The Care Quality Commission published its State of Care 2025/26 assessment on 23 October 2026. It reports rising and more complex needs alongside some improvements in access, but finds that progress remains uneven and inequalities persist.
For commissioners, the changing adult social care market is a central concern. CQC describes care-home provision becoming more concentrated while homecare fragments into smaller providers. It links these changes to financial pressures and differences in local authorities’ ability to plan and shape provision. It will continue to examine their implications for quality, choice, and personalisation.
CQC’s account also includes examples of better practice. It highlights Wigan’s work with providers and people using services to develop local provision and reduce reliance on placements outside the borough. Its wider assessment connects social care, community services, hospital discharge, workforce, and prevention.
For people developing commissioning practice, this raises a useful question: how do local decisions about markets, relationships, and resources change what people can actually access? That is a question for examining local evidence with people and providers, rather than assuming that the same commissioning arrangement will work everywhere.
Read CQC’s full report and its publication announcement. The findings and examples above are CQC’s; the question for commissioning practice is the PSTA’s reflection.