An analysis of local authority CQC assessment reports: What does 'good' look like?

On April 1, 2023, the Care Quality Commission (CQC) assumed a new duty to assess local authorities’ performance in delivering of their adult social care (ASC) responsibilities under Part 1 of the Care Act 2014. Alongside this duty, the Secretary of State was given the power to intervene if an assessment determined that a local authority is meet its statutory obligations.

The CQC Single Assessment Framework for local authority ASC was developed through a process of co-production with partners, agencies and people with direct experience of drawing on ASC care and support services.

While the methodology adopted by the CQC differs in tone and approach from that of Ofsted, both share a common goal of delivering meaningful evaluations that drive improvement. The CQC framework emphasises assessment rather than an inspection, however, like Ofsted, the process culminates in a single performance rating for local authorities. These ratings are categorised as outstanding, good, requires improvement, or inadequate.

To support local authorities in understanding and achieving excellence, Partners in Care and Health conducted an analysis of the first 19 published assessment reports including the five pilots. This analysis aims to provide an initial view on what ‘good looks like’ for each of the nine quality statements from the perspective of the CQC assessment teams.

By providing this analysis, Partners in Care and Health seeks to offer a resource for local authorities to proactively prepare for assessments and continuously enhance their ASC provision.

In summary, this document is designed to empower local authorities with actional insights and practical tools for driving improvement, ensuring compliance and ultimately delivering better outcomes for those who draw on adult social care services.  

Overall themes from local authorities with a final rating of Good

• Leadership and governance: Consistently demonstrated strong, and stable leadership with effective governance frameworks in place where leaders were visible, engaged and proactive in driving improvements.
• Workforce: Evidence of a well-trained and supported workforce where ongoing professional development and training was invested in resulting a strong staff morale and a positive culture.
• Coproduction and community engagement: Evidence of collaboratively working with community organisations with a strong coproduction framework where people with lived experience were actively involved in shaping services.
• Early intervention and prevention: Early intervention, prevention and reablement services are prioritised and well developed and people are supported to maintain their independence.
• Person centred and strength-based approaches: Services are tailored to meet individuals' needs, focusing on their strengths, abilities, and goals, while respecting personal preferences and cultural diversity.
• Equity in experience and outcomes: Health and social inequalities proactively addressed with targeted strategies in place to engage underserved populations and those people from seldom heard groups/communities with culturally sensitive practices in place.
• Accessble and timely: Services were accessible and assessments and reviews were timely, waiting lists managed effectively and urgent cases prioritised.
• Innovation and learning: Learning is actively embedded from feedback and performance data with evidence of good quality assurance arrangements and processes. Evidence of innovation to improve efficiency and peoples outcomes.
• Safeguarding: Robust safeguarding systems with timely responses and effective advocacy support.

The following section provides a summary of the current approach developed by the CQC to conducting assessments, determining scores, and arriving at the final rating.

Example of scoring

Evidence categories

The following section presents specific examples drawn from published reports, illustrating what ‘good looks like’ in cases where a local authority achieved a score of 3 (Good: Fully meets the expected standards) or higher for each quality statement.

Quality statement 1: Assessing needs

For the ‘assessing needs’ quality statement published reports are divided into seven sub-sections (NB: the five pilot site reports did not include the same sub-sections being in for subsequent reports):

1.  Assessment, care planning and review arrangements 
2. Timeliness of assessments, care planning and reviews
3. Assessments and care planning for unpaid carers, child’s carers and child carer 
4. Help for people to meet their non-eligible care and support needs 
5. Eligibility decisions for care and support 
6. Financial assessments and charging policy for care and support 
7.  Provision of independent advocacy

At the time of this report seven local authorities have received a score of 3 (Good) of which two were pilot sites. Key areas of strength highlighted in the reports focus on:

Assessment, care planning and review arrangements

• Personalised and strengths-based approach: Assessments/reviews focus on a person’s strengths, goals, and abilities to ensure their needs are met effectively. 
• Proportionate: Assessments are proportionate to level of risk and need. 
• Accessibility: Multiple channels are available for accessing assessment services, such as online self-assessment portals, telephone options, and in-person visits. 
• Multi-disciplinary/partnership working: Front-line ASC staff work in multi-disciplinary teams and or have good partnership working processes which enables them to liaise swiftly with colleagues to ensure the appropriate professional undertakes the assessment and were appropriate a joint assessment with colleagues is undertaken where this is in the persons best interests. 
• Personalised support planning: Support plans are coproduced with people, with a ‘do with’ rather than ‘do to’ approach and reflect people's right to choose, built on their strengths and what they want to achieve, and how they wish to live their lives. 
• Human rights focus: Assessments/reviews incorporate human rights principles, ensuring equity and inclusion in support planning.

