Question to the Department of Health and Social Care:

To ask Her Majesty’s Government when the Care Quality Commission carried out its last risk assessment of the adult social care market; what were its findings, and how many (1) residential care homes, and (2) nursing homes, were involved in that assessment.

The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England.

The CQC reviews the state of care in all sectors it regulates and publishes its State of Care report annually. The CQC published this report in October 2016 and this report provides the most comprehensive view yet of what the CQC’s expert-led inspections have found. The report includes analysis of information up to 31 July 2016; at that point the CQC had inspected and rated more than 16,000 adult social care services, including, 9,100 residential homes and 3,649 nursing homes. A copy of the CQC’s The state of health care and adult social care in England Care Report 2015/16 is attached.

Despite challenging conditions, adult social care services have so far been able to maintain quality. The CQC observed that 71% received a ‘Good’ rating overall and 1% were rated as ‘Outstanding’. 26% of services were rated as ‘Requires Improvement’ and 2% of services were rated ‘Inadequate’. This figure was much lower than last year’s figure of 7% of services rated ‘Inadequate’. Three-quarters of those that we had rated as ‘Inadequate’, and then re-inspected, improved, but a quarter of services originally rated ‘Inadequate’ did not improve enough to change their overall rating on re-inspection.

Since the publication of the 2016 State of Care report, the CQC has completed its comprehensive programme of inspecting all adult social care services locations in England that were registered before 1 October 2014. The CQC plans to publish more detailed analysis of these findings in Summer 2017.

The CQC also monitors through its Market Oversight scheme the financial sustainability of those care organisations that local authorities would find difficult to replace should they fail and become unable to carry on delivering a service. Where the CQC identify significant risks to the sustainability of a provider’s business, they can respond by taking steps, including requiring a risk mitigation plan or an independent review of the business. Over the last five to six years, residential capacity has remained broadly stable in terms of beds.

The Care Act 2014 placed duties on local authorities making them responsible for ensuring there is an effective pool of quality providers of social care in their area with capacity to meet the needs of their local population. The Department is working with CQC to monitor care home capacity. Although there are inevitable entries and exits from the care market, we have not seen a significant decline in the numbers of care home beds. We have also empowered the CQC to monitor the finances of large and difficult to replace care providers. The Care Act 2014 gave local authorities duties to step in and make sure people continue to receive care were their care provider to fail financially and services stop.

It is up to local authorities how they spend the extra money coming into the system but we would expect the additional resources to help them commission services that are sustainable, diverse and offer sufficient high quality care and support for people in their areas.