CQC report highlights variation in adult social care across England despite broadly positive local authority performance

The Care Quality Commission (CQC) has published its first national report on how local authorities in England are meeting their adult social care responsibilities, highlighting significant variation in people’s experiences while finding that most councils are performing well overall.

The report, Local Authority Assessments 2023–2026: Emerging Themes and Findings, brings together evidence from 143 local authority assessments carried out since the national assessment programme began in December 2023. The assessments examine how councils are delivering their duties under Part 1 of the Care Act.

According to the CQC, 60% of local authorities assessed were rated Good, 35% Requires Improvement, 3% Outstanding, and 2% Inadequate.

While the overall picture is positive, the regulator says there remains considerable variation in the quality of adult social care across England. It notes that many authorities rated Good are only just above the threshold, while performance among those rated Requires Improvement ranges from authorities close to achieving Good to others approaching Inadequate.

The report identifies several themes that consistently influenced people’s experiences of care and support.

Strong leadership was found to be the most significant factor affecting the quality of adult social care, influencing everything from first contact with services through to ongoing support.

The CQC also identified weaknesses in governance, oversight and safeguarding arrangements in some local authorities, alongside delays in assessing people’s care needs and carrying out reviews. These delays were found to affect both people receiving care and unpaid carers.

Prevention emerged as another key finding. Authorities with well-developed prevention strategies were better able to support people’s health, wellbeing and independence, while areas without effective preventative approaches experienced wider pressures across their adult social care systems.

The report also highlights persistent challenges around identifying unpaid carers and ensuring they receive timely support. In many cases, carers were only identified once they had reached crisis point.

Transitions from children’s services into adult services were identified as one of the most consistent areas of risk, with considerable differences in the experiences of young people moving between services.

The CQC found that local authorities with a strong understanding of their communities, effective equality strategies and meaningful co-production with people who use services were better placed to tackle inequalities and develop services that reflected local needs.

Variation was also identified in commissioning practices, with the regulator noting there is no nationally consistent standard for how services are commissioned across England. The report found co-production was most effective where people with lived experience directly influenced commissioning decisions, resource allocation and service design.

The assessment programme also found no statistically significant relationship between a local authority’s level of deprivation, measured using the Index of Multiple Deprivation, and its overall performance rating.

The CQC said it will use the findings from the report to support future engagement with local authorities, government and national organisations, with the aim of driving improvement across adult social care and informing future policy development.

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