Timeliness of assessments, care planning and reviews

• Robust triage processes: Clear and effective triage processes are in place which result in assessments/reviews being completed in a timely manner. 
• Waiting safe and well: Procedures and processes are in place to ensure those awaiting allocation for assessment/review are triaged regularly with RAG rating system in place, e.g. those RAG rated as urgent allocated for immediate assessment. Those on waiting lists are contacted on regular basis to review if their circumstances have changed and reassess level of risk and reprioritise where necessary. 
• Clear customer journey: Clear and transparent pathways are in place from assessment, to support planning, implementation of support package to six week/annual review.

Assessment and care planning for unpaid carers, child’s carer and child carers

• Carers assessments: The needs of unpaid carers are recognised as distinct from the person with care and support needs and carers are identified early through initial assessments of people’s needs. 
• Multi-agency carers strategy: A comprehensive and collaborative carers strategy is in place that has been coproduced with carers. The strategy incorporates an agreed partnership pathway for identifying and addressing the needs of carers, including young carers. It also sets out a clearly defined set of priorities that the local authority and its partners aim to achieve in order to further improve outcomes for people with caring responsibilities.

Help for people to meet their non-eligible care and support needs

• Information and advice: A variety of advice and information is available in accessible formats to support people with non-eligible care needs, including those with no recourse to public funds. This provision includes guidance on accessing services, facilities, and other agencies that can assist with non-eligible care and support requirements.

• Eligibility decision for care and support

• Eligibility framework: The framework and associated documented procedures and processes for eligibility for care and support are transparent, clear, and consistently applied. Decisions and outcomes are timely and transparent.

Financial assessment and charging policy for care and support

• Charging policy: A charging policy that is easy to understand and that is available in range of accessible formats is published on the Councils website. •
• Staff training: All staff who undertake financial assessments receive training on how to complete such assessments and how to ensure that those people drawing on services and unpaid carers are aware of the availability of direct payments and how direct payments can be utilised. 
• Timely completion of financial assessments: Financial assessments are completed within the local authorities target timeframe.

Provision of independent advocacy

• Staff training and awareness: Staff are provided with training on the purpose of advocacy and the various types of advocacy available. This ensures that staff understand the significance of advocacy, how to access it, and when it should be utilised to enable people to fully participate in assessments, as well as in care and support planning. 
• Availability: Advocates are available in timely manner ensuring that assessment and support planning is not delayed.

Quality Statement 2: Supporting People to Live Healthier Lives

The ‘supporting people to live healthier lives’ quality statement is divided into five sub-sections within the published reports: 

1. Arrangements to prevent, delay or reduce needs for care and support 
2. Provision and impact of intermediate care and reablement services 
3. Access to equipment and home adaptations 4. Provision of accessible information and advice 
4. Direct payments

Eleven local authorities have received a score of 3 (Good) of which four were pilot sites. Key areas of strength highlighted in the reports focus on:

Arrangements to prevent, delay or reduce needs for care and support

• Early intervention and prevention job roles: Specific roles (Community and Prevention Coordinators, Community Connectors, Local Area Coordinators etc.) are in place to support adult social care locality and front-door teams with identifying locally place based community based activities as well as working with community groups, VCSE organisations and providers in identifying gaps and development of new initiatives tailored to people’s needs. 
• Joining of public health and adult social care directorates: Where public health and adult social care and commissioning had formed into one single directorate improved joint working and delivery of early intervention and prevention services was identified as well as delivering seamless pathways and processes. 
• Partnership approach: Early intervention and prevention key priorities identified via the Joint Strategic Needs Assessment (JSNA) and Health and Wellbeing Board, result in a clear set of partnership actions which are monitored to ensure progress is achieved via the Health and Wellbeing Board.
• Early intervention and prevention strategy: The local authority has a clearly defined vision, strategy, and action/ transformation plans aimed at preventing, reducing, or delaying the need for care and support. This is either encapsulated within a standalone Early Intervention and Prevention Strategy or embedded as a core component of the overarching ASC Strategy with evidence that the strategy/vision has been well embedded as can be clearly articulated by staff.

