Cabinet
Subject: Improving Outcomes in Adult Social Care
Date of meeting: Thursday, 17 September 2026
Report of: Cabinet Member for Communities, Equalities, Public Health & Adult Social Care
Lead Officer: Corporate Director for Homes & Adult Social Care
Contact Officer: Steve Hook, Edward Yeo
Email: Steve.Hook@Brighton-hove.gov.uk
Ward(s) affected: (All Wards);
Key Decision: Yes
Reason(s) Key: Is significant in terms of its effects on communities living or working in an area comprising two or more electoral divisions (wards).
1.1 Following February 2026 Cabinet Paper on Adult Social Care Improvement Plan, this report will update on progress on agreed actions highlighting improved outcomes for residents requiring care and support. The Improvement Plan is designed to fulfil statutory obligations arising from regulatory judgement and to set targets for additional areas of improvement.
1.2 The Care Quality Commission (CQC) is responsible for independently assessing how local authorities discharge their adult social care duties under Part 1 of the Care Act 2014. Introduced through the Health and Care Act 2022, the assurance framework provides national oversight of council performance in areas such as assessing needs, supporting people, safeguarding, leadership and governance. CQC assessments are no longer viewed as one-off inspections; instead, they form part of a continuous assurance model based on self-assessment, regular engagement, evidence reviews, case tracking and, most importantly, the experiences of people who draw on care and support and their carers. The aim is to provide assurance that local authorities are meeting their statutory responsibilities, driving improvement and delivering high-quality, person-centred services.
1.3 For Brighton & Hove, CQC regulation is closely aligned with the Council Plan priorities, particularly creating a fair and inclusive city, a healthy city that helps people to thrive, and a responsive and learning council with well-run services. The CQC framework tests whether residents receive timely, equitable and effective support, whether services help people live independently and safely, and whether the council demonstrates strong leadership, governance and continuous improvement. Improvements arising from CQC assurance therefore contribute directly to reducing inequalities, improving health and wellbeing outcomes, strengthening resident experience, and ensuring the council learns from feedback and evidence to deliver sustainable, responsive services for local people.
1.4 This report will also explain the next phase of Care Quality Commission Inspection Framework and the requirements for Brighton & Hove City Council.
2.1 Cabinet notes the progress of Adult Social Care Improvement Plan as part of bi-annual update
2.2 Cabinet notes the next stage of Care Quality Commission (CQC) Inspection Framework including anticipated expectations for Brighton & Hove
3.1 Care Quality Commission (CQC) Inspection Framework – as reported in February Cabinet Paper
3.1.1. A new regulatory framework for Local Authorities with responsibilities for Adult Social Care was announced in 2022, the first pilot inspections were completed by early 2024. Brighton & Hove City Council was notified of the Inspection Process starting in November 2024, with an onsite inspection completed in April 2025.
3.1.2. The Regulatory Framework measures how well Local Authorities deliver their responsibilities under Part 1 of the Care Act 2014.
3.1.3. A report has been completed by CQC and has given the overall rating for Brighton & Hove City Council as ‘Requires Improvement’, with a score breakdown below;
|
Quality Statement |
Score |
|
Score Assessing Needs |
1 |
|
Supporting people to live healthier lives |
2 |
|
Equity in experience and outcomes |
2 |
|
Care provision, integration and continuity |
2 |
|
Partnerships and communities |
2 |
|
Safe pathways, systems and transitions |
2 |
|
Safeguarding |
2 |
|
Governance, management and sustainability |
2 |
|
Learning, improvement and innovation |
2 |
Score 1 – shows significant shortfalls (inadequate), Score 2 shows some shortfalls (Requires Improvement), Score 3 shows a good standard (good). Score 4 shows an exceptional standard (outstanding).
3.2 Section 50 notice – as reported in February Cabinet Paper
The CQC issued Brighton & Hove a section 50 notice for a score of 1 in Assessing Needs, which means that they gave formal notice of the judgement to the Secretary of State for Health & Social Care. As a result of this the Council worked closely with Local Government Association to complete a response plan, which was shared with Department for Health & Social Care (DHSC).
