The Care Quality Commission has issued the first outstanding rating for a council since it resumed assessing local authority adult social services at the end of 2023.
The London Borough of Camden earned the accolade after the regulator found that it was offering “exceptional levels of service”, with no waiting lists across key services and a strong focus on tackling inequalities.
Camden is the 26th of the 153 councils in England to receive an assessment from CQC since its so-called local authority assurance process started in December 2023.
Of the others, 14 have been rated good, 11 requires improvement and none inadequate.
High scores across all areas assessed
Alongside their ratings, councils are given a score out of 100 indicating how well they performed against the nine quality statements that make up the assessment, for which the authorities are awarded a mark of 1-4.
Camden’s score was 89 – 11 more than the next best performer so far – thanks to it receiving the top score of 4 – which denotes an “exceptional” standard – in five of the quality statements. These were equity in experience and outcomes; partnerships and communities; safe pathways, systems and transitions; governance, management and sustainability, and leadership, improvement and innovation.
It was scored a 3 for the other four statements: assessing needs; supporting people to lead healthier lives; care provision, integration and continuity, and safeguarding.
Other councils encouraged to learn from borough
James Bullion, chief inspector of adult care and integrated care, CQC
The CQC’s chief inspector for adult social care and integrated care, James Bullion, said that Camden provided “high-quality and person-centred support”, underpinned by “strong partnership working, a commitment to equity and a focus on prevention”.
“Overall, Camden should be extremely proud of this assessment and the outstanding care they’re providing to people,” he added.
Other local authorities should look at this report to see if there’s anything they can learn.”
No waiting lists in key areas
In recent years, councils have struggled to manage demand without waiting lists for assessments and support, prompting the previous government to make cutting waiting times a priority.
However, the CQC found Camden had no waiting lists for care assessments, hospital discharge, care home placements, home care services, reablement, Deprivation of Liberty Safeguards assessments and safeguarding cases.
This was on the back of “significant action to reduce waiting times”, aided by the borough investing in 12 additional social worker and occupational therapy posts as part of a recent restructure.
Though there were high numbers of reviews overdue, this had reduced since October 2023, with partners praising the timeliness of reviews.
‘A prevention approach’ and meeting non-eligible needs
“A prevention approach was evident at all levels of the local authority,” the CQC found.
Camden uses the ‘three conversations’ model, under which practitioners seek to connect people with community sources of support and only determine if they are eligible for care and support if these do not resolve the challenges and risks that they face.
The CQC found that family group conferencing was also used effectively to support people without eligible needs to make decisions and link them with community groups.
There were also “many examples” of the council commissioning charities and social enterprises to provide services such as befriending, transport and shopping, as well as mental health and housing.
A higher proportion of older people discharged from hospital (4.7%) received reablement services than the national average (2.9%), with a higher proportion (87.2%) still at home three months after a discharge than average (83.7%), while feedback on reablement services was positive.
Equity ‘at the heart of services’
The regulator said it found that Camden had placed equity “at the heart of its adults’ services”, with the authority using data analysis to “identify and reduce inequalities in people’s care and support experiences and outcomes”.
This included plans to improve health and social care outcomes for the borough’s Bengali and Somali communities through the Better Care Fund in 2024-25.
The authority had also prioritised accessibility and inclusion arrangements for autistic adults and people with learning disabilities, sensory loss, multiple disadvantages, autistic adults or interpretation requirements.
‘Proactive’ monitoring of service quality
The London borough proactively monitored the quality of commissioned services.
This involved regular quality assurance visits, involving resident and carer feedback and analysis of CQC provider reports, and action plans to support those rated requires improvement by the regulator.
The council also took steps to ensure care staff in provider services were paid the London Living Wage plus travel and had appropriate working conditions.
Though adult social care vacancy levels across the borough in 2023-24, at 16.8%, were double the national average 8.1%, turnover rates were lower (10% vs 25%).
The CQC said Camden had “effective systems processes and practices to make sure people were protected from abuse and neglect”. This included having no waiting lists and an effective multi-agency safeguarding hub, through which all referrals were routed.
Rating is ‘testament to staff dedication, compassion and expertise’
Camden’s cabinet member for health, wellbeing and adult social care, Anna Wright, said the rating was a “testament to the dedication, compassion, and expertise of our adult social care staff”.
