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Adult Social Care Briefing

Writer: Cheryl Baird
Cheryl Baird
Oct 29
8 min read

Issue 018 | 29 October 2026


This week’s briefing focuses on CQC’s latest State of Care findings, continuing pressures around Deprivation of Liberty Safeguards, new national infection prevention and control guidance, confirmed minimum wage rates for April 2027, adult social care reform and learning from a newly published Safeguarding Adult Review.


This Week’s Headline


CQC State of Care 2025/26: Leadership, Workforce and Market Pressures Remain Central Concerns

The Care Quality Commission published The state of health care and adult social care in England 2025/26 on 23 October 2026.

The adult social care findings provide an updated picture of quality, governance, workforce pressures and changes in the care market.


What Has Changed?

Among 3,783 care homes assessed, CQC reports that 67% were rated Good, 3% Outstanding, 27% Requires Improvement and 3% Inadequate.

For the well-led key question, 31% of assessed care homes were rated Requires Improvement and 3% Inadequate.

Among 2,121 assessed homecare services, 76% were rated Good, 4% Outstanding, 18% Requires Improvement and 2% Inadequate.

CQC also reports wider pressures across adult social care, including:

  • local authorities overspending their annual adult social care budgets by a combined £715 million;

  • continued workforce recruitment and retention pressures;

  • weaknesses in staff skills and competency in some poorly rated services; and

  • a care home market increasingly concentrated in larger homes, alongside a more fragmented community care market.


Why It Matters

The findings reinforce the need to look beyond whether governance arrangements exist and consider how well they work.

Policies, audit programmes and reporting structures provide limited assurance if they do not identify deterioration, clarify accountability or lead to sustained improvement.

The market findings are also relevant to providers managing increasing workforce costs, variable local authority fees, occupancy pressures and changing referral patterns.

For nursing services, the findings on staff skills and competency also underline the importance of clinical leadership, supervision and practical competency assurance.


Actions for Providers

  • Compare CQC’s well-led findings with current governance arrangements, particularly accountability, escalation and oversight of improvement actions.

  • Review whether workforce assurance includes practical competency and supervision alongside training compliance.

  • Consider how local commissioning pressures, fees, occupancy and referral patterns are affecting service sustainability.

  • Test whether previously identified quality concerns have improved in practice and whether those improvements have been sustained.


Deprivation of Liberty Safeguards

Continuing Delays and Weaknesses in DoLS Oversight

CQC’s State of Care report also considers the operation of the Deprivation of Liberty Safeguards.


What Has Changed?

At the end of 2024/25, 118,850 DoLS applications remained incomplete.

Official statistics show that 21.1% of standard applications were completed within the statutory 21-day period.

CQC also reports 205,205 provider notifications relating to DoLS during 2025/26, an increase of 10.3% on the previous year.

CQC’s analysis identifies weaknesses in some services involving application records, communication with local authorities and awareness of people’s current authorisation status.

The report also considers the implications of the Supreme Court judgment published in June 2026 and notes that its full effect on DoLS application volumes and practice remains uncertain.


Why It Matters

Lengthy assessment times can leave providers managing complex restrictions while applications remain unresolved.

This makes the provider’s own records, mental capacity assessments, care planning and communication with the supervisory body particularly important.

It also reinforces the need to understand restrictions in practice rather than relying solely on whether an authorisation is recorded as current.


Actions for Providers

  • Review outstanding DoLS applications and arrangements for following these up.

  • Check that restrictions are accurately reflected in care plans, risk assessments and mental capacity documentation.

  • Confirm that changes in circumstances and authorisation outcomes are recorded and communicated.

  • Include DoLS and Mental Capacity Act practice within routine governance review.


Infection Prevention and Control

New National IPC Resource Published for Adult Social Care

The UK Health Security Agency and Department of Health and Social Care published a new consolidated infection prevention and control resource for adult social care on 28 October 2026.


