CQC assessment of adult social care

The Care Quality Commission has today published the results of its assessment of adult social care here in Salford. Let me be clear from the start, the CQC has rated our adult social care services as inadequate and that is not acceptable, not for the people of Salford, not for your families and not for anyone who should be able to rely on us when they need support the most. On behalf of the City Council, I want to apologise unreservedly to every resident, every family member who has had a poor experience. You have been let down and you deserve far better as your directly elected mayor, along with the Chief Executive and others. We take responsibility for making sure we put this right.

People will rightly ask, how did we get here? And what changes now? For nearly a decade, adult social care in Salford has sat in a complex set of arrangements, with council staff transferring into an integrated care organisation as NHS employees with the Salford Royal Foundation Trust, initially from 2016 and since 2021 as part of the Northern Care Alliance NHS Foundation Trust. It started with around 450 staff and grew significantly over time to around 2000 members of staff, with a budget of 213 million. Whatever the intention back then, what matters now is this the arrangements haven't delivered consistently good outcomes for Salford people, and they have not given us the grip and the accountability that we need.

That's why in April last year, well before this report was published, we made the decision to bring adult social care back under the direct leadership and management of your City Council, following the Northern Care Alliance, informing us that they no longer wish to deliver the services through the integrated arrangements, ending our current joint integrated arrangements with the Northern Alliance and Greater Manchester Mental Health Trust. And that change is already underway, with us already having delivered on my manifesto commitment to the people of Salford, bringing Aspire back in-house on 1 April of this year, giving the City Council direct control over the support and services we deliver to adults with learning disabilities, cognitive impairments, physical disabilities and complex health needs.

Last month, we also welcomed 300 colleagues back into the City Council from the integrated arrangements with the NHS, with more joining in the next phase of the transition. This isn't change for change sake. It is about putting Salford people first. Making sure decisions are made closer to local needs, to local voices and to local communities, and supporting a workforce that does incredibly important work every day across our city.

Now, I don't want anyone watching this to hear warm words and wonder if anything will feel different. So let me put it plainly. We're working with the CQC, the Department for Health and Social Care and partners across our city, and we are focusing on the basics that matter to our residents. Safe practice, timely responses, clear oversight and listening to people's lived experiences, especially when people are waiting for help or when risks are rising. And to strengthen political leadership and accountability for improvement.

I've asked the Deputy City Mayor, Councillor Tracy Kelly, to take on cabinet responsibility for adult social care and health going forward. Councillor John Merry will continue to serve the residents of Broughton within his ward, while supporting the ceremonial mayor as their deputy in our city's centenary year. I'd like to thank John for his years of service within the mayoral team, especially given the difficult job he's had to navigate. The impacts of Salford Royal merging with Oldham Royal Rochdale Infirmary and Fairfield Hospital to form the Northern Care Alliance. The winding up of Salford's Outstanding Clinical Commissioning Group, and also the ongoing financial and governance impacts of NHS reforms on Salford, with the creation of integrated care systems up and down the country.

I will also take a more direct leadership role through the city's governance arrangements, co-chairing Salford's Integrated Care Partnership and Health and Wellbeing Board. Because improvement cannot sit in one corner of the organisation or one part of the system. It has to be owned, driven and delivered day in, day out with transparency, mutual accountability and urgency. I'm frustrated and disappointed by this outcome, and hugely let down by a once cheerleaded national policy initiative heralded as innovative and ground breaking. Supported by new care models programme and vanguard funding nationally, which was anticipated to deliver efficiencies, reduce hospital admissions and eliminate duplication across our health and social care systems in Salford.

The Care Quality Commission's assessment of adult social care in Salford does not reflect Salford's values, nor does it reflect the Salford way and my own expectations as the directly elected mayor. But we will not respond with defensiveness and we will not hide behind complexity. We will respond with action, and it is also right to recognise that the CQC judgement is about our local authority adult social care arrangements. It is not an inspection of every care home or every care provider in the City of Salford. In fact, the vast majority of adult social care providers in Salford are rated as good by the CQC.