“The report highlights Camden’s positive and inclusive culture and our willingness to innovate and to test and learn,” she added. “It’s great to see the report also highlights the strong partnerships that we have built – with providers, health services, and our wider community – to deliver the best possible outcomes for our residents.”
She added: “We know that there are more improvements we must make, and I want us to build on this success and keep developing our services to ensure that people in Camden can rely on the best possible care and support.”
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I have news for the CQC, outsourcing care and support of vulnerable people to ‘community’ resources which are underfunded and generally volunteer led might be reframed as “innovation” the reality for families like ours is not so rosey. Get a referral, farm it out then conclude that you’ve discharged your statutory duty and close down so while we wait for weeks for a response Camden can pretend it does not have waiting lists is at best a ruse and at worse knowingly peddling an untruth. Perhaps previous ADASS relationships inevitably foster unconscious positivity.
The average house price in Camden is 1.1 million. Is there a possible co-relation between the tax take of a council and it’s performance. Greater resources equals greater outcomes.
It would be interesting to see LAs scored alongside the rankings of deprivation?? Isnt Camden a pretty affluent area? Whats the level of homelessness and poverty in Camden?
This would add such greater value to the ‘scores’ being given.
Yes, you are correct, a lot of families have moved from inner London to outer London and the counties. The inner London LA’s retained the same funding whereas outer London LA’s have more demands with the same resources agreed before their populations rose
Very interesting. I suspect that other area will most likely look to criticise the equity of this due demographics.
When are CQC going to focus on the function of assessment and the duty to assess.
“(Camden) only determine if they are eligible for care and support if these do not resolve the challenges and risks that they face.” This approach leaves the duty to assess still triggered and not fulfilled. How can this be lawful and be considered good practice?
And Camden also happens to be Keir Starmer’s constituency. How fortunate!
You sound likes GB news viewer, grow up.
Nothing wrong with GB news, stop with projecting your own inner bias and view that all social workers should think and feel the same way. If you don’t like GB news – fine – other’s can make up their own minds, you don’t think or talk for me. Keir Stamer is a wealthy elite liberal politician, who lives in wealthy Camden (fact), and has won the election based upon misinformation. He has devastated this country with his employer tax hikes, which meant I lost a job in social care that I loved. I was agency, held the post for 2 years, and was let go due to all the cuts. He is much worse than the Tories. Personally I think you should grow up.
Ever been to Camden? Ever seen the rotting neglected council estates next to those million pounds houses? Ever been in a bus through Camden? Ever bought a dubious looking takeaway away in Camden? Ever lived in Camden? Ever went to school in Camden? I have done all of those things. I detest the Labour party and Starmer, my politics are way too left wing for those charlatans, but even I can distinguish between I’ll informed barbs about supposed Camden Elites and the realities oh how I grew up and his my parents still live in Camden. Your privilege is to watch whatever you choose but my privilege is to tell you truths. I’m sick of places being labelled as rich and privileged or crime ridden no go areas based solely on prejudice. Anyone setting foot in London will see wealth and privilege cheek by jowl with zero hours contract workers barely making a decent wage even with Universal Credit. A street in Camden, or Kentish Town to be precise, does not define the Borough of Camden. It’s bad enough growing up in a council state and struggling through a comprehensive school to train to be a social worker without the constant misinformed barbs from constantly whining fellow social workers. I rant because I’m extremely annoyed at this.
And by the way I agree with what Francis wrote. Camden council and CQC are colluding in a sleight of hand con. Those of us who have family in Camden who have gone through the referral process for an assessment know that the conclusions CQC choose to draw are way off from our experiences. Perhaps James Bullion would care to explain for us how the inspection was set up, how much notice was given to Camden, what ‘heads up’ pre inspection information was sent to Camden, what proportion of the inspection involved face to face or verbal communication with service users/those awaiting an assessment and whether the inspection was mainly reviewing documentation and other paper records provided by Camden. Transparency is the benchmark is it not?
Lemme tell you there most certainly ARE waiting lists. In some neighbourhoods there are people waiting MONTHS for assessments. Safeguarding Enquiries backlogged, with nobody to allocate to due to staff leaving.
Are CQC talking about the right borough?
Are you suggesting Camden misrepresented their data?