How CQC’s findings shape the future of home care and where Ola Prestige Care Services fits in
Introduction
The Care Quality Commission’s State of Health Care and Adult Social Care in England 2024/25 presents a clear, sometimes stark picture: services are under pressure, people are waiting for care, and outcomes vary widely by geography and circumstance. Crucially for home-based and domiciliary care providers, the report highlights how gaps in community services, workforce shortages, and fragmented discharge arrangements increase risk for people when they leave hospital, and can lengthen recoveries or increase the chance of readmission.
Two themes stand out for providers like Ola Prestige Care Services: mental health and community mental health waiting times, and hospital reablement/post-discharge support (the bridge between hospital care and safe independent living at home). Both areas are central to excellent domiciliary care, and both are under pressure nationally. This article is a detailed, practical analysis of the CQC findings, what they mean for home care in Dartford and Kent, and how a nurse-led, CQC-regulated provider can respond with better outcomes for clients and families.
What the CQC found: headline issues that matter to home care
1. Access to services and long waits for community mental health support
The easy-read CQC summary flags that many people wait months for community mental health services; the report notes that significant proportions of people reported waiting three months or more for community mental health care. Long waits push need into crisis, increase carer strain, and put pressure on emergency services and hospitals.
Why this matters for home care
- People with emerging or chronic mental health needs need early, consistent community support to remain independent at home.
- Delays to therapy, crisis teams, or community psychiatric nursing increase the likelihood families will need paid domiciliary services to reduce risk, while also increasing complexity and required skills for carers.
2. Discharge processes and post-hospital support are inconsistent
The CQC emphasises that hospitals and community services do not always work together effectively. While some areas manage safe discharge and subsequent support well, many do not; staffing gaps and capacity constraints in home care and community nursing limit the ability to provide timely, personalised reablement after hospital discharge.
Consequences: poorly coordinated discharges can lead to:
- Delayed return home or being discharged before appropriate support is arranged;
- Increased risk of deterioration or readmission;
- Families left to manage complex care without support.
3. Workforce pressures and skills gaps across health and social care
CQC highlights staffing problems: there are many vacancies in adult social care, fewer district nurses per older person than in past years, and shortages of staff with the right clinical skills in hospitals and community teams. These shortages directly impact both mental health community provision and the ability to deliver timely reablement at home.
4. Unequal experiences for certain groups
The report points out that older people and people in deprived areas are more likely to be readmitted within 30 days of discharge, while people with dementia, autistic people, and those with learning disabilities often face additional barriers to accessing services or leaving hospital with a robust plan. These uneven experiences highlight where targeted, specialist home care can make a difference.
5. Areas of improvement and innovation
Even within the pressures, CQC records positive steps: local integration pilots, better use of technology and AI in some services, and examples where joined-up approaches have shortened waits or improved discharge planning. These examples provide models for scaling good practice.
Mental health: the community gap, risks, and the role of domiciliary care
The scale and shape of the problem
CQC’s easy-read highlights that a significant number of people are waiting long periods for community mental health support. Waiting for over three months was reported by many respondents; prolonged waits erode mental wellbeing and increase crisis risk.
Long waiting times for mental health support amplify demand for practical, supportive home-based care in several ways: families need help maintaining routines, managing medication, supporting social engagement, and responding to mental health crises. When community mental health teams cannot meet demand promptly, domiciliary carers frequently become first-line support, but they may lack specialist training, supervision, or clinical backup.
Key risks when mental health services are delayed
- Increased loneliness, social withdrawal and functional decline.
- Poor medication adherence or unmanaged side-effects.
- Escalation to crisis, requiring emergency care or admission.
- Heightened carer stress and burnout (often family-carers), leaving people vulnerable.
What good community-aligned home care must do (practical checklist)
To mitigate risk and fill gaps responsibly, home care should offer more than tasks, it must be clinically aware, trauma-informed, and integrated with mental health services:
- Mental-health aware training for carers (recognition of early signs, supportive communication, de-escalation).
- Clear escalation pathways and direct contacts to community psychiatric nurses, GPs, crisis teams.
- Medication oversight and liaison with prescribers to flag concerns quickly.
- Structured companionship and activation to prevent isolation and encourage engagement in therapies and routines.
- Carer support and supervision, including clinical supervision from nursing leads and access to on-call clinical advice.
A nurse-led provider is well placed to deliver these components because clinical leadership ensures that non-clinical carers do not work in isolation and that escalation and clinical governance are embedded.
Evidence-led rationale
CQC’s findings make it clear that mental health community services and social care must be aligned to prevent avoidable deterioration and crisis admissions. Where integration exists, outcomes improve; where it doesn’t, waiting lists lengthen and pressure shifts to emergency care. For domiciliary providers, this underscores why investment in training and clinical governance is not optional, it is integral to safe, effective community mental health support.
