Themes from local authority CQC published assessment reports

On April 1, 2023, the Care Quality Commission (CQC) assumed a new statutory duty to assess local authorities' performance in delivering their adult social care (ASC) responsibilities under Part 1 of the Care Act 2014. In alignment with this new oversight role, the Secretary of State for Health and Social Care was granted powers to intervene where an assessment determines that a local authority is not meeting its statutory duties.

The CQC’s Single Assessment Framework for local authority ASC was developed through a co-productive process involving partners, sector leaders, and people with lived experience of adult social care. This framework is intended to support meaningful evaluations of service quality, capability, and outcomes, rather than adopting a purely regulatory or compliance-driven model. While the CQC’s methodology differs in tone and structure from that of Ofsted, both share the core objective of driving improvement through transparent, evidence-based assessments that result in a single performance rating.

Local authorities are assessed against nine quality statements, with outcomes categorised as Outstanding, Good, Requires Improvement, or Inadequate. Each assessment aims to build a holistic picture of how effectively the local authority meets its statutory responsibilities and improves the lives of people who draw on care and support. As of April 2025, the CQC has published assessment reports for 32 local authorities. Among these:

• One local authority has received an Outstanding rating
• 19 local authorities have received a Good rating
• 12 local authorities have received a Requires Improvement rating
• No local authority has yet to receive an Inadequate rating.

Building on our earlier analysis of the first 19 published reports, this updated report offers a thematic and comparative analysis of the full set of 32 published assessments. This broader dataset provides a more comprehensive view of how the Single Assessment Framework is being operationalised by CQC and what standards and themes are emerging in practice.

Through this report, Partners in Care and Health aims to:

• Enable local authorities to identify, prioritise, and implement the changes needed to meet or exceed statutory requirements
• Promote the delivery of consistently high-quality adult social care services across England
• Provide local authorities with practical insight and examples of what ‘good’ and ‘outstanding’ look like across each of the nine quality statements
• Support local authorities to proactively prepare for upcoming assessments and build a culture of continuous improvement.

In doing so, this document offers a valuable resource for adult social care leaders, practitioners, and governance bodies striving to deliver better outcomes, uphold statutory obligations, and ensure that people who draw on care and support can live the lives they want to lead.

Best performing quality statement overall

Across the 32 local authority assessments published by the Care Quality Commission (CQC), 26 authorities received a score of 3 (Good/Outstanding) or above for Quality Statement 5: Partnerships and Communities. 

This includes:

• 24 authorities rated as Good
• Two authorities rated as Outstanding
• Only six authorities received a score of 2 (Requires Improvement).

High performance and consistency

• The overwhelmingly positive ratings for this quality statement suggest that the majority of local authorities demonstrate a strong foundation in multi-agency collaboration, integrated care arrangements, and engagement with the wider community.
• Scores of 3 and 4 reflect that these authorities are successfully fostering coordinated and inclusive care, often working seamlessly with partners across health, housing, VCSE organisations, and community networks.

System integration as a strength

• The evidence points to partnerships and joint working being among the most embedded and stable features of adult social care systems across England.
• Good and Outstanding rated authorities often benefit from place-based models, neighbourhood team structures, or integrated care systems that facilitate information sharing, co-planning, and streamlined transitions between services.

Outliers needing targeted improvement

• The six authorities rated Requires Improvement under this quality statement represent outliers
• For these localities, challenges may include:
  • Siloed working practices
  • Limited engagement with VCSE or community providers
  • Underdeveloped co-production mechanisms
  • Weak leadership in place-based partnership arrangements

Implications for sector-wide learning

• The consistency of positive performance in partnership and community working offers a potential blueprint for wider sector improvement.
• These high scores could be leveraged to:
  • Model good practice for underperforming localities
  • Promote peer learning and regional collaboration
  • Anchor other more variable areas of performance, such as assessment or safeguarding, in strong partnership infrastructure.

The data suggests that collaborative working is a core strength across the sector, contributing significantly to overall performance in adult social care. While there remains room for improvement in a small number of areas, the ability of most authorities to deliver integrated and community-oriented care and support stands out as a resilient feature of the current adult social care landscape.

