The Care Quality Commission (CQC) has today published a report titled Local Authority Assessments 2023–2026: Emerging Themes and Findings drawing together findings from the first-ever national programme of assessments of local authorities in England. The programme, which began in December 2023, assessed how local authorities are delivering their adult social care duties under Part 1 of the Care Act. The report provides the most comprehensive picture of how local authorities are managing the needs of people who use adult social care services across England.
The report, based on 143 of local authority assessments already published, finds that local authorities are broadly performing well in the face of significant challenges, with 60% rated as good, 35% rated as requires improvement, 3% rated as outstanding and 2% rated as inadequate.
However, CQC cautions that many authorities rated as good sit at the lower end of that threshold, suggesting there is room for improvement and within those rated as requires improvement some local authorities are on the cusp of good, while others are closer to inadequate.
The report identifies a number of key themes:
- Strong leadership within a local authority is the single most important factor when it comes to determining the quality someone’s experience of care, from first contact to receiving help or using a service.
- We found some examples of systemic weaknesses in governance, oversight and assurance of safeguarding.
- Prevention and supporting people to maintain their health, wellbeing and independence, has emerged as critical. In authorities without an effective prevention strategy the gaps show up everywhere.
- Assessing needs was found to be a significant area of weakness in some areas, with delays in care assessments and reviews affecting both people using services and their unpaid carers.
- Local authorities that were managing equalities well, understood their communities and had well-resourced co-produced strategies and action plans on how they could tackle inequality.
- Uneven identification of carers, and inconsistent access to support emerged as a persistent and systemic issue. Identification was highlighted as the biggest issue, as carers are often only seen in crisis.
- Transitions from children’s to adult services were identified as one of the most persistent areas of risk, with unwarranted variation in people’s experience during this period.
- We saw stark variation in co-production and commissioning and a lack of nationally consistent standards.
- Co-production was most effective when people with lived experience clearly inform what is commissioned, how resources are allocated and how services are delivered.
- There is no statistically significant relationship between the average Index of Multiple Deprivation scores for local authorities and their overall ratings.
Chris Badger, Chief Inspector of Adult Social Care and Integrated Care, CQC said:
“This report represents a significant milestone – for the first time, we have a comprehensive national picture of how local authorities are delivering adult social care across England. What we’ve found is that, overall, local authorities are rising to meet some very real and very complex challenges, and there is much to celebrate in the commitment and skill we’ve seen from staff and leaders across the country. However, we found 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.
“One of the more striking findings is that we 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.
“Prevention also stood out as a critical theme. Where it’s working well it runs through everything – from how carers are identified, to how transitions are managed, to how safeguarding concerns are picked up early. The authorities that get prevention right tend to get a lot of other things right too.”
“The findings in this report are not just a measure of where the sector is today – they are a roadmap for where it needs to go. We hope local authorities, their partners and national decision-makers will use these insights to drive the improvements that people relying on adult social care so urgently need.”
The CQC will use the findings to inform engagement with local authorities, government and parliament, and national stakeholder organisations, with the aim of encouraging local improvement and influencing policy.
