6 key summary points from the CQC's State of Care Report 2015/16

#Guidance & Reports
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The CQC's 2015/16 'State of Care' report

Earlier this month, the Care Quality Commission (CQC) revealed its annual 'State of Care' report. The report delves into all the data the CQC has gathered in 2015/16 from inspections of over 21,000 health and social care units in England.

The report is a 145-page document containing statistics, case studies, commentary and insights that give an extremely comprehensive analysis of the state of care in England.

Visit the State of Care section on the CQC website

In this post, I summarise the report in 6 key points and outline what the State of Care 2015/16 report reveals about health and social care in England:

1. The majority of care providers are providing good quality care despite a challenging environment

Both health and social care services are largely found to be delivering good or outstanding care when inspected. This is encouraging considering the increased pressures of demand and costs experienced across health and social care throughout 2015 and 2016.

During this period of, as the CQC puts it, 'unprecedented challenges', delivering high-quality care whilst managing costs and budgets effectively is more important and more challenging than ever. The majority of providers in England's care system are managing to do this:

  • Adult social care services: 71% rated good and 1% outstanding
  • Core services provided by NHS acute hospital trusts: 51% rated good and 5% outstanding
  • GP practices: 83% rated good and 4% outstanding
Adult social care current overall ratings, as at 31 July 2016
Adult social care current overall ratings, as at 31 July 2016

2. Of the services that were inadequate and required improvement, a significant amount have made advances

Back in May, Sarah published a post on this blog that celebrated the fact that more than 12,000 people in England's care homes were receiving better care than at the same point two years before. You can see the post here: Three cheers for England's improving care homes. The CQC's State of Care report also reveals significant improvements in levels of care across all sectors.

Of the 596 homes that were previously inadequate, more than three-quarters improved their rating in 2015/16, and almost a quarter improved so much they were rated as providing 'good' levels of care.

However, the CQC does mention in its report that it is starting to see more services failing to improve. Of the 2000+ providers that were rated as 'requires improvement', less than half actually did improve their ratings. Again, financial and increased demand pressures were cited as a likely reason. 47% of providers stagnated, 8% of providers actually declined in their levels of care and were rated as 'inadequate'. The chart below is a great way to visually digest the rating changes for providers rated as 'requires improvement' or 'inadequate'.

Change in rating on re-inspection across all sectors, where initial rating was inadequate or requires improvement, as at 31 July 2016
Change in rating on re-inspection across all sectors, where initial rating was inadequate or requires improvement, as at 31 July 2016

The CQC states that,

Strong, visible leadership continues to be a major factor in delivering and sustaining high quality services, and in making improvements. The best providers often had a stronger drive to improve, were focused on how to make services better for people, and were committed to collaborating with others to achieve this.

3. Public opinion of services is largely positive

On the whole, people's views of health and social care are positive. Of people who spoke with the CQC:

  • 74% agreed that local NHS services were good in the main
  • 62% receiving adult social care services funded by their local authority were either extremely or very satisfied with the care and support they received

However, the CQC does mention that the quality of care varies considerably, both within and between different services. It was typically apparent where people from different backgrounds and with different needs were receiving variable quality of care

4. Adult social care services have been able to maintain good quality care

Despite increasing pressures, almost three-quarters of adult social care services such as care homes and home care agencies are providing good quality care. Also, as mentioned in point 2 above, many services have been able to show improvements in their quality of care. This is particularly notable considering nursing bed growth has stagnated recently, despite demand growing ever stronger.

The graph below indicates that the smaller social care providers are managing to deliver good quality care the most effectively. Yet, it tends to be these smaller providers that are struggling to cope with the current demand and financial pressures. In the report, the CQC does raise concerns over the sustainability of maintaining the current good quality of care (see point 6).

Current overall ratings by size and type of service, as at 31 July 2016
Current overall ratings by size and type of service, as at 31 July 2016

5. Hospitals are under increasing pressure

Demand for our health care services is at an unprecedented level. In the early part of this year, hospital bed occupancy rates hit 91%, the highest quarterly rate for more than six years. Bed-blocking has been a real hot topic this year, causing great concern for the Government and NHS trusts. Despite this, more than half of NHS acute core services were rated as 'good' or 'outstanding' by the CQC.

The increase in demand for NHS services is not being met with an increase in funding. Many point to this as a reason why some trusts are failing to provide good quality care, and the CQC's analysis does show that better ratings are associated with a better median year-end financial position. However, the CQC report also highlights that the good and outstanding NHS trusts are well-led and are finding out of the ordinary ways to effectively manage budgets and cope with demand.

This suggests that whilst the financial state of the NHS needs to be addressed by the Government, there is plenty of room for improvement and there are trusts demonstrating that good and outstanding care is achievable despite significant pressures.

6. The CQC raises concerns around the sustainability of continuing to deliver quality care...and offers some suggestions

The CQC acknowledges that maintaining good levels of quality care is going to be challenging for all care providers while demand and financial pressure continue to increase. Everyone is facing similar pressures across health and social care, and the CQC is keen to see all parts of local health and care systems working together to help transform care in local areas. The providers that are overcoming current pressures are the providers that are trying new models of delivering care, and it is clear that other providers will need to do the same to cope with pressures.

An excellent example of collaboration between local care services and finding new ways to improve care is the Red Bag initiative. Learn more about the initiative in one of our earlier blog posts:

The Red Bag: A ‘brilliantly simple’ initiative making a ‘big difference’

Plenty of positives and plenty to learn

The State of Care report 2015/16 highlights the many positives in England's care system. It also provides us with a lot to take away and implement in our own care services. Perhaps the biggest gleaning from this year's report is how providers are having to find more and different ways to cope with increased pressures than ever before.

These pressures are unlikely to go away soon and it is vital that health and social care services learn from each other and work together to find new ways to deliver good and outstanding levels of care. In a world of change, the care sector is right in there, and by joining forces and innovating, we will continue to improve.

Download the CQC's 2015/16 State of Care report

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