2009/10 was the last year in which services were regulated under the Care Standards Act 2000 and the Health and Social Care Act 2003. New laws governing the regulation of health care and adult social care in England came into force in 2010. This report by the Care Quality Commission (CQC) uses criteria and methods inherited from predecessor organisations and previous legislation and covers all of the services that CQC regulated and assessed under the previous legislation, ie. adult social care services (care homes, nursing homes and home care agencies); the NHS and independent health care services; and councils and primary care trusts (PCTs), which provide and purchase (commission) adult social care and health care services for their communities. The report has four main sections: safe care, choice and control, person-centred services, and standards of care.
Notable results include:
- There was a continuing rise in the numbers of private sector health services and in the proportion of private care services, and a continued reduction in the number of NHS beds and in-house care services provided by local councils. This has presented more options for people who fund their own care or treatment or where treatment is purchased by the NHS. However access to council-funded services has been reduced and the number of adults receiving a community care service fell by nearly 5% against the previous year despite rapid growth in the number of older people in the population likely to need support. This meant that proportionally fewer people benefited from the wider choices becoming available to people who still qualify for a service.
- The variable quality of inpatient mental health services continued to cause concern. Over-occupancy and inadequate staffing on wards and a lack of one-to-one work with patients were noted and the CQC Mental Health Act Commissioners sometimes had concerns about the level and indiscriminate nature of restrictions placed on patients. The CQC also note the over-representation of some black and ethnic minority groups in patients detained or subject to orders under the Mental Health Act.
- Safe care standards improved in relation to safe working practices, hygiene and infection control and protecting adults from abuse and neglect in hospitals, care home and home care services. Overall, performance in social care improved again, and so continued the trend of recent years. However, there was mixed progress in avoiding unnecessary hospital admissions and ensuring effective hospital discharge, with much variation between councils.