Provision and impact of intermediate care and reablement services

• Strength-based reablement support plans: People receive detailed reablement support plans which focus on the persons areas of strengths and identifies their needs and outcomes wanted as part of their reablement programme, with regular reviews to ensure the level of care and support is tailored to the persons progress and move towards independence. 
• Occupational therapy: Occupational therapists are used within the front-door and as part of Transfer of Care Hubs (TOCH) and intermediate and reablement services to support a more therapy and preventative led approach.
• Partnership approach: The Transfer of Care Hub (TOCH) is based on a multi-disciplinary partnership approach between the local authority, hospital teams, VCSE organisations and housing and substance misuse teams where appropriate, with range of options available to people as part of their reablement journey that reflect peoples differing needs e.g. intermediate care beds, time to think assessment beds and short-term domiciliary intervention and reablement services. 
• Home First: A partnership approach to ‘home first’ is in place whereby local authority and key partners focus on supporting people both before and after hospital visits with the aim of keeping people living in a place they call home for longer and avoiding unnecessary hospital admissions. 
• Mental health enablement: Local authority and or partnership mental health enablement services are in place which keep people well and prevent/reduce mental health relapse and admission to hospital.

Access to equipment and home adaptations

• Timely access to assessment and equipment/home adaptations: People are assessed within the target timescales set by the local authority by either an occupational therapist or, where appropriate, a Trusted Assessor. Equipment and minor home adaptations required to support the persons independence and enable them to continue living in their own homes is provided promptly. 
• Assistive technology: ASC teams actively, innovatively and appropriately use a range of assistive technology to support people to maintain their independence and meet their sensory needs. 
• Trusted Assessors: ASC staff are trained as Trusted Assessors and conduct assessments for low-level equipment. The approach has accelerated the process of providing essential equipment to people and enabled Occupational Therapists to focus on more complex cases whilst eliminating waiting lists and delays for assessments requiring their expertise.

Provision of accessible information and advice

• Website: The local authority website provides clear and transparent information on a person’s rights under the Care Act as well as ways to meet their care and support needs. In addition, the webpages have the option of being able to provide translations and easy read versions of the information as well as a live BSL translator service. 
• Community locations: The local authority utilises community resources such as GP surgeries, libraries, church halls, drop in cafes etc. to display information and advice on people’s rights under the Care Act and information and advice on how to meet care and support needs. 
• Coproduced strategy: The local authority has coproduced an Information and Advice Strategy with partner organisations (including VCSE), residents, people who draw on services and carers which clearly sets out the vision, strategy and action plan priorities regarding accessible information and advice. Action plan priorities are monitored by the ASC leadership team and progress shared at the Health and Wellbeing Board. 
• No Wrong Door: No matter which route into ASC a ‘no wrong door’ approach is taken ensuring people receive the right information and advice and are quickly connected to local services.

Direct Payments

• Information and advice: People have access to range of information and guidance (available in a range of accessible formats) regarding direct payments on the Councils website. Information and guidance resources covers topics such as how they can be used, the benefits and how to employ a personal assistant. 
• Staff training: ASC staff receive mandatory and refresher training which focuses on myth-busting regarding how direct payments can be used and the benefits. As such, direct payments are utilised widely and creatively for example, people and carers using a direct payment to go away for the weekend, support with cleaning and to support hospital discharge before a care package can start. 
• Staff guidance: Easy to understand guidance is available to staff on how to set up, support and audit/monitor a direct payment. 
• Personal assistants: Personal assistants can access a wide range of training and support from the local authority adult social care academy.

Quality Statement 3: Equity in Experience and Outcomes

The equity in experience and outcomes quality statement is divided into two sub-sections within the published reports:

1. Understanding and reducing barriers to care and support and reducing inequalities. 

2. Inclusion and accessibility arrangements.

Eight local authorities have received a score of 3 (Good) of which two were pilot sites. Key areas of strength highlighted in the reports focus on:

Understanding and reducing barriers to care and support and reducing inequalities

• Equality, diversity and inclusion strategy: The local authority’s equality, diversity, and inclusion strategy clearly sets out the objectives and approaches to promoting equality, both within the workforce and across the local area, setting clear targets for health, accessibility, engagement, and inclusion. The strategy is informed by data within the JSNA and strengthened by the joint Health and Wellbeing strategy. The strategy clearly sets out how it aims to reduce barriers to support and enable the local authority to reduce health inequalities and improve outcomes for those from seldom heard communities/groups which includes people with protected characteristics under the Equality Act 2010. 
• Equality, diversity, and inclusion boards: The local authority maintains both a corporate and an Adult Social Care and Commissioning Equality, Diversity, and Inclusion (EDI) Board. The ASC EDI Board provides monthly reports to the corporate EDI Board on the progress of its EDI priority action plan and equality impact assessments. These contributions form an integral part of the overarching corporate EDI Action Plan. 
• Staff training: All adult social care staff receive mandatory and refresher training on equality, diversity and inclusion, cultural and religious competency and anti-racism. Documented practice guidance is also in place to support staff on how to ensure cultural competence in practice. 
• Consultation, engagement and coproduction: The local authority proactively engages with people and groups identified as experiencing health inequalities and poorer outcomes and experiences to better understand and address specific risks and issues experienced by them. 
• Equality duty: Staff are aware of the local authorities Public Sector Equality Duty (Equality Act, 2010) in the way they deliver Care Act duties and functions and are able to articulate how people may be at risk of having unmet needs and poorer outcomes as a result of protected characteristics. 
• Workforce representative of the local community: The local authorities ASC workforce is representative of the diversity of the local community it serves. 
• Reducing workforce inequalities: The local authority is taking active steps towards reducing inequalities in their workforce as well as in the ASC provider workforce market, through removing gender and ethnicity pay gaps. 
• Culturally competent care and support provision: Culturally competent care and support provision is available that fully meet people’s cultural needs.

