State of Care 2025
Last Friday the Care Quality Commission’s annual State of Care report was published, summarising the year in health and social care in England.
We attended the launch event of the report, where we heard from the chief inspectors and leaders at the CQC about what comes next for health and care. In roundtable discussions, we advocated for consideration of how these facts and figures affect people receiving care on the ground, and urged the regulator to adapt how it inspects and rates providers based on the current state of the sector. With solutions to the complex challenges that adult social care faces potentially years down the line, regulation must protect people under the existing broken system.
The report addressed key themes in adult social care that are relevant to recent or upcoming policy changes, which we have summarised below.
Key statistics
New requests for care up 4% on last year.
Vacancy rates in homecare are double that of care homes (10%) .
32% of 130 adult social care workers had experienced or witnessed race or ethnicity-based discrimination at work .
Adult social care workers are twice as likely to be in poverty than the average worker.
The number of homecare services registered with the CQC increased by 11% in the last year.
84% of care home rooms are occupied, compared to 78% in 2021/22.
Key points for adult social care and older people
Care homes for older people with a higher proportion of residents receiving local authority-funded care have higher occupancy levels compared with care homes that have more self-funded residents. With continued rising costs, local authorities may not only have less funding to provide social care, but also fewer care home spaces available to them. This could leave a reduced range of options for people whose care is funded by a local authority.
Providers of care homes for older people in the scheme have said that services in some regions have relied heavily on staff recruited from overseas to reduce their staff vacancy rate and reliance on agency staff. If overseas staff leave and cannot be replaced, workforce pressures will limit the delivery of care and have wide-reaching impacts for the sector.
The number of homecare services registered with the CQC increased by 11% in the last year. The number of homecare hours delivered between January and March 2025 was 5% higher than in the same period in 2024, reflecting the policy shift in local authorities too commission more community services to support more people to stay in their homes for longer. Most authorities are aiming to commission more community services for this reason.
As reported in the CQC’s dementia care report earlier this year, inspections over the past year have found poor support for people living with dementia. Staff have a poor understanding of the specific needs of people with dementia, and providers and staff do not always have the knowledge of person-centred approaches and dementia-friendly environments, which could affect people’s safety. Read our response to the dementia report here.
There are ongoing concerns about Deprivation of Liberty Safeguards (DoLS) being appropriately applied. Applications have increased significantly over the last decade, far beyond the levels expected when the safeguards were designed. This puts pressures on LAs who must authorise applications, and often results in lengthy delays in processing applications. Get support with DoLS here.