14.Lord Laming proposed a special inquiry select committee to consider Adult Residential Care Services.
15.Adult social care is the support provided to adults (both older people and people of working age) with physical disabilities, learning disabilities, or physical or mental illnesses, and their carers. This may include personal care (such as support for eating, washing or getting dressed) or help with domestic routines (such as cleaning or going to the shops). Adult social care needs are becoming increasingly complex and costly. Whilst public discourse tends to focus on social care for the elderly, the Economic Affairs Committee’s 2018 report found that almost half of all public funding for social care is spent on the working-age population.
16.The Government have recently announced their plans for social care reform. A white paper on health and social care integration was published in February 2021 and the Health and Care Bill was introduced to Parliament on 6 July 2021. Plans to introduce a new, UK-wide 1.25 per cent Health and Social Care Levy, from April 2022 to fund additional spending on social care were announced in September 2021.
17.Adult social care in England is provided by more than 14,000 different provider organisations, most commonly through care homes and nursing homes, and domiciliary care agencies. The delivery of social care is fragmented. The Nuffield Trust has described “a number of different intersecting markets, each with different mechanics, features and ambitions and providing services to a huge number of people with a wide range of needs.” They outlined additional complexity within the system: “within these overlapping markets, care is provided by a vast and diverse set of providers. Furthermore, there is substantial regional variation in the structure, size and features of the provider market.”
18.The Care Quality Commission (CQC) is responsible for regulating social care. The CQC does not regulate all types of social care activities, however, and so there are many care providers about which little is known. A recent report estimated that in 2019–2020 only 68% of adult social care establishments were regulated by the CQC. The Government have announced plans to introduce CQC oversight of Local Authorities’ commissioning of adult social care through the Health and Care Bill.
19.A special inquiry committee could examine the role of the CQC in ensuring that social care needs are met by local authorities and could examine how NHS trusts and local authorities could better coordinate and ensure that the appropriate bodies are delivering the appropriate care. In addition, an inquiry could seek to make recommendations on how to streamline and consolidate social care provision and ensure that all providers are regulated. Furthermore, an inquiry could explore the duty place of care that exists between local authorities and recipients of social care and could examine if additional enforcement powers might be needed, and if so, what body they might be discharged to.
20.A special inquiry committee on this topic might consider the following:
9 House of Commons Library, Adult Social Care Funding (England), Library Note, , 11 December 2020, p 5
10 King’s Fund, ‘Key facts and figures about adult social care’ (2 July 2021): November 2021] [5
11 Economic Affairs Committee, (7th Report, Session 2017–19, HL Paper 392), para 41
13 [Bill 183 (2021-22)]
14 HC Deb, 7 September 2021,
17 Skills for Care, The state of the adult social care sector and workforce in England (October 2020) p.26: November 2021] [accessed 5
18 [Bill 183 (2021-22)] as amended in Public Bill Committee, section 25
19 The Lord Carter report on operational productivity and performance in English NHS acute hospitals found that as many as 8,500 beds in acute trusts were blocked with patients who were medically fit to be transferred but couldn’t be due to delays in organising the next stage of their care, or a lack of suitable care being available through their local authority. Department for Health and Social Care ‘Independent report: Productivity in NHS hospitals’ (5 February 2016): [accessed 5 November 2021]. See also House of Commons Health Committee, (Second Report, Session 2013–14, HC 171), para 39
20 Care Act 2014,