London Borough of Southwark: local authority assessment

The local authority centred equity at the heart of its adult social care services, which came through consistently throughout our assessment. The local authority had regard to its Public Sector Equality Duty (Equality Act 2010) in the way it delivered its Care Act with continuous learning about its communities and helping them overcome inequalities. There were clear and well understood equality objectives and well-resourced strategies to reduce inequalities and improve the experiences and outcomes for people who were more likely to have poor care. The local authority had a thorough understanding of the Southwark population profile and inequalities faced by residents. It analysed equality data on people accessing social care and used this information to identify and reduce inequalities in people’s care and target resources. There was evidence this was improving people’s access and outcomes. For example, the local authority’s investment in positive behavioural support for autistic younger adults and people with learning disabilities had prevented their needs increasing and reduced admissions to mental health units.

The local authority had thorough strategic plans to address local inequalities and ensure people's rights were respected. There was a published equality framework and joint health and wellbeing action plan 2025-27, with associated action plans that were routinely reviewed. These identified early help and prevention as key to reducing inequalities across the borough. As part of the Southwark 2030 vision, there was a strong emphasis on tackling inequalities in mental health care and improving life expectancy for people with mental health care needs. The local authority conducted equality impacts assessments and needs analysis to assess the impact of change on local people when developing policies, projects and service commissioning, including the Southwark health and wellbeing strategy. These assessments were mandatory and used evidence-based research and extensive community engagement to ensure positive impact on residents and mitigate any negative effects on people with protected characteristics.

Southwark was a very diverse borough and approximately 48% of people identified as being from Black, Asian or Minority Ethnicity backgrounds and 8% identifying as LGBTQ+. Almost 40% of Southwark residents were born outside of the UK and more than 80 languages were spoken in the borough. The local authority was a designated ‘Borough of Sanctuary’ for asylum seekers and refugees, and the public health team worked closely with other services to undertake health checks and provide advice for asylum seekers to access the support they needed and prevent their needs from escalating.

The local authority recognised disparities in different communities’ access to social care and partnered with local community and voluntary groups for under-represented groups such as an Irish pensioners group and a Black and African support group to support different cohorts of people get the support they needed. This focused on prevention, stigma reduction, and helping people to know how to access services. The local authority used people’s feedback to develop new culturally competent health interventions, including targeted mental health outreach for Black residents and minority ethnicity groups.

Local authority leaders and staff demonstrated a commitment to understanding and reducing barriers to care and reducing inequalities in people’s experience and outcomes. They had a comprehensive understanding of local inequalities and equality, diversity and good understanding of strengths, gaps, actions and outcomes to improve equity. The local authority prioritised six population groups to tackle entrenched health inequalities, which aligned with its Joint Health and Wellbeing Strategy: carers, residents with disabilities, LGBTQ+ people, asylum seekers and refugees, rough sleepers and Black, Latin American and minoritised ethnic groups.

The local authority proactively engaged with the people and groups where inequalities were identified, to understand and address specific risks and issues experienced by them. This included comprehensive use of data to identify and understand where inequalities were. For example, in additional to its main joint strategic needs assessment (JSNA), the local authority had developed specific JSNAs for different local communities, including Latin American and LGBTQ+ communities, and a needs assessment for the Gypsy, Roma, and Traveller community. The JSNAs identified specific inequalities and needs for those most at risk of discrimination. The local authority worked with these communities directly to understand their challenges and the JSNAs were co-produced with them and VCSE partners. The JSNAs informed commissioning plans and service specification revision, for example to improve support for LGBTQ+ unpaid carers. This demonstrated the local authority considered the needs of different communities with targeted health and care interventions, and led to actions such as mandatory LGBTQ+ led awareness training for staff to improve understanding of inequalities. This had reduced underreporting in case management data.

The local authority had a place-based approach to direct resources to areas of highest deprivation and respond to local disparities. This supported the delivery of services such as a resident health and wellbeing programme closer to people’s homes to support easier access for local people. Through various commissioning projects and funding streams, the local authority supported many local services that catered to the diverse population. For example, the local authority offered several resources for LGBTQ+ unpaid carers through local and London-wide organisations. The local authority commissioned a London LGBTQ+ community centre and provided funding for a new cultural centre. It gave grants to local events through its Southwark Pride Fund. The local authority worked with local NHS partners to support access to a dedicated Southwark LGBTQ+ talking therapies wellbeing group. These interventions reduced and delayed people’s care needs.

There was a commitment amongst leaders to represent their communities. Staff and leaders were proud that the demographics of the leadership team reflected the diversity of the borough. The frontline adult social care workforce was also reflective of local communities, with approximately 46% of staff from Black, Asian and minority ethnicity backgrounds. Some staff reflected other local populations, for example the Traveller community. They worked with those communities, supported good cultural competency and understanding of different needs, and reduced cultural barriers to accessing care. The local authority applied Workforce Race Equality Standards (WRES), and there was anti-discriminatory practice and anti-racism training for all staff, as well as cultural competency counselling to improve staff awareness and knowledge of different community needs. This improved staff cultural empathy, insight and competencies in practice.

The local authority invested heavily to become an anti-racist organisation and had a zero-tolerance approach to discrimination, with clear priorities to address inequalities in initiatives like Southwark Stands Together (SST), launched in May 2025. More than 5,000 Southwark residents shared their lived experiences of racism and inequality to shape the first SST action plan. This work was collaborative, inclusive, and designed to improve people’s experiences. The local authority continued to convene listening forums and accountability panels to ensure transparency and resident challenge for SST, with annual progress reports and community updates. SST was embedded in the Southwark Health and Wellbeing Strategy as a driver of equity.

