City of London Adult Social Care Rated 'Good' Despite Report Delays and Concerns

City of London Adult Social Care Rated 'Good' Despite Report Delays and Concerns

City of London's adult social care services have been rated 'Good' by the Care Quality Commission (CQC), despite concerns raised by councillors about delays in receiving the assessment report and the service being close to a 'Requires Improvement' rating.

The Health and Social Care Scrutiny Committee heard that the CQC's assessment, conducted between February and July 2025 and published in July 2026, highlighted strengths in areas such as strengths-based assessments and hospital discharge processes. However, it also identified areas for development, including engagement with seldom-heard groups, support for unpaid carers, and data quality.

Councillor Christopher Paul Boden expressed surprise at the 'Good' rating, noting the service scored 64 out of a potential threshold of 62, and raised concerns about the 14-18 month delay in receiving the report. Simon Cribbens, Executive Director of Community and Children's Services, acknowledged these concerns, stating the CQC's methodology was more suited to larger authorities and that the council had robustly challenged the outcomes. The assessment was initiated in February 2025, with fieldwork in July 2025, and the final report published a year later in July 2026. Councillor Boden suggested that quicker report delivery would make them more useful to members. The CQC has since launched a new inspection methodology including annual engagement meetings to foster ongoing dialogue.

Mr Cribbens explained that the CQC's methodology was more suited to larger authorities, requiring a format and data expectations common with very large local authorities. He noted that the City of London does not have a care home within its boundaries, a fact that was viewed negatively by the CQC despite the availability of numerous facilities nearby and a bespoke approach to meeting needs, often outside the city where individuals may have family connections. This was considered a 'very negative point' on the CQC's checklist rather than a narrative that was received.

Councillor Gail Beer, Chair of Healthwatch City of London, felt some aspects of the report did not fully reflect resident experiences, particularly regarding safeguarding. She highlighted concerns about conversion rates from concerns to inquiries and timescales, noting that the impact on rough sleepers, where identification and safeguarding are particularly challenging, was not adequately captured. She also identified a need to improve how work is recorded, particularly when initial contact is made on a 'concerned base' rather than an inquiry base, an issue she has taken back to the service.

In response to the identified areas for development, the City of London Corporation has undertaken several initiatives. To improve engagement with seldom-heard groups, the council is on a development journey to both understand the needs of seldom heard groups and ensure that a robust strategic plan had been put in place. Plans include working with voluntary sector organisations to improve engagement and awareness, and wider community engagement initiatives. A guide titled Working with people more difficult to reach was developed in August 2024, setting out intentions to explore barriers to engagement with residents' advisory groups.

Regarding support for unpaid carers, the council has a Carer's Strategy 2023-2027 with planned actions to improve outcomes. This includes training professionals to proactively identify and support carers, and helping individuals recognise their caring role and where to seek help. The recommissioning of carers services in 2024 involved unpaid carers, and there are plans for their involvement in contract monitoring. However, feedback indicates a need to better understand carers' needs and a desire for a carers employment programme.

The CQC report also identified gaps in the recording of protected characteristics, requiring strengthening. The local authority has recognised the need to improve its use of evidence-based data to understand population needs and reduce inequalities. Senior leaders are working with partners to ensure data is shared and consistently collected. While equality data is collected, areas such as sexual orientation and religion need improvement. The council has rolled out anti-racist approaches to support staff in asking more sensitive questions and will continue to address these challenges through anti-racist practice standards, advocacy services, and culturally sensitive training. Equality, Diversity and Inclusion groups have been focusing on improving data collection and engagement over the past 18 months. Councillor Boden noted the ongoing challenge of poor data quality and the need for better data sharing with the NHS. New systems like Optum are being implemented to pull together health and social care data and identify individuals at greater risk of frailty.

Despite these challenges, staff described having a manageable workload and sufficient capacity to spend adequate time during assessments, ensuring good rapport and effective support planning. The service was awfully close to requiring improvement, scoring 64 against a threshold of 62.

Public reports pack 15th-Oct-2026 11.00 Health and Social Care Scrutiny Committee