Inclusion and accessibility arrangements

• Accessibility and Inclusion Groups: ASC have in place accessibility and inclusion groups that are led by staff and community champions that meet regularly. These groups oversee accessibility of information and advice across the directorate such as ensuring webpages have text to speech, translation and a question and answer function. 
• Interpretation and Translator Service: Staff have quick and easy access to a variety of interpreter and translator services such as video conferencing, language line, in person translators and interpreters to ensure language is not a barrier to the assessment and care and support planning process.
• Specialist Teams and Skill Sets: The local authority has in place either a Sensory and Impairment Team or sensory and impairment staff collocated across teams to ensure all people receive a holistic and strength-based assessment/review that they can actively participate into the best of their ability.
• Staff guidance: A range of accessibility guidance tools are in place on how to ensure that any information produced or provided meets quality standards such as use of simple language, right tone and no jargon.

Quality Statement 4: Care Provision, Integration and Continuity

The quality statement ‘care provision, integration and continuity’ is divided into five sub-sections within the published reports:

1. Understanding local needs for care and support.
2. Market shaping and commissioning to meet local needs. 
3. Ensuring sufficient capacity in local services to meet demand. 
4. Ensuring quality of local services. 
5. Ensuring local services are sustainable.

Fourteen local authorities have received a score of three (Good) of which five were pilot sites. Key areas of strength highlighted in the reports focus on:

Understanding local needs for care and support

• Use of data and information: Public health and ASC collectively collate data on demographics, health conditions and mortality rates and the impact of behaviour on health in their JSNA as well as wider detriments of health and wellbeing such as deprivation, employment, housing and homelessness. This information is used to explore new ways of working that address inequalities and target the people and places who needed support ensuring they have equal access to assessment/services and that their outcomes and lived experiences are improved. 
• Partnership working: Local authority leaders work closely with key partners to identify areas where there is evidence of health inequalities and develop partnership strategies to improve health and wellbeing outcomes. 
• Coproduction: Commissioning strategies are coproduced with people with lived experience and carers to ensure the focus is on what matters to people, what their collective outcomes are and what their best life looks like. 
• Good understanding of local need: The local authority works closely with residents, partners, VSCE and providers to understand the care and support needs of people and communities, including those who are most likely to experience poor care and outcomes, people with protected characteristics, unpaid carers and people who fund or arrange their own care, now and in the future. 
• Localised partnership hubs: Partnership hubs, that consist of ASC, health and a wide range of VCSE organisations are located geographically and allow for targeted support to the needs of the local area, to provide a wide range of information, advice, signposting and referral to appropriate services. Market Shaping and Commissioning to Meet Local Needs 
• Joint priorities: Commissioning strategies are aligned with the strategic objectives of partner agencies, across the local area and the Market Position Statement and Market Sustainability Plan evidences joint priorities and approaches which makes specific reference to identified groups in planning and shaping future services (e.g. mental health enablement to keep people well and reduce hospital admissions, housing support options for people with complex and high risk needs). 
• Person-centred care and support: Commissioning strategies and market shaping activity supports prevention and delaying people’s need for care and support with a focus on developing good practice and supporting the market to deliver person-centred strength-based care and support as a standard priority. 
• Robust market shaping: Market shaping focuses on sustainability, managing the risk of provider failure, and understanding evolving localised needs through data. A wide choice of services are available and bidding processes encourage and provide opportunities for smaller organisations, which might be offering a more specialist service to a narrower part of the community. 
• Coproduction: Strategic procurement plans are aligned with national policies and evolving needs, and people with lived experience are actively engaged in coproducing service development that aims to provide choice and flexibility, including self-funders and those using direct payments. • Outcome Focused Commissioning: Contract management focuses on the persons outcomes and whether peoples support plan outcomes are being met.
• Responsive care and support services: The commissioning service engages in continuous improvement and exploration of alternate care and support models, which demonstrates their commitment to developing high-quality, responsive care and support services.

