Employing a skilled and motivated workforce is vital to ensuring good quality services are provided to adults with care and support needs, and their carers. It will also assist to:

• improve service satisfaction levels of adults and their carers;
• enhance staff job satisfaction;
• embed standards and safe working practices;
• reduce the number of complaints from adults and carers;
• reduce the number of staff disciplinary hearings and dismissals;
• improve staff retention levels.

As part of a wider competency framework which also includes staff supervision and appraisal, workforce development links staff learning and development to other activities, such as strategic planning, workforce planning, performance management and career development.

1. Introduction

Employers need to ensure, to the best of their ability, that the people they employ – as paid staff, volunteers or contractors – are committed to providing good quality care and support to adults who receive care and support services from them, their carers or other family members including children.

Undertaking thorough criminal records checks is part of a number of safer recruitment measures, which are designed to try to prevent unsuitable people being employed to work with vulnerable people. This is in addition to thorough recruitment processes, training, staff supervision and appraisal programmes which are all key to ensuring good working practices.

2. Disclosure and Barring Service

The Disclosure and Barring Service (DBS) helps employers make safer recruitment decisions. It is responsible for:

• processing requests from organisations for criminal records checks (known as DBS checks) on individuals;
• deciding whether it is right that a person is put on, or removed, from a barred list;
• placing or removing people from the DBS children’s barred list and adults’ barred list.

3. Barred Lists and Duty to Refer

There are two barred lists maintained by the Disclosure and Barring Service in relation to those who are:

• barred from working with children;
• barred with working with adults.

A person who is barred from working with children or adults will be committing a criminal offence if they work, volunteer or try to work or volunteer with the group from which they have been barred.

An organisation which knows they are employing someone who is barred to work with that particular group will also be committing a criminal offence.

Legally an organisation must inform the Disclosure and Barring Service if a member of staff or a volunteer is dismissed (or where they would have been dismissed if they had not resigned or otherwise left) because they pose a risk of harm or have caused harm to a child or adult.

See the DBS Referral Flowchart.

4. DBS Checks

This is the Find out which DBS Check is Right for your Employee tool

Through undertaking DBS checks, the DBS helps organisations identify people who may be unsuitable for the job.

4.1 Types of Disclosures

There are different types of disclosure:

• a basic check, which shows unspent convictions and conditional cautions;
• a standard check, which shows spent and unspent convictions, cautions, reprimands and final warnings;
• an enhanced check, which shows the same as a standard check plus any information held by local police that’s considered relevant to the role;
• an enhanced check with a check of the barred lists, which shows the same as an enhanced check plus whether the applicant is on the adults’ barred list, children’s barred list or both

4.2 Adult first check

See Types of DBS Checks and How to Apply (DBS)

DBS adult first is a service available to organisations who can request a check of the DBS adults’ barred list. Depending on the result, a person can be permitted to start work, under supervision, with adults before a DBS certificate has been obtained.

There are strict criteria:

• the role must require a criminal record check by law;
• it must be eligible for access to the DBS adults’ barred list;
• the organisation must have requested a check of the DBS adults’ barred list on the DBS application form.

The DBS’ reply to an adult first check request will state either:

• option 1: ‘Registered Body must wait for the DBS certificate’; or
• option 2: ‘no match exists for this person on the current adults’ barred list’

It will also state that it is only the first part of the criminal record check application process and that further information will follow.

If the adult first check indicates that the Registered Body must wait for the DBS certificate, it may indicate there is a match on the DBS adults’ barred list. However, further investigation is required to confirm this and the organisation should wait to receive the certificate.

4.3 Update Service

The DBS also provides an online Update Service, to which staff or volunteers can subscribe and renew annually for a small fee (free for volunteers). This helps them keep their DBS certificate up to date, so it can be taken with them from one job to another, as long as they remain within the same workforce (adults, for example) unless:

• an employer asks them to get a new certificate;
• they need a certificate for a different type of ‘workforce’ (for example, they have an ‘adult workforce’ certificate and need a ‘child workforce’ certificate);
• they need a different level certificate (for example, they have a standard DBS certificate and need an enhanced one).

Employers can do immediate online checks of a person’s status, as long as they have registered with the Update Service. The Update Service is for standard and enhanced DBS checks only (see Section 4.1 Types of Disclosures above).

A new DBS check will only be required if the Update Service check indicates there has been a change in the person’s status, due to new information added.

