5. Working with Care and Support Providers

5.1 Introduction

Safeguarding is everyone’s business. This section considers a range of issues about quality and safety, positive practice, safeguarding concerns and managing large scale enquiries. Partnerships between safeguarding and commissioning functions and their interdependent roles and responsibilities towards providers are explored. It is essential to know what works well to support a positive culture of cooperation and information sharing with joint accountability for risk and benefits. It identifies the role and responsibilities of the five groups that influence quality:

• Professionals and staff 
• Commissioners and funders (Local authorities, CCG and NHS England) 
• Regulators (CQC, Trust Development Agency, Monitor)
• The public, including adults who use services, their families and carers
• Providers - A provider for the purposes of this policy and procedure is any care or health provider who delivers support and care to a group of individuals. This would include but is not exclusive to the following:
  • Domiciliary Care Providers
  • Residential Care Homes
  • Nursing Homes
  • Supported Living
  • Private hospitals
  • NHS provision
  • Day Care/Opportunities Providers
  • Rehabilitation Units for people who misuse drugs or alcohol
  • Voluntary agencies 
  • Respite provision
  • Hospices

By working in partnership these groups can assist early identification if providers are at risk of falling standards that might lead to wider concerns and the need for safeguarding intervention. There is a clear responsibility on commissioners and providers to ensure safe, quality services that will reduce the need for safeguarding interventions.

This section is relevant to all providers not just those in the CQC inspection regime. The CQC are responsible for inspecting and monitoring providers registered under the Health and Social Care Act 2008. It has statutory powers to inspect how well services are performing against ‘Fundamental Standards’ of quality and safety, and can take proportionate enforcement action to ensure providers improve where there is poor care.

This section explores work with providers as a means for responding to potential business failure (contracts and commissioning responsibilities) and details how allegations of organisational abuse are managed where safeguarding concerns are identified as serious matters within an organisation as opposed to single concerns that may be addressed under Section 42 (safeguarding responsibilities). Safeguarding concerns in this sense relate to patterns of reported abuse or neglect about one provider, or where a single concern indicates a serious matter that warrants closer inspection under adult safeguarding processes. In some instances, safeguarding action may be initiated following a Safeguarding Adult Review, or run in parallel to one.

The focus of this section is on prevention, in particular actions that might be taken in response to concerns about quality issues, to reduce the risk of escalation to safety and safeguarding issues.

Finally, this section aims to ensure that people have a voice in influencing how services are delivered and where there are concerns, and how their views and experiences lay at the heart of improvements.