There is good practice in our city and we must build on that. Salford is recognised by the World Health Organisation as an age friendly city and will mark ten years of that accreditation this autumn. We've led on fair pay for care workers and invested significantly in fee rates and uplifts to sustain that commitment. We've also taken a stand on ethical employment practices in social care. Today is about being really honest. People have been let down and being equally clear that we indeed will fix it by changing the way that adult social care in Salford is delivered. Taking back control of social care. Bringing staff and services back home safely to the City Council, supporting our residents and families to live healthy lives for as long as they possibly can in their own homes, in their own local communities and with their friends, families and loved ones. Targeting our resources to those residents and families that need it the most. And listening to our residents, families and communities about their experiences of health and care services and working with them to meet their needs around health and care.

Working across the system to deliver effective quality and timely health and adult social care services, and improving our infrastructure to support those services. I'm working, of course, with our partners to deliver on the prevention and wider determinants of health and wellbeing.
The city Council's motto is that the welfare of the people is the highest law. That isn't just a phrase. It's a promise. And I'm determined with our chief executive, Stephen Young. The deputy mayor, Councillor Tracy Kelly, and our director of adult social services, Becky Wilkinson. Also with our staff and with our partners across the system. To turn this around to deliver quality services, quality support that every Salford resident has the right to expect.

The Care Quality Commission has published the results of its assessment of Adult Social Care here in Salford.

The CQC has rated our adult social care services as inadequate.

Following the inspection I have been appointed to be the Cabinet Member with responsibility for leading our improvement plan.

I am determined to change how adult social care in Salford is delivered and change it for the better.

I take the findings of this inspection extremely seriously and all of the agencies who have a role in the delivery of social care in Salford acknowledge the issues that have been identified by the inspectors.

I appreciate that many of you will be concerned and frustrated by this news. To say that I am disappointed is an understatement but I am determined to put this right.

Working alongside the City Mayor and a new leadership team, which has been put in place, we will drive improvement and deliver change at pace.

I should point out that this wasn’t an inspection of residential care homes in the city nor of those who deliver in-house care services.

In fact 94% of adult social care providers in the city are rated as Good by the Care Quality Commission.

I want to assure you that we have an improvement plan and we are working openly and constructively with the CQC and with our health and social care partners to improve the care and support that is provided.

In April last year we announced that adult social care services will be brought into the direct management of the City Council.

Last month 300 employees were welcomed into the council. More employees will join us next month in the latest phase of our improvement programme.

This is a fundamental change to how we deliver adult social care in Salford. It is designed to put residents first, support our workforce and align decision making more closely with local needs, local voices and local communities.

The City Council is investing an extra £4.5 million over the next 2 years to support the improvement plan and fund the recruitment of more adult social care staff.

Our improvement journey is being shaped by the people who use our services, our carers and by our staff.

We’re working with colleagues from across the region to deliver the Greater Manchester Social Care Commission and we look forward to the publication of the commission’s recommendations later this month.

I am confident that the improvements that we are putting in place will enable us to achieve our longstanding vision for high-quality, inclusive, and sustainable adult social care in Salford.

Here is the latest update from the Independent Chair of the Salford Adult Social Care Improvement Board, Kath O'Dwyer:

On behalf of Voluntary, Community and Social Enterprise (VCSE) organisations from across the city, Salford CVS presented to the July meeting of the Improvement Board.

There are more than 1,600 voluntary organisations, community groups, registered charities and social enterprises in Salford. The main focus of more than three quarters of those organisations is mental and/or physical health and wellbeing.

The importance of the VCSE sector being at the heart of a change of culture across adult social care in Salford was stressed in the presentation as was the sector’s desire to work together with health and social care sector partners to ensure the best for the people of Salford.

It was explained that the VCSE sector has professional knowledge and experience to co-create and co-design adult social care commissioning, the development of services and lead community activities that support the ‘prevent, reduce and delay’ agenda.

Further updates to the board included:

Improvement Advisor

The Board was informed that formal confirmation is expected from the Department for Health and Social Care of the appointment of Professor Graeme Betts as Salford’s Improvement Advisor. He will work with us on our improvement plans, and advise government on whether or not we are making sufficient progress.

Members of the board welcomed the imminent appointment and the opportunity to work with Professor Betts.

