Leading health and social care organisations respond to CQC State of Care 2020-21 report

Influential organisations, including Age UK, Royal College of Occupational Therapists (RCOT), and Healthwatch, have weighed in on the Care Quality Commission’s (CQC’s) latest State of Care report.

Published annually, the State of Care report looks at the quality of care over the past year and makes recommendations to the UK Government as to how care can be improved.

From this year’s findings, CQC particularly emphasises the need for new models of care to be introduced to ensure people get the care they need. It also highlights that the adult social care workforce is particularly facing staffing pressures and says that recent government funding initiatives needs to be used to enable new ways of working that recognise the interdependency of all health and care settings.

In addition, the regulator suggests that longer-term funding needs to be committed to the hospital discharge process to ensure people can leave hospital in a timely manner and free up NHS resources to treat emergency patients.

Responding to this year’s report, Caroline Abrahams, Charity Director at Age UK, welcomed CQC’s suggestions stabilise the social care sector, but highlighted that urgent funding is needed in the Spending Review 2021.

She said: “This report shouts out the clearest possible warning that the basic foundations of social care – the workforce and funding – are now looking so rocky that urgent Government action is required on both to keep the system viable.

“Care workers need better reasons to stay in the job when retail and hospitality now offer much more attractive pay and conditions, and councils need a funding package from the Chancellor’s Spending Review that enables them to build more care capacity in their localities over the next few years, not further reduce it, as is currently on the cards, given their alarming budget shortfalls.”

One of the consequences of an understaffed and overstretched social care sector, Caroline highlighted, is that older people are unable to leave hospital when they medically fit to be discharged as there are no care options to support them when they get home.

Caroline continued: “We support the CQC’s recommendations to bring more stability to the social care system, especially their focus on the importance of professionalising the care workforce, with registration one of a number of measures required to give our talented care staff a proper career framework and terms and conditions commensurate with the skills needed to do the job.”

Ultimately, however, she warned that social care is in “serious trouble” and that all eyes are on the chancellor to see if he delivers a ‘much-needed’ cash injection at the Spending Review 2021.

Also responding to CQC’s findings, Royal College of Occupational Therapists (RCOT) Chief Executive Steve Ford underlined the profound impact on patient care due to care home closures and “unprecedented” social care staffing pressures.

He detailed: “The findings of this report provide us with a deeply concerning insight into the impact the pandemic has had across Social Care, which was already grappling with tens of thousands of vacancies and poor pay and working conditions prior to COVID-19.

“Patient care is being impacted due to unprecedented pressure with many care homes being forced to close as they cannot recruit or retain staff. Occupational therapists deal with well over 40% of local authority social care referrals across the UK and are seeing the impact of a depleted and exhausted workforce that has little optimism for the winter pressures ahead.

“The announcement of £162.5m by the government to boost the adult social care workforce is welcome, but another sticking plaster of support with a lack of long-term thinking is again impacting the future of care. The government must listen and produce a social care workforce plan to protect and invest in the future, so that care staff have parity of esteem in pay and conditions with their NHS colleagues.”

The Care Workers’ Charity has welcomed some of the suggestions made by the CQC in its recent State of Care report.

It commented: “We are glad to see sufficient recognition of the immense mental pressure placed upon the social care workforce, with the report highlighting the desperate need for mental health and wellbeing support for social care workers who are “exhausted and depleted”. That these burnout levels are noted as being linked to increased sickness levels, as well as higher staff turnover rates demonstrates the devastating and long term impact that this trauma has had, and continues to inflict, on our social care teams.

“As rightly stated in the report, “They cannot work any harder- they need support…”. We echo the frustrations that there continues to be an absence of a people plan for social care—and continue to call on the Government to urgently action this.”

However, the charity has expressed concerns over parts of the report, stating that parity of esteem between the health and social care sectors needs to be achieved.

“Integration of health and social care systems is once again noted as being beneficial, and something to strive towards- but we believe that before this can happen we must achieve parity of esteem between the two sectors.

“The current lack of parity was indicated in State of Care, which found that adult social care providers were rarely included in planning and decision making. Experiences cited by the report included those revolving around the discharge of health care patients into adult social care services, which we know had a devastating impact on care home settings as patients with COVID-19 were discharged from hospital at the beginning of the pandemic.

“We do feel that this lack of parity of esteem is an issue that could have been more thoroughly explored given that the report is in a unique position reporting on both health and social care sectors.”

Cathie Williams, Association of Directors of Adult Social Services (ADASS) Chief Executive, added that while the UK Government announcement of short-term workforce funding is welcome, it does not go far enough and is “very late in the day”.

She remarked: “The government’s announcement of a further short-term injection of funding for workforce is welcome but a small proportion of what is needed and very late in the day given the worsening recruitment and retention situation.

“One-off Covid funding has ensured the short-term, but not the long-term viability of struggling providers. Little has been done to reward and retain the dedicated and compassionate people working in social care.  Too many people are missing out on vital care and support.

“We look forward to the Spending Review and to the consultation documents which the government promises will address the short and longer term challenges and enable those of us who are older or disabled and who are carers to live the lives we want to live. Without further action, a bleak winter lies ahead.”

Sir Robert Francis QC, Chair of Healthwatch England, urged the government to act on the recommendations in CQC’s report: “The steps the CQC are recommending, like extending the extra funding to help people leave hospital safely and ensuring there is enough dental capacity, will help give services the breathing space they need to get through this winter.

“However, come spring we need to grasp the opportunity to build a better NHS and social care system. A system that tackles heath inequalities head-on, ensuring that no matter who you are or where you live, you can access high-quality care that meets your needs. A system that is sustainable, is designed round the needs of people and breaks perennial cycle of winter crises.”