Ensuring sufficient capacity in local services to meet demand

• Partnership working: The local authority works proactively in identifying where services are required to meet people’s needs and work in close partnership with health, providers and the VCSE to provide these services. 
• Timely interventions: Care and support packages, supported living, residential and nursing placements can all be accessed in timely manner ensuring people receive the care and support they need without delay. 
• Limited out of area placements: Few people are placed out of area given sufficient capacity within the local market. Where people are placed out of area regular contact and reviews are undertaken to ensure oversight and progress of the placement in reaching the persons support plan outcomes.

Ensuring quality of local services

• Good or above: The majority of regulated services are rated good or above by CQC. 
• People's experiences: The local authority actively gathers people's experiences of services using a wide variety of methods. 
• Cautions list: A monthly provider RAG rated cautions list (red possible risk no new services should be commissioned until concerns resolved, amber, medium risk and new packages should only be commissioned after a risk management discussion and agreed by relevant management) is shared with relevant teams across the ASC directorate and with neighbouring local authorities and reviewed monthly by the ASC and commissioning governance and assurance board. 
• Robust contract monitoring and quality assurance arrangements: Documented contract monitoring and quality assurance policies, procedures, practice guidance’s are in place, and quality assurance banded assessment tools are used that provide a robust and detailed scoring benchmark across 16 areas (including nutrition, environment, medication, and risk). In addition, staff can clearly articulate arrangements to monitor the quality and impact of the care and support services being commissioned for people and how and when they support improvements when needed.

Ensuring local services are sustainable

• Strategic planning: The local authority has a good understanding of the challenges faced by their provider marker as a result of regular engagement with the provider market via regular contract monitoring visits and monthly provider forum meetings. As such, the local authority is able to factor in these challenges as part of their wider strategic planning. 
• Investment in provider market: The local authority has considerably invested in the provider market to support them to develop and maintain a good quality workforce. Providers are required to agree to the local authorities care standards as part of their contract agreements, which sets out the expected working conditions for care workers. This includes ensuring a sustainable wage is paid which is competitive with local service industries. Also, that staff should receive sick pay, holiday pay and that travel is paid in addition to the staff salary. 
• Training opportunities: The local authority provides training to the provider market which has resulted in a high percentage of provider ASC staff with either a completed care certificate or in progress or partially completed. 
• Future proofing: The local authorities market sustainability plan clearly outlines current and future market conditions, including risks to support services.

Quality statement 5: Partnerships and communities

The quality statement ‘partnerships and communities’ is divided into four sub-sections within the published reports:

1. Partnership working to deliver shared local and national objectives. 
2. Arrangements to support effective partnership working 
3. Impact of partnership working 
4. Working with voluntary and charity sector groups.

Of note, this is the only quality statement to date which has resulted in a score of four (Outstanding) for one local authority. Fourteen local authorities received a score of three (Good) or which three were pilot sites. 

Key areas of strength highlighted in the reports focus on:

Partnership working to deliver shared local and national objectives: Score of four:

• Significant commitment to partnership working: There is a real commitment across the local authority to partnership working which enables strong and collaborative relationships with partner organisations which secures the best outcomes for people. The maturity and long-term stability of the senior leadership team means that the approach is consistently implemented and well understood through teams across the ASC directorate.
• Integrated senior leadership post: The post of Director of Health Integration is jointly funded with the local authority and the Integrated Care Board (ICB). The postholder is part of the local authority ASC senior leadership team which supports positive relationships with acute Trusts and has promoted the voice of ASC in joint strategies agreed with the ICB.
• Partnership working is the key to positive outcomes for people: The local authority have an integrated hospital discharge team that is jointly funded with health. The integrated way working ensures that staff in this team are able to gain advice and guidance promptly when needed which results in people receiving a seamless service with limited delays.

Partnership working to deliver shared local and national objectives: Score of three

Themes:

• Partnership strategies: The local authority has documented strategies evidencing collaboration with partners to agree and align strategic priorities, plans and responsibilities. 
• Equal voice: The local authority has a voice and influence in the place-based partnership with a number of leadership roles.
• Improving outcomes: Joint programmes with health include a focus on improving outcomes for people which are aimed to achieve greater levels of joined up working and make the most effective use of resources and integration focussing on a multi-agency approach. 

Arrangements to support effective partnership working: Score of four

Themes:

• Governance, accountability and ownership: Where there is partnership working there are clear arrangements in place for governance, accountability, quality assurance and information sharing. In addition, staff are very clear about their roles and responsibilities and that of the partners who they work with.

Arrangements to support effective partnership working: Score of three

Themes:

• Key partnership areas of focus: There is an overall BCF plan and approach to integration with key areas of focus on prevention and intervention, improving pathways, focus on digital transformation and improved quality assurance. Impact of partnership working: Score of 4 Themes
• Ability to address concerns or issues quickly: The local authority has established systems to monitor and evaluate the impact of partnership working on both the costs of social care and the outcomes for people. Alongside formal governance arrangements, the positive working relationships with partners ensure that any concerns or issues arising are addressed promptly and effectively wherever possible. 