Base line practice audit

Following a tender process, Achieve Health and Social Care has been awarded work to undertake a base line practice audit. It will take place in August. A fully developed quality assurance delivery plan is to be developed alongside the audit.

Co-production

A Making it Real Board is being established, involving and highlighting the importance and contribution of those with lived experience. The board will feed into the Improvement Board as will a soon to be established Co-production Advisory Group and a Shadow Improvement Board drawn from our adult social care workforce.

A further co-production workshop on a collective vision for adult social care in Salford is to take place next month. The workshop is to be supported by colleagues from Social Care Futures.

Direct payments

The decision has been made to establish a Self- Directed Support Steering Group to lead the development and implementation of direct payments, personal health budgets and individual service budgets to promote more choice and control for our residents around how their care and support needs are met.

Risk management

A risk oversight workshop has taken place to determine Adult Social Care Corporate and Directorate Risks and the process that is required to support oversight of risk. 

Recruitment

The process to recruit two Programmes Officers and two Project Officers to the Improvement Team is underway.

Performance

The number of people waiting for care act assessments in Salford is falling. We have seen a steady decline in these numbers in recent months. The number of people waiting for occupational therapy initial assessments is also falling but significant challenges remain and sustained improvement is required.

Governance

Formal governance arrangements for adult social care in Salford were shared, explaining the process for decision making.

Strategic commissioning

The strategic commissioning team operates across areas of work including mental health, learning disabilities, autism, carers, older people (dementia), intermediate care, advocacy and Healthwatch.

The Procurement and Market Development team quality monitors key contracts to support adult social care in Salford and supports the sector with improvement and any safeguarding concerns.

Strategic commissioning presented plans for the development of a Market Position Statement. It will explain the structure of the adult social care market and will set out priorities for improvement.

An Interim Commissioning Consultant has been appointed to lead the Adult Social Care Commissioning Improvement Programme. Her role is to work with colleagues, partners and stakeholders to understand the current commissioning position, identify strengths, gaps and opportunities for improvement, and develop a clear programme of change.

Unify Programme

Following the completion of the transfer of adult social care staff from Greater Manchester Mental Health Trust (GMMH) to the council in June 2026 meetings are taking place between the council and GMMH to discuss and agree future collaboration arrangements.

The final transfer of staff from the Northern Care Alliance into the council will take place on 1 October 2026, and is being managed in a safe and thorough way.

Next steps

I’m looking forward to working with Professor Graeme Betts once his appointment as our Improvement Advisor is confirmed. I am sure he will be a great asset to the city and to our Improvement Board.

Together we are beginning to build momentum and I am excited and determined to ensure we continue to make progress.

Kath O’Dwyer
Independent Chair

Here is the latest update from the Independent Chair of the Salford Adult Social Care Improvement Board, Kath O'Dwyer:

The focus of this month’s ASC Improvement Board was on professional practice and the work and responsibilities of staff who undertake assessments, support plans and reviews.
 
The Improvement Board looked at guidance that aims to ensure good quality social care practice when working directly with individuals and carers about their care and support needs, in Salford.

The board considered:

• The Adult Social Care Practice Model.
• The Quality Assurance Framework that helps us to understand the quality of practice and how we ensure learning and improvement.
• The Board was informed about practice support that is available to the workforce to support practice standards and quality of practice.
• Plans were shared about how adult social care is focussing on equality, diversity and inclusion, to ensure all people who are supported by adult social care receive fair, person-centred support while respecting their needs, and backgrounds.
• An update on the Adult Social Care Improvement Plan was provided.
• Discussion on the performance scorecard which illustrated our areas of strong performance and highlights where improvement is needed.
• Unify Programme update.

The following issues were considered as part of the above agenda:

Salford Adult Social Care Practice Model

A model has been developed to guide the support good practice and the delivery of care and support services, ensuring care is person-centred, responsive to individual needs, and effective. The model focusses on four stages:

• People using community activities and natural support networks (these are the every day people and relationships that help people thrive such as friends, family and communities).
• Early help and prevention – to avoid health and care issues where possible.
• Short-term support to help people live independently.
• Supporting people through specialist services.