Hospital reablement and post-discharge care: the critical bridge
Why reablement matters now
The period immediately after hospital discharge is high-risk. CQC notes that some older people are more likely to be readmitted within 30 days and that many people feel unready to leave hospital or that their post-discharge care does not meet their needs. These are precisely the vulnerabilities our reablement services aim to address.
Age UK’s work also highlights the prevalence of readmission among older people and the systemic pressures that contribute to it: where community and reablement supports are limited, readmissions rise and people’s recoveries are jeopardised.
Core elements of successful reablement (what CQC and evidence recommend)
Reablement is short-term, goal-oriented support that focuses on restoring independence rather than doing tasks for someone. Key features include:
- Nurse-led assessment and clinically informed care planning from the first contact.
- Structured rehabilitation activities (mobility practice, ADL training, equipment use).
- Medication reconciliation and management immediately after discharge.
- Nutrition and hydration support tailored to recovery needs.
- Coordination with therapists (physio, OT) and primary care to follow rehabilitation goals.
- Family/carer involvement and education so gains are maintained.
CQC stresses the importance of safe, joined-up discharge and local examples show that when health and social care coordinate, readmission risks fall and recovery is quicker.
Practical shortfalls that produce readmission risk
From the CQC findings, common failure points are:
- Discharge before adequate community support is arranged.
- Home care teams that are under-resourced or lack clinical oversight (so small changes in condition are missed).
- Poor communication between hospital teams and domiciliary providers about goals, equipment, and medicines.
What reablement looks like when done well (a short pathway)
- Pre-discharge nurse assessment and a clear, time-bound care plan.
- Immediate medication reconciliation & a 24–72 hour priority visit to check understanding and tolerance.
- Daily reablement visits for a set period (e.g., 2–6 weeks), reducing as goals are met.
- Therapy links (remote or in-person) feed into the plan.
- Handover to ongoing domiciliary care or community services once independence is restored.
What the CQC findings mean locally (Dartford & Kent) and practical implications
Local pressures mirror national patterns
The CQC’s national findings, long community mental health waits, workforce shortages, inconsistent discharge arrangements map closely onto local realities across Kent and the DA postcode area: rising demand from an ageing population, friction at the hospital-community boundary, and limited availability of skilled district nursing and specialist community psychiatric staff. This local dynamic increases the probability that families will seek private, high-quality reablement and mental-health-aware home care to secure timely support.
For families and commissioners: priorities to reduce readmissions and improve outcomes
- Commission short, intensive nurse-led reablement packages after discharge (not open-ended hourly care).
- Specify mental-health competence and supervision for carers supporting people with a diagnosis.
- Insist on direct lines between provider clinical leads and hospital discharge teams for rapid information sharing.
- Fund outcome-based KPIs (recovery of ADLs, reduced readmission, client satisfaction) rather than solely hours delivered.
How Ola Prestige Care Services responds: a model aligned to CQC learning
Ola Prestige Care Services has shaped its model to meet precisely the gaps CQC highlights. The practices below show how a nurse-led, CQC-regulated domiciliary provider can reduce risk, improve recovery, and deliver the dignity the report calls for.
1. Nurse-led clinical governance and leadership
Clinical leadership ensures that every reablement package is clinically informed, medicines are reconciled accurately, and carers are supervised for complex cases. This reduces the chance of missed deterioration and supports escalation to GPs or community teams.
Why it matters: CQC points to skill shortages and the need for services with the right expertise; nurse leadership directly addresses that weakness.
2. Rapid post-discharge response & goal-led reablement
A priority visit within 24–72 hours of discharge (when possible), followed by a short-term reablement schedule with measurable goals (mobility, washing/dressing, medication independence). Ola Prestige Care’s approach emphasises measurable restores of function rather than indefinite task delivery.
Why it matters: The CQC notes people often feel unready to leave hospital and that coordinated post-discharge care is uneven; rapid, goal-oriented reablement reduces that risk.
3. Mental-health aware training and escalation pathways
All carers receive mental-health awareness training; complex cases are supported by the nursing team and connected to community mental health services. Ola Prestige Care prioritises liaison with local CMHTs and crisis teams to ensure carers aren’t expected to manage risks alone.
Why it matters: With community mental health waits and skills challenges flagged by CQC, a model that proactively trains and clinically supports carers mitigates risk and improves continuity.
4. Medication safety & reconciliation protocols
Robust medication reconciliation at first contact after discharge, plus daily medication checks until adherence is stable. Carers are trained to identify side-effects and report immediately to the nursing lead.
Why it matters: Missed medications and errors are recurrent drivers of early readmission; CQC highlights medication as a key issue in post-discharge safety. Clinical oversight reduces error.
