By Phil Eckersley (Founder and Managing Director of Bridgewater Home Care)
The Care Quality Commission’s State of Care 2024/25 report paints a picture of a sector at a crossroads.
Domiciliary care is expanding at a record pace, driven by demographic change and growing demand for people to receive support in their own homes. Yet, the very services that make independence possible for older and vulnerable people, including those with dementia, are facing the toughest conditions we’ve seen in decades.
For those of us who have dedicated our careers to building sustainable, person-centred home care businesses, this report is both a wake-up call and a moment of opportunity.
In this blog, we’ll dive into the facts around care, what they mean for individuals with dementia and what can be done to tackle these issues.
The increased pressure on care services
The report confirms what many of us already feel on the ground: the system is under immense pressure.
Vacancy rates in home care are currently at 7%, a decrease from previous years, but still an issue for many organisations and remain higher than unemployment at 4.7%.
Alongside issues with hiring and staff retention, the expectations of regulators and clients are increasing. The CQC is clear that quality is inseparable from workforce wellbeing, leadership, and human rights compliance. In simple terms, a provider that doesn’t invest in its people, its values, and its systems cannot deliver safe or outstanding care.
The need to prioritise staff and client care
Too often, home care is viewed through a transactional lens as an hourly cost rather than a life-changing relationship.
But those of us close to the work know that care is not a commodity; it’s a human service built on trust, continuity and compassion. Every act of care, from helping a client dress in the morning to preparing a meal or managing medication, carries emotional and relational weight.
At Bridgewater, we have always championed a values-led model of care. We recruit for empathy, patience, and integrity, not just experience.
We invest in ongoing training and support for our staff and reward long-term commitment. We also support our teams to grow into leaders, whether that’s as Senior Care Specialists, Dementia Champions, or future franchise owners themselves.
When care professionals feel valued, supported, and proud of what they do, the ripple effect is extraordinary: clients thrive, families relax, and quality improves across every metric.
How the industry impacts Dementia care
One of the most urgent themes in the CQC report is the growing impact of dementia.
The economic cost is set to more than double to £90 billion within 15 years, but the human cost is far greater. For every statistic, a family is affected, navigating confusion, loss, and love, often without the right professional support.
The CQC found that an inconsistent understanding of dementia remains widespread, which in turn affects the quality of care towards those living with the condition.
Too many people living with dementia still receive care that focuses on physical needs while overlooking emotional, sensory, and communication support. In some cases, nutrition and hydration needs were not adequately met.
How services succeed in caring for dementia clients
The best services, those rated Outstanding, demonstrate the opposite. They build care around the person, not the diagnosis. They use creativity and empathy to maintain identity, dignity, and purpose. Whether that’s involving clients in baking, reminiscence, or community activities, the difference lies in seeing the person first.
At Bridgewater, dementia care is not a specialism; it’s a core skill. Every carer receives dementia awareness training, and our senior teams are encouraged to become Dementia Friends and Champions. We understand that great dementia care isn’t just about what we do, it’s about how we do it: with patience, consistency, and genuine human connection.
How can we improve the quality of dementia care?
The Importance of Leadership and Evidence
CQC’s message to providers is unambiguous: if you can’t evidence it, you didn’t do it.
Inspection under the new Single Assessment Framework demands robust proof of impact – not only on safety and effectiveness, but on quality of life, wellbeing, and inclusion.
This is where smaller, values-driven providers have an advantage. They can act quickly, innovate locally, and build more personal connections and a deeper understanding of our clients and teams. Documenting this strategy is crucial so that inspectors, commissioners, and families can see the evidence of impact.
At Bridgewater, we combine human connection with professional discipline. Every care plan, review, and outcome is measured and recorded, and all of our franchises follow the same care structure for consistency across the board. We don’t do this because the regulator demands it, but because it helps us learn, improve, and celebrate the difference we make.
Sustaining excellence
The report’s warning about financial fragility is real. Many small providers are handing back local authority contracts because fee rates are unsustainable. Yet, this is also driving innovation.
Providers that diversify by balancing private and funded work, focusing on specialist dementia care, and building strong community partnerships are proving that quality and sustainability can go hand in hand.
Bridgewater’s franchise network is built around this exact principle, combining commercial strength with community purpose.
Our franchisees are empowered business owners who deliver exceptional care through consistent standards, shared systems, and a strong support infrastructure. Together, we’re building a network that can grow without losing its heart.
Key takeaways
The State of Care report shows where we stand on dementia care and care quality in general and points towards where we need to go:
- A sector where home care is recognised as a professional, respected career.
- Where dementia care is rooted in understanding, empathy, and dignity.
- Where data and human stories work together to demonstrate impact.
- And where business owners in social care can thrive because they lead with values.
Bridgewater Home Care was founded on the belief that excellent care begins with excellent people. That belief has never been more relevant.
If you’re interested in becoming part of a company that puts culture, evidence, and compassion at the centre of its work, get in touch today and discover how to become a Bridgewater franchise owner.
