The care of the thousands of people with dementia is being compromised by a shortage of staff in both adult social care and in the NHS, and a lack of understanding of the needs of those living with dementia, according to a new report by the CQC.
The report, based on engagement with people living with dementia and their loved ones and an analysis of information held by the CQC, highlights a severe shortage of staff, a lack of dementia-specific training for nurses and delayed patient diagnoses. The issues are at all levels – in the community, in care homes and in hospitals.
James Bullion, interim chief inspector of adult social care at the CQC, said:
“This report shines a light on the challenges that people with dementia and those who care for them face when accessing and using health and social care services,”
He added that the CQC plans to use the findings from the report “to develop, alongside people with lived experience, providers and other stakeholders, a definition of what good, joined-up dementia care looks like so that we can apply it to all areas of our regulatory activity.”
Jen Keen, Alzheimer’s Society’s associate director of evidence, policy and influencing, welcomed the report and the CQC’s commitment to developing a dementia strategy.
“We know that dementia care needs an urgent overhaul in the UK. This report paints a stark picture of long-standing issues which cannot be ignored including staffing challenges, a lack of dementia-specific training, and pressure on unpaid carers. It also highlights some shocking findings notably a concerning disparity in the rates of abuse notifications in care homes where the majority of people were living with dementia.”
Dementia is a significant health issue in the UK; in February 2025, nearly half a million people in England had a dementia diagnosis. The actual number of people living with dementia is estimated to be much higher (figures from the Department of Health and Social Care estimate the figure to be over 700,000).
That number is increasing due to population growth and an ageing population, note the CQC, and by 2040 it estimates that 1.2 million people are expected to be living with dementia in the UK.
Two-thirds of care homes support at least one person with dementia, and in around a third of care homes, the majority of people supported have dementia, according to current CQC data.
The CQC found that staffing issues are more likely to be reported at care homes where more people have dementia; as the proportion of people with dementia increases, staff-to-person ratios decrease, staff turnover increases, there are fewer qualified staff, and fewer staff have named supervisors. This issue makes high quality care more difficult to achieve.
In addition, the CQC’s analysis of notifications of adverse events found that care homes that support more people with dementia have a higher rate of adverse events.
In the community, ongoing care is often lacking and the CQC heard from those living with dementia and their loved ones that they very often have to seek out community charity support groups themselves.
Staff issues, including shortages of staff and a lack of training for staff, was an issue in adult social care and in acute settings and reflected in what people told the CQC about the care their loved ones received. Issues included loved ones being left alone for long periods of time, lack of checking on fluid and food intake, and a lack of consistency in care staff meaning no relationship could be built up, something that is very important to those with dementia.
It is not just more staff that are needed, but more with training in dementia care. The lack of training of health and social care staff means that they do not always understand the specific, personal care needs of people with dementia and as a result care environments, like hospital wards and care homes, sometimes do not support people’s wellbeing.
Adult social care providers are already struggling to recruit and retain sufficient staff, recruiting staff with specialist training is an additional challenge. The CQC notes that data from Skills for Care highlights that only 29% of the care workforce in England have had any kind of dementia training.
A statutory duty for dementia-specific training for all CQC-registered providers, is something that Jen Keen, of the Alzheimer’s Society’s would like to see:
“It’s vital that the findings from this work help to drive real improvements to dementia diagnosis and care, including a statutory duty for dementia-specific training for all care providers registered with the CQC, as well as a long-term social care workforce strategy.”
The waiting time for diagnoses is being affected by staffing issues. The CQC found that although increased numbers of people are being admitted to relevant services, average staffing levels have not increased to reflect this leading to services struggling to cope with demand. The average waiting time from referral to diagnosis increased from 124 days in 2021 to 151 days in 2023.
There is a high geographical variation between diagnosis rates; in the South West, 61.2% of people aged over 65 estimated to have dementia had a recorded diagnosis, compared with 70.1% in the North West.
As well as the bad, the report also looked at what constitutes good care for those people living with dementia, which comes down to care provided in considered environments by well-trained, compassionate professionals who understand the person and how best to relate to them.
In addition, good community support through diagnosis and beyond, including from a GP, can improve wellbeing and help people through the diagnosis and assessment.
The findings of the CQC report will inform the regulator’s new dementia strategy. As part of this, the CQC is set to produce statutory guidance for providers on how to care for people with dementia, as well as a definition of good practice.
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