The quality of care in England’s hospitals and nursing homes is suffering due to poor staffing levels and pressure on resources.

In its first general report on hospitals and social care facilities, the Care Quality Commission (CQC) has warned that one in four care services are failing.

The most common failings were in relation to staffing, workforce skills and the welfare, nutrition and dignity of patients.

The regulator noted that financial pressures were resulting in hospitals and nursing homes being systematically under-staffed, with the result that care was not focused on the needs of the patient.

David Behan, CQC Chief Executive (pictured), commented: “Health and care services need to rise to the challenge of responding to the increasingly complex conditions suffered by our ageing population. That means delivering care that is based on the person’s needs, not care that suits the way organisations work.”

The CQC report follows reports that many hospital trusts are failing to meet financial targets and facing potential closures or takeovers.

Showing the other side of the coin, the quality and safety regulator’s findings echo the warnings of the Mid Staffordshire enquiry.

The report covered 291 health and social care providers of all types except GP services, which it will report on in 2013.

Of the providers inspected, the following had failed on at least one standard of care: 22% of NHS hospitals, 19% of private hospitals, 28% of care homes and 12% of dental practices.

In private hospitals, the CQC observed, the most serious failings related to mental health and learning disabilities.

One in six NHS hospitals (16%) lacked adequate staff levels, resulting in poor drug management and record keeping.

In addition, 15% of NHS hospitals did not meet the personal and dietary needs of elderly patients, while 10% did not respect their dignity.

Health Secretary Andrew Lansley has criticised press reports that healthcare contractor Serco is providing ‘understaffed’ GP services.

The company is under investigation by the Care Quality Commission following allegations that its out-of-hours GP service failed to sustain either helpline support or GP provision adequately.

In a letter to The Guardian, Lansley stated: “It is premature to draw conclusions until the Care Quality Commission has concluded its investigations”.

Lansley also noted that Serco was contracted by NHS Cornwall PCT to provide the service before the current Government’s NHS reforms.

The CQC investigation follows complaints from Conservative and Liberal Democrat MPs in Cornwall that their concerns over the GP service were not being addressed by Serco or the PCT.

‘Whistleblowers’ allege that the service allowed queues of up to 90 patients to build up on its helpline, repeatedly missed target times to visit very ill patients at home, and repeatedly cancelled home visits to reassign doctors to call centre triage.

Concerns have also been raised about the use of staff without medical training for initial patient telephone assessment.

Serco admitted temporary failings but claimed these have been addressed, while the PCT said: “We are disappointed that rumours still persist around the quality of service provided by Serco”.

However, Liberal Democrat MP Andrew George commented: “There has been a pattern of complaints and concerns that have come to me particularly over the last year that give rise to question over the safety of the service, alongside other information that suggests the service is being run on the very margins of what is clinically safe.”

Serco was contracted to provide the out-of-hours service in 2006. The contract was renewed in 2011.

The NHS will receive an immediate cash injection of up to £100m to support local community-based services during the winter months.

The additional ‘frontline commissioning funding’, which has been allocated to the emerging Clinical Commissioning Groups (CCGs), must be committed for specific purposes by mid-February or returned to the DH.

The money, amounting to £2 per patient, is to be spent on developing local care services and reducing unnecessary hospital admissions; as such, its remit may include prescribing.

While it may soften the immediate frontline impact of cuts in NHS spending, the new cash injection is only 2% of the £5bn ‘efficiency savings’ required of the NHS in 2012.

Consistent with the DH policy of shifting the focus of healthcare from acute to community-based services, the funding could (for example) be spent on improving patient access to GP services, improving services provided to nursing homes, or developing home-based services.

Health Secretary Andrew Lansley said: “I am pleased to be able to give the NHS up to £100 million in extra funding to spend directly on local frontline care for their patients during the winter months.”

He emphasised that giving a cash boost to the new CCGs would strengthen the role of local clinicians and thereby ensure that patients “receive the right care according to their individual needs”.

The money must be signed off by the PCT clusters for specific service improvement purposes: it cannot be used to help cover the cost of existing services.

This is the first time that the DH has specifically identified funding to be allocated to the new CCGs, though PCTs already delegate commissioning funds to support the CCGs in providing services.

CCGs will need to inform their PCT clusters how the funding will be utilised by mid-February 2012; each PCT cluster will similarly need to inform the relevant SHA cluster by the end of February 2012, and money not allocated will be returned to the DH.

This funding window provides an added incentive for pharmaceutical companies to demonstrate the value of their solutions for community-based healthcare.