4.4 Cautions and convictions

4. Regulated Activity with Adults

See Regulated activity: Adults (Department of Health and Social Care)

Regulated activity is work which involves close and unsupervised contact with adults, and which cannot be undertaken by a person who is on the Disclosure and Barring Service’s Barred List for adults.

There are six categories of people who will fall within the definition of regulated activity (including anyone who provides day to day management or supervision of those people):

1. Providing health care;
2. Providing personal care (for example providing / training / instructing / or offering advice or guidance on physical assistance with eating or drinking, going to the toilet, washing or bathing, dressing, oral care or care of the skin, hair or nails because of an adult’s age, illness or disability; or prompting and supervising an adult to undertake such activities where necessary because of their age, illness or disability);
3. Providing social work;
4. Providing assistance with cash, bills and / or shopping;
5. Providing assistance in the conduct of a person’s own affairs, for example by virtue of an enduring power of attorney;
6. Conveying/transporting an adult (because of their age, illness or disability) either to or from their place of residence and a place where they have received, or will be receiving, health care, personal care or social care; or between places where they have received or will be receiving health care, personal care or social care. This will not include family and friends or taxi drivers.

There is a duty on a ‘regulated activity provider’ to find out whether a person is barred before allowing them to carry out regulated activity tasks in their work.

It is a criminal offence for a person on one of the barred lists to carry out regulated activity tasks, or for an employer/voluntary organisation knowingly to employ a barred person in a regulated activity role.

5. Further Reading

5.1 Relevant information

Disclosure and Barring Service

Criminal Record Support Service (NACRO)

Check Someone’s Criminal Record as an Employer (UK Government)

DBS Checks for Adult Social Care Roles (Disclosure and Barring Service)

1. Introduction

This chapter provides a summary of the ways in which local and national performance indicators and outcome information can be used to measure how well care and support services are achieving the outcomes which matter most to people. It provides information about the national Adult Social Care Outcome Framework (ASCOF) as well as locally agreed performance information.

A summary of the ASCOF is published annually by NHS England. Health and Wellbeing Boards can use ASCOF data, alongside other local information sources to inform their Joint Strategic Needs Assessment and the development of Joint Local Health and Wellbeing Strategies (see Joint Strategic Needs Assessments and Joint Local Health and Wellbeing Strategies).

2. Adult Social Care Outcomes Framework

ASCOF is used both locally, regionally and nationally to measure progress against key priorities and strengthen transparency and accountability. It measures how well care and support services achieve the outcomes that matter most to people, and provides comparable information on the outcomes and experiences of people who use adult social care, and carers.

The ASCOF sets outcomes-based priorities developed from six key objectives for people who are using care and support, unpaid carers and professionals who provide care and support:

1. Quality of life: people’s quality of life is maximised by the support and services which they access, given their needs and aspirations, while ensuring that public resources are allocated efficiently.
2. Independence: people are enabled by adult social care to maintain their independence and, where appropriate, regain it.
3. Empowerment – information and advice: individuals, their families and unpaid carers are empowered by access to good quality information and advice to have choice and control over the care they access.
4. Safety: people have access to care and support that is safe and which is appropriate to their needs.
5. Social connections: people are enabled by adult social care to maintain and, where appropriate, regain their connections to their own home, family and community.
6. Continuity and quality of care: people receive quality care, underpinned by a sustainable and high-quality care market and an adequate supply of appropriately qualified and trained staff

The Adult Social Care Outcomes Framework: Handbook of Definitions states:

The key roles of ASCOF are:

• Locally, the ASCOF provides councils with robust information that enables them to monitor the success of local interventions in improving outcomes that matter to most people, and to identify their priorities for making improvements. Local Authorities can also use ASCOF to inform outcome-based commissioning models.

• Locally, it is also a useful resource for Health and Wellbeing Boards who can use the information to inform their strategic planning and leadership role for local commissioning.

• Locally, the ASCOF also strengthens accountability to local people. By fostering greater transparency on the outcomes delivered by care and support services, it enables local people to hold their council to account for the quality of the services that they provide, commission or arrange. Local authorities are also using the ASCOF to develop and publish local accounts to communicate directly with local communities on the outcomes that are being achieved, and their priorities for developing local services.

• Regionally, the data supports sector led improvement; bringing councils together to understand and benchmark their performance. This, in turn, stimulates discussions between councils on priorities for improvement, and promotes the sharing of learning and best practice.

