Adult social care assurance: A guide to support the development of your adult social care self-assessment (Part one)

• Accountability for the quality and performance of adult social care at the core
• Specific to local context and circumstances
• Supported by staff and partners who are engaged in the self-assessment
• Users, carers and their advocates are accorded greatest importance
• Rigorous in the analysis of strengths and areas to improve
• Action oriented and used to support and track improvement
• Nuanced around CQC’s assessment framework
• Clear and concise with a clear focus on the outcomes achieved
• Evidence based with data used to inform and understand performance;
   

This guidance has been prepared to support councils to undertake a comprehensive adult social care self-assessment that draws out their strengths and areas for improvement.  

While there is no mandatory requirement for local authorities to produce an adult social care self-assessment it is recognised as a valuable exercise that can provide an objective, honest and authentic opportunity to focus improvement planning and delivery in a way that ensures local ownership.

The self assessment guidance is comprised of two parts.  This part, part one, provides an introduction to self-assessment and how it can support work to drive improvement and excellence in adult social care.  

The second part provides tools and templates to support the self-assessment process. 

We have also developed reports and datasets in LG Inform which will provide councils with easy access to data and insight relevant to the self-assessment.  These can be used alongside local performance information to inform evidence-based discussion, triangulated with authentic feedback from people who draw on social care to give a fair and balanced picture.  

The self-assessment process, focusing on four key questions, enables evidence-based judgements to be arrived at that can focus efforts to share good practice and support improvement: 

• What are we aiming to do?
• How are we doing and how do we know?
• What is working well and what needs to be improved?
• What are we going to do?

There are some important principles underpinning good self-assessment:

• Always back up findings with evidence, recognising that what is asserted without evidence can be dismissed without evidence.
• Triangulate evidence from different sources is essential – this means considering the entire array of performance data, direct observation of practice/documents and, vitally in the case of adult social care, the balanced views of people with lived experience, staff, partners, and other stakeholders.
• Recognise the difference between process assurance (evidence that the right plans, policies and procedures are in place, for example: Joint Strategic Needs Assessment (JSNA); prevention strategy; practice audit plan; complaints policy) and outcomes assurance (evidence of the impact achieved via these plans, policies and procedures, for example, extent of health inequalities; percentage of people approaching ASC who are successfully supported elsewhere; numbers of audits undertaken and percentage of audits rated positively; numbers of complaints received and percentage resolved at stage one).
• Use self-assessment to establish the baseline from which improvement plans are developed with a clear governance framework to monitor the progression. 
• Be prepared to share findings from self-assessment as, when aggregated, these can play a key role in defining the composition and priority accorded to different elements of the ASC sector-led improement offer and to inform and shape policy priorities.

Learning from councils who have tested and used earlier versions of this guidance, has highlighted that the process of completing a self-assessment will directly impact on its value to the organisation.

Specifically:

• the importance of strong executive leadership, with clarity on why the self-assessment is being completed, who it is for and how it will be used
   
• the need for a clear process agreed at the start, either based on the framework offered in this guidance, or an alternative approach that has been adopted by the council
   
• the value of early engagement with staff, people with lived experience and key partners from the start will ensure greater confidence in content and accuracy as well as ownership of the findings
   
• the need to allow sufficient time and resource to ensure effective engagement through the process
   
• the benefit of identifying a 'pen holder' who may not be an adult social care subject matter expert, but is skilled at drawing together and presenting back the evidence produced through the self-assessment process in the final document that is concise and clear.

While not seeking to limit the scope of the self-assessment, and recognising that the process and any documentation should primarily be developed to meet the needs of the council, the templates and tools set out in Part 2 have been designed around the Care Act duties and CQC assessment framework themes and quality statements.  

This is to ensure that the process of completing and regularly reviewing the self-assessment will mean that councils are well positioned, if and when they are subject to a CQC assessment.
 

What the CQC say about the self-assessment and how they will use it

Self-assessment is an opportunity for your local authority to:

• assess and judge your own performance in relation to the quality statements
   
• use evidence to support your judgements
   
• highlight key successes, risks and challenges
   
• identify actions needed to address the most pressing risks.

In the CQC assessment framework, ‘self-assessment’ is an evidence item in the ‘feedback from staff and leaders’ evidence category. It forms part of the overall evidence they will gather and use to assess each of the nine quality statements.

There is no mandatory requirement for local authorities to produce a self-assessment for CQC to review. However, if you choose not to complete a self-assessment, the CQC will need to spend more time in the on-site part of their assessment. This is because they will need to gather and analyse required evidence from various sources. 
 

CQC themes and quality statements 

Part two offers tools and templates that can be used to support the gathering of evidence in a systematic way.   

It is a three-stage process which recognises that every council will want to ensure that their self-assessment report reflects their corporate style and approach to ensure local ownership.     

 

Reports are available in LG Inform to support the self-assessment. They are designed to provide an intelligence-based resource that enables effective comparison and benchmarking with other councils to inform and evidence the self-assessment. They cover:

• Local context including information about an area and its population, focusing on aspects directly and indirectly related to health and social care such as life expectancy, deprivation, employment. This also includes some measures that look at adult social care in the wider council context.
• Activity and need focusing on what we know about the activity and need for adult social care provision in an area. 
• Provision drawing on data published by the CQC about registered locations providing a broad picture of social care provision looking at capacity, quality and the range and diversity of provision.
• Workforce linking closely with Skills for Care to draw out some key headline measures from their detailed workforce profiles.

All the data sources used will be maintained, updated and refreshed as they become available, and the reports will evolve based on feedback to give councils access to the latest and most useful intelligence available.

While there is no mandatory requirement for local authorities to produce a self-assessment, the process of undertaking an objective, honest and authentic self-assessment of a council’s strengths and areas for improvement is a valuable opportunity to focus improvement planning and delivery in a way that ensures local ownership.

The aim of this guidance is to support councils with adult social care responsibilities to undertake a comprehensive self-assessment of their performance in relation to their care duties in a way that will also meet the needs of the CQC as part of the local authority adult social care assessment framework.