cited challenges in recruiting new staff, while 31% faced difficulties retaining them. 

Notably, staff vacancy rates in care homes decreased from 11% in January-March 2022 to 7% in April-June 2023. Additionally, the independent adult social care sector has seen a significant increase in overseas recruits, with around 70,000 individuals commencing direct care roles in 2022/23 compared to approximately 20,000 in 2021/22. 

Providers acknowledge the diverse skills these overseas staff bring, aiding in resolving staffing issues. 

However, this positive trend is countered by a surge in unethical international recruitment practices, prompting a quadrupling of concerns regarding modern slavery, labour exploitation, and international visas, reaching 37 referrals in 2022/23 compared to the previous year.

Deprivation of Liberty Safeguards

The Deprivation of Liberty Safeguards (DoLS) system faces persistent issues, leaving numerous vulnerable individuals without legal protection for extended periods. 

In 2022/23, the number of applications for depriving a person of their liberty exceeded 300,000, with only 19% of standard applications processed within the mandated 21-day timeframe. 

Delays in the introduction of the Liberty Protection Safeguards suggest that these challenges are likely to continue

Systems

Over the past year, significant changes have occurred in the functioning of health and social care in England, marked by the formalisation of new integrated care systems. 

Local systems are now tasked with implementing plans to mitigate unwarranted disparities in population health and inequities in people’s access, outcomes, and encounters with health and social care. 

Local authorities are actively addressing workforce challenges in adult social care and striving to bridge gaps in care as they chart the course for the future. However, they must demonstrate an understanding and readiness to navigate the evolving and intricate needs of local populations. 

Recognising and addressing carers’ requirements is imperative, as unpaid carers play a pivotal role in local care systems, and many are grappling with financial issues. 

The effectiveness of urgent and emergency care services serves as a barometer for the coordinated functioning of health and care services within local systems. 

Nevertheless, individuals continue to experience deficiencies in urgent and emergency care, signalling the need for responses at the local system level.

You can read the full assessment here.

Using the Findings to Help Your Business

Incorporating the insights from the CQC’s ‘State of Care’ Health and Social Care Assessment into your care home can be a vital step towards enhancing your care offerings. 

Addressing the access to care issue entails proactive measures to ensure prompt and equitable access to healthcare for all residents. Prioritising person-centred care in supported living services fosters a more inclusive environment. 

Streamlining appointment booking processes and facilitating referrals can mitigate waiting times, and reduce the reliance on urgent and emergency care. 

For quality of care, focusing on staff wellbeing, training, and support is crucial to maintaining high care standards. Initiatives promoting diversity and cultural competence can combat inequalities, ensuring that all residents receive individualised care. 

Additionally, in addressing workforce challenges, implementing fair pay structures and providing support to staff is paramount. 

Effective recruitment and retention strategies should be developed, and the diverse skills brought by overseas recruits should be harnessed while upholding ethical recruitment practices. 

Recognising a carers’ essential role and offering them adequate support is vital, potentially reducing financial challenges they face. 

Lastly, improving urgent and emergency care services can significantly enhance the care coordination within local systems, contributing to a seamless healthcare experience. 

As a care home owner/manager, you can draw on the report’s findings to create a more inclusive, well-supported, and efficient care environment.

Health and Social Care Assessment: How Can Fulcrum Support You?

If you think your care home needs support in rectifying any areas where it may be falling short, or would like peace of mind that you’re providing high-quality care, we can help. 

At Fulcrum, we offer comprehensive audits, or ‘mock inspections’, that allow us to deep dive into the inner workings of your home, gaining insight into where you’re doing well, and where you need to improve. 

We can look at everything from care records to cleanliness, helping you achieve a CQC rating you can be proud of. 

Following a consultation, we can guide you through the process to ensure:

• Your residents are living healthy, happy and fulfilling lives;
• Your home is clean, secure and accessible;
• Your staff feel appreciated, and are happy, well-compensated, and equipped to provide excellent care;
• Your technology, systems and reporting is streamlined, efficient, and effective;
• You’re providing exceptional, person-centred, and dignified care.

To find out more about how we can help you, please contact a member of our Fulcrum Care team. 

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