What Has Changed?

Infection prevention and control (IPC) in adult social care (ASC) brings together national guidance relevant to care homes, nursing homes, supported living, domiciliary care and other adult social care settings.

The resource covers:

  • standard infection control precautions;

  • transmission-based precautions;

  • outbreak management;

  • staff health;

  • vaccination;

  • common infections; and

  • infection prevention during clinical interventions and procedures.

Separate guidance covers outbreak management and clinical procedures including wound care, invasive devices, aseptic technique and specimen handling.


Why It Matters

This gives providers a current national reference point for reviewing existing IPC policies and practice.

For nursing homes, the clinical sections are particularly relevant where staff undertake wound care, catheter care or other procedures where infection prevention depends on consistent technique and competency.

The outbreak guidance also provides an opportunity to review how services manage infection risk alongside people’s wellbeing, relationships and visiting arrangements.


Actions for Providers

  • Review existing IPC policies and guidance links against the new national resource.

  • Check that outbreak plans reflect current reporting and escalation arrangements.

  • Review practical competencies where wound care, invasive devices or aseptic procedures are undertaken.

  • Consider whether learning from previous outbreaks has led to changes in staffing, equipment, communication or practice.


Workforce and Financial Sustainability

Minimum Wage Rates for April 2027 Confirmed

The Low Pay Commission published its recommendations on 28 October 2026, which the Government accepted in full.


What Has Changed?

From 1 April 2027, the National Living Wage for workers aged 21 and over will increase from £12.71 to £13.21 per hour.

The confirmed rates are:

  • 21 and over: £13.21

  • 18 to 20: £11.27

  • 16 to 17: £8.31

  • Apprentice rate: £8.31


Why It Matters

For providers, the impact extends beyond staff currently paid at the statutory minimum.

Maintaining appropriate differentials for senior carers, team leaders and other roles carrying additional responsibility may create further cost pressures.

The effect will vary according to current pay structures, staffing establishments, contracted hours and the balance between commissioned and privately funded care.


Actions for Providers

  • Model the April 2027 increases using actual staffing establishments and payroll information.

  • Consider the effect on pay differentials as well as minimum rates.

  • Include associated employment costs within financial planning.

  • Use the updated cost position in preparation for 2027/28 commissioning and fee discussions.


Adult Social Care Reform

Casey Commission Timetable Confirmed

Budget 2026 confirms that Baroness Casey’s Independent Commission on Adult Social Care will report in 2027.

The Government also restates its longer-term ambition to establish a National Care Service in England, including personal care free at the point of use for older people.


What Has Changed?

The confirmed 2027 timetable provides greater clarity about when the Commission’s recommendations are expected.

The detailed model, funding arrangements and implementation plans for a National Care Service have not yet been established.


Why It Matters

The direction of policy is relevant to longer-term service planning, investment and workforce strategy, but providers still need to plan against current commissioning and funding arrangements.


Actions for Providers

  • Include the Commission timetable within strategic horizon scanning.

  • Continue financial and service planning against current arrangements.

  • Monitor future consultation and implementation proposals as more detail becomes available.


Safeguarding and Professional Practice

Somerset Review Highlights Learning on Self-Neglect and Escalating Risk

Somerset Safeguarding Adults Board published a Safeguarding Adult Review concerning three men on 28 October 2026.

The review examines severe self-neglect, complex health needs and difficulties engaging with services.


What Has Changed?

The review identifies recurring themes involving:

  • recognition and escalation of increasing risk;

  • mental capacity;

  • information sharing;

  • persistent engagement where people decline support;

  • professional challenge where agencies disagree; and

  • coordinated multi-agency working.

Its recommendations are directed towards the Somerset safeguarding partnership, but the learning is relevant more widely across adult social care.


Why It Matters

Self-neglect can create difficult decisions where autonomy, mental capacity and increasing risk need to be considered together.

