The Care Quality Commission had concerns about safety and care at half of NHS hospitals and care homes providing nursing last year, reveals its latest report on the state of health and social services in England.

The regulator’s annual analysis shows just 51 per cent of NHS hospitals and 51 per cent of care homes were fully compliant with an essential standard demanding “effective, safe and appropriate care” for patients.

Inspectors had “minor concerns” about 16 per cent of NHS hospitals and moderate to major concerns about 33 per cent, says the State of Care report, which covers the year up to March 2011.

There were minor concerns about 22 per cent of care homes relating to nursing and moderate to major concerns at about 27 per cent.

Failure to meet the standard was one of the top three reasons why NHS and adult social care providers were served with official compliance or warning notices, said the CQC.

The overview report also shows NHS hospitals and care hospitals were most likely to fall down on standards around risk management with moderate to major concerns about more than a fifth of hospitals and 14 per cent of care homes.

This is the first year the CQC has reported on the state of care under new health and social care legislation – the Health and Social Care Act 2008.

The regulator said the findings were therefore a “baseline” for future reports.

The report also suggested NHS organisations were less good at respecting and involving patients in making key decisions about their care compared to independent providers.

The report shows 71 per cent of NHS hospitals and 70 per cent of care homes with nursing met standards on respect and involvement, compared to 93 per cent of independent hospitals and clinics.

In addition more than 10 per cent of NHS hospitals and care homes with nursing had moderate to major concerns about consent to care and treatment.

CQC chair Dame Jo Williams said the report provided “a valuable picture of people’s experiences of access to care services, the choice and control that they have when using services, and the quality of the care that is provided”.

“The next few years will see a changing landscape in care, but we are committed to maintaining a relentless focus on compliance with essential standards of safety and quality,” she added.