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Enormous variation in social care quality reinforces need for urgent funding review

Huge disparity has been revealed in the quality of care homes across the country by a new Independent Age report that looked into the number of providers that had been rated poorly in inspections.

The study looked into the proportion of care homes that were performing badly (receiving ratings of ‘required improvement’ or ‘inadequate’ from the CQC) in March, and found that the north west was the worst-performing region. After that, Yorkshire & the Humber and the south east were also poor performers.

Seven of the eight worst-performing English local authorities for care home quality were located in the north west, as a third of care homes were found to not be up to scratch.

In contrast, the best-performing regions were located in London, the east of England and the south west.

At a local level the variation was even more stark, as more than half of the care homes in five authority areas – Stockport, Salford, Tameside, Manchester and Kensington and Chelsea – were found to be performing badly.

In the north west town of Bury, for example, one in eight homes were poor performers, whereas in the neighbouring town of Salford a huge three out of five homes were rated ‘inadequate’ or ‘requires improvement’.

This demonstrates an unacceptable disparity between the quality of care across the country, argued Simon Bottery, director of policy at Independent Age, adding: “No one should be forced to live in an unsatisfactory care home but our analysis shows this is the grim reality in some parts of the country.”

Bottery claimed that the market was not providing a decent choice for older people and their families, and there was little indication that local authorities or the government were doing enough to address the problem.

“Money is likely to be one cause but not the only one. The government has an opportunity to address this in its upcoming Green Paper on social care but, in the meantime, councils must demonstrate that they understand the reasons for care home failures and are working to resolve them,” he said.

Vice chair of the LGA’s Community Wellbeing Board, Cllr Linda Thomas, agreed that the results were concerning and something that councils take very seriously.

But she also emphasised that it was important to note many care homes in England were still performing to a high standard.

“The CQC’s most recent state of care report found that across the country more than 70% of social care services are rated good or outstanding and only 2% as inadequate,” said Cllr Thomas.

She also noted that 40% of care homes were not commissioned by councils and not all care homes had contracts with local authorities.

“The fees councils pay, the contracts they manage and the support offered, all contribute to performance levels,” explained Cllr Thomas.

“But crucially, it is the way in which services are run by providers that is the most critical factor in ensuring a high quality of care. The findings of this report further reinforces the need for an urgent review of how adult social care is funded, if we are to tackle the serious threats to social care provision, including any variation in care home quality.”

And Margaret Willcox, president elect of the Association of Directors of Adult Social Services, added that people and their families deserved better standards of care – but agreed that a good number of homes were still performing up to the required standard.

“However, the CQC raised concerns that the sustainability of the adult social care market is approaching a tipping point,” she warned. “Despite councils working hard with providers and the sector to maintain and improve the quality of care provided, the chronic and historic underfunding of social care has severely impacted on their ability to do so.”

Willcox pointed to reductions in funding, increased demand due to people living longer and with more complex needs, and the cost of the National Living Wage as elements that were putting huge pressure on councils and providers – all of which are finding it hard to recruit and retain staff, especially in the home care sector.

“The £2bn for adult social care for the next three years will help plug the funding gap for adult social but this is only a short-term measure,” she continued.

“Adult social care needs to be a national priority. The forthcoming social care Green Paper provides a critical opportunity to future-proof adult social care and improve quality, and we look forward to working with the sector to help the government achieve this vital goal for the benefit of society as a whole.”


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