Best performing quality statements for those local authorities who received overall rating of Good and above

The strongest areas of performance among the 20 local authorities rated Good or above were:

• Quality Statement 8: Governance, Management and Sustainability
• Quality Statement 9: Learning, Improvement and Innovation

All 20 local authorities (19 Good + 1 Outstanding) received either:

• A score of 3 (Good) – 19 authorities, or
• A score of 4 (Outstanding) – one authority.

This consistency suggests that foundational leadership, accountability structures, and continuous improvement cultures are well embedded across local authorities performing at or above the Good threshold. These domains appear to provide the backbone for organisational stability and resilience.

Across all 32 local authority assessments, the following quality statements achieved a score of 4 (Outstanding) in at least one local authority:

These results highlight standout local authorities demonstrating exceptional practice in:

• promoting equity and inclusion
• building robust, co-owned partnerships
• ensuring seamless and safe care transitions
• embedding effective leadership and innovative, data-informed practice.

Most underperforming Quality Statement: Assessing Needs

• 24 of 32 local authorities received a score of 2 (Requires Improvement) for Quality Statement 1: Assessing Needs
  • This includes authorities with overall ratings of Good and Requires Improvement.

This highlights the following across the ASC landscape with a focus on:

• Challenges with timely, strengths-based assessments and reviews
• Concerns around eligibility decision-making
• Inconsistencies in meeting carers’ needs and review processes.

No Scores of 4 Achieved in these Quality Statements

Across the entire cohort of 32 published assessments, no authority achieved a score of 4 (Outstanding) in the following:

• Quality Statement 1: Assessing Needs
• Quality Statement 2: Supporting People to Live Healthier Lives
• Quality Statement 4: Care Provision, Integration and Continuity
• Quality Statement 7: Safeguarding

These domains may reflect more complex, operational aspects of care and support delivery, where achieving excellence is significantly more difficult. This suggests these areas may require:

• Greater cross-system alignment
• Improved data, training, and practice standards.

Based on the 19 local authorities that received an overall rating of Good in their CQC assessment, the following cross-domain themes have emerged, offering valuable insight into strengths, recurrent weaknesses, and opportunities for improvement.

Foundational strengths

A consistent theme across the ‘Good’ rated local authorities is the strong performance in core organisational infrastructure, particularly in the following domains:

• Quality Statement 4: Care Provision, integration and continuity
• Quality Statement 8: Governance, management and sustainability
• Quality Statement 9: Learning, improvement and innovation.

These quality statements were dominantly scored at level 3 (Good), indicating that: 

• Leadership is stable, visible, and engaged
• The workforce is sufficient and skilled, with sound planning in place
• Organisational culture is positive and inclusive
• Learning systems and quality assurance mechanisms are embedded
• Care markets are monitored and shaped proactively, ensuring continuity and responsiveness.

Recurrent areas of development: assessment and equity in experience and outcomes

Despite overall good performance ratings, persistent challenges exist in core practice areas:

• 13 out of 19 authorities who received an overall rating of Good, scored 2 (Requires Improvement) in Assessing Needs (QS1). This may reflect issues in the quality, timeliness, and person-centred strengths-based nature of needs assessments and subsequent support planning.
• 11 out of the 19 authorities with an overall rating of Good scored 2 (Requires Improvement) in Equity in Experience and Outcomes (QS3). This may suggest inconsistent approaches to addressing inequalities, particularly for underrepresented and marginalised groups.

These domains may highlight a need for better co-produced assessments, culturally competent practice, and targeted inclusion strategies.

Inconsistent performance in prevention and safeguarding

Preventative care and safety systems showed variability, with several authorities not yet meeting good practice thresholds:

• Seven out of 19 authorities who received an overall rating of Good scored 2 (Requires Improvement) in Supporting People to Live Healthier Lives (QS2) which may indicate gaps in proactive health and social care wellbeing strategies, early intervention, and personalised early intervention and prevention.
• Six out of 19 scored 2 in Safeguarding (QS7) which may point to approaches to risk thresholds, decision-making robustness, and response times to safeguarding concerns and completion of section 42 (2) safeguarding enquiries.

While safeguarding systems are generally in place, challenges appeared to remain across a number of local authorities in terms of application and consistency of safeguarding culture.

Partnership working shows potential

Encouragingly, partnership working (QS5 Partnerships and Communities) remains a relative strength across ‘Good’ rated local authorities:

• Two authorities scored 2 (Requires Improvement)
• 16 authorities scored 3 (Good)
• One authority achieved 4 (Outstanding).

