England’s health and social care watchdog is so far behind on inspections that most providers have either never been assessed or not received a quality rating for at least four years. The Care Quality Commission has failed to inspect or update ratings for nearly 70 per cent of residential care homes and 83.5 per cent of home care and other non-residential social care services and sites since 2022 or earlier, according to analysis by trade body the Homecare Association. It defines an out-of-date rating as one published four or more years ago.
The backlog calls into question Andy Burnham’s vow to fix a “broken” care system, experts said. The prime minister has promised to create a National Care Service, which aims to end decades of political wrangling over social care and provide personal care on “NHS principles”. Baroness Louise Casey, a Whitehall fixer, is drawing up a blueprint for the service, due next summer, after Burnham said if we “carry on like this . . . broken social care will break the NHS too”.
Martin Green, chief executive of Care England, which speaks for care home operators, said an “up-to-date regulator that inspires confidence” was “a foundational pillar of any national care system”, adding: “We don’t have that.” Jane Townson, chief executive of the Homecare Association, said some members had waited more than five years for a first CQC inspection and others over seven years for subsequent checks, leaving families without reliable safety data. By May this year, 36.9 per cent of community social care locations in England were unrated, while 46.6 per cent were last rated between four and 10 years ago, the analysis found. “There is little point promising a National Care Service without ensuring people can trust the quality and safety of the care they receive,” Townson said. While the rate of inspections is slightly higher for care homes than community care — which includes home care and support for learning disabilities or mental health needs — the number of community providers has grown rapidly as care homes have closed down.
According to healthcare analyst Laing Buisson, for-profit providers account for 85 per cent of older people’s care homes across the UK, with not-for-profit providers on 11 per cent, and councils and the NHS on 4 per cent. Julian Evans, head of healthcare at real estate group Knight Frank, said the dearth of assessments by the CQC was a “shocking state of affairs”, adding that problems had been exacerbated by a shift away from deploying specialist inspectors in fields such as mental health and elderly care. Set up in 2009, the CQC reports to the Department of Health and Social Care and has faced severe criticism in recent years.
In 2024, then health secretary Wes Streeting said the watchdog was “not fit for purpose” after a review by Penny Dash, chair of NHS England, identified “significant internal failings” and warned social care providers were waiting too long for their ratings to be updated. Last year, a separate review found the regulator had implemented a botched reorganisation, including the failed design and implementation of a new £100mn IT system. Despite the criticism, the CQC’s workload is set to grow.
Ministers said this month that it would gain oversight of the rapidly expanding private market for ADHD and autism assessments. Chris Badger, chief inspector of adult social care and integrated care at the CQC, said the regulator had made “strong progress” on its pledge to carry out more inspections and that it was now doing 75 per cent more assessments per month than in March last year. “However, we know that more needs to be done to provide an accurate and up-to-date picture of care quality, and this remains a key focus for us,” he added.
Source: Financial Times Companies · Summarized by HeadlinesBriefing