Findings from the CQC’s 2022/23 State of Care Report — which looks at the state of health care and adult social care in England —highlighted a great deal of excellent care, with staff working hard to do their best in often very difficult circumstances. There were also areas requiring significant improvement, however.

The CQC found that meaningful change and improvement can be achieved by better awareness of (and adherence to) policies and procedures, sharing best practice, and investing in staff training.

One area that the report mentions is the management of physical conditions, for example Sickle Cell Disease. The Sickle Cell Society has reported that many healthcare staff have a “low awareness” of the condition, and that “frequent reports of negative attitudes towards sickle cell patients suggests that such attitudes are often underpinned by racism.” The CQC found that better management and adherence to policies and procedure is key to changing this:

• “not all trusts had policies or procedures to support staff to offer safe and effective treatment, including the right pain relief
• some trusts had policies for either children or adults, but not both
• there was a gap in the knowledge of agency staff”.

The CQC’s conversations with care providers highlighted these gaps, and prompted many to review their practice (such as policies and training). The CQC are following up with them to make sure they have made improvements in these areas.

Another area of concern was around autistic people and people with a learning disability. They found that they often suffered with unequal access to care, or delays in seeking medical attention for them. Again, the CQC’s recommendations highlight the importance of good staff training and procedures:

• providing training for staff to meet regulatory requirements, noting the Oliver McGowan draft code of practice on statutory learning disability and autism training that was out for consultation until autumn 2023
• making reasonable adjustments to premises, processes, and communication

When the CQC looked at staffing challenges, the same themes came through. Some care providers had high levels of vacancies, which meant people were often treated by temporary staff who were unfamiliar with their needs. The CQC found that staff did not always follow the trust’s policies and procedures on reporting and recording incidents. From 1 July 2022, all health and social care providers registered with CQC must ensure that their staff receive training on autism and learning disability at a level appropriate to their role.

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