IMMEDIATE RELEASE
Following today's publication of the Care Quality Commission (CQC)'s State of Care report, the Homecare Association is happy to see evidence that investing in homecare, particularly the earlier support purchased by self-funders, reduces unplanned hospital admissions and readmissions. Poor commissioning by local authorities and the NHS, including hyper-fragmentation of hours and low fee rates, coupled with the CQC’s ongoing failure to inspect homecare providers, is putting people at risk.
The CQC's latest report shows:
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The proportion of very small homecare providers (serving 4 or fewer people) has grown to 28%, raising concerns about financial resilience and market stability. Recent data from Skills for Care suggest that at least 43% of homecare providers employ fewer than 4 careworkers.
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New requests for local authority-funded care were 4% higher in 2023/24 than the previous year, and 8% higher than in 2019/20.
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The proportion of older people receiving local authority-funded long-term care has dropped dramatically from 8.2% to 3.6% over the last 20 years.
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Vacancy levels in homecare are more than double those in care homes.
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More homecare providers are handing back local authority contracts because of rising costs.
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In areas where a greater proportion of people self-fund their care (such as homecare or a care home) there are lower rates of attendance at emergency departments, emergency admissions (including avoidable admissions), and readmissions within 30 days for older people.
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In areas where the gross expenditure of local authorities per population on social care is higher, there is increased attendance at emergency departments for older people.
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The lower the rate that local authorities pay per unit of care (such as a week in a care home or an hour of homecare), the higher the rates of emergency department attendance and emergency admissions (including avoidable admissions). This confirms our long-held position that inadequate fee rates for homecare create the conditions for unsafe, poor quality care.
Alongside this, the Homecare Association's recent analysis reveals that the regulator's own performance in overseeing homecare has deteriorated significantly over the past year.
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As of August 2025, 70.3% of community social care providers had either never been rated by the CQC (33.5%) or had a rating of 4 to 8+ years old (36.8%).
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The number of uninspected locations has increased by 64% in just 14 months, from 2,879 to 4,727.
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At current inspection rates, the backlog grows by 312-424 locations every month.
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Only 29% of homecare locations have up-to-date CQC ratings – projected to fall to just 15% by 2030 if current trends continue.
Chief Executive of the Homecare Association, Dr Jane Townson OBE, said:
"Today's State of Care report suggests that more investment in homecare would support the government’s three shifts from hospital to community, sickness to prevention and analogue to digital. Self-funders who can access quality homecare earlier are less likely to have unplanned admissions or readmissions to hospital.
“The CQC has reinforced concerns raised by the Homecare Association that poor commissioning of homecare, characterised by hyper-fragmentation of provision and inadequate fee rates, is creating the conditions for unsafe and unsustainable services, risking harm to individuals.
“The CQC’s failure to inspect and rate over 70% of homecare services leaves the public in the dark and erodes trust in the sector. Outdated or missing ratings distort the market, punish responsible providers, and leave people at risk.
“The rapid growth of very small providers is leading to market instability, weakening oversight, and inefficient delivery. Government must encourage a fourth shift from fragmentation to integration, as we have long advised.
"We stand ready to work with the CQC, the government and other stakeholders to improve commissioning, provision and regulation of homecare. This requires a willingness for all parties to change ways of working, as well as adequate investment. We need accessible, safe, quality care and support, so we can all live well at home and flourish in our communities."
ENDS
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