CQC rates Lewisham’s adult social care responsibilities as Requires Improvement

The Care Quality Commission (CQC) has rated the London Borough of Lewisham as Requires Improvement in how well it is meeting its responsibilities for adult social care under the Care Act 2014.

The assessment examined how the local authority works with communities and partners to promote wellbeing and independence and ensure people can access appropriate care and support when needed.

CQC assessed Lewisham across nine areas, awarding scores ranging from one, where evidence shows significant shortfalls, to four, representing an exceptional standard.

Lewisham scored two out of four for assessing people’s needs, equity in experience and outcomes, care provision, integration and continuity of care, partnership and communities, safe pathways, systems and transitions, and governance, management and sustainability.

It scored three out of four for supporting people to lead healthier lives, safeguarding, and learning, improvement and innovation.

CQC found a mixed picture of people’s experiences when accessing adult social care, identifying both strengths and areas where improvements were required.

People’s experiences of assessments and care planning were inconsistent. Some people felt listened to and involved in decisions about their care, while others felt disconnected from the process and said support did not always reflect their individual needs.

Delays to assessments and reviews also meant some people were waiting too long to receive support.

Inspectors found the authority did not always identify and respond promptly to unmet needs, with delays limiting its ability to proactively monitor changes in people’s circumstances and manage emerging risks.

CQC also identified concerns around the experiences of unpaid carers.

National data from 2023/24 showed 44.29% of carers in Lewisham found it easy to access information and advice, compared with an England average of 59.06%.

Some carers reported that respite provision was not practical or culturally appropriate.

The assessment also found that people did not always experience equitable access to care and support.

Autistic people, people with learning disabilities, people with mental health support needs and people from ethnically diverse communities did not always receive services that fully reflected their needs or experiences.

People from groups whose voices are seldom heard often felt underrepresented in strategic decision-making, while services did not always reflect the needs of Lewisham’s diverse communities. CQC also found that commissioned home care services were not always representative of the borough’s diversity.

Mental health pathways were another area of concern. Gaps in pathways and their management meant the authority could not always be assured that people were receiving timely and appropriate support.

However, CQC identified a number of strengths within the borough.

People described occupational therapy and enablement services as life-enhancing and said the support had helped them regain confidence and independence.

Staff demonstrated a strong commitment to supporting people well, with inspectors finding several examples of effective partnership working that helped people maintain their independence.

Partnership working across health and social care had also been strengthened, helping neighbourhood teams identify people at increased risk earlier and coordinate support more effectively.

CQC found Lewisham had developed a positive culture of continuous learning and improvement, with staff receiving ongoing access to training and lessons being learned and shared when things went wrong.

The authority had also prioritised co-production, working with people with lived experience to help shape services and plans for future improvement.

CQC said Lewisham understood where improvements were needed and had already begun taking action across a number of priority areas.

The regulator said it would return to assess how this work develops and the difference it makes for people across the borough.

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