Harrow’s ability to safeguard children and look after those in care has been rated as “adequate” by inspectors – the minimum requirement.

Ofsted investigators who inspected the council in May found that 13 areas of the service were adequate, eight good, and one – health services for children in care – rated inadequate.

Although the report said there was much “working well” in the borough, it said services to protect the most vulnerable children in the borough “require improvement”, with social workers changing too often and children on protection plans “for too long without evidence that their circumstances are improving”.

It singled out healthcare for the borough’s 156 children in care as needing urgent improvement, adding “health visitors and school nurses have not received training on how to undertake assessments beyond how to complete the documentation”.

It also said NHS Harrow has taken years to appoint a designated doctor and nurse to direct care for looked-after children despite being told to, leaving “no effective” leadership in making sure children were healthy.

The council admitted it was “disappointed” by the report, and opposition councillor Christine Bednell said it must serve as a “wake-up call” for the council and NHS Harrow.

She said: “Harrow deserves better than this – the issues at the heart of this report affect some of Harrow’s most vulnerable young residents, and these services are among the most vital the council provides.

“Nobody should be taking any comfort from its conclusions because these services are fundamental to the welfare of some of our most vulnerable young residents. The council and NHS Harrow simply must do better.”

The inspection is the first since the system was overhauled two years ago after a review of child protection following the death of 17-month-old Peter Connelly, known as Baby P, in Haringey in 2007. Neighbouring Brent was given a similar ‘adequate’ rating last year, and Barnet was rated as ‘good’ in an inspection in January.

Portfolio holder for schools, Councillor Brian Gate, said: “Protecting vulnerable children is at the heart of everything that we do in Children’s Services and it is a duty we take extremely seriously.

“Although we are disappointed by this report it is clear from the inspectors’ findings that we have the foundations in place to become an outstanding service.

“The majority of our services were judged as either good or adequate. We have made a good start despite challenges such as a big rise in child referrals – which have been part of a national trend.

“We have a clear vision of how to improve the safety of Harrow’s children which is being delivered through our new operating model. Our approach is based on a thorough analysis and understanding of the key issues for children’s services, however it is too early to evaluate the impact of these changes.

“Raising standards in safeguarding is ultimately my responsibility as well as our partners within the health partnership. We are working closely with health, police, and all partners to ensure we address the shortfalls identified within this report.”