Impact of partnership working: Score of 3

Themes:

• Meeting complex needs: Partnership working is effective in delivering a holistic response to people with complex and multiple needs. For instance, the Housing Complex Case Panel, a multi-agency initiative, focuses on supporting individuals at risk of losing their tenancy and includes representation from local authority leaders. Similarly, the Enhanced Vulnerability Forum serves as a problem-solving platform that adopts a multi-agency approach to provide support for rough sleepers and individuals experiencing homelessness. 

Working with voluntary and charity sector groups: Score of four

Themes:

• Collaborative working with the Voluntary, Community, Faith and Social Enterprise organisations: The local authority works collaboratively with voluntary, community, faith and social enterprise (VCFSE) organisations to understand and meet local social care needs. The local authority not only commissions the VCFSE sector but also commission services that support the organisations themselves, for example services to encourage and recruit volunteers. 
• VCFSE Alliance: A VCFSE Alliance is in place which provides overarching organisation for those smaller organisations who provide a wide range of services within the community. The VCFSE is involved in the development of commissioning strategies and support the local authority to better understand the needs of people within different communities, particularly with regard to where people may be at risk of not receiving services.

Working with voluntary and charity sector groups: Score of four 

Themes:

• Shared priorities with the voluntary and community sector: There are good examples of integrated working and co-production with the voluntary and charity organisations to deliver shared and local objectives that improve outcomes for people.

Quality statement 6: Safe pathways, systems and transitions

The quality statement ‘safe pathways, systems and transitions’ is divided into three sub-sections within the published reports:

1. Safety management 
2. Safety during transitions 
3. Contingency planning

Thirteen local authorities have received a score of 3 (Good) of which four were pilot sites. Key areas of strength highlighted in the reports focus on:

Safety management

• Documented internal service moves: Clear documented processes and procedures are in place to ensure that when people move from one service to another this is done in a safe way, which includes escalation processes where risks or problems are identified. 
• Safe and effective transitions: The local authority has a good understanding of the risks to people across their care and support journeys and work proactively with health colleagues and other organisations to ensure systems are in place that support safe and effective transitions.
• Accurate information sharing and shared management of risk: The local authority and health partners have shared IT access to peoples care records which supports accurate information sharing and shared risk management.

Safety during transitions

• Documented procedures and process maps: The local have documented procedures and process maps in place for all major transitions including children to adult services (preparing for adulthood), hospital discharge (including mental health) and reablement, moving out of area, moving between services, and changing from self-funded to funded care. Process maps are easy to follow and give good direction for staff and people using services. 
• Safety and continuity of care and support: Care and support is planned and organised with people and or their families (were appropriate) together with partners and organisations to promote safety across care and support journeys and continuity of care and support. 
• Preparing for adulthood: The preparing for adulthood process with young people and their families starts when the young person reaches the age of 14. Staff work closely with families, ensuring assessments are completed in a timely manner for young people identified as having eligible care and support needs. 
• Acute hospital discharge processes: The local authority have a partnership integrated discharge team/transfer of care hub which ensures the transition from the acute hospital to the community is seamless, effective and timely.

Contingency planning

• Business continuity plans: Robust business continuity plans are established and in place both within ASC and with commissioned providers, to ensure the uninterrupted delivery of care and support services in the event of potential service disruptions or provider failure. Furthermore, proactive engagement and monitoring arrangements with partners have enabled the local authority to undertake forward planning to address any such eventualities effectively.

Quality Statement 7: Safeguarding

The quality statement ‘safeguarding’ is divided into four sub-sections within the published reports:

1. Safeguarding systems, processes and practice 
2. Responding to local safeguarding risks and issues 
3. Responding to concerns and undertaking Section 42 (2) Enquiries 
4. Making Safeguarding Personal

Eleven local authorities have received a score of 3 (Good) of which four were pilot sites. Key areas of strength highlighted in the reports focus on:

