CBF response to CQC State of Care Report 2021

The CBF's response to the CQC State of Care Report, an annual assessment of health care and social care in England, published 22nd October 2021

Today (22nd October) the Care Quality Commission have published their annual State of Care Report reviewing health care and adult social care 2020 to 2021.  

The report reiterates concerns that have been highlighted by people with learning disabilities, families and charities throughout the pandemic – children and adults with a learning disability have faced increased challenges and poor quality of care and support.  

Today’s State of Care report emphasises how many of the issues faced by individuals are not new, but rather have been exacerbated by the pandemic.  

People with a learning disability, for example, are significantly more at risk from COVID-19 – but our review of community care for people with a learning disability found that their physical health, including how COVID-19 may present, was not always considered.

Our inspections of services for people with a learning disability or autistic people continue to find examples of care so poor that we need to take action to keep people safe.

The report also finds that services have been slow to adapt in response to the pandemic, and many of the challenges remain.  

People still faced difficulties in accessing services – including day services, education placements, respite care and health services (GPs, dental, mental health).

The CQC warn of a crisis in the workforce which must be tackled to prevent a “tsunami” of people without the care they need over the coming months. The report is clear that if promised government funding for social care is to have any effect, a focus on developing a clearly defined career pathway, with training and consistent investment, and higher overall levels of pay for social care staff is essential.  

The report urges providers and systems to ensure known health inequalities that people with learning disabilities and their families continue to experience daily are addressed, supporting recommendations that have yet to be delivered from numerous other reports.  

Closed cultures 

Despite a recognition in the report of the increased risk of closed cultures in learning disability services, at the start of the pandemic the CQC stopped in person inspections without alternatives in place and failed to maintain robust scrutiny of these services to ensure safety and quality, despite many of them being acknowledged as “high risk” environments.  

Data published by NHS Digital yesterday (21st October) showed an increase in the number of children and adults with learning disabilities and autistic people in inpatient settings. Increases in the number of restrictive interventions in inpatient settings were also reported (4,070 in July 2021), including 225 incidents of prone restraint.  

What next? 

This report provides further evidence of the failure to “transform care” for many people with learning disabilities, which requires a well-led, effective and co-ordinated cross system approach. The Care Quality Commission must ensure that its inspections of learning disability services, including community and inpatient services are robust and effective in recognising poor care and support and taking prompt action when it is uncovered. Likewise, it must not register any new services which do not fit the model of care, and which are large, institutional and not within the community.  

As Covid 19 continues to impact everyday life, the government must demonstrate with effective action that it is prioritising the health and care needs of individuals with learning disabilities and their families and tackling the inequalities emphasised by the pandemic so far. 

This is another report that shows that we can and must do better. Progress is too slow.

Support from the CBF

Family Support Service

If you have been affected by any of the issues raised in this statement, you can call the Family Support Service on 0300 666 0126

Or email us at

We are open at the following times:

Monday – Thursday: 9am – 5pm

Friday: 9am – 3pm

We offer information about challenging behaviour to anyone who provides support to a child, young person or adult with a severe learning disability. We can also signpost you to other specialist organisations and sources of information.

Please note we are a small support service so you may not be able to get support straight away. We will support families with urgent concerns as a priority.

Resources on our website

Please consult the following information section on our website, for information sheets and signposting:

What to do when things go wrong

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