The Section 50 notice highlighted 2 main areas of concern1. Waiting times for assessment including waiting well procedures and 2. Completion of annual reviews. The Adult Social Care Improvement Plan addresses these areas of concern.
The score of 1 against assessing needs which resulted in the Section 50 notice also impacted on the outcome scores for several of the other Quality Statements. Most notably these were Equity in Experience and Outcomes, Care Provision, Integration and Continuity, Safe Pathways, Systems and Transitions. These ratings remained at 2 – requires improvement - due to the wider impact of how our assessing needs score effects user experience and the monitoring of services we provide.
Since the CQC Inspection on-site visit there has been improvement in the key areas, specifically Annual Reviews and Wait times in teams explained further below.
Since the submission of the improvement plan to DHSC, we have been working closely with a Department of Health & Social Care Advisor, who has been attending regular meetings both as 1-1’s with key members of staff and the monthly Improvement Board meetings. The Improvement Board is the key operational group delivering on identified workstreams, chaired by Director of Adult Social Services (DASS) and attended by senior managers in Adult Social Care.
The DHSC advisor has recognised the progress made against key actions, and we are anticipating the Section 50 notice being removed in Autumn 2026.
3.3 Brighton & Hove City Council’s Learning Organisation Framework
3.3.1 TheAdult Social Care Improvement Plan was developed by being:
· …connected – Adult Social Care are working closely with support from external stakeholders (e.g. Department for Health & Social Care, Local Government Association, Benchmark authorities) and internal stakeholders with experience of regulation (Children’s Social Care and Housing). This ensures that we identify best practice examples and can build from shared experiences.
· …confident – the areas for development identified during the inspection, reflected the areas identified in the self ssessment – Wait times, Annual Reviews, out of area placements, Use of residential care. We know that improvement in those areas will lead to improved outcomes for residents and results in future regulation.
· …innovative and creative– Adult Social Care has identified opportunities to introduce new ways of working and new technology to support delivery of key actions. E.g. use of digital tools to support case work and speed up processes around reviews and contact whilst individuals wait for a service.
· …diverse and inclusive– Adult Social Care has a diverse workforce that reflects the diversity of Brighton & Hove. The diversity of our workforce is monitored as part of a national programme and have an established infrastructure to ensure we continue to hear from ethnically diverse groups in the city.
· …healthy and psychologically safe – The council recognises that our staff played an important part in the CQC Inspection and will continue to monitor responses by Adult Social Care staff in Staff Surveys and engagement opportunities.
3.3.2 Areas of Improvement
As a result of the Requires Improvement judgement, Brighton & Hove is working closely with Local Government Association (LGA) to support the improved outcomes. The support offered by LGA is offered to all Local Authorities who received Requires Improvement or Inadequate rating. Copied below are the key areas of improvement that were submitted for the Stage 3 (6 months after release of CQC report) return completed in June 2026
3.3.3 Progress so far
We have made significant progress in our Residential Admissions reporting. Following clarification from DHSC, we have brought ourselves in line with national benchmarking and separated s117 service users from our reporting. This has meant a significant improvement explained below
· Move from 15th in peer group to 3rd in peer group for Residential & Nursing Placement for 18–64-year-olds
· Move from 14th in peer group to 7th in peer group for Residential & Nursing Placement for 65+
