Fears have been raised that vulnerable people in Norfolk are getting a raw deal - because the quality of their care lags far beneath the national average.
Of more than 450 county care providers, only 70.9pc were rated as good or outstanding by watchdogs as at the end of April - below the national average of 83.7pc and regional average of 84pc.
It means Norfolk is ranked sixth bottom among 151 local authorities for the percentage of care providers - care homes, nursing and home support - rated good or outstanding by the Care Quality Commission.
Alarmed Norfolk County Council bosses have set a target to get 85pc of all types of care provision rated either good or outstanding by April 2024.
They are also concerned at "significant variance" across the county.
For example, in the Norwich area, 81.8pc of nursing is rated good or outstanding, but it is between 55.5pc and 66.7 across the rest of the county.
Home support quality stands out in the west and north of the county, where 81.8pc and 86.4pc, respectively, is rated good or outstanding – but that figure is only 62.5pc in the east.
Thirty-eight Norfolk care homes or providers closed permanently between 2020 and 2022.
Council bosses have identified a number of reasons for the issues, including:
* Norfolk's rural nature makes it difficult to recruit workers, nurses and managers, which had prompted James Bullion, the council's director of social care to issue a recruitment plea.
* The size of the county has made it difficult for the authority to make sure quality is maintained
* Some care homes and facilities are ageing and not suitable for modern needs.
A group of county councillors was tasked with looking into the issue and the authority has hired extra staff to carry out quality checks.
At the end of April, bosses from across the Norfolk care system met to talk about the problems.
And on Monday (June 6), the Conservative-controlled cabinet at Norfolk County Council is likely to agree to set up a new board to drive up the quality of privately provided adult social care.
The new Care Quality Programme Board will be led by the county council and the NHS Norfolk and Waveney Clinical Commissioning Group, working with care homes and providers to make improvements.
That new board will operate within the new Integrated Care System which will begin next month, bringing together hospitals, councils, GP practices, community and mental health trusts and other care providers.
Bill Borrett, the county council’s cabinet member for adult social care, said: “We’re absolutely committed to supporting the care sector: throughout the pandemic we have distributed over £55m in extra funding and just a few months ago we announced a big uplift in the fees we pay providers for care.
"But support needs to be more than just funding: we need to look at how the care sector works and how it fits in with the wider health and care system."
Christine Futter, chief operating officer of Norfolk and Suffolk Care Support and a director of Norfolk Care Association (NorCA), which represents social care organisations, said: "NorCA are committed to working together with Norfolk County Council and other partners to find solutions to improving quality in the care market.
"We must not forget we do have some excellent care provision already but wish to work collaboratively to find ways together to raise the ratings in Norfolk.
"We are keen to engage with the care market to identify initiatives that can assist them to make improvements and build on best practice, whilst recognising the enormous strain and pressure they have been under during COVID."
Tim Adams, Liberal Democrat county councillor, said: "I have been pushing the council to do more to improve the quality of social care in Norfolk for over three years now so we are delighted some action has finally been taken on this.
"It will need the council to show real leadership and to significantly up its game if we are to see the rapid improvements that are needed."
And Emma Corlett, deputy leader of the Labour group, said more care should be provided directly by the council.
She said: "Rather than continue to pour money in to a broken system, we should embark on a programme of insourcing to make care fair - fair for those providing it, for those receiving it and for unpaid carers, who continue to pick up the pieces of a failed system too often at cost to their own health."
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