What the State of Care report asks of your leaders and your teams

On 23/10/2026 the Care Quality Commission published State of Care 2025/26, its yearly assessment of health and adult social care in England. Most of the headlines are about access, waiting lists and a social care market under financial strain. Read it as a provider, though, and another thread runs right through it. It’s about the people who lead services and the skills of the people who deliver care.

The good news comes first. Seven in ten of the 3,783 care homes CQC assessed were rated good or outstanding, and so were eight in ten homecare services. That’s care teams doing a hard job well, often in difficult conditions.

CQC is just as clear about where things fall short. Below are five challenges from the report, what we’d suggest doing about each one, and where we can help.

1. Leadership is the area most in need of improvement

What the report found. CQC names leadership as the biggest area for improvement. Around a third of care homes were rated requires improvement (31%) or inadequate (3%) for the well led key question. The weak points were governance, accountability and clarity about who is responsible for what. CQC is also clear that well led services deliver safer, more person centred care.

This fits what we see elsewhere. Skills for Care’s State of the adult social care sector and workforce 2026 shows registered managers now have the highest vacancy rate of any role, at 10.2%. In services where the registered manager had been in post under a year, care worker turnover was 28.3%, against 20.6% where they’d been in post 20 years or more. Skills for Care is careful to call these links rather than proof of cause.

What we’d suggest. Look at the systems behind the care, not only the care itself. Could every senior person in your service say who owns which decisions? Do your meeting notes show a decision, an owner and a date? Are your managers appraised and developed, or simply appointed? And who is your next registered manager, and what are you doing to get them ready?

How we can help. Our leadership and management programmes are built for exactly this. Lead to Succeed runs over five days and develops the everyday leadership that holds a team together. Well-Led runs over four days and builds the governance, systems and direction a service needs to be well led and to show it. Shorter programmes for first line managers and coaching skills sit alongside them.

2. Training on file doesn’t always mean competence in practice

What the report found. Where adult social care services were rated inadequate for the safe key question, CQC found they didn’t always make sure staff had the skills, knowledge or competence to meet people’s needs safely.

The gap between training and practice is well documented. The Second national analysis of Safeguarding Adult Reviews, April 2019 to March 2023, published in June 2024 by the Local Government Association and the Association of Directors of Adult Social Services, looked at 652 reviews. Management oversight was a negative factor in 31 per cent of them. Supervision and management oversight was praised in 3 per cent. The same analysis notes there’s no guarantee that what people learn in training carries over into practice.

What we’d suggest. Treat an attendance record as the starting point, not the evidence. Pair training with competency sign off for role specific tasks. Use supervision to check what staff are doing differently since the training, and record it. When an inspector asks how you know your team is competent, the answer should be more than a certificate.

How we can help. Our practice management programmes cover statutory and mandatory training, alongside programmes for managers such as Safeguarding Adults at Risk for Managers. Every programme is built around your own policies, procedures, documents and values as standard, so staff learn what your service expects of them, not a generic version.

3. Cost and time are getting in the way of development

What the report found. Most social care employers (83%) say qualifications matter for care workers moving into management. Yet cost and the time it takes to train staff were the most common barriers to investing in their skills. Budgets are tight across the system too, with councils overspending their adult social care budgets by £715 million in 2025/26.

What we’d suggest. When money and time are short, spend them where the risk is highest. Start with an honest look at your training records against the gaps your last inspection, audits or incidents pointed to. Fewer, better targeted sessions often do more than a full calendar. Bring the training to your team rather than sending your team to the training, which cuts travel and the cost of covering shifts. And check what funding you can claim before you book, not after.

How we can help. We don’t run open courses. Every session is delivered to your own team, at your site or by Live Learn, planned around your shifts and costed per session, agreed with you up front. If you provide adult social care in England, Learning and Development Support Scheme funding is available towards eligible training, and we can talk you through what applies.