5. Family involvement & education
Families are included in goal setting and taught how to support mobility, safe transfers, and simple rehab exercises. This keeps progress sustainable once intensive reablement ends.
Why it matters: CQC emphasises person-centred care — reablement is stronger when the family is part of the plan and understands its role.
6. Data, outcomes and continuous improvement
Ola Prestige Care measures reablement outcomes (e.g., ADL scores, reduced hospital readmission, client satisfaction) to demonstrate value and continually refine practice.
Why it matters: Evidence of reduced readmissions or faster independence supports commissioning and demonstrates alignment with CQC’s call for services to deliver safe, effective care.
Practical recommendations (for providers, commissioners, and families)
For home care providers
- Develop nurse-led reablement pathways with explicit, short-term goals and measurable exit criteria.
- Invest in mental-health awareness and clinical supervision for staff.
- Build direct, standardised communication templates with local hospitals for discharge handover (meds, risk, goals).
- Use outcome metrics (reablement success, readmission reduction) when negotiating contracts.
For commissioners and local health systems
- Commission targeted reablement bundles (time-limited, clinical oversight) rather than open-ended hourly care.
- Fund rapid response slots for home visits (24–72 hours) post-discharge.
- Strengthen community mental health capacity and ensure community mental health teams have clear pathways to work with domiciliary providers.
- Support workforce development (training bursaries, career pathways) to reduce vacancies in social care and district nursing.
For families and referrers
- Ask whether the provider offers nurse-led reablement and rapid post-discharge visits.
- Ensure there’s a clear plan for medicines reconciliation and follow-up.
- Check that carers receive mental-health awareness training and that there is clinical oversight/liaison with community mental health if needed.
Measuring success: metrics that matter
To be accountable and to demonstrate the difference that good reablement and mental-health-aware domiciliary care make, track:
- 30-day readmission rates for clients supported by post-discharge packages (aim for reduction vs. local baseline).
- ADL improvement (e.g., Barthel Index or similar) across the reablement period.
- Medication adherence and adverse events reported in first 7 days post-discharge.
- Client/family satisfaction and perceived readiness for discharge.
- Escalation response times when carers raise clinical concerns.
CQC’s message is clear: services must show they keep people safe and improve outcomes; robust measurement is how providers prove it.
Challenges and realistic next steps
Key barriers to rapid improvement
- Workforce shortages: Recruitment and retention remain a systemic barrier. CQC flags that there are many roles to fill in adult social care, and fewer district nurses per older person than a decade ago.
- Fragmented commissioning: Short contracts and narrow specifications can prevent providers from investing in clinical leadership and training.
- Variable local integration: Not all Integrated Care Systems have the same capacity to coordinate hospital discharge and community reablement.
Practical next steps for providers like Ola
- Demonstrate clinical governance and publish reablement outcomes to win commissioner confidence.
- Build formal links with local hospitals, therapy teams and CMHTs (memoranda of understanding or referral pathways).
- Offer apprenticeship and training pathways to grow the workforce locally and reduce reliance on agency staff.
A forward look: what better integration would deliver
If the CQC’s positive examples (where systems work together and innovation is used wisely) were scaled, the benefits would include:
- Shorter waits for community mental health care and fewer crises.
- Safer discharges with rapid, clinically governed reablement leading to fewer avoidable readmissions.
- Better value for money: targeted reablement reduces long-term care needs and hospital costs.
- Greater public confidence in local care pathways and reduced stress for families.
Ola Prestige Care’s model is a nurse-led, clinically governed, mental-health aware, and outcome-focused to operate in that better-integrated future.
Conclusion: Where Ola Prestige Care Services fits in
CQC’s State of Care 2024/25 is a call to action: services must be safer, more joined up, and more person-centred. For older people and adults with mental health needs, the evidence is unequivocal, the moments after hospital discharge and the availability of timely community mental health support are determinative for outcomes.
Ola Prestige Care Services is positioned to be part of the solution: our nurse-led approach, rapid reablement pathways, mental-health-aware training, and focus on measurable outcomes align with the CQC’s findings and recommendations. We believe that clinical leadership, strong communication with local health services, and outcome-focused reablement can reduce readmissions, restore independence, and protect the dignity of people recovering at home.
If you are a family seeking safe, clinically governed reablement or a clinician considering post-discharge options choose a provider who operates to CQC standards, offers nurse leadership, and measures outcomes. Recovery begins at home; make that first step count. Call us today for a free care conversation — we’ll listen, plan, and support every step.”
References & further reading (selected)
- Care Quality Commission — The State of Health Care and Adult Social Care in England 2024/25 (Easy Read). Key findings and summaries referenced throughout. Care Quality Commission
- Age UK — The State of Health and Care of Older People in England 2025 (report on readmissions, health trends, and social care pressures). ageuk.org.uk