"Too much variation" in adult social care provision, CQC local authority assessments find

The Care Quality Commission (CQC) has published the findings from its first national programme of local authority assessments, concluding that while most councils are performing well in delivering adult social care, significant variation remains in the quality of support people receive across England.

The report, based on 143 published assessments carried out since December 2023, found that 60% of local authorities were rated 'Good', 35% 'Requires improvement', 3% 'Outstanding' and 2% 'Inadequate'. However, the regulator warned that many authorities judged 'Good' were only just above the threshold, while some rated 'Requires improvement' were close to either improving or declining further.

Drawing together findings from the first three years of assessments under Part 1 of the Care Act, the report identifies leadership as the single most important factor influencing people's experience of adult social care, from initial contact through to receiving ongoing support.

The CQC also identified prevention as a defining feature of high-performing authorities, finding that councils with effective strategies to support people's health, wellbeing and independence also tended to perform strongly in safeguarding, support for unpaid carers and transitions between children's and adult services.

The report highlights several areas where improvement is needed, including weaknesses in safeguarding governance, delays in care assessments and reviews, inconsistent identification and support for unpaid carers, and significant variation in how young people are supported through the transition from children's to adult services. Inspectors also found marked differences in approaches to co-production and commissioning, noting the absence of nationally consistent standards.

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."

He added: "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."

Concluding, Badger said: "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."

Responding to the report, the Social Care Institute for Excellence (SCIE) said the findings illustrated both the strengths of the sector and the continuing inequalities in people's experiences of care.

Gerard Crofton-Martin, Interim Chief Executive at SCIE, said: "Stark variation has become a hallmark of social care in England. It is indefensible that some people receive timely, personalised support that enables independence and dignity, while others receive support that fails to meet even their basic needs.

"This report provides further evidence that too many people continue to be let down by weaknesses in the social care system. The findings on safeguarding, assessments and reviews, and transitions from children’s to adult services highlight areas where people can be exposed to significant harm.

"The report also highlights, however, what good care should look like. Where local authorities understand their communities, invest in proactive, preventive care, and commit to genuine co-production, people experience better outcomes."

Crofton-Martin said embedding best practice across the sector was now "mission-critical", adding that SCIE's work on national standards of care and new research on inequities in social care could help address the variation identified by the CQC.

Think Local Act Personal (TLAP) also welcomed the report, calling for greater focus on people's lived experiences rather than organisational performance alone.

Dr Clenton Farquharson CBE, Associate Director of TLAP, said: "The CQC findings remind us that good adult social care is not defined by the rating on a report, but by the lives people are able to live because of it. The strongest councils are those where people, families, carers, and communities help shape decisions from the beginning, not simply comment on them afterwards. Co-production is not an engagement exercise; it is a way of making better decisions, building trust, and creating services that reflect people’s real lives."

He added: "The report also reminds us that we must look beyond overall ratings. A council can be performing well overall, while some communities continue to experience poorer access, longer waits, or fewer opportunities. Equity means asking not only, ‘How is the system performing?’ but, ‘Who is benefiting, who is missing out, and what are we going to do about it?’

"The next stage of improvement should move beyond measuring whether the right processes are in place to understanding whether people experience greater choice, stronger relationships, more independence, and the opportunity to live gloriously ordinary lives. Ultimately, the measure of success is not whether a system works for organisations, but whether it works for the people who draw on support."