Read the report here: The state of health care and adult social care in England 2025/26
The Care Quality Commission (CQC) has published its annual assessment of health and adult social care in England, highlighting continuing pressures on access to support, funding, workforce capacity and the sustainability of social care provision.
The CQC also identifies signs of improvement across health and care, including falling social care vacancy and turnover rates, and provides examples of effective local partnerships and innovative services. However, progress is struggling to keep pace with rising demand, and people's access to support and outcomes continue to vary significantly depending on where they live and their circumstances.
For VODG members, the report reinforces longstanding concerns about the sustainability of social care funding, access to support, workforce pressures and the need for commissioning that enables providers to deliver high-quality, community-based support for people in need.
Access to adult social care
The report highlights continuing difficulties in accessing publicly funded adult social care. At the end of 2024/25, 223,000 fewer adults were receiving long-term council-funded social care support than 20 years earlier.
The CQC also reports that 70% of new requests for council-funded support resulted in no further action beyond the provision of information, with the financial threshold for state-funded care having a large impact on eligibility for support.
The report finds that access to services varies considerably across England, with local circumstances influencing the support available to individuals. These pressures are particularly relevant to people who need specialist or ongoing support, including disabled people and people with complex needs.
For VODG members, the findings highlight the growing gap between demand for support and access to publicly funded services. Delays or barriers to care can result in poorer outcomes for people with varying and complex support needs, increasing pressure on wider public services.
The changing social care market
The CQC describes a market undergoing two contrasting changes with residential care consolidating, and homecare fragmenting. The report warns that these changes are taking place without a clear overall plan and a funding model that remains fragile. Differences in local authorities' ability to assess future needs and shape provision, combined with financial pressures, are influencing the availability and type of care in local areas.
The CQC also notes that some providers are increasingly seeking people who can self-fund care to remain financially viable. People who depend on council-funded support may face reduced choice and availability, particularly in areas where provision is already under pressure.
For VODG members, the findings emphasise the need for strategic commissioning and sustainable funding arrangements that maintain specialist and community-based services, and ensure services remain available to those who rely on publicly funded care.
Funding and commissioning
The CQC highlights the financial pressures facing local authorities and their ability to commission and sustain adult social care. Local authority expenditure on adult social care rose by 9% between 2023/24 and 2024/25, reaching just under £30 billion. Councils also overspent their adult social care budgets by £715 million in 2025/26.
The report notes that the average weekly cost of a care home place and the average hourly cost of homecare both increased by 7% between 2023/24 and 2024/25. This illustrates the growing costs of delivering care, although the pressures and financial circumstances of individual providers vary.
The CQC's assessments of local authorities highlight the importance of commissioning in shaping local services. Its assessment of Wigan Council, rated outstanding, provides an example of effective collaboration with providers and people who use services to develop local provision, address health inequalities and reduce reliance on placements outside the borough.
For VODG members, the report stresses the importance of commissioning arrangements that support quality, equity and sustainability. The CQC state that sustainable funding and improved commissioning are needed to help local authorities shape services around people's needs and improve their lives.
Workforce and quality of care
The CQC reports some improvement in adult social care workforce vacancy and turnover rates, although both remain a concern. Average vacancy rates in 2025/26 were 4.6% in care homes and 9% in homecare. Turnover rates were just over 23% in care homes and 19% in homecare. The report also highlights concerns about reduced international recruitment.
The CQC identifies leadership as an important area for improvement across adult social care. Its assessments found that well-led services were more likely to provide safer, more person-centred care, while weaknesses in governance, accountability and staffing could affect service quality.
For VODG members, this underlines the importance of a long-term workforce strategy, investment in skills and leadership, and progress on fair pay for adult social care that supports recruitment, retention and delivery of high-quality care and support.
Inequalities
For people with learning disabilities, the CQC reports that 80% of people aged 14 and over on their GP's learning disability register had received an annual health check in the 12 months to March 2026. Rates varied between 70% and 86% across integrated care board areas.
The report also notes that only around a quarter of the estimated 1.3 million people with a learning disability in England were recorded on their GP's learning disability register, based on data from March 2024.
Furthermore, the report found that pressure on mental health services across the care pathway has continued to rise in 2025/26. People who live in the most deprived areas and people in ethnic minority groups have greater levels of need, yet not everyone is able to access the care they require. The report expressed particular concern about children and young people’s mental health.
The report stressed that local innovation, including neighbourhood-based approaches, integrated teams and closer working between health services and voluntary, community, faith and social enterprise organisations can help address barriers to care and provide support within people's communities, although the CQC notes that sustaining and expanding successful initiatives can be difficult under financial pressure.
For VODG members, the findings underline the importance and leadership that VCFSE organisations can provide, and highlight the value of partnership working to ensure that disabled people, and adults and young people experiencing mental health challenges, who face barriers to care are considered in local planning and service development.
Conclusion
The CQC's State of Care 2025/26 describes a social care sector facing significant financial, workforce and capacity pressures, alongside changes in the structure of provision and continuing inequalities in access to support.
The report identifies positive developments, including improvements in staffing indicators, examples of effective commissioning and local partnerships, and a substantial proportion of services rated good or outstanding.
VODG welcomes the CQC’s calls for sustainable investment in social care, effective commissioning, action to address workforce pressures and a renewed focus on reducing inequalities experienced by disabled people. funding, improved commissioning and investment in leadership, alongside action on workforce, prevention and inequalities. VODG will continue to work with stakeholders in Government to enact the relevant changes.