Assessing needs “significant area of weakness” in some local authority areas: CQC

In a report published earlier this month (14 July), ‘Local authority assessments 2023 to 2026: Emerging themes and findings’, the CQC observed that overall, local authorities are 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, the CQC cautioned that many local authorities rated as good sit at the lower end of that threshold, suggesting there is room for improvement.

The report, based on 143 of local authority assessments already published, found that more than three-quarters of local authorities achieved the lower scores of 1 or 2 for how they assess needs, mainly because of the delays that people, including unpaid carers, experienced in receiving an initial assessment and timely review.

Meanwhile, the report found “systemic weaknesses” in governance, oversight and assurance of safeguarding, and identified staff knowledge and understanding of DoLS and community deprivation of liberty orders as an area for improvement.

The CQC identified the transitions from children's to adult services as one of the most “persistent areas of risk”, observing “unwarranted variation in people's experience during this period”.  

It said: “Clear communication and ensuring that young people and their families and carers knew what to expect when moving out of child services was essential to a successful transition. This involved supporting families through the process of moving from a focus on the families’ ability to provide care, to supporting a young adult to be independent. However, communications about transitions varied, with young people and families raising concerns about the quality of communications.

“The transition process ran more smoothly when local authority teams worked well together both within the local authority and with partners. However, many inspectors described siloed working between children’s and adult services, with unclear lines of responsibility and limited shared ownership.”

Other key themes were outlined as follows:

• Strong leadership within a local authority is the single most important factor when it comes to determining the quality of people’s experience of care, from first contact to receiving help or using a service. 
• Prevention, and supporting people to maintain their health, wellbeing and independence, have emerged as critical.
• Identifying unpaid carers and providing inconsistent access to support for them emerged as persistent and systemic issues. Identifying unpaid carers was highlighted as the biggest issue, as they are often only seen when in crisis.  
• 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, said: "This report represents a significant milestone – for the first time, we have a comprehensive national picture of how local authorities are meeting their responsibilities to meet people’s care and support needs across England. We found overall that 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 local authorities that get prevention right tend to get a lot of other things right too."

Lottie Winson