This suggests a strong foundation of collaborative practice, with many authorities effectively engaging with:

• Health and care partners
• VCSE sector organisations
• Community leaders and co-production forums.

These partnerships provide a platform for further service transformation and improved local integration.

Summary table: Thematic overview for those rated ‘Good’

Based on the analysis of the 12 local authorities rated as ‘Requires Improvement’ in their CQC ASC assessment, three dominant thematic areas emerge, indicating systemic challenges that cut across structural, operational, and leadership domains.

Core system areas of development

A significant volume of score 2 (Requires Improvement) ratings were concentrated in the following foundational quality statements:

• Quality Statement 1: Assessing Needs
• Quality Statement 3: Equity in Experience and Outcomes
• Quality Statement 4: Care Provision, Integration and Continuity
• Quality Statement 8: Governance, Management and Sustainability.

This pattern may point to :

• Inconsistent strength-based assessments, with limited personalisation and or timely review processes
• Unequal access and variable experiences for people from marginalised and underserved communities
• Fragmented care and support planning and delivery, with limited focus on continuity, Insufficient strategic oversight and effective governance frameworks.

Recurring safety and risk issues

A notable number of authorities exhibited consistent issues in safeguarding and safe pathway, systems and transitions:

• Eight out of 12 authorities scored 2 in both:
  • Quality Statement 6: Safe Pathways, Systems and Transitions
  • Quality Statement 7: Safeguarding.

This may suggest vulnerabilities in:

• Safeguarding thresholds and decision-making, with potential inconsistencies in identifying and managing risk
• Delayed or poorly coordinated hospital discharge and or young peoples transitions processes
• Gaps in out-of-hours support, provider monitoring, and risk escalation protocols.

System-level observations: Governance as a bottleneck

• 11 of 12 authorities received a score of 2 in Governance, Management and Sustainability

This may reflect a systemic challenge across most RI-rated authorities, including:

• Limited use of data for performance management
• Insufficient accountability structures
• Absence of robust quality assurance and audit frameworks.

Summary Table: Thematic overview

These insights provide a roadmap for targeted sector support, particularly in strengthening governance, inclusive practice, and safe, strengths-base, person-centred delivery systems.

An overall rating of good is often achieved without high quality statement scores

• 18 of the 20 local authorities rated Good or above did not achieve a score of 4 (Outstanding) in any individual quality statement.
• Only four of those authorities received no scores below 3, indicating a clean performance across all domains.

This trend suggests that a consistent, reliable level of service delivery is often sufficient to achieve an overall Good rating. Authorities are rewarded for competence and stability, even where safeguarding, assessment and support planning and or innovation or sector-leading practice may be limited.

Assessment and equity are consistent development areas

A significant proportion of local authorities across all overall ratings (Good and Requires Improvement) received a score of 2 in: 

• Quality Statement 1: Assessing needs
• Quality Statement 3: Equity in experience and outcomes.

These findings point to systemic challenges in:

• Delivering timely, strengths-based, and person-centred assessments
• Ensuring equity of access and experience for diverse and underserved populations.

Governance as a stable pillar of good performance

• All local authorities rated Good or Outstanding received at least a score of 3 in Quality Statement 8: Governance, Management and Sustainability
• This was one of the most consistently strong domains across the dataset 

Governance and leadership processes appear to be mature and reliable across well-performing authorities. This includes: 

• Clear performance management frameworks
• Robust risk oversight
• Strategic planning and quality assurance mechanisms
• Stable leadership team with good visibility.

Effective governance is acting as a critical enabler of good overall performance, even in cases where frontline practice requires improvement (e.g.QS1).

Safeguarding remains a persistent risk area

• Over 30 per cent of local authorities with an overall rating Good received a score of 2 in Quality Statement 7: Safeguarding

Despite its importance, safeguarding remains a challenging area, particularly regarding:

• Thresholds for action
• Responsiveness to risk
• Consistency of practice across agencies.

This suggests a continued need for multi-agency learning, leadership attention, and investment in safeguarding systems and culture. 

Summary table: system-wide observations

To date, only one local authority, the London Borough of Camden, has received an overall rating of Outstanding out of the 32 CQC ASC assessments published to date (at the time of this publication). Camden’s rating offers a powerful example of what sector-leading practice looks like under the Single Assessment Framework for local authorities.

