Relatives & Residents Association

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Adult Social Care at tipping point

12¸October 2016:  This year’s State of Care report by the CQC uses a vivid mental image for the current state of adult social care in this country, describing the present “market” in provision as fragile and the sustainability of even present levels of care as in doubt.

The Report confirms the picture of care homes (with nursing) that callers to our helpline tell us about. The report says ‘it is nursing homes that remain the biggest concern’ with 37% requiring improvement and 4% rated as inadequate.

Most nursing home residents are elderly, frail people who are unable to move elsewhere if they find themselves in a poor home that fails to improve.

Worryingly the Report states that almost half of services rated as ‘requiring improvement’ had not improved at their re-inspection, with 8% deteriorating further to ‘inadequate’.

The key paragraph of the Chairman’s foreword sets out the impact of present policies very clearly. Its warning will be no surprise to R&RA members, and has already been picked up and quoted by the Health Select Committee in their letter to the Chancellor last week – (see In The News, 26 October):

imageThe fragility of the adult social care market and the pressure on primary care services are now beginning to impact both on the people who rely on these services and on the performance of secondary care.

The evidence suggests we may be approaching a tipping point. The combination of a growing and ageing population, people with more long-term conditions and a challenging economic climate means greater demand on services and more problems for people in accessing care.

This is translating to increased A&E attendances, emergency admissions and delays to people leaving hospital, which in turn is affecting the ability of a growing number of trusts to meet their performance and financial targets.image

The CQC report underlines this. It records that while adult social care services had broadly been able to maintain quality so far and many had provided good quality care (71% rated good), there were already grounds for concern.  Of services already rated inadequate, nearly a quarter when reinspected had not improved at all; and of those already found to require improvement, half showed none at all and 8% had worsened to “inadequate”.  The number of nursing home beds for people with greater care needs had stopped rising while demand was still growing, and large providers were starting to hand back home care contracts as “uneconomic and undeliverable”.

 

 


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