How good is care across the country?

When we check on how good health care and social care is across England, we don't just look at the care people get from their services, we also look at how it is bought. This makes a big difference to how good it is.

We found that in 2009:

• health care and social care carried on getting better
• some services and parts of the country did really well
• a few services were not good enough
• some did not keep people safe enough
• some did not have enough staff to meet people's needs
• others were not trained properly.

Social care for adults

There are 25,000 social care services in England most of these are privately run.

They include:

• care homes
• home care agencies
• nursing agencies
• shared lives schemes, where people give care and support to someone else in their own home.

We checked how good services were and found:

• 3 out of 4 of them were "good" or "excellent"
• that means 1 in 4 care homes or home care agencies were "ok" or "poor".

We checked 148 councils looking at the social care they were arranging for local people and found that:

• nearly all of them were 'good' or 'excellent'
• 8 councils were only 'ok' and we asked them to get better urgently
• no councils were 'poor'.

Health care

England has 392 NHS trusts:

• 169 acute and specialist, short term and special care
• 152 primary care, for services like GPs
• 57 mental health services
• 11 ambulance trusts, and
• 3 for people with learning disabilities.

We checked how good NHS health care was and found:

• 3 out of 20 were "excellent"
• nearly half were "good"
• 1 in 3 were "fair"
• 1 in 20 were "weak".

We found that NHS trusts had got better but acute hospital trusts had done a bit worse. Fewer of them get an "excellent" score.

There are also more than 3,000 health care services that are not run by the NHS. They passed 2 out of 3 of the checks we have for them.

Keeping people safe in care services

Everyone using health care or social care has the right to be kept safe. People can be hurt by poor care or abuse.

Staff also have the right to be safe at work.

Lots of people worry about catching something when they go into hospital.

We found:

• the NHS has got much better at stopping people catching an infection in hospital, but
• 1 in 4 acute NHS trusts did not pass a check we have stopping people catching an infection
• 1 in 10 NHS trusts need to get better at keeping people safe
• 1 in 10 councils need to get better at keeping people safe, and
• 1 in 3 councils need to have better safety training for staff.

Training for staff

We know you cannot have good safe care without well trained staff. But we have found lots of services do not train staff as well as they should.

We found:

• 3 in 4 NHS trusts, and
• 1 in 20 care homes did not pass our checks on training.