“Care Market Must be Shaped Around People’s Needs” Warns Care Leader
Social care leader Mike Padgham has called for urgent action on funding and commissioning following today’s publication of the Care Quality Commission’s State of Care 2025/26 report.
Mr Padgham, Honorary President of the Independent Care Group (ICG), said the report’s findings on the changing ownership and structure of care services reinforced longstanding concerns about the sector’s fragile financial foundations.
He said: “This report describes problems that those of us on the front line have been raising for years. The fragile care market and the way care is commissioned remain fundamental weaknesses.
“CQC highlights two different trends: care home provision is consolidating, with increasing involvement from institutional investors, while home care is fragmenting into a growing number of smaller providers. We need to ask whether these changes are delivering the services people actually need, in the places they need them.
“My concern is that financial pressures are determining the shape of social care without a clear plan for its future. We should be shaping provision around people’s needs, rather than leaving it to emerge from a struggle for financial survival.
“Large and small providers can deliver excellent care. What matters is quality, continuity, accountability and whether people have a meaningful choice. Smaller, local providers also bring valuable experience and community relationships that we cannot afford to lose.”
Mr Padgham said fair commissioning was essential to creating a more stable and responsive service.
“We cannot keep commissioning care on the cheap and expect a sustainable service. Fees must reflect the actual cost of delivering good care, including decent pay, training and effective leadership.
“Social care needs a funding model that gives providers stability and the flexibility to respond to people’s changing needs. Contracts must offer enough certainty to plan, retain staff and invest in services.
“Otherwise, we risk having care available on paper but unavailable to the person who needs it, because the funding does not cover its delivery.”
He said CQC’s warning about providers increasingly seeking self-funding clients should prompt particular concern.
“I have repeatedly raised the unfairness of people paying privately being expected to help make up the shortfall in publicly funded care. That cannot be a lasting answer.
“If providers cannot afford to accept publicly funded placements or care packages, choice becomes narrower for those who depend on council support. Behind that are families struggling to cope and people waiting for help.”
Mr Padgham called for stronger partnerships between councils, the NHS, providers and people receiving care.
“Councils face enormous financial pressures themselves. Government must give them the resources to commission properly, and commissioners must involve providers and people using services before decisions are made.
“We need less bureaucracy, meaningful consultation and a shared plan for local care needs. The independent sector wants to help and must be involved as an equal partner.”
He added: “You cannot fix the NHS without fixing social care. Investment in care at home and in care homes helps prevent avoidable admissions and supports people to leave hospital safely.
“Care staff continue to do an extraordinary job. They deserve recognition, respect and better pay. But fair pay must come with fair funding: we need a minimum price for care alongside minimum standards of pay.
“I welcome the Government’s commitment to reform, but people needing support cannot put their lives on hold.
“After nearly four decades in social care, I have seen too many reports identify familiar problems without the action that should follow. This report must lead to fairer commissioning, sustainable funding and a clear plan for the care our communities need.
“We know what needs to change. What we need is action this day.”
