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CQC Assurance framework for local authorities – Ensuring Safety

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The Care Quality Commission (CQC) will use a new framework to assess how well local authorities are performing against their duties under Part 1 of the Care Act 2014. This framework was developed through co-production with partners, agencies and people with direct experience of using care and support services.

The assessment framework uses a subset of the quality statements from the overall assessment framework. This is because local authorities are being assessed against a different set of statutory duties to registered providers.

The assessment framework for local authorities comprises 9 quality statements mapped across 4 overall themes.

For each theme we set out:

  • The I statements and quality statements that we will assess:
    • Quality statements are the commitments that local authorities must commit to. Expressed as ‘we statements’, they show what is needed to deliver high-quality, person-centred care.
    • I statements are what people expect. They are based on Think Local Act Personal’s ‘Making It Real’ framework.
  • Sections of the Care Act to which the quality statements relate
  • Required evidence categories for each quality statement and sources of evidence.

The FOUR domains are as follows:

You can find out about each of those by clicking the links above.

Theme 3: Ensuring Safety

Theme 3: How the local authority ensures safety within the system

This theme covers:

  • Section 42 safeguarding enquiries
  • reviews
  • safe systems
  • continuity of care.

Safe systems, pathways and transitions

Quality statement

We work with people and our partners to establish and maintain safe systems of care, in which safety is managed, monitored and assured. We ensure continuity of care, including when people move between different services.

  • When I move between services, settings or areas, there is a plan for what happens next and who will do what, and all the practical arrangements are in place.
  • I feel safe and am supported to understand and manage any risks.

Summary

  • Safety is a priority for everyone. There is a strong awareness of the risks to people across their care journeys. The approach to identifying and managing these risks is proactive and effective. The effectiveness of these processes is monitored and managed to keep people safe.
  • Care and support is planned and organised with people, together with partners, and communities in ways that improve their safety across their care journeys and ensures continuity in care. This includes referrals, admissions and discharge, and where people are moving between services.
  • The views of people who use services, partners and staff are listened to and taken into account.
  • Policies and processes about safety are aligned with other key partners who are involved in people’s care journey to enable shared learning and drive improvement.

Related sections of the Care Act

Care Act 2014:

  • Section 1: Wellbeing principle
  • Sections 6-7: Cooperation generally and in specific cases
  • Section 19(3): Power to meet needs for care and support
  • Section 37(1), (3), (4), (5)(a), (e), (f), and (6) to (15); Section 38(1)(a) and (2) to (8): Continuity of care and support when adult moves
  • Section 48: Provider Failure (Temporary duty to provide services)
  • Section 58-65: Transition for child to adult care and support

Required evidence

People’s experience

  • Direct feedback from:
    • people with care and support needs
    • unpaid carers
    • people who fund or arrange their own care, those close to them and their advocates
  • Feedback from people obtained by community and voluntary groups. For example:
    • advocacy groups
    • adult and young person’s carers groups
    • faith groups
    • groups representing people who are more likely to have a poorer experience of care and poorer outcomes
    • people with protected equality characteristics
  • Feedback that people have sent to the local authority and feedback it has gathered itself through surveys or focus groups
  • Feedback from CQC’s Give feedback on care facility (if available).
  • Compliments and complaints
  • Healthwatch
  • Case tracking

Feedback from staff and leaders

  • Council adult social care portfolio holder
  • Overview and scrutiny committee
  • Principal social worker
  • Social work teams
  • Out-of-hours duty teams
  • Care provision: Quality monitoring team
  • Director of adult social services
  • Director of children’s services
  • The local authority’s self-assessment of its performance for the quality statement

If available

  • Staff feedback from the local authority’s own surveys
  • Peer review

Processes

  • Safety management systems:
    • approach to identifying and managing risks to people across their care journeys
    • monitoring the effectiveness in keeping people safe.
  • Safety during transitions and continuity of care, including
    • referrals, admissions and discharge
    • where people are moving between services (including children into adulthood, hospital discharge, moving to another local authority and when transitioning between services)
  • Contingency planning and emergency preparedness for provider failure and disruptions in the provision of care and support
  • Alignment of safety management policies and processes with other key partners who are involved in people’s care journey to enable shared learning and drive improvement.
  • Arrangements with health partners to ensure delegated healthcare duties and medicines support provided by social care staff are carried out safely
  • Information sharing protocols

Feedback from partners

  • Community and voluntary sector groups, including those representing:
    • people who are more likely to have a poorer experience of care and poorer outcomes
    • people with protected equality characteristics
    • unpaid carers
  • Care providers
  • Local health partners
  • Ambulance and paramedics
  • Health and wellbeing board
  • Safeguarding Adults Board
  • Advocacy providers

If available:

  • Local Government Social Care Ombudsman
  • Reports from Ofsted for inspecting local authority children’s services (ILACS)
  • SEND area review reports
  • Feedback from other regulators

Outcomes

We will not look at evidence under this category.

