The quality of private sector care is generally lower than in council-run facilities, the health regulator has warned.

The Care Quality Commission annual report revealed there was a higher level of satisfaction reported by patients receiving treatment at council or voluntarily run organisations.

In April 2010, services run directly by councils and those run by voluntary organisations had the highest proportion of services rated good and excellent (91 per cent), but they had a smaller share of the market.

Privately run services had a smaller proportion of good and excellent ratings (81 per cent), although this was a “significant” improvement on May 2008, the report said.

The CQC also found that mental health services varied greatly in how they involved patients in planning care and reviewing treatment.

The regulator said a particular area of concern was that many detained patients who were certified as consenting to treatment appeared to be refusing to give consent or lacked the capacity to do so.

Elsewhere, the report found that there had been a reduction in the number of people contracting healthcare-associated infections.

There was a 35 per cent drop in reported cases of MRSA between 2008-09 and 2009-10, while reported cases of Clostridium difficile fell by 29 per cent.

CQC chairman Dame Jo Williams said: “There have been significant improvements in outcomes for people who use services and these services should be congratulated for the work they have done.

“However, the overall picture is far from perfect… The next few years will be a crucial time for health and social care in England.”