• At the national level, the ASCOF demonstrates the performance of the adult social care system as a whole, and its success in delivering high-quality, personalised care and support and achieving good outcomes. Meanwhile, the framework supports ministers in discharging their accountability to the public and Parliament for the adult social care system, enabling oversight of care and support services and continues to inform, and support, national policy development.’ (Department of Health and Social Care).

The ASCOF draws together data from a range of sources, including data collected by local authorities (for example client level data collection, the Adult Social Care Survey (ASCS) , Survey of Carers in England (SACE), the adult social care workforce data set and the safeguarding adults data collection) and nationally collected data from the Office of National Statistics and Care Quality Commission (CQC).

Data collected under the ASCOF is not used by the government to manage the performance of local authorities, rather it should be used to inform and support sector led improvement and strengthen local transparency and accountability.

3. Further Reading

3.1 Relevant information

Adult Social Care Outcomes Framework – Handbook of Definitions (DHSC) 

Measures from the Adult Social Care Outcomes Framework (NHS England)

Social Care User Surveys (ASCS and SACE Data Collections, NHS Digital)  

Care Data Matters: A Roadmap for Better Data for Adult Social Care (DHSC) 

1. General Principles

The Care and Support Statutory Guidance (Department of Health and Social Care) details a number of key principles and standards which the local authority must have regard to when carrying out its activities or functions, as specified below.

• Promoting Wellbeing. This means actively seeking improvements in particular aspects of wellbeing at any stage of the process from the provision of information and advice to reviewing a care and support plan, including:
  • personal dignity;
  • physical and mental health and emotional wellbeing;
  • protection from abuse and neglect; control by the individual over their day to day life; participation in work, education and training;
  • social and economic wellbeing;
  • domestic, family and personal;
  • suitability of living accommodation;
  • the individual’s contribution to society.
• The importance of beginning with the assumption that the individual is best placed to judge the individual’s wellbeing. Building on the principles of the Mental Capacity Act 2005, the local authority should assume that the person knows best about their own outcomes, goals and wellbeing. The local authority should not make assumptions as to what matters most to a person.
• The individual’s views, wishes, feelings and beliefs. Considering the person’s views and wishes is critical to a person centred assessment and care and support system. The local authority should not ignore or downplay the importance of a person’s own opinions in relation to their life and their care. Where particular views, feelings or beliefs (including religious beliefs) impact on the choices that a person may wish to make about their care, these should be taken into account. This is especially important where a person has expressed views in the past, but no longer has capacity to make decisions themselves.
• The importance of preventing or delaying the development of needs for care and support and the importance of reducing needs that already exist. At every interaction with a person, the local authority should consider whether or how the person’s needs could be reduced or other needs could be delayed from arising. Effective interventions at the right time can stop needs from escalating, and help people maintain their independence for longer (see Preventing, Reducing or Delaying Needs chapter).
• The need to ensure that decisions are made having regard to all the individual’s circumstances (and are not based only on their age or appearance, any condition they have, or any aspect of their behaviour which might lead others to make unjustified assumptions about their wellbeing). The local authority should not make judgements based on preconceptions about the person’s circumstances, but should in every case work to understand their individual needs and goals (see Assessment).
• The importance of the individual participating as fully as possible in decisions about them and being provided with the information and support necessary to enable the individual to participate. Care and support should be personal, and the local authority should not make decisions from which the person is excluded (see Assessment).
• The importance of achieving a balance between the individual’s wellbeing and that of any friends or relatives who are involved in caring for the individual. People should be considered in the context of their families and support networks, not just as isolated individuals with needs. The local authority should take into account the impact of an individual’s need on those who support them, and take steps to help others access information or support (see Assessment chapter).
• The need to protect people from abuse and neglect. In any activity which the local authority undertakes, it should consider how to ensure that the person is and remains protected from abuse or neglect. This is not confined only to safeguarding issues, but should be a general principle applied in every case (see Adult Safeguarding chapter).
• The need to ensure that any restriction on the individual’s rights or freedom of action that is involved in the exercise of the function is kept to the minimum necessary for achieving the purpose for which the function is being exercised. Where the local authority has to take actions which restrict rights or freedoms, they should ensure that the course followed is the least restrictive necessary (see Deprivation of Liberty Safeguards chapter).

These principles must be considered in relation to every individual.  This will ensure an approach that looks at a person’s life holistically, considering their needs in the context of their skills, ambitions, and priorities – as well as the other people in their life and how they can support the person in meeting the outcomes they want to achieve. The focus should be on supporting people to live as independently as possible for as long as possible.