Best practice and guidance

Safeguarding

Quality statement

We work with people to understand what being safe means to them as well as with our partners on the best way to achieve this. We concentrate on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. We make sure we share concerns quickly and appropriately.

  • I feel safe and am supported to understand and manage any risks.

Summary

  • There are effective systems, processes and practices to make sure people are protected from abuse and neglect.
  • Section 42 safeguarding enquiries are carried out sensitively and without delay, keeping the wishes and best interests of the person concerned at the centre. People can participate in the safeguarding process as much as they want to. 
  • There is a clear understanding of the key safeguarding risks and issues in the area and a clear, resourced strategic plan to address them.
  • Lessons are learned when people have experienced serious abuse or neglect and action is taken to remove future risks and drive best practice
  • People are supported to understand safeguarding, what being safe means to them, and how to raise concerns when they don’t feel safe, or they have concerns about the safety of other people.
  • People are supported to make choices that balance risks with positive choice and control in their lives.
  • People are supported to understand their rights, including their human rights, rights under the Mental Capacity Act 2005 and their rights under the Equality Act 2010.

Related sections of the Care Act

Care Act 2014:

  • Section 1: Wellbeing principle
  • Sections 6-7: Cooperation generally and in specific cases
  • Sections 42-43: Safeguarding adult at risk of abuse or neglect
  • Sections 68: Independent advocacy support (safeguarding enquiries and reviews)

Required evidence

People’s experience

  • Direct feedback from:
    • people with care and support needs
    • unpaid carers
    • people who fund or arrange their own care, those close to them and their advocates
  • Feedback from people obtained by community and voluntary groups. For example:
    • advocacy groups
    • adult and young person’s carers groups
    • faith groups
    • groups representing people who are more likely to have a poorer experience of care and poorer outcomes
    • people with protected equality characteristics
  • Feedback that people have sent to the local authority and feedback it has gathered itself through surveys or focus groups
  • Feedback from CQC’s Give feedback on care facility (if available)
  • Compliments and complaints
  • Healthwatch
  • Survey of Adult Carers (SACE), Adult Social Care Survey (ASCS) – see detailed metrics
  • Case tracking

Feedback from staff and leaders

  • Council adult social care portfolio holder
  • Overview and scrutiny committee
  • Principal social worker
  • Social workers
  • Out-of-hours duty team
  • Director of adult social services
  • Local authority designated officer (LADO), Designated Safeguarding Officer or Multi-agency Safeguarding Adults Team
  • The local authority’s self-assessment of its performance for the quality statement

If available

  • Staff feedback from the local authority’s own surveys
  • Peer review

Processes

  • Systems, processes and practices to make sure people are protected from abuse and neglect. Processes and pathways for managing:
    • safeguarding alerts
    • Section 42 enquiries
  • Safeguarding Adults Board annual strategic plan and annual report
  • Oversight and quality assurance of safeguarding cases, themes, trends, outcomes:
    • timeliness of responding to concerns and section 42 enquiries
    • actions to address any safeguarding themes, trends and key safeguarding risks
  • Lessons learned when people have experienced serious abuse or neglect and action to remove future risks and drive best practice. Response to Safeguarding Adult Reviews and other reports and reviews that feature safeguarding responsibilities. This includes:
    • Regulation 28 reports (Report to Prevent Future Deaths)
    • domestic homicide reviews
    • mental health reviews and serious incident reviews
  • Support for people to understand how to raise concerns when they don’t feel safe, or if they have concerns about the safety of other people and to understand their rights. This includes their human rights, rights under the Mental Capacity Act 2005 and their rights under the Equality Act 2010
  • Training and support for staff involved in safeguarding work to undertake safeguarding duties effectively.
  • Skills for Care data on safeguarding, Mental Capacity Act, DOLS training (if available)
  • NHS Digital Safeguarding Adults Collection – see detailed metrics

Feedback from partners

  • Community and voluntary sector groups, including those representing:
    • people who are more likely to have a poorer experience of care and poorer outcomes
    • people with protected equality characteristics
    • unpaid carers
  • Local health partners
  • Care providers
  • Advocacy providers
  • Safeguarding Adults Board (SAB)
  • Independent Domestic Violence Advisors (IDVA)
  • Independent mental capacity advocates
  • Coroner Regulation 28 Reports

If available:

  • Police safeguarding lead
  • Specialist domestic abuse services
  • Local Government Social Care Ombudsman
  • Feedback from other regulators

Outcomes

We will not look at evidence under this category.

Best practice and guidance

For more information and resources on North Yorkshire’s preparation for inspection visit: https://nypartnerships.org/cqc-assurance

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