There was good evidence of work with the VCSE sector to reach into communities and work with people with lived experience to understand and address different inequalities and impact of structural barriers to accessing care. The local authority provided £28m in funding annually to Southwark charities and had introduced new services for specific communities and cohorts, including funding culturally competent local voluntary sector groups. There were funding streams specifically for black and minority ethnicity-led VCSE organisations, to build capacity and sustainability, following feedback from community groups about unequal access. The local authority worked with local VCSE groups to co-produce a dedicated Black Carers Project with targeted support, in recognition that black carers were less likely to access mainstream carers’ support. This had a positive impact of greater reach into underrepresented communities, and the local authority used feedback from the project to inform wider carers’ service commissioning. There was some evidence of increased carer support uptake from within black communities.

Leaders recognised some communities were mistrustful of statutory services so the local authority was conducting ‘deep dives’ to improve trust and hear from seldom-heard voices in the community. For example, the local authority was reaching into local Somali community groups to improve awareness and understanding of local support services. The local authority co-developed the Black Elders Centre with local volunteers with culturally relevant spaces and programmes tailored to older black residents. Feedback from people showed this helped reduce isolation and promoted wellbeing in a trusted environment.

The local authority had an outreach health promotion van which visited communities to support people to access regular health checks, smoking cessation and alcohol dependency support, and diabetes support. The aim was to empower people to access health and social care services and live healthier lifestyles. The van visited local community festivals and roadshows to improve awareness of local authority and NHS services, particularly amongst Black, Asian and minority ethnicity populations. In 2024 the outreach team conducted over 3,500 ‘Vital 5’ checks and signposted people to urgent health support to manage their health risks. Feedback from people accessing the health promotion van was very positive. NHS partners told us the local authority supported people from marginalised groups well with competent practice and commitment to equality. The local authority and NHS partners jointly commissioned ‘health and wellbeing hubs’ to improve access to community support and mental health services for disadvantaged people.

The local authority also participated in a tenant health and wellbeing programme, which brought together teams across ASC and NHS to address social and health inequalities with appropriate housing. The local authority’s ‘Community Ambassadors’ programme targeted vaccinations uptake in particular communities. Ambassadors were volunteers who represented their communities and supported awareness raising. Data showed this resulted in short-term increases for specific prevention campaigns, such as certain maternal and seasonal vaccinations.

The local authority supported work to overcome barriers for vulnerable people. Staff worked with a local care provider to provide 3-month social care work placements for care leavers. The work placements were created to support care leavers develop skills and confidence to improve their career opportunities. As a result of this project 2 care leavers had secured employment with the care provider involved in the project. This demonstrated a proactive approach to improving equity as care leavers often face greater challenges and poorer outcomes in comparison to those who do not have care experience.

Southwark was awarded ‘Dementia Friendly’ borough status in 2023, which recognised the local authority actively worked to include and support people with dementia to improve their quality of life and independence. The local authority continued to embed good practice and support for people living with dementia, including supplementary dementia awareness training for home care staff, new extra care housing schemes, staff learning networks, ‘dementia cafes’ for people to access support, and closer partnership working with health to support early diagnosis. The local authority had allocated £300,000 to local charities to ensure their offer included dementia support.

Local political leaders recognised higher prevalence of safeguarding concerns in some local communities, but such concerns were often hidden or not reported. A cross-partnership committee was created to specifically address domestic violence, which had established ‘safe spaces’ in the community for people to confidentially discuss their concerns with a professional. However, elected members recognised more work was required to identify and support people experiencing domestic violence promptly, particularly in the Latin American community as interpreters often did not speak the specific Latin American Spanish dialect, which risked misinterpretation.

The local authority had inclusion and accessibility arrangements which considered people’s diverse communication needs and supported them to engage in ways that worked for them. Staff asked people about their communication preferences and requirements, and they were trained and supported to use different methods to meet people’s diverse communication needs. They had access to visual aids to support communication and understanding, for example, information in large print or translated into other languages. The local authority introduced webtools to translate and print website information into other languages. Tracking data indicated the tool was well utilised.

The local authority commissioned external translation and interpretation support, including face-to-face translation and technology to support deaf people to contact local authority departments by telephone. This included people whose first language was British Sign Language (BSL). Frontline staff also highlighted a diverse workforce that spoke different community languages, which supported people to articulate and advocate for their needs at the first point of contact. Specialist support workers helped people with learning disabilities to communicate their needs using techniques from their speech and language assessment and Makaton. NHS partners shared an example of a social worker using an amplifier to communicate with a patient, to ensure they could participate fully in their Care Act and mental capacity assessments.

Frontline staff sensitively asked people about their accessibility and sensory needs and language preferences in early conversations about their care and this was captured on the electronic record system. Staff recognised different cultural communication needs and that some cultures preferred oral communication to written. They had cultural competency training and tailored their approach according to people’s needs. The local authority’s accessible materials included Braille, audio format, easy read and enlarged font size documents. The local authority developed colour schemes for all official documents to support colour blind people access information. There was ongoing work to improve local authority website accessibility. Including co-production with people with physical and learning disabilities to ensure it met different accessibility needs.

Staff described many examples of supporting inclusion in practice. For example, staff had liaised with the local leisure centre to improve support for people with disabilities to access the facilities. As a result, the leisure centre changed its lighting to make the environment more inclusive for people with sensory needs and ensure universal services were as accessible as possible for all residents. This demonstrated staff advocating for people.