FAQs - Care Quality Commission’s local authority assurance

The Care Quality Commission (CQC) is the regulator for health and social care services in England. It is the CQC’s responsibility to make sure that health and social care services are safe and deliver high-quality care.

CQC registers care providers and makes sure that providers meet required standards to deliver care. CQC also inspects and rates services to make sure they continue to meet these standards. CQC can also take action if a service is found to be offering inadequate and unsafe care.

Since 2024, CQC also assesses local authorities to see how well they are meeting the requirements set out in the Care Act 2014. This is called local authority assurance, access more information about the CQC’s role here.

Local authorities have responsibility for commissioning social care for their local area. This means that local authorities plan, purchase and monitor services. Local authority assurance is the process where the Care Quality Commission goes into councils to assess how well they are meeting the requirements set out in the Care Act. More information about the Care Act 2014 can be accessed here.

A team from CQC visits a local authority when it is being assessed. Before the visit, the assessment team collates information about the council, including an information return and possibly a local authority’s self-assessment document. The CQC also speaks to people who draw on care, as well as providers. More information about the assessment process can be found here.

Local authority assurance should tell us how well councils are performing when it comes to providing and arranging care. As part of the local authority assurance process, councils often complete a self-assessment. This self-assessment can help local authorities understand what they should be focusing on in future to improve.

The idea is that people drawing on care can have greater confidence that adult social care services are high-quality and safe. Local authority assurance can encourage councils to improve the way they arrange care. Our project is exploring whether CQC assurance is the right process to assess how local authorities meet their Care Act duties. We’ll also consider how assurance is impacting the local social care system.

CQC assesses local authorities against a framework that is made up of four themes:

• Theme 1: Working with people
• Theme 2: Providing support
• Theme 3: How the local authority ensures safety within the system
• Theme 4: Leadership

Mapped to each theme are nine quality statements (we statements) and I statements based on Think Local Act Personal’s (TLAP’s) Making it Real initiative. Making it real statements are coproduced and use peoples’ lived experience of drawing on health and care services.

The statements are used to hold local authorities to account and show what is needed to deliver high-quality, person-centred care.

The local authority assurance assessment framework uses a subset of the quality statements from CQC’s overall framework. This is because local authorities are being assessed against a different set of statutory duties compared to registered providers.

Making it Real aims to help people understand what a good experience of care looks and feels like. supporting the CQC to gather the correct answers for the evidence categories. These statements highlight what people expect and in turn help inspection teams to assess whether local authorities are meeting these standards.

More information about the assessment framework can be found here.

The local authority assurance assessment process should gather evidence from people who draw on care about their experience of accessing services.

The CQC may gather feedback from voluntary, community, faith and social enterprise groups that work with people drawing on care. Unpaid carers are also contacted to get their feedback.

Case tracking is also used to gather evidence of people’s experiences from first contacting the local authority to when people are drawing on services. Information is collected on assessment, care planning, care reviews and people’s experiences. People’s care records are reviewed with their consent. The CQC contacts a number of people, or possibly their family and friends, to gather more feedback on their experiences.

Local authorities may produce a document where they self-assess themselves against the CQC’s quality statements. Local authorities may include feedback from people who draw on care in this document.

More information about how CQC assesses local authorities can be found here.

The Care Quality Commission publishes a report after a local authority has been through the assurance process.

Local authorities can be assessed as either: Inadequate; Requires improvement; Good; or Outstanding.

The reports have summaries and scores of how well local authorities perform against each of the quality statements.

More information about how the CQC works out local authorities’ ratings can be found here.

Local authority assessment reports can be found on the CQC website.

Local authorities are assessed against a framework that sets out quality statements. When a local authority is assessed, each of these quality statements are scored between:

4 = Evidence shows an exceptional standard
3 = Evidence shows a good standard
2 = Evidence shows some shortfalls
1 = Evidence shows significant shortfalls

More information about the scoring methods used by CQC to determine a local authority’s rating can be found here.

If a quality statement receives a score of ‘1’ the CQC notifies the Secretary of State. Quality statements within the leadership theme are not reported as these statements do not map to the Care Act 2014.

Following notification, the Department of Health and Social Care provides guidance to the local authority. The Department may intervene or highlight required improvement activity and coordinate this with other organisations, including Partners in Care and Health a collaboration between the Local Government Association and the Association of Directors of Adult Social Services.

More information about CQC ratings can be found here.