The adult social care sector is under pressure and there are issues around the sustainability of provision, due to the increasing complexity of people’s care needs, significant cuts to local authority budgets, increasing costs, high vacancy rates, and pressure from local commissioners to keep fees as low as possible. Despite this pressure, inspections to 31 May 2015 showed that almost 60% of services were providing good or outstanding care. I t is concerning, however, that up to that date 7% of services were rated inadequate. Safety is the biggest concern: of those  inspected, a third required improvement for safety and 10% were rated inadequate for safety. In these services, contributory factors were staffing levels, understanding and reporting safeguarding concerns, and poor medicines management.