The coronavirus pandemic has pushed the “fragile” social care sector even closer to the edge, the head of the care regulator has warned.

Covid-19 exposed and exacerbated problems in social care such as the pressing need for reform, investment and workforce challenges, the Care Quality Commission (CQC) said.

Chief executive Ian Trenholm said: “Covid has pushed social care even closer to the edge, and we need to make sure that action takes place now, and it is more than just funding – this is funding and workforce and operations support.”

Mr Trenholm said providers are still struggling to see the impact of Government-pledged money on the ground, adding: “These are businesses that were already operating on wafer-thin margins, Covid has made that worse, that money needs to arrive in days, rather than weeks and months.”

And, noting the sector’s high workforce turnover, he said he hopes to reach a point where a 17-year-old school pupil starts to think of social care “as an aspirational place to work”.

It comes as the CQC launched its annual assessment of the state of health and social care in England for 2019-20.

The report found evidence of a lack of communication between sectors during the pandemic, with some care homes feeling “completely isolated and stranded”.

One care home manager was called at 10.30pm to be told 24 residents had tested positive for coronavirus, and was left without support overnight to deal with the situation, it said.

As of March 2020, 80% of adult social care services were rated as good and 5% as outstanding, the analysis found.

But the proportion of inpatient services for people with a learning disability and/or autistic people that were rated inadequate was 13% – triple the proportion the previous year.

They have been at greater risk during the pandemic because wards are often unsuitable environments in which to socially distance, the CQC said.

Liz Kendall, Labour’s shadow minister for social care,  said the Prime Minister must bring forward his promised long-term plan for the sector, adding: “People with learning disabilities and autism are being particularly badly let down, especially in private sector inpatient units.

“This is especially worrying during a period where family contact has been reduced or stopped, leaving thousands of people alone in services that aren’t fit for purpose.”

And 3% of care homes (512 homes, accounting for just under 23,000 beds) had never been rated higher than “requires improvement”.

A further 8% had previously received one “good” or “outstanding” rating but were currently below this standard.

Before Covid-19, service users and professionals had raised concerns about low staffing levels in care homes reducing the quality and safety of care.

The regulator said inspectors have not seen any clear relationship between care home ratings and numbers of Covid-19 deaths in the first months of the outbreak.

In community social care, 3% of providers (212, covering more than 9,000 people), had never been rated higher than “requires improvement” as of March 2020.

A further 5% had previously received a higher rating before falling back to a lower one.

Access to services was also noted as an issue, particularly child and adolescent mental health services, residential nursing care and high-quality home care.

The report warns that, until the long-term impact of reduced or delayed referrals as a result of Covid is understood, there is a risk that children may be suffering alone and experience further deterioration in their mental health.

Dr Jennifer Dixon, chief executive of the Health Foundation, said: “So many people are going without the social care they need. Care workers are under enormous pressure and providers are at risk of collapse.

“This is the fifth successive year that the Government’s own regulator has raised the alarm about the social care sector, with ever more stark warnings that continue to be ignored.

“The Prime Minister made a very clear promise to fix social care once and for all. Will this Government finally deliver?”

Veronica Gray, director of policy at Hourglass, noted that “there has been no improvement in the ratings for adult social care over the last twelve months, highlighting yet again that much more needs to be done”.

She continued: “Likewise, additional long-term funding and secure investment in adult social care is now long overdue. There needs to be a level playing field.”

Richard Murray, chief executive of The King’s Fund, said the “most concerning” part of the report is that few of its findings are a surprise.

He added: “The pandemic has increased the urgency with which long-overlooked challenges need to be addressed.

“Ahead of the oft-promised reform of social care funding, there is an immediate need for short-term funding to stabilise the beleaguered sector and support providers to implement adequate infection control.”