This is a summary of the report to Parliament describing the state of health care and adult social care services in England in 2011/12. CQC has drawn on evidence from its register of care providers, its inspections, the experiences of people who use services, and national statistics. It also includes findings from CQC’s themed inspection programmes, which examine concerns that CQC has about the way certain sectors or types of service operate. In 2011/12, CQC looked at dignity and nutrition for older people in NHS acute hospitals, and services for people with learning disabilities. Overall CQC is finding that the increasing complexity of conditions and greater co-morbidities experienced by people are impacting on the ability of care providers to deliver person-centred care that meets individuals’ needs. It is also seeing increasing pressures on staff, both in terms of the skills required to care for people with more complex conditions and in terms of staff numbers.