CQC State of Care 2025-26

The State of Care 2025-26, CQC's most recent oversight of the health and care sector is based on their inspection, assessment and registration activities alongside feedback from people who use services, their families and carers, as well as evidence from other regulatory activity and strategic projects.

With regard to ASC, the Report paints a mixed picture of health and social care in England with some encouraging improvements, particularly the stability of the adult social care workforce. However, rising demand, workforce challenges, inequalities and pressures on community services continue to create significant risks. Access to care remains the biggest issue and CQC describes this as one of the most persistent challenges across both health and social care.

Major concerns

Around 223,000 fewer adults receive long-term council-funded social care support than 20 years ago, despite growing demand
For around 70% of new requests for council-funded care, no ongoing support is provided beyond information and advice
The £23,250 social care means-test threshold has remained unchanged for 15 years meaning increasing numbers of people are falling into what we call the 'missing middle', those who are ineligible for funded-can't and can't afford to pay for all or some of their care
Concerns remain about the sustainability of local authority funding and wider care markets
Staffing shortages, training gaps and leadership weaknesses continue to affect quality. The area most often requiring improvement in social care services is "Well-led".

Hospital discharge

On any given day, almost 13,000 people remained in hospital despite being medically ready for discharge
Delayed discharges continue to be linked to shortages in community and social care provision
One in eight delays for people in hospital for more than 14 days was caused by delays transferring people between health and social care services

Adult social care workforce and delivery

More homecare hours are being delivered, enabling more people to be supported in their own homes
Care home provision is consolidating in larger chains, but an increasing fragmentation of home care services
Vacancy and turnover rates have improved but remain high
Reduced international recruitment is now a significant concern
Providers report that the cost and time required for training are major barriers to workforce development
Services rated inadequate frequently demonstrate weaknesses in recruitment, staffing levels, skills and competence

Inequalities

One of the strongest themes is that where people live increasingly influences the care they receive.

CQC found:

People in more deprived areas experience poorer access, longer waits and worse outcomes
Significant variation exists between Integrated Care Board (ICB) areas
Mental health needs are often greatest in the most deprived communities
Children in deprived communities experience substantially worse oral health outcomes
Health outcomes for people with severe mental illness, learning disabilities and some ethnic minority communities continue to lag behind national averages

CQC's overall conclusion is that there are "green shoots of recovery" across parts of health and social care, but rising demand, widening inequalities, workforce pressures and fragile funding arrangements mean improvements are not keeping pace with need. Adult social care remains essential to the functioning of the wider health system, yet access and sustainability challenges continue to threaten its ability to meet growing demand.

This report provides strong evidence for continued investment in social care workforce, prevention, community services and local authority funding, alongside a greater focus on leadership and partnership working across health and care systems.

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