In a speech later, Baroness Casey will say the Nuffield Trust and the Institute for Government report shows ‘no one is in charge' of social care.

She will say: ‘Successive Governments have been asleep at the wheel. In research we're publishing today the lack of "stewardship" of social care comes through clearly.'

The report, which is part of a series on England's adult social care sector being published by the commission, shows social care sector has become dominated by private providers in a ‘largely uncontrolled and unintended way'.

Previous Nuffield Trust research has described the Care Quality Commission's role as being like a ‘spectator at the site of a car crash'.

The new research shows two people with the same condition can have different experiences depending on where they live, with self-funders paying on average, 40% more for the same service than people supported by the council.

In addition, England is the only country in the UK without a mandatory register of care workers. 

Nuffield Trust deputy director of research and report co-author, Natasha Curry, said social care was ‘confused and complex', adding ‘we need a clear vision on how to untangle the chaotic structure the sector has currently'.

Institute for Government associate director, Stuart Hoddinott, said social care had ‘evolved haphazardly and with little clear planning'.

Reaction 

Sir Ciarán Devane, chief executive of The NHS Alliance, said: ‘The failure over many years by successive Governments to bring in lasting reform is felt by our members in the difficulties they face managing the flow of very frail patients. Social care plays a vital role in keeping people well and supported in the community. Too little support means more people needing hospital care, while shortages in social care can leave patients stuck in hospital when they are well enough to leave. Helping people leave hospital as soon as they are well is in everyone's interests. Patients can continue their recovery at home, while hospital beds are freed up for those who need them most.

 

‘Health service leaders will do all they can to help make any reform of the social care system a success. However, those changes must focus on prevention and delivering better outcomes for people, rather than simply to manage pressures elsewhere in the system. Everyone deserves to receive the same level of assessment, care and treatment, regardless of what their health condition is. They must get the support they need to stay independent, at home and out of hospital wherever possible.'