These principles will vary in their relevance and application to individuals. For some people, spiritual or religious beliefs will be of great significance, and should be taken into particular account. The local authority should consider how to apply these further principles on a case by case basis. This reflects the fact that every person is different and the matters of most importance to them will accordingly vary widely.

2. Principles of Adult Safeguarding

See Adult Safeguarding.

In relation to the local authority’s duty to adults experiencing or at risk of abuse or neglect, the six key principles below underpin all adult safeguarding work. They are followed by the relevant ‘I’ statements (Revisiting Safeguarding Practice, Department of Health and Social Care).

• Empowerment: People are supported and encouraged to make their own decisions and give informed consent. People must always be treated with dignity and respect, and staff should work alongside them to ensure they receive quality, person-centred care which ensures they are safe on their own terms.
• “I am asked what I want as the outcomes from the safeguarding process and these directly inform what happens.”
• Prevention: It is better to take action before harm occurs. Prevention and early support are key to effective safeguarding. The principle of prevention recognises the importance of taking action before harm occurs and seeks to put mechanisms in place so they do not reoccur.
• “I receive clear and simple information about what abuse is, how to recognise the signs and what I can do to seek help.”
• Proportionality: The least intrusive response appropriate to the risk presented. This means doing the least intrusive response appropriate to the risk presented.
• “I am sure that the professionals will work in my interest, as I see them and they will only get involved as much as needed.”
• Protection: This involves organising and delivering support and representation for those in greatest need who may not be able to do it themselves.
• “I get help and support to report abuse and neglect. I get help so that I am able to take part in the safeguarding process to the extent to which I want.”
• Partnership: Effective safeguarding cannot be delivered in isolation and should involve other partners and systems that interact with or impact on a person. Local solutions are best achieved through services working with their communities, professionals and services as a whole.
• “I know that staff treat any personal and sensitive information in confidence, only sharing what is helpful and necessary. I am confident that professionals will work together and with me to get the best result for me.”
• Accountability: Accountability and transparency in delivering safeguarding. This recognises the importance of being open, clear and honest in the delivery of safeguarding and ensuring there are systems in place to hold practitioners and services to account.
• “I understand the role of everyone involved in my life and so do they.”

For more information see Revisiting Safeguarding Practice (Department of Health and Social Care) 

3. Further Reading

3.1 Relevant chapters

Promoting Wellbeing

Preventing, Reducing or Delaying Needs

Local authorities and integrated care boards (ICBs) have equal and joint duties to prepare Joint Strategic Needs Assessments (JSNAs) and Joint Local Health and Wellbeing Strategies (JLHWSs), through the health and wellbeing board.

The purpose of the JSNA and JLHWS is to improve the health and wellbeing of the local community and reduce inequalities for all ages.

Joint Strategic Needs Assessment

A JSNA is an assessment of the current and future health and social care needs of the local community. These are needs that could be met by the local authority, ICBs, or the NHS.

The JSNA is produced by the local health and wellbeing board, and is unique to the local area. The intention is for health and wellbeing boards should consider a wide range of factors that impact on their communities’ health and wellbeing, and local assets that can help to improve outcomes and reduce inequalities. Each local area is free to undertake the JSNA in a way best suited to its local circumstances; there is no template or format that must be used and no mandatory data set to be included.

A range of quantitative (numeric) and qualitative (non-numeric) evidence should be used in the JSNA. There are a number of data sources and tools that the health and wellbeing board may find useful for obtaining quantitative data (see Measuring Outcomes in Adult Social Care chapter). Qualitative information can be gained in a variety of ways, including views collected by the local Healthwatch organisation or by local voluntary sector organisations, feedback given to local providers by service users, and views fed in as part of community participation within the JSNA and JLHWS process.

Joint Local Health and Wellbeing Strategy

The JLHWS should turn the JSNA findings into clear outcomes that the health and wellbeing board wants to achieve, which will inform local commissioning and development of locally led initiatives that meet the outcomes agreed and the needs identified.

The JLHWS is the strategy for meeting the needs identified in the JSNA. As with JSNAs, it is produced by the health and wellbeing board, is unique to each local area, and there is no prescribed format.

However, the board must have regard to the integrated care strategy when preparing their joint local health and wellbeing strategies, as well as having regard to the NHS priorities and the statutory guidance (see Section 4.1 Relevant information).

The JLHWS should explain what priorities the health and wellbeing board has set in order to tackle the needs identified in the JSNA.

4. Further Reading

4.1 Relevant information

Statutory Guidance on Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies, Department of Health and Social Care

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