Safeguarding systems, processes and practice

• Multi-agency safeguarding policies and procedures: The local authority works in accordance to locally agreed multi-agency safeguarding policies and procedures produced and published by the local Safeguarding Adults Board (SAB) that all partners are signed up to. 
• Effective safeguarding processes: Effective systems and processes are in place to effectively safeguard people from abuse and or neglect in a timely manner when safeguarding concerns are raised. 
• Information sharing: Information sharing protocols are in place to ensure the timely and appropriate sharing of information. 
• Leadership and strategic oversight: The SAB consists of senior representatives from a range of organisations which provides leadership and strategic oversight and direction of adult safeguarding work across the safeguarding partnership system. 
• Skilled and knowledgeable staff: All staff involved in safeguarding work are suitably skilled and knowledgeable and supported to undertake their safeguarding duties effectively and safely. 
• Multi-agency working: Dedicated staff attend the Multi Agency Risk Assessment Conference (MARAC), Prevent Panel and Multi-Agency Public Protection Arrangements (MAPPA) meetings and disseminate actions, intelligence and learning to appropriate staff/teams. 
• Voice of the person: The SAB promote a coproduction approach and have a lived experience safeguarding sub-group that supports in the development of the annual strategic plan and review of partnership safeguarding policies and procedures. In addition, the voluntary sector and advocacy services are active members of the SAB which is seen as essential to ensure the SAB here’s the voices of people with lived experience.

Responding to local safeguarding risks and issues

• Responding to provider safeguarding concerns: Safeguarding teams/safeguarding leads attend monthly meetings with commissioners and quality assurance teams, the integrated care board and CQC locality lead, where provider safeguarding concerns can be raised and investigated quickly. In addition, this forum provides oversight as to what is happening across the local area and can identify key themes, patterns and trends. 
• Independent oversight and scrutiny: There is independent oversight, scrutiny and auditing of safeguarding activity which is part of the wider quality assurance work. Findings from audits is fed back to individual practitioners, teams and across the directorate where appropriate to further improve practice and ensure the sharing and embedding of learning. 
• Robust Safeguarding Adults Review (SAR) process: A well established and clearly documented SAR process is in place as well as SAR panel. Independent SAR authors are commissioned to provide a report which consists of both findings and recommendations for the safeguarding partnership. Learning from SARs is successfully shared and embedded across partner agencies to reduce risk and prevent similar occurrences.

Responding to concerns and undertaking Section 42 (2) enquiries

• Working proactively with providers: The local authority safeguarding team/safeguarding practitioner and or lead work proactively with providers with evidence of an open and supportive culture focused on keeping people safe. 
• Timely safeguarding concerns triaging: All decisions regarding safeguarding concerns and immediate safety planning (where appropriate) are made within locally agreed target timescales. 
• Timely safeguarding enquiries: Safeguarding enquiries and safety planning are completed/implemented within locally agreed timescales. 
• Quality assurance: Where the local authority ‘causes’ an agency to lead on the safeguarding enquiry regular meetings are held to ensure safety planning is implemented and that the enquiry is progressing. Quality assurance arrangements are in place to ensure the enquiry and safety planning is proportionate to the level of risk.

Making Safeguarding Personal

• Ease of access to advocates: Appropriate advocates are easily available to support people through the safeguarding process, ensuring their wishes, views and outcomes are central to the safeguarding enquiry process. 
• Person centred: Making Safeguarding Personal is at the heart of safeguarding practice ensuring that enquiries are carried out sensitively, without delay and keep the wishes, outcomes and best interests of the person central to the enquiry and safety planning process. 
• Understanding of legislative framework other than Care Act 2014: Staff undertaking safeguarding duties have a good understanding of ensuring people are supported through the safeguarding process in line with their human rights and the implementation of the Mental Capacity Act 2005 and the Equality Act 2010.

Quality statement 8: Governance, management and sustainability

The quality statement ‘governance, management and sustainability’ is divided into three sub-sections within the published reports:

1. Governance, Accountability and Risk Management 
2. Strategic Planning 
3. Information Security

Fourteen local authorities have received a score of 3 (Good) of which four were pilot sites. Key areas of strength highlighted in the reports focus on:

