2021 CQC State of Care report

In October CQC published its annual report regarding the State of Care being provided in England. In comparison to last year’s report, they had been better able to assess the impact of the covid pandemic on the health and social care sectors.

State of Care is our annual assessment of health care and social care in England. The report looks at the trends, shares examples of good and outstanding care, and highlights where care needs to improve.

Coronavirus impact 

Apart from the obvious impact of the coronavirus on subjects such as the increase in hospital waiting lists and a reluctance for families to place their elderly relatives in care homes, it also talked about the impact it has had on people’s mental health. The health and social care staff who have continued to work all the way through the last year and a half are exhausted and facing burnout. It warns about what may happen should the country face a difficult winter coping with the various challenges that will be thrown at it. 

One of the graphs in the report shows the difference in occupancy in care homes compared to pre pandemic figures.

Figure: Non-specialist care home financial occupancy, England, January 2020 to March 2021 compared with 2019 average. Source: CQC Market Oversight data. Note: figures for 2020/2021 are average occupancy ratesper quarter. Y axis has been truncated and does nor start as 0.  (CareQuality Commission:The state of health care and adult social care in England 2020/21 page 40)

Staff vacancies

The increase in staff vacancies is also highlighted and the report calls for urgent action to tackle staffing pressures and the stresses caused by staff shortages, and the long-term impact of emotional exhaustion of staff. Monthly data from information submitted to CQC by providers of residential care show their staff vacancy rate rising steadily from 6.0% in April 2021 to 10.2% in September 2021. Skills for Care has also estimated that turnover rates across adult social care remained high in 2020/21, at 28.5% overall. For registered nurses, the rate was higher at 38.2%; this compared with 8.8% for equivalent roles in the NHS.

When looking at the ratings that had been awarded to agencies during inspections by service type the number of ratings had improved, based on previous year’s figures 

Domiciliary Care ratings

According to the report, 5% of domiciliary care services are now rated as Outstanding compared to 4% in 2019 and only 1% in 2016. The number of services rated good is now 83% compared to 80% in 2019 and only 59% in 2015.

Source: CQC Ratings data, 31 July 2021. Note: percentages may not add to 100 to rounding. The 2021 ratings also included 2 insufficient evidence to rate´overall ratings for nuirsing homes, which represented 0,05% of the total ratings (including insufficient evidence to rate´). Numbers in brackets denotes the number of rated locations as at July 2021. ( CareQuality Commission:The state of health care and adult social care in England 2020/21 page 77)

Technology and integration

Towards the end of the report, it talks about things that could be improved and how this could be done. Integrated care systems, bringing together commissioners and providers of health and social care services with local authorities and other partners, intend to offer a more strategic outcomes-based approach to care. The pandemic has sped up some of this collaboration, strengthened relationships between system partners, and provided the opportunity for peer support and the sharing of resources.


CareQuality CommissionThe state of health care and adult social care in England 2020/21
Pages 4, 9, 40, 42, 66, 77

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