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If the CQC were a boat, it would be a rowing boat…
… drifting quietly towards the weir, while its oarsman lectured everyone else on navigation.
Their latest State of Care report tells us nothing we don’t already know.
Services are doing more, and people still struggle to get dependable, timely help.
We know.
The report’s central message… demand, complexity and inequality are outpacing improvement.
We know.
The report also raises a question about the regulator itself...
... how confidently can CQC judge the system when its own capacity to inspect it has fallen so dramatically?
Social care provides the clearest example of a system changing without sufficient direction.
Care homes are consolidating into larger groups and companies.
Home-care is becoming fragmented.
Bed numbers have remained broadly stable since 2019, despite an ageing population.
It’s an open secret, care providers increasingly try to sell to people able to fund their own care, meaning...
... financial survival and investment decisions decide provision…
...before public policy can establish what communities need.
Size alone doesn’t determine quality. CQC’s findings suggest that both large and small homes can perform well.
The practical questions are all about continuity, staffing, resilience and whether councils can commission appropriate care at prices they can afford.
We know, they can’t.
Children’s services expose a particularly serious weakness in the prevention agenda.
More than 80,000 children and young people have waited over a year for community health appointments. The number waiting for first contact with mental health services rose 31% over two years.
Delays during childhood can affect development, education and family stability. Prevention means timely services, adequate staffing and clear accountability.
There are improvements worth recognising, including more GP appointments and shorter elective waits, but…
… increased activity doesn’t mean that services are catching up.
- Community mental health open-referrals increased by 34% over three years.
- Contacts rose 26%.
- Emergency care is a mixed picture.
- Some waiting measures improved,
- while waits exceeding twelve hours after a decision to admit, increased.
CQC points to weaknesses in leadership and governance, but those explanations are not the whole picture.
Councils overspent their adult social care budgets by £715 million in 2025/26.
Better management cannot, by itself, make one pound do the job of two, or create an available workforce.
Accountability must extend to national decisions about resources, alongside local decisions about their use.
That principle also applies to CQC.
Its published figures show they did;
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more than 16,000 inspections in 2019/20,
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down to 10,356 in 2022/23,
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falling to 6,230 inspections and assessments in 2023/24, and
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just 3,825 published assessment reports in 2024/25.
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CQC output fell 63% between 2022/23 and 2024/25.
Definitions were blurred, so these are not perfectly comparable counts of inspection visits, but the reduction can’t be disguised by fluffing the numbers.
CQC attributes its difficulties to technology problems, changes to its assessment framework and operational restructuring.
Not very dissimilar to the rest of the NHS.
In January 2025, it identified 500 assessments that were ‘stuck’.
What does that mean? Dunno.
The organisation judging leadership and timely action had serious problems delivering its own responsibilities.
Recovery deserves recognition. Report of the September 2026 board meeting records; 10,328 assessments against a target of 9,000... err...
... that recovery target covered eighteen months, from April 2025 to September 2026…
… really it’s fiddling the numbers and not becoming of a regulator.
The cumulative total can’t establish CQC annual inspection activity has returned to its former level.
Why should it. The age of ‘inspection’ went out with Rover cars and skiffle.
Management reminder, Deming’s 3rd Point for Management Urges leadership to...
'... cease dependence on inspection
and instead build quality in
from the start.'
The words, pot and kettle and black capture a concern that ministers will have to address.
CQC’s failures don’t invalidate every finding.
National waiting figures and patients’ experiences remain important evidence.
Inspection is pointless but judgements about coverage, recency and the selection of services assessed require skill and care... and data.
Neither does the evidence establish that fewer inspections caused poorer care, but… all the facts point to…
... the CQC makes no difference.
We know what we need…
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shorter children’s waits,
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dependable access to council-funded support,
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continuity of carers,
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fewer delays between hospital and community services, and
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fresher, credible regulatory judgements.
The CQC wider executive leadership team costs £1.475–£1.540 million in salaries.
Pension-benefit values, totalled £1.765–£1.830 million. The chair and non-exec’s costs ~£130,000.
The regulator’s failures are an intrinsic part of the state of care and if they are not… why do we need them?
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