Care system 'urgently needs proper funding'

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"What's happening, we think, is that where people aren't getting access to [social] care, and we are not preventing people's needs developing through adult social care, is that they are presenting at A&E", said David Behan, the CQC's chief executive.

The NHS was now "on its knees" and a major increase in hospital admissions due to flu or the sickness bug norovirus could lead to collapse, he added.

Housing And Care 21 was working with 150 local authorities to provide care for elderly and disabled people, amounting to 35,000 hours of home care a week. "Another inspection will be conducted within six months to ensure the required improvements have been made". Most worryingly, in 8% of cases, the quality of care had deteriorated so much that the rating was downgraded to "inadequate". However, half of services previously rated as "requires improvement"- a total of 904 providers - had no change in their rating.

"However, patients also told us they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment".

Between November 2015 and May 2016, 32 councils had residential and nursing home contracts handed back and 59 had home care contracts handed back, and the CQC warned that more contracts are likely to be cancelled in the future.

In 2015, Age UK estimated that more than a million older people in England were living with unmet social care needs (such as not receiving assistance with bathing and dressing); a rise from 800,000 in 2010. Also, 81% of local authorities have reduced their real-term spending on social care for older people over the last five years. The combination of a growing and ageing population, more people with long-term conditions, and a challenging economic climate means greater demand on services and more problems for people in accessing care.

Against that, people don't want their taxes increased.

"Therefore the practice will remain in special measures and kept under review".

"We have found too much acute care that we rated inadequate - particularly urgent and emergency services and medical services", the report stated. It will be increasingly hard for NHS trusts to make improvements to these services unless they are able to work more closely with adequately funded adult social care and primary care providers.

Margaret Willcox, vice-president of the Association of Directors of Adult Social Services, said: "We are at a tipping point where social care is in jeopardy and unless the Government addresses the underfunding of the sector, there will be worrying consequences for the care market, the NHS and, most importantly, for older and disabled people, their families and carers".

The fact that growing numbers of mainly frail, elderly people are being left without the help they need with basic chores such as washing, dressing and cooking "creates problems in other parts of the health and care system, such as overstretched A&E departments or delays in people leaving hospital", he added.

"Turning to primary care, since Global Positioning System provide the vast majority of NHS services - over 300 million patient visits a year - it is particularly pleasing that the CQC report they are the provider sector providing the highest proportion of good and outstanding care".

"It is essential that health and social care organisations work together in a more co-ordinated way".

Peter Pinfield, chairman of Worcestershire's Healthwatch, said: "Things are really creaking".

And despite the best efforts of doctors and nurses, many patients are receiving "very poor care" within the NHS.

"[This includes] moving services closer to people's homes, exploring the relationship with local care partners to improve hospital discharge rates, and supporting more people to manage their own care through the use of technology". On Monday Stephen Dorrell, the ex-Conservative health secretary, said that the government's policy of giving social care less and less money was "insane economics and bad social policy" and undermined its claim to be backing the NHS.

The annual State of Care report provides the most comprehensive view yet of CQC's inspection findings from its new regulatory approach, which it rolled out two years ago. None received the top rating of outstanding, the report showed.

Chris Ham, Chief Executive of The King's Fund, said the report provided "overwhelming evidence" that the social care market is unsustainable in its current form. However, inspectors said the trust must make a number of further improvements in end of life care.