Delays in needs assessments and reviews are a major weakness across local authority adult social care delivery, according to the Care Quality Commission (CQC) ‘s first national analysis of its council assurance programme.
The regulator found that over a third of local authorities were rated as ‘Requires Improvement’ in the analysis published today, in what it describes as the ‘most comprehensive national picture' to date of how councils are delivering adult social care responsibilities under part 1 of the Care Act.
It said the review - based on 143 completed assessments - shows that councils are ‘ broadly performing well in the face of significant challenges’, with 60 per cent rated good, 3 per cent outstanding and 2 per cent inadequate.
However, the regulator warned that many authorities classified as good were positioned ‘close to the lower threshold’ of that rating, ‘suggesting there is room for improvement’.
"Too much variation"
Similarly, it said that there is a broad range among those rated as RI, with some nearer to good, and others closer to inadequate.’
The report identifies leadership, prevention strategies and commissioning effectiveness as critical determinants of performance, with substantial variation observed between authorities.
CQC adult social care chief inspector Chris Badger said the report is a “a significant milestone” and showed there is “much to celebrate in the commitment and skill we've seen from staff and leaders across the country”, but warned of “too much variation in the delivery of the key foundations of adult social care provision, highlighting a gap in national standards about what people, providers and partners can expect”.
He added that one of the most “striking” findings is that the regulator “did not find a statistically significant relationship between deprivation and performance.
“That doesn't mean deprivation doesn't matter – it absolutely does. But it tells us that strong leadership, effective commissioning and prevention strategies, as well as a genuine commitment to co-production can make a real difference regardless of local circumstances, and that good outcomes are possible in every context,” he added.
The watchdog highlighted delays in needs assessments and reviews as a major weakness across the country, with more than three-quarters of authorities achieving lower scores in this area. It also identified inconsistent approaches to co-production, commissioning and support for unpaid carers.
Sector leaders responding to the report argued that the findings reinforce long-standing concerns about inconsistency in the care system. Social Care Institute of Excellence interim chief executive Gerard Crofton-Martin said that “stark variation has become a hallmark of social care in England” and described it as “indefensible” that some people receive timely, personalised support while others receive care that fails to meet basic needs.
However, Mr Crofton-Martin also highlighted the report's examples of effective practice, noting that where local authorities understand their communities, invest in prevention and commit to genuine co-production, people experience better outcomes. He argued that embedding best practice across the system is now “mission-critical” and linked this to wider work on national standards and addressing inequity in access to care.
Think Local Act Personal (TLAP) associate director Dr Clenton Farquharson CBE said the findings demonstrate that good adult social care should be judged by the lives people can lead as a result of the support they receive, and not just regulatory ratings.
He described co-production as “not an engagement exercise” but a mechanism for making better decisions and building trust, adding that councils should be judged not only on overall performance but also on who benefits and who is missing out.
