The Care Operator — Edition #9

Good morning. Five things to know heading into the weekend.

The numbers are in — and they're not great. Of the 111 local authority assessment reports published so far, 39 received a "Requires Improvement" rating and two were rated Inadequate (Blackpool and East Riding of Yorkshire). Three London boroughs — Barking & Dagenham, Camden, and Kensington & Chelsea — were the only councils to achieve Outstanding. The remaining 67 (60%) were rated Good.

CQC confirmed this week that all 153 on-site assessments are now complete. Final reports will be published by early summer.

Here's the detail that matters: the margin between Good and Requires Improvement is razor-thin. Nineteen councils got the lowest possible Good score of 64 out of 100. Seven Requires Improvement councils scored 62 — just two points behind. Westmorland and Furness missed Good by a single point. Meanwhile, directors are raising concerns about the process itself. Derby's strategic director described the factual accuracy process as a "beast" and said his authority identified numerous inaccuracies in its report. ADASS vice-president Phil Holmes said the process had been "bumpy" and called for a simpler approach. CQC is now considering introducing "assurance meetings" as part of its next-phase approach from April.

Why this matters for providers. These assessments judge how well your local authority commissions and oversees care — including how it shapes the market you operate in. A council rated Requires Improvement on commissioning, workforce planning, or market sustainability is a council that may struggle to fund and support providers properly. Cross-reference your council's result with the funding changes we covered on Wednesday. If your council scored poorly and the ring-fence is coming off its social care grants, that's a compound risk.

The workforce cliff-edge we flagged is now visible in the data. Just 3,178 Skilled Worker visas were granted to care workers in 2025, down from 107,847 in 2023. That's a 97% collapse. In the final quarter of 2025, just 23 overseas care workers were granted entry to the UK. Twenty-three.

This follows the government's July 2025 decision to end overseas recruitment of care workers under the Skilled Worker route. Current visa holders can extend or switch employers until July 2028, but no new international recruitment is possible. The broader Skilled Worker visa picture is equally stark — total grants fell to 45,797 in 2025, the lowest since the UK left the EU.

Why this matters. England's adult social care sector has 73,000 vacant roles and a vacancy rate of 6.3%, nearly three times the national average. International recruitment was the pressure valve. It's now shut. Domestic recruitment has to fill the gap — but the sector is competing with retail, hospitality, and the NHS, all of which pay more for comparable work. Providers who haven't already built a domestic recruitment pipeline need to start now. The transition period buys time for existing international staff, but the flow of new workers has stopped.

New research from the Joseph Rowntree Foundation, published this week, makes the economic case that low care worker pay generates billions in hidden costs through staff shortages and turnover. As of March 2024, 40% of adult social care workers in England were paid below the Real Living Wage. The sector's 8% vacancy rate is roughly three times higher than comparable low-paid sectors like retail and manufacturing.

The report identifies two categories of hidden cost: direct financial costs (recruitment at up to £3,600 per worker, training, agency spend) and lost output costs (vacancies, onboarding inefficiency, reduced care delivery). The report also highlights that social care is often a "stepping stone" into the NHS, with 9% of care worker turnover moving into NHS roles that pay more for similar work.

Why this matters. This research drops at exactly the right time. The Fair Pay Agreement consultation closed in January. Secondary legislation is expected by autumn 2026. The JRF report provides the evidence base that paying more isn't just fair — it's cheaper than the alternative. If you're making the case to your board for above-NLW pay, or to your local authority for higher fees, this report is your ammunition. MHA, which has paid the Real Living Wage for eight years, told JRF that it has reduced turnover, cut agency spend, and improved resident experience as a result.

Published this morning: the latest adult social care provider statistics quarterly update, covering data to February 2026. This includes care home occupancy levels, resident numbers, domiciliary care recipients, visiting data, COVID absence rates, flu vaccination uptake, and digital social care record adoption. The data tables are on GOV.UK now.

Why this matters. This is your benchmarking data. If your occupancy is below the national average, or your digital social care record adoption is lagging, this is where you find out. The quarterly stats also feed into DHSC's monitoring of whether the sector is stable enough to absorb the funding changes taking effect in April. Pay attention to any movement in care home occupancy — it's the canary in the coal mine for market sustainability.

Two dates for your diary. On Wednesday 19 March, the Health and Social Care Committee holds the final evidence session of its "cost of inaction on adult social care reform" inquiry. This will be the last chance for witnesses to feed evidence before the committee writes its report — which will be the most significant parliamentary document on social care reform in years.

Then on Wednesday 26 March, the same committee will question senior health figures on the government's plans to abolish NHS England and merge it with DHSC. This matters for social care because the structure of the NHS directly affects how integrated care systems work, how Better Care Fund money is pooled, and how neighbourhood health services are commissioned.

JRF report: "The hidden cost of low pay in the social care sector" — published this week at jrf.org.uk. Essential reading if you're negotiating fees, making a business case for above-NLW pay, or preparing evidence for the Fair Pay Agreement process. The report quantifies what most providers already know intuitively: turnover is ruinously expensive, and the recruitment-training-departure cycle costs more than just paying properly in the first place.

LGC's analysis of the CQC local authority assessments — the piece that broke down the one-third failure rate, the razor-thin scoring margins, and the directors raising concerns about process accuracy. If you only read one thing about how your commissioning environment is being judged, make it this.

23 — the number of overseas care workers granted entry to the UK between October and December 2025. In the same quarter of 2023, tens of thousands were arriving. The international recruitment pipeline that stabilised many providers' staffing models over the last three years has been switched off. Domestic workforce strategy is no longer optional.

Three stories this week point in the same direction. A third of councils aren't meeting the CQC's standard for adult social care. International recruitment has collapsed. Low pay is costing the sector billions in turnover. Each of these is manageable on its own. Together, they describe a system where the people who fund care, the people who provide care, and the people who work in care are all under simultaneous pressure — and the structural fixes (Fair Pay Agreement, new CQC frameworks, funding reform) are all at least eighteen months from landing.

Providers who are thriving right now aren't waiting for the structural fixes. They're paying above the floor where they can. They're building domestic recruitment pipelines. They're engaging with their local authority before the budget is set, not after. They're reading the CQC local authority assessment and using it to ask harder questions of their commissioners.

The system is being rebuilt. But you still have to operate in the one that exists today.

Have a good weekend.

If someone forwarded this to you, subscribe at thecareoperator.com — it's free.

Hit reply if there's something you want us to cover. We read every message.

— The Care Operator