3.3.4 We are also anticipating further improvement in benchmarking when client-level data is fully implemented.
3.3.5 Prioritised Actions and Updates
|
Prioritised actions |
Update |
|
Expanded Reablement Offer |
Having appointed a Senior Programme Manager for Reablement, we have reviewed case files to help support the case for an expanded Reablement offer. As part of the review, we have evidenced the opportunity for an expanded reablement programme and remodelling of existing services. The business case has identified a pilot phase, which we anticipate launching in July 2026. |
|
Reduced number of placements in Residential & Nursing Homes |
As described above we have made significant improvement in our benchmarking performance following clarification on data returns by DHSC. Having established a task & finish group we have now returned this to business-as-usual approach, channelling the work into our existing meetings with other Council departments including Housing colleagues. |
|
Reduced Wait Times for Assessment |
As described above we are working closely with Care and Health Improvement Adviser to source external support to review our pathways and embed a culture of proportionality. We have introduced new tools in proportionate reviews, which have now launched and are being monitored within teams. |
|
Waiting Safely Framework |
Waiting Safely Framework has successfully launched and is well understood by operational teams. As part of the framework, we have included approaches to contact, which will be monitored by our performance team. The categorisation of cases will support improvement in data quality identifying anomalies at team level and further improve confidence in our reporting |
|
Increased Annual Reviews |
We have achieved the target of 45% of annual reviews completed on time in 2025/26 and have a further target to improve to 55% for 26/27. We have allocated targets to teams, which can now be monitored on a regular basis. This will spread the targets throughout the year and give each team a focus on regular reviews. |
3.4 Future CQC Approach
Care Quality Commission has recently briefed Local Authorities on the next phase of Inspection Framework. Regulation was reintroduced for Local Authorities in 2024, with previous Inspections delivered in 2010/11, the first phase was an opportunity for ‘baselining’ to understand the performance of Local Authorities and how that compared nationally. The next phase of the Inspection Framework is to move to a regular pattern and a ‘business-as-usual’ approach. This means that:
· Quality Statements will be the same – How Local Authorities work with people, Providing Support, Ensuring Safety within the System and Leadership
· Stronger focus on unpaid carers experience and improved co-production processes
· The end-to-end process will be shortened, lasting 19 weeks from the point of notification to the publication of the report.
· Communication approach will change, with more regular meetings and longer time on site (5 days)
· Rating characteristics have been introduced to provide clarity on how the overall judgement was reached and areas for improvement
3.5 Next Steps
3.5.1 Self-Assessment
To prepare for the new Inspection Framework, explained further below, Adult Social Care teams will start a series of workshops to help develop an updated Self-Assessment. The Self-Assessment will be in keeping with new guidance published by CQC and will incorporate learning from the previous years’ experience. When complete the Self-Assessment will be shared with Lead Member for Adult Social Care for oversight.
3.5.2 Proportionality & Pathways Workshops
We are currently working closely with Local Government Association, who are supporting all Local Authorities with a Requires Improvement judgement. The LGA will support Brighton & Hove Council in delivering workshops to review all of our assessment pathways and help embed a culture of proportionality. The LGA support with our management of waiting lists.
4.1 CQC Inspection has highlighted areas of improvement for Adult Social Care in Brighton & Hove that match our self-assessment completed at the start of the Inspection Framework. In identifying and addressing those areas there has been improvement in key metrics explained in this report. If performance had continued on a similar trend (e.g. low performance on annual reviews, under-utilised re-ablement and high residential admissions) there would have been a deterioration in resident outcomes and compliance with statutory duties. The next phase of Inspection Framework will support our continuous improvement journey, engaging with staff and ensuring better outcomes for residents with adult social care needs.
5.1 Brighton & Hove City Council has engaged closely with internal & external stakeholders since the introduction of the CQC Inspection Framework. The regular communication will continue and includes:
· Email communication for regular updates, before the Inspection timetable has been announced, during the Inspection and post Inspection result
· Attendance at Partnership Boards such as the Learning Disability Partnership Boards to engage with our communities
· Ongoing work with local Voluntary, Commnity and Social Enterprise Sector organisations such as Bridging Change to ensure we are reaching our BRM Communities and serve their needs appropriately, particularly in respect of initial contact with Adult Social Care and Safeguarding.
· Workshops delivered by Brighton & Hove and supported by LGA
· All staff briefings chaired by Director of Adult Social Services (DASS) explaining our current performance, the Inspection process and how staff will be involved.
