The inspectorate delivered the warning following a focused visit in April to evaluate Stoke-on-Trent City Council's child protection arrangements for vulnerable adolescents.
Inspectors praised work by the council to improve support for children at risk of sexual, criminal and gang exploitation as well as those who go missing from care, home or school.
But they found that managers and staff are experiencing workload pressures as a result of high caseloads, with most social workers, including newly qualified staff, supporting 30 children each.
Ofsted said current caseloads are "inappropriate and unsustainable" because the children involved have complex needs.
Inspectors also said they found problems with managers' decisions not being recorded properly.
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