The review illustrates how concerns can escalate when individual professionals recognise risk but the overall multi-agency response remains fragmented.

This is particularly relevant to homecare and community services, where staff may be among the few professionals regularly observing changes in someone’s living conditions, health or ability to manage daily life.

There is also relevant learning for care homes supporting people who repeatedly decline care, treatment or other interventions.


Actions for Providers

  • Review how repeated refusal of care or support is recorded, assessed and escalated.

  • Check that staff understand how to raise concerns where risk continues to increase despite previous referrals.

  • Use safeguarding supervision to explore complex capacity decisions and professional disagreement.

  • Make sure communication with external professionals results in clear decisions, responsibilities and follow-up arrangements.


Leadership Reflection

When the Evidence Tells a Different Story

There is a familiar theme running through this week’s publications.

CQC identifies weaknesses in leadership and governance despite services having established management arrangements. Its DoLS findings show the difficulties created when applications, restrictions and changing circumstances are not consistently tracked.

The Somerset review demonstrates the challenges created by fragmented responses to complex risk, while the new IPC guidance brings together information that needs to translate into day-to-day practice.


For senior leaders, the value of assurance lies in what it tells us about actual care.

A safeguarding process may be in place, but how effectively does it work when several agencies disagree about the level of risk?

An IPC policy may be comprehensive, but how confidently can staff apply it during an outbreak?

An action may be marked as complete, but is there evidence that practice has changed?

These are the questions that turn governance information into useful assurance.


Five Things I’d Be Thinking About This Week

  1. Governance: Do our assurance arrangements show whether practice has improved, rather than simply whether actions have been completed?

  2. Mental capacity and DoLS: Are outstanding applications, changing restrictions and authorisation outcomes being monitored effectively?

  3. Infection prevention: Does our current IPC guidance reflect the new national resource, particularly around outbreaks and clinical procedures?

  4. Workforce and costs: What will the April 2027 wage increases mean for our staffing budget, pay structure and fee negotiations?

  5. Safeguarding: When someone repeatedly declines support and risk continues to increase, are escalation arrangements sufficiently clear?


Sources

Editorial Note

This briefing reviews material developments published or substantively updated between 23 and the morning of 29 October 2026.

Official material from CQC, NICE, NHS England, GOV.UK including DHSC and UKHSA, HM Treasury, the Low Pay Commission and relevant safeguarding and sector sources was reviewed.

Items have been selected according to their practical relevance to providers of adult social care for older people rather than simply because they were published during the period.

CQC’s State of Care report provides regulatory findings and sector analysis rather than new inspection requirements.

The new IPC material is national guidance for adult social care. The minimum wage changes take effect from April 2027. The National Care Service remains part of the Government’s longer-term reform programme.

The Somerset Safeguarding Adult Review contains recommendations for the local safeguarding partnership alongside wider professional learning relevant to other services.

The Why It Matters, Actions for Providers, Leadership Reflection and Five Things I’d Be Thinking About This Week sections contain professional interpretation and practical considerations based on the cited evidence.


Looking Ahead

29 October – Adult Social Care Survey

The Department of Health and Social Care has scheduled publication of Adult social care survey, England: 2025 to 2026 report for 29 October 2026.

The publication will provide official statistics on the outcomes and experiences of people aged 18 and over receiving long-term adult social care services in England.

The survey had not yet been published when this briefing was prepared.

Its findings will be worth reviewing once available, particularly for what they tell us about people’s experience of care, quality of life and the impact of services.


Looking Towards 2027

The April minimum wage changes, the Casey Commission timetable and longer-term care reform proposals will all remain important developments to follow.

For providers preparing financial plans and reviewing service models, the immediate priority is understanding confirmed cost changes while keeping longer-term policy proposals under review.



Overhead view of an adult social care briefing on a wooden desk, surrounded by governance papers, folders, a tablet, notebook, glasses and stationery. A cream sheet in the centre is titled “Adult Social Care Briefing”.

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