The model has a three-step approach:

Promoting independence

• Considering what is the first point of contact people have with adult social care.
• Working with other organisations and community partners to find the best support option.
• Dealing with any safeguarding concerns - protecting adults with care and support needs from abuse, neglect, and harm and supporting their wellbeing and human rights.

Helping people live independently and making services and care safe

• Short-term interventions (care to improve health) – reablement (help individuals regain independence and daily living skills after illness, injury or health issues) and, carers’ services.
• Advice/provision of equipment and adaptations to people’s homes.
• Helping people manage crisis.

Working with people who need to live with care and support

• Considering whether people can receive care under the Care Act criteria.
• Maintaining a focus on people’s well-being and independence.

This model is being implemented across the Adult Social Care service and it focusses on working with people’s strengths, promoting their independence and wellbeing and using a strengths-based practice approach.

Practice handbook

The handbook sets out guidance for staff for using a strengths-based approach to adult social work and social care in Salford. The aim is to help create effective relationships between professionals and people, supporting people to live independent lives with a focus on early support and prevention of issues.

We will develop a practice framework that represents our values and behaviours when supporting Salford residents and we have plans to deliver a workforce development programme to support the delivery of strengths-based practice.

ASC Quality Assurance and Practice Framework (QAPF)

The quality assurance framework sets out clear guidance to enable adult social care staff to deliver and monitor safe, effective, and responsive care and support that leads to positive outcomes for Salford residents. It focusses on assessment of needs and developing support plans in line with relevant legislation.

The framework ensures everyone is accountable for quality of support and care, learning and reflection and promoting transparency and trust with people who use services. The aim is to have a culture where learning is encouraged and shared. The board is pleased with everyone’s commitment and effort to make improvement.

Recruitment

The council is recruiting to roles including:

• Carers Lead, Co-production and Engagement Lead and Practice Development Leads to be appointed by 12 June.
• Equality, Diversity and Inclusion Lead - interviews will take place on 15 and 16 June.

Co-production of services

A plan and report are being developed for the council’s work with people who are supported by adult social care, those with lived experience, and staff, to co-produce (plan and review) services and care.

It is essential people who are using, or have used, services are involved in this process because every conversation results in ideas for improvement. An adult social care vision statement and strategy are in development and is being co-produced with partners and people with lived experience.

A direct payments project group will be set up so we can begin to design our direct payments systems in Salford, promoting more choice and control for residents who require care and support.

Delivery partner

A transformation delivery partner will be recruited to work with the council on transforming adult social care services and developing new ways of working. They will support the planning and decisions on resources such as finances, staff and equipment required to meet the wide range of different needs of adults who require care to improve their health and wellbeing.

The partner will support workforce and strength-based practice development – a process that focuses on people’s strengths and assets and the health and wellbeing outcomes they hope to achieve, supporting their independence and wellbeing and to remain at home in their community.

Work will also include reablement and short-term support - helping individuals regain their independence and confidence after a change in their health or circumstances – and Technology Enabled Care (TEC) to support independent living.

There will be a review of adult social care commissioning systems to ensure they are effectively supporting improvement and transformation and the aims for adult social care going forward.

Communications

A communications plan is being developed for the next six months to ensure effective communication between the adult social care workforce, stakeholders, corporate leadership and politicians.

Unify Programme

The transfer of adult social care staff from Greater Manchester Mental Health Trust (GMMH) to the council was completed on 1 June 2026. Preparation is underway for adult social care staff from Northern Care Alliance to transfer to the council on 1 October.

A plan is in place to support the embedding of staff and systems as they join the council. Initial feedback from staff transferring has been positive.

Next steps

As chair, I am setting up meetings with managers and staff from different teams to discuss the work of the board and better understand the local issues. I’m excited to build on the momentum of our work together - driving meaningful improvements to services and championing change that transforms the lives of local people and strengthens our communities.

Kath O’Dwyer
Independent Chair

Here is the latest update from the Independent Chair of the Salford Adult Social Care Improvement Board, Kath O'Dwyer:

The Care Quality Commission (CQC) visited the city in November 2025. Following the overall assessment Salford City Council received a rating of inadequate for its adult social care. The CQC published the results of its assessment of Adult Social Care in Salford on 15 May 2026.

