The Care Quality Commission’s (CQC) State of Care 2024–25 report offers a revealing snapshot of the health and social care system in England and paints a mixed picture for those receiving care at home and in the community. While some receive compassionate, person-centred services that support healthy, independent living, many still face delays, shortages and unequal access.
This article explores what the State of Care 2024–25 report reveals about the condition of home and community services in England, what progress has been made, and where urgent action is still needed to ensure that everyone can access high-quality care, close to home.
Access to good care at home and in the community: The big picture
The report provides a broad assessment of health and adult social care in England, examining service access, quality and areas needing improvement.
For home care and community services, it notes some positive work alongside significant pressures and gaps.
Home care and community services: What’s working?
- Some providers deliver truly person-centred care in people’s homes and communities. These services prioritise independence, choice and compassion, showing how home care and community services can help people to live independent and healthy lives at home
- Stability in adult social care is improving in some respects: for example, bed-occupancy in social care homes is rising once more, which helps provider viability
- Recruitment and retention in adult social care has improved, but the report stresses this progress remains fragile
The big issues for home care and community services
Growing unmet need
- It’s evident that demand for adult social care support continues to increase, however, supply doesn’t always keep pace
- The demand on local authorities is intensifying with mounting requests for care and support that are not always met
- Many delayed hospital discharges result from patients waiting for home care packages or care home beds to become available
Regional variation and inequities
- Regional disparities are having a significant impact on people attempting to access services
- Inequalities persist, people in deprived areas face poorer access and outcomes. The report reminds us that access and community services are unevenly distributed
Staffing and workforce pressure
- The report highlights workforce concerns in community and home care recruitment, retention, training and support remain major challenges. Without a stable workforce, home care and community service quality suffers
Quality and experience of care at home/community
- While some services excel, the report highlights that many people do not receive quality home or community-based support. Some wait too long or lack needed support, affecting independence, dignity and outcomes
- Community services integration with hospital discharge, home care and local authority social services remains weak leading to failure in one part affecting the entire system.
Implications for practice: What this means on the ground
- Local authorities and providers must plan for rising demand for home and community support, considering funding, staffing, commissioning models and infrastructure
- Inequalities in service availability and readiness must be addressed. Rural or deprived areas may need tailored solutions to ensure timely access to community services and home care
- Workforce strategy is crucial. Recruiting, training and retaining home care workers and community support staff must be a priority as relying on international recruitment alone is risky
- Better integration is needed. Home care, community services, and hospital/social-care discharge must be coordinated. Delays in one area, such as waiting for home care after hospital discharge, worsen outcomes and increase system costs
- Quality matters, not just quantity. It’s not enough to offer a home-care slot or community service if it’s poorly delivered. Person-centredness, timely access, responsiveness and dignity are central
Looking ahead – hope and caution
There is cause for cautious optimism, some services are doing well, providers are innovating and people are being supported in their homes. But the report is clear that unless systemic issues are addressed, home care and community services risk being the weak link in the health and social care system. The pressures of demand, workforce, regional variation and integration are very real.
The report underlines that achieving the “right care, at the right time, in the right place” will increasingly mean in the home and the community.