This rare achievement reflects a system that not only meets statutory expectations but consistently exceeds them through innovation, inclusivity, and impact. Camden has demonstrated a deeply embedded culture of co-production, equitable access, and integrated working, underpinned by strong governance and a relentless focus on learning and improvement. The key factor in their rating is having a compelling narrative for adult social care.

The insights from this assessment provide a valuable reference point for other local authorities aiming to move from ‘Good’ to ‘Outstanding’ and offer a practical vision of what excellence in adult social care can look like in practice.

London Borough of Camden scores

1. Equity at the core of service delivery

• Equity is not an add-on but a "golden thread" throughout Camden’s vision, strategy, and delivery.
• There is a clear, proactive focus on supporting diverse and underserved communities (e.g. people experiencing homelessness, mental health conditions, asylum seekers, LGBTQ+ individuals, and ethnic minorities).
• Evidence of exceptional use of family group conferencing (FGC) across all teams, which supported person-centred solutions, particularly for complex needs like homelessness and dual diagnosis.
• Camden's citizen-led vision (“We Make Camden”), co-produced through a citizens’ assembly, demonstrates inclusive governance and community empowerment.

2. Power-sharing partnerships and integrated working

• Evidence of robust and mature relationships with NHS, VCSE, housing, and education partners.
• The Integrated 0–25 Transitions Team offers seamless support for young people, combining children and adult social workers in one team.
• Co-commissioning of services and neighbourhood-based care models (e.g., East integrated neighbourhood team) ensures no waits for hospital discharge or home care placements.
• VCSE organisations are treated as equal partners, with the Better Care Fund supporting more than 80 collaborative projects.

3. Exceptional safe systems and transitions

• No delays in assessments, placements, or safeguarding—a rare achievement nationally.
• Robust out-of-hours support, risk dashboards, and contingency planning ensuring safe pathways.
• Evidence of effective multi-agency safeguarding, with strong learning from reviews and clear governance.
• Strong performance in DoLS (Deprivation of Liberty Safeguards) and clear management of emerging risks like cuckooing.

4. Data-informed governance and leadership

• Camden has embedded “courageous leadership” training and a relational power-sharing culture, clearly led from the top.
• Governance is strategic, well-defined, and backed by real-time data dashboards and predictive analytics.
• Their Adult Social Care Strategic Plan aligns with public health, housing, and community initiatives.
• Integrated care and support is future-focused, with emphasis on psychological safety, trauma-informed practice, and workforce stability. 

5. Relentless focus on learning and innovation

• The council has fostered a culture of improvement, offering staff extensive training and embedding reflective practice.
• Creative initiatives included:
  • An autistic-led research film project with the British Association of Social Workers
  • A Leadership Programme for Autistic People
  • Use of technology-supported care monitoring to promote independence
• Regular co-production forums, reflective workshops, and participatory planning has led to embedded lived experience in service design.

6. Market shaping and workforce sustainability

• Home care services were recommissioned on a neighbourhood model, improving local delivery and workforce conditions.
• Camden is a signatory of the Ethical Care Charter, promoting fair pay and working conditions.
• There is a positive relationship with providers, supported by a provider oversight board and quarterly quality assurance cycles.

7. Managing challenges transparently

• Although some carer feedback and satisfaction metrics lagged behind national averages, Camden was transparent about challenges, with action plans in place.
• Camden openly acknowledged gaps in autism support, carer support, and dual diagnosis services and had active improvement programmes underway.
• The Council demonstrates a “learning mindset” by adapting and investing in areas with known deficits.

Camden’s Outstanding rating is not the result of perfection in every metric, but rather a reflection of its:

• Compelling narrative
• Values-driven culture
• Inclusive and equitable service design
• Seamless and safe systems
• Empowered workforce and communities
• Transparent leadership and accountability.

These characteristics combined to create an ecosystem that continually evolves, improves, and centres the needs and rights of people drawing on care and support.

The early findings from the CQC assurance framework reflect a sector that is:

• Striving for stability amid complex demand and stretched budgets/financial challenges
• Confident in its governance and partnerships
• But also challenged by inequalities, assessment practice, and safeguarding culture.

The data tells a story of competent but cautious systems, where excellence is emerging but not yet embedded.