The Adult Social Care Improvement Board was established in February 2026. The Board includes local Salford health and social care system partners. Together with Salford City Council, partners are committed to collectively, proactively and robustly addressing, and delivering at pace, the improvements that are required.

The initial focus of the Improvement Plan have been identified as:

• Development of Adult Social Care data so we can better understand our areas for improvement, what works well and what service areas need attention
• Ensuring that when people are waiting for an assessment or a service they wait well, with the right information and guidance provided to them
• Safeguarding Adults Development Plan that strengthens our safeguarding pathway and support to individuals
• Stronger out of hours arrangements to support decision making

This briefing provides an update on the meeting which took place on Thursday 28 May 2026.

The Chair, the Chief Executive of Salford City Council Stephen Young and Becky Wilkinson, Executive Director Adult Social Care and Health (DASS), and the wider ASC Leadership Team have reflected on the publication of the CQC assessment report. It was noted that staff, partners and political representatives had all shown a determination to address the issues raised by the CQC and to change the way that adult social care is delivered in Salford.

The Chair advised that it is important that we update our residents, our staff and our stakeholders regularly and in a transparent way as we progress on the improvement journey. It was acknowledged that by working together and listening to those with lived experiences of adult social care in Salford, we will deliver the necessary changes, improve services and make sure that people in Salford get the support that they deserve.

Co-production:

The Board was updated on the work to develop an Adult Social Care Vision for the City. 120 people, including people using services, carers, residents, staff and partners attended the ‘Getting Excited, Getting Going – Shaping our Social Care Future in Salford' event in April organised by the charity Social Care Futures. Follow up co-production workshops are to be held in June and July.

Unify Programme:

In April last year it was announced that adult social care services will be brought into the direct leadership and management of the City Council. In April 2026, 300 employees were welcomed into the Council from Aspire. More employees will join the Council in June from GMMH, followed by the integration of more adult social care staff from NCA in the autumn to complete the Unify transformation programme.

The Board was assured that the City Council was working closely with the Northern Care Alliance NHS Foundation Trust (NCA) and the Greater Manchester Mental Health NHS Foundation Trust GMMH) to deliver the transfer.

Bringing services together will enable organisations and the teams within those organisations to do what they do best, and ensure Care Act compliance. The transformation will further improve workforce stability and enable continuity of care for those residents that we support.

Risks:

An adult social care risk register was presented to the board and will be further reviewed as a standing item at future meetings so that the Improvement Board has oversight of risks and the mitigation and management of them.

Workforce Development:

The Chair highlighted the importance of staff development and access to timely and effective training. The Board heard that 9 out of 10 colleagues have now completed mandatory training modules.

A culture of learning and sharing best practice is being encouraged through Learning Lunches, Practice Educator sessions and through Salford’s ASYE training programme, and this focus will continue.

Plans are in place to launch a workforce development programme around Strengths Based Practice and S42 Safeguarding Enquiry Training. This will follow the transfer of staff back into the council and is planned to commence in September 2026.

The need to provide support and training to managers across the teams was also highlighted.

Digital and Data:

Successful recruitment has been completed for two new roles to support the Digital and Data workstream. The focus of the workstream is on data & intelligence, system configuration & assurance to support effective practice, and the development of future technology.

Performance:

Board members were told that overall the number of people waiting for an assessment in Salford is coming down. Waiting times for Carers Assessment, Occupational Therapy Assessments and Financial Assessments are also reducing but it was acknowledged that we need to go further and faster to improve people’s experiences of adult social care in the city. A new Waiting Well Policy is to be launched in June.

Recruitment to the Improvement Team continues. A Head of Service has been appointed and Programme and Project support roles are currently being advertised.

Work has started to identify and update the improvement plan priorities. A further revised improvement plan will be shared at the July Board and will provide proposals for the medium and longer term priorities.

The focus for the June board will be on Practice, Quality Assurance and case file audit outcomes.
These board updates will be published after each monthly Improvement Board.

As chair, I am keen to meet with managers and staff and discuss the work of the board and better understand the local issues, and as such I hope to arrange to meet with groups over the coming months.

Kath O’Dwyer
Independent Chair