· Other communication – video’s, briefing notes and team meetings
· Regular attendance and participation at regional groups to maximise learning opportunities.
6.1 There are no direct financial implications as a result of this report. However, The Adult Social Care Improvement Plan informs budget management and development and informs a single Adult Social Care Transformation Plan that is part of the delivery of the council’s Medium-Term Financial Strategy. This plan both meets the requirements for service improvements such as in relation to reviews performance and for 2026/27 this has resulted in service investments of £1.122m leading to improvements and identified savings of £10.092m which is monitored and reported monthly. Savings achieved through increased reviews performance currently stand at £1.5m as at TBM04, a significant achievement.
Name of Finance Officer consulted: Brian Smith Date Consulted: 02/09/2026
7.1 The Health and Social Care Act 2022 and associated regulations provide CQC with statutory powers to independently assess how well Local Authorities deliver their responsibilities under Part 1 of the Care Act 2014. Where one or more of the quality statements is given a score of 1 by CQC, pursuant to Section 50 of the Health and Social Care Act 2008 (as amended), CQC must inform the Secretary of State for Health and Social Care.
Name of lawyer consulted: Sandra O’Brien Date consulted 16/06/26
8.1 We recognise that the level of staffing resources allocated to assessment services, and the current financial challenge of the council represents a significant risk in terms of improving the responsiveness and quality of assessment and meeting the new requirements of CQC regulation.
This is particularly in relation to reducing wait times for assessment and increasing reviewing performance. It is essential that the need for quality improvement and achieving financial stability in Adult Social Care are risks that require an integrated single plan for delivery around managing demand and improving service performance. This level of service transformation is not possible without a level of up-front investment to assist in delivering the changes needed.
8.2 Risk Mitigation
Therefore, an investment fund of just over £1m has been agreed to 31 March 2027 to support the development of Adult Social Care Services to deliver on a single Demand Management Transformation Plan and Service Improvement Plan as follows:
Ø £332K – Social Work Professional Development and Leadership
Ø £684K – Set–up a Dedicated Review Team and increased Brokerage Support for more targeted placements
Ø £81K – Developing a Reablement offer via an experienced Programme Manager
Ø £25K for consultancy on a Telecare review
Ø Total: £1.122M
The Dedicated Review Team and enhanced Brokerage resource have been Operational from January this year, as has the Reablement Programme Manager. We have seen the benefits of this investment already during this year as evidenced by our improved reviews performance and reduced waiting times for assessment. We are confident that these additional resources will help drive forward our Transformation Programme successfully over the coming year and will be reviewed in the light of the continuing demand for improvements and savings over the course of future regulatory requirements and the Medium-Term Financial Plan up to March 2030.
9.1 The implementation of the Adult Social Care Improvement Plan has several key equality implications given the CQC findings and Council’s Statutory Duties under Care Act and Public Sector Equality Duty. The Improvement Plan will positively impact groups with protected characteristics, ensuring that they have equity in access, assessment and when in receipt of services. By addressing key improvement areas in wait times, reablement and residential admissions outcomes will improve for those individuals and their families.
10. Health and Wellbeing Implications:
10.1 In delivering Adult Social Care Improvement Plan, Brighton & Hove City Council will improve Health & Wellbeing outcomes for its residents. As evidenced in the paper above the council has identified key improvement areas using evidence including benchmarking with other local authorities. The improvements identified will be tracked and monitored through existing governance processes.
11.1 The Adult Social Care Improvement Plan provides a clear framework for responding to the CQC judgement and strengthening outcomes for residents who draw on care and support. Progress has already been made in key areas, including annual reviews, waiting safely arrangements, reablement planning and improved use of performance data. Continued delivery of the plan, alongside the Demand Management Transformation Plan, with an updated self-assessment and preparation for the next phase of CQC assessment, will support the Council to evidence sustained improvement, meet its statutory duties, and maintain a clear focus on safe, timely and person-centred support for residents and unpaid carers.