Media Releases
23 Oct 2026
by Dr Jane Townson

CQC's State of Care report confirms homecare is being reshaped by accident, not design

The Homecare Association welcomes the Care Quality Commission (CQC)'s State of Care 2025/26 report. It recognises good or outstanding care in eight out of ten homecare services assessed under its current framework, while warning that weak commissioning, fragile funding and workforce pressures threaten sustainability and access to support.

The CQC warns that the social care market is being reshaped largely by accident rather than by design. It identifies commissioning as one of the most powerful levers for improving quality, equity and sustainability, but finds significant variation across England.

The regulator draws on our Homecare Deficit 2025 research as evidence that commissioning practices leave homecare capacity unused and push providers away from state-funded care. Our new report, Fee Rates for State-Funded Homecare in 2026-27, shows councils in England pay an average of just £25.37 per hour for homecare, leaving a funding gap of around £2.3 billion.

Dr Jane Townson OBE, Chief Executive of the Homecare Association, said:

“Homecare workers are delivering good or outstanding care in eight out of ten services the CQC has assessed, often in very difficult circumstances. That is a credit to them. However, the CQC is right to warn that the social care market is being reshaped by accident rather than by design.

“We are pleased the CQC has drawn on our research. Our evidence shows most councils buy an average of 500 hours of care or fewer a week from each provider - a third of the 1,500 hours a service needs to run efficiently.

"Care packages are spread thinly, capacity sits idle and providers are pushed towards people who pay for their own care simply to stay viable. Meanwhile, people with assessed needs wait for support and older people remain in hospital when they are ready to go home.

“Councils in England now pay an average of £25.37 an hour for homecare - £9.05 below our Minimum Price of £34.42, the lowest rate needed to pay care workers the National Living Wage and run a safe, regulated service. Not a single contract in our latest research met that Minimum Price.”

Key messages

  • Good care deserves recognition, alongside stronger quality assurance. Of the 2,121 homecare services assessed under the CQC’s current framework by August 2026, 80% were rated good or outstanding. The CQC cautions that its largely risk-based assessment sample may not represent the whole sector. Our Unseen & Unrated analysis found that, at 5 May 2026, 83.5% of community social care locations had either never been rated or held a rating at least four years old. We welcome the CQC’s recent progress, but assessment activity in January to April 2026 was still only around a quarter of the rate needed to maintain a three-year cycle.

  • Leadership makes the difference. The CQC identifies leadership as the area most in need of improvement. Our analysis of 1,052 CQC homecare inspection reports found visible, accessible leadership is the factor that most distinguishes outstanding services.

  • Commissioning is not keeping pace. The CQC reports that homecare services have grown by 42% since 2019, while commissioning was among the lowest-scoring areas in its local authority assessments. It finds that inconsistent fee-setting, insufficient attention to workforce pressures and weak provider engagement constrain quality and sustainability. Our discussion paper, Homecare: commissioning is the key to quality, fair work and better outcomes, illustrates how, in a modelled example, geographic zoning and fewer providers could enable the same visits to be delivered by 35% fewer careworkers, with 65% less mileage - releasing scarce workforce capacity and reducing travel.

  • Fees fall far short of the cost of care. Our latest research finds an average council fee in England of £25.37 per hour for 2026/27, 26% below our Minimum Price of £34.42. Three in five contracts examined (61%) pay less than £26.17, our modelled direct cost of employing a careworker at the National Living Wage, before other operating costs. Average fee uplifts of 3.7% fell short of the 4.1% increase in the National Living Wage.

  • A £2.3 billion funding gap undermines sustainability. We estimate that around £2.3 billion more is needed annually across council- and NHS-funded homecare in England to cover National Living Wage employment costs and sustainable provision. Greater London has the lowest average council fee in our latest research, at £22.66 per hour.

  • Access remains a serious concern. The CQC reports that around 223,000 fewer adults received long-term council-funded support at the end of 2024/25 than 20 years earlier. Almost one in four people receiving homecare now fund it themselves. Delays in completing transfers between hospital and social care accounted for one in eight delayed discharges among people who had been in hospital for at least 14 days in 2025/26.

  • The workforce remains fragile. Almost one in ten homecare roles are vacant and nearly one in five staff left their job last year. International recruitment fell by a further 40%.

Dr Jane Townson OBE added:

“Homecare is vital public infrastructure. It keeps people safe and well at home and is central to the Government’s ambition to shift care into the community.

“The CQC makes clear that funding, commissioning, workforce, prevention and inequalities must be addressed together. Better-performing councils already demonstrate the value of aligning these priorities and working meaningfully with providers.

“Yet the Fair Pay Agreement, guaranteed hours and neighbourhood health cannot succeed while public bodies buy care minute by minute at prices that do not cover the cost of employing careworkers lawfully. Providers need sufficient, predictable income to invest in their teams, maintain capacity and deliver continuity.

“Providers must also take responsibility for quality: safe medicines management, competent staff, effective leadership and action when things go wrong. People choosing care need reliable, current information, which means the CQC must have the capacity to assess services promptly.

“We welcome the Government’s commitment to a National Care Service that starts in the home. But free at the point of use must also mean fair at the point of delivery.”

What must happen

  • Legislate: a National Contract for Care Services with a statutory minimum price for homecare, based on a transparent national cost method.
  • Invest: an immediate, ring-fenced injection of at least £2.3 billion in England to close the homecare funding gap, rising to around £3.0 billion so care workers receive pay equivalent to NHS Band 3.
  • Reform commissioning: end purchasing by the minute and move to neighbourhood contracts that give providers enough predictable local hours and pay for capacity. Government should convene councils, the NHS, providers, careworkers and people drawing on care to produce model commissioning guidance and payment clauses, co-design a national framework and contract, and launch demonstrators.
  • Regulate effectively: guarantee every new service a first CQC assessment within 12 months and clear the community backlog.

ENDS

Notes to editors

  1. The Homecare Association is the UK’s leading membership body for homecare providers, with over 2,100 members.
  2. The Care Quality Commission publishes The state of health care and adult social care in England 2025/26 (HC 691) on 23 October 2026.
  3. Homecare Association reports referenced in this statement:

 

Contact
E-mail: [email protected]
Telephone: 020 8661 8160
Mobile: 07435 91065

 

Related topics

Care service regulation
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