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The state of health care and adult social care in England 2013/14

We have found some outstanding care and rated many services as good. We have also found services that are inadequate or require improvement. This variation in the quality and safety of care in England is too wide and unacceptable. The public is being failed by the numerous hospitals, care homes and GP practices that are unable to meet the standards that their peers achieve and exceed.

It is no excuse that this problem has existed for years – quite the opposite. CQC is calling time on this unacceptable lottery, and challenging every health and care provider in England, and every commissioner and oversight body, to deliver the high standards of care that each person has a right to expect.

This report gives our perspective on the state of health care and adult social care in England in 2013/14 as we start to build a deeper and better understanding of the quality of care. It offers a unique perspective across more than 40,000 care services.

CQC’s purpose is to ensure health and social care services provide people with safe, compassionate, high-quality care and to encourage services to improve. We provide robust, fair and consistent judgements of quality of care that expose poor care and variation in care, and make quality transparent in a way that it has never been before.

We have started to inspect and rate care services using a new more rigorous approach which has given us a deeper insight than we have ever had before. Through this new approach and our new ratings, we are championing and celebrating the success of good and outstanding care. We are also improving our performance in taking serious action against inadequate providers – by stopping providers from operating or by requiring them to improve through our civil and criminal enforcement actions.

Understanding the quality of care is complex – it is about how people experience services, it is about the outcomes of the services (for example the clinical effectiveness of hospital care or the dignity of end of life care) and about how safe they are. These dimensions of quality are underpinned and influenced by the quality of the leadership and the culture that the leadership creates within a provider. Using the transparency of inspection helps to recognise outstanding care, highlight areas of poor care and galvanise people to act to improve the quality of care.