Governance, accountability and risk management

• Transparent and learning culture: There is a culture of learning, transparency and accountability that is embedded throughout the local authority, driven by leaders and cabinet members who have a clear vision of how the local authority needs to realign to meet future service demands. 
• Strong place-based partnership working: There are strong working links with place-based partners ensuring priorities and funding arrangements are agreed through strategic commissioning boards to reduce the risk of delays in service provision. 
• Clear vision and priorities: There is a clear vision for ASC and commissioning with a set of priorities that are understood by staff at all levels across the directorate, which is brought to life by preventative, person centred, strengths-based and community asset-based approaches. 
• Effective partnership boards and forums: Partnership boards and forums provide clear and effective overview and scrutiny as well as quality assurance and review processes through regular meetings, updates, data analysis and reviews to inform partnership learning and service improvement. 
• Strong visible leadership: There is strong visible leadership from senior managers who have a good understanding of the challenges faced by the local authority as a result of effective coproduction, engagement and use of data and performance insights. Practice Standards: Adult social care and commissioning practice standards frameworks are in place which are directly linked to CQCs I and We quality statements which the Principle Social Worker and Principle Occupational Therapist hold responsibility for ensuring excellence in service delivery through effective interactions with people and diligent practice and performance by practitioners/occupational therapists. 
• Role of quality assurance: A quality assurance framework is in place which has a clear set of regular quality assurance activities which the Principal Social Worker and Principal Occupational Therapist lead on and report findings to the monthly governance and assurance board. 
• Adult social care risk register: An adult social care risk register is in place with appropriate risks escalated to the corporate risk register. Identified risks have both immediate risk mitigations and long-term solutions that form part of improvement and transformation plans. The risk register is reviewed monthly at the governance and assurance board. Progress on risk actions are reported monthly to the Corporate Management Team with fortnightly briefings to the portfolio holder for ASC.
• Performance reporting: An adult social scorecard is in place with key performance indicators as well as a suite of PowerBI dashboards that provide an in-depth picture of performance that are monitored monthly at the performance and reporting board. 
• Stable leadership team: A stable leadership team is in place, all of whom are passionate about providing good outcomes for people. The culture of the local authority is one which senior leaders, including the chief executive are proud of. The culture is clearly understood by staff at all levels and one which is positive and empowering.

Strategic planning

• Adult social care strategy: The local authority uses information about risk, performance, inequality and outcomes to inform its ASC strategy and to allocate resources effectively. 
• Overview and scrutiny: The overview and scrutiny committee has confidence in the scrutiny role and its relationship to the Director of adult social services (DASS). In addition, there is good cross-party working in the committee which allows for challenges and scrutiny of ASC plans and strategies. 
• Robust improvement/delivery plan: ASC and commissioning have in place robust improvement/delivery plans based on improving outcomes for people. 
• Workforce strategy: A workforce strategy is in place to support recruitment and retention which was developed based on information gathered from various sources including exit interviews, internal and wider surveys and engagement sessions with staff.

Information security

• Robust data and information security procedures: The local authority have arrangements to maintain the security, availability, integrity and confidentiality of data, in relation to records and data management systems and staff receive a host of training regarding information security. Information sharing protocols support the safe sharing of personal information in ways that protect people’s rights and privacy. Information is clearly published on the local authority website in relation to information security with details how a person can access records held about them.
• Information sharing arrangements: Sharing of information is in accordance with the Data Protection Act 2018 and the Human Rights Act 1998 with confirmation that staff working in ASC (and the NHS) will process people's information in accordance with Caldicott Principles.

Quality Statement 9: Learning, Improvement and Innovation 

The quality statement ‘learning, improvement and innovation’ is divided into two sub-sections within the published reports:

• Continuous learning, improvement and professional development 
• Learning from feedback

Eighteen local authorities have received a score of three (Good) of which five were pilot sites. Key areas of strength highlighted in the reports focus on:

Continuous learning, improvement and professional development

Learning development and improvement: There is an inclusive and positive culture of continuous learning and improvement across the local authority. Staff at all levels are supported to take part in learning and development opportunities, which includes specific specialist training to enable staff to carry out their roles more effectively as well as achieve professional qualifications. 

Sharing of knowledge and training: Local partnerships are actively used to share knowledge and resources locally. In addition the local authority works closely with partners to address specific training needs and areas where joint training will improve understanding of roles and responsibilities across organisations. 

Making a difference: Staff are proud to work for the local authority and the work they undertake to make a positive difference to people’s lives. • Experiences and Voice of People: There are systems in place to gather the views of people who draw on services, which includes formal co-production boards but also through asking for direct feedback following a period of contact with the local authority. This enables the local authority to monitor the effectiveness of their partnership working and to identify areas where improvements are needed.

Learning from feedback

The Views of People: The local authority is proactive in obtaining the views of people who draw on services as well as the partner agencies they are working with. The views of people are central to the development of strategy and form the basis of improvement activity and decision making. Lessons Learned: There are robust processes in place to ensure learning happens when things go wrong and examples of good practice are shared across teams by the ASC senior leadership team. 

Local Government Social Care Ombudsman (LGSCO): Within the last 12 months no complaints were upheld from the Local Government Social Care Ombudsman.

This publication has provided a framework of what ‘good looks like’ utilising the insights derived from the first 19 published reports used to inform this report. These include the five pilot authorities. By outlining what good practice and performance looks like across the nine quality statements, this framework begins the process of providing a practical guide for local authorities to identify and implement improvements.

As local authorities embark on their preparation for CQC assessments and their ongoing improvement journeys, this framework is intended to serve as both a reference and a tool for achieving excellence. The ultimate goal remains steadfast: to deliver high-quality, person-centred, and equitable adult social care services that improve the lives of people with care and support needs and carers.