Safeguarding and quality in commissioning care homes


Key points for commissioners

Commissioners ask care homes to demonstrate that they:

  • work as part of multi-agency partnerships to promote good safeguarding practice
  • use a ‘best interests’ process to protect people who may lack the capacity to make decisions or raise concerns to protect themselves. Taking account of (and recording) all relevant circumstances including the person’s past wishes, feelings and values; the views of people who know them; ways in which the person can be involved and whether the person may regain capacity at a future time
  • provide access to advocacy
  • understand the circumstances under which a local authority or PCT may appoint an Independent Mental Capacity Advocate
  • can demonstrate robust recruitment procedures
  • have robust whistleblowing policies in place.

There is a raft of legislation and policy alongside a regulatory framework to protect people at risk from abuse, neglect and harm.

Commissioners and providers should have a working knowledge of the legislative and policy framework for safeguarding. Commissioners should ensure that providers are clear about their legal responsibilities. Provider’s policies, procedures and practice should be underpinned by legislation and national and local policy guidance.

It is important that commissioners take responsibility for safeguarding adults by ensuring that the care services they commission provide good quality and promote safety in the context of personalisation.  

Many people living in care homes are unable to protect themselves. There should be robust systems in place to protect these individuals, underpinned by local multi-agency policy and procedures.

Identify people who may be at particular risk and develop strategies to address this

People with communication difficulties who, as a result of disability or cognitive impairment, may be unable to alert someone in the event of abuse neglect or harm:

  • Provide advocacy and befriending services.

People who face language or cultural barriers:

  • Develop culturally appropriate services.
  • Make links with local community groups and volunteers.
  • Provide interpreting services.

People from seldom-heard groups, e.g. older people who are gay who may face discrimination or may lack a voice within the community:

  • Provide advocacy.
  • Ensure support is available from representative groups.
  • Identify discrimination and work with local partners to address it.


  • Provide information to ensure self-funders understand their rights and have access to local authority support such as assessment and advocacy.

People who are placed ‘out-of-area’:

  • Ensure people have access to information and advocacy.