Care England responds as government regulator confirms “postcode lottery” in social care and local authorities report £715mn overspend

Care England, the largest and most diverse representative of adult social care providers in England, has responded to ADASS’ spring survey and the CQC’s report on emerging themes from its first wave of assessments of local authorities regarding their statutory duties to commission care and support. ADASS’s spring survey found a reported overspend of £715m as NHS CHC eligibility changes force those with more complex needs to be funded by local authorities, The CQC’s report found that over a third of local authorities in England were rated either as “requires improvement” or “inadequate”, and that over three quarters of them were rated as such when it came to assessing the needs of those either requiring care or their unpaid carers due to consistent delays and a lack of regular reviews.

Professor Martin Green OBE, Chief Executive of Care England, said:

“The findings of these reports will come as no surprise to anyone experiencing publicly funded care in this country. When commissioners are forced to constantly worry about who is paying and how much, it’s the people who they are required to support that are missing out. From unpaid carers left unsupported or seeing the support programmes in their areas cut, to care providers and local authorities constantly having to fight for the funding to deliver or commission care safely and to a high standard, this report only adds to countless warning signs showing the social care sector is in crisis.”

The CQC’s report also uncovered widespread failings in understanding the role of prevention, along with weaknesses in safeguarding processes and transitioning residents from children’s to adult services.

Commissioning practices were further found to vary significantly between local authorities, where inconsistent fee-setting, a failure to account for mounting workforce pressures in fee-setting, poor engagement with providers, and leadership culture were identified as contributing factors to varying quality. It was further noted that financial or political considerations often shaped strict thresholds on access to support in some places rather than purely the assessed needs of the individual. This approach was linked to higher unmet need, and this further diminished some councils’ understanding of the level of need in their areas.

CQC noted positive examples of commissioning, for example those personalised to individuals with diverse sexual orientations or cultural or religious backgrounds, along with commissioning that prioritised workforce development and prevention, particularly in coastal areas.

Professor Martin Green continued:

“This report isn’t simply an indicator of things going wrong. It does positively provide examples of what good commissioning looks like, and we hope that local authorities will take these examples more seriously when they come from the regulator, and not just the care providers, where I also note the CQC identified poor engagement with providers as a contributing factor to poor commissioning too.

I think the pictures it paints of truly personalised care, commissioned to meet the needs of individuals, not to balance books or competing priorities, should inspire local authorities that better is possible, even within current constraints. I know that Care England and care providers continue to be ready to support councils to improve in these areas, and I encourage them to speak to those providing these vital services to better understand what’s needed to support people who need it most.”