Nearly two thirds of councils in England are rated as ‘good’ when it comes to the delivery of adult social care but many are struggling to retain that rating, according to the Care Quality Commission’s (CQC) first national assessment programme of local authorities.

The CQC report, Local authority assessments 2023 to 2026: Emerging themes and findings, is based on 143 assessments carried out under Part 1 of the Care Act since December 2023.

It finds that 60% of local authorities are rated ‘good’, 35% ‘requires improvement’, 3% ‘outstanding’ and 2% ‘inadequate’.

However, the CQC cautions that many councils rated ‘good’ sit at the lower end of that threshold, while ratings within the ‘requires improvement’ category vary significantly, with some authorities close to good and others nearer to inadequate.

Strong leadership emerged as the single biggest factor shaping the quality of people's experience of care, from first contact through to receiving support, according to the CQC’s findings.

The report also identifies systemic weaknesses in some areas around safeguarding governance and oversight and highlights effective prevention strategies as critical to maintaining people's health, wellbeing and independence.

Other key themes include weaknesses in needs assessments, with delays affecting both service users and unpaid carers, and inconsistent identification of and support for unpaid carers, who are often only recognised in a crisis.

Transitions from children's to adult services remain one of the most persistent risk areas, alongside stark variation in co-production and commissioning practice, according to the CQC.

Notably, the report found no statistically significant relationship between local deprivation levels and overall council ratings, suggesting performance is not simply a reflection of local socio-economic conditions.

The adult social care crisis

Upper-tier authorities with statutory responsibility for adult social care are buckling under the weight of rising demand and chronic underfunding. The latest annual survey from the Association of Directors of Adult Social Services (ADASS) found councils are on course to overspend their adult social care budgets by £715m in 2025/26 — the largest overspend at this point in the year since the pandemic.

The Casey Commission is due to publish its first recommendations for reforming the adult social care system this year, with a fuller report following in 2028 — though Casey has told the Health and Social Care Committee she is open to accelerating that timeline if needed.

CQC comment

Chris Badger, chief inspector of Adult Social Care and Integrated Care, CQC described the CQC report as ‘a significant milestone’, adding: ‘For the first time, we have a comprehensive national picture of how local authorities are delivering adult social care across England.’

He said that local authorities were rising to meet ‘some very real and very complex challenges’ but noted that there was too much variation in the delivery of adult social care services.

‘One of the more striking findings is that we did not find a statistically significant relationship between deprivation and performance,’ he continued.

‘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.’