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Version: 4
Published: December 2025
Review due: November 2028
This document underpins the Pan Sussex Safeguarding Procedures. It seeks to outline the operational framework for managing safeguarding provider concerns.
The threshold for considering provider concerns is indicated when a number of adults have been allegedly abused, or patterns or trends are emerging from information, intelligence or data that suggests the care and support regime presents a significant risk to people or is negatively impacting on their lifestyle.
The Quality Assurance and Safeguarding Information Group (QASIG) can also request a decision to initiate a meeting or discussion to be held for any providers identified by the group as being of concern.
A provider concern should be triggered where there are significant safeguarding concerns or multiple Section 42 safeguarding enquiries and a wider public interest issue or possible risk to other adults. This includes all adults who are supported by the provider, irrespective of who is commissioning their care.
Whilst West Sussex County Council has a duty to coordinate safeguarding enquiries, effective responses to provider concerns should be based on a multi-agency approach. This results in robust partnership working, collective responsibility and shared accountability across agencies.
This framework supports the need to have individual Section 42 safeguarding enquiries and the adherence to the key principle of Making Safeguarding Personal. From safeguarding enquiries, the key themes found, identified risks, and outcomes for the adult should be recognised and considered in the provider concern process.
It is essential that collaborative working and appropriate information-sharing across agencies takes place to identify any previous enquiries and allegations involving any named individuals or the organisation. The provider concerns framework aligns to the principles of no delay.
A provider concern may have some or all of the following identifying factors:
At every stage of the concern, unless there is a specific reason not to, the provider concern process should involve the provider, alongside supporting relevant agencies.
The nature of the concern will influence which agencies need to be involved, as well as the required level of authority for agency representatives. The following information gives an overview of the key roles and responsibilities in this process.
The host authority is the local authority and Integrated Care Board in the geographical area where abuse or neglect has occurred. They are responsible for:
The placing authority is the local authority or Integrated Care Board that has commissioned the services for an individual, by the provider under investigation. They are responsible for:
The Care Quality Commission (also known as CQC) acts independently and is a valued partner in the process of information-sharing and working to identify and address areas of concern. The CQC can only use its civil and criminal enforcement powers in relation to breaches of legal requirements set out in the Health and Social Care Act. CQC have to evidence that a breach has occurred before they can proceed with enforcement powers. The CQC’s approach to inspection and enforcement focuses on five key questions about care:
Where there has been a recent inspection it might be helpful for providers to share pre-publicised reports, to support the principle of openness and transparency. In some instances, providers may be addressing issues identified by inspections and adult safeguarding and it makes sense to address both through agreed joint processes.
A lead agency should be identified and will be responsible for coordinating the enquiry. In most cases, the local authority will lead on safeguarding action in consultation with partners. Health agencies may also lead on the enquiry, especially where the concern is about health provision, as their clinical knowledge and expertise is likely to be needed. As with all criminal matters, the police will be the lead for criminal proceedings and must be consulted about any additional proposed action.
The purpose of this stage is to determine whether to initiate provider concerns. This includes:
During the initial provider concerns meeting, you should:
The provider will be informed by the Lead Enquiry Officer (LEO) of the concerns and will be asked to share as much information as possible, without compromising any subsequent lines of enquiry. They will be informed of the process and provisional timescales if available. If there is a criminal investigation, the provider will be informed in accordance with police advice.
Information-sharing regarding a provider of concern is considered on a case-by-case basis. Where there is a service-wide concern, information-sharing should always include adults who use the provider’s services and their carers so that there is transparency, and they are able to make informed choices and retain their independence. If concerns specifically apply to individual(s) with specific needs and there are no wider risks or concerns, information-sharing may only be with those on a ‘need to know’ basis.
Effective communication with adults is essential. They will be kept updated (where appropriate) so that if emergency decisions are made, they have a greater understanding of the associated risks. Adults who are thought to lack capacity to make a specific decision need to be provided with all practicable support to enable them to make their own decision before it can be concluded that they lack capacity regarding the decision and a best interests process is entered into (see our information about the Mental Capacity Act). This may be achieved in a variety of ways such as the help of a family member or friend, an advocate, or Independent Mental Capacity Advocate, an interpreter, or other communication assistance or aids.
The purpose of this stage is to:
The improvement plan is a plan for measuring the effectiveness if interventions. This is with a view to ensuring safety, governance, compliance, and clinical effectiveness, with reference to the experience and desired outcomes of adults using the service. This must be in accordance with any recommendations Contracts and Commissioning have in place.
If there is a Contract Officer, or other relevant member of staff they should be part of these meetings.
In the event that the provider advises that they are unable to make the improvements or of possible service failure or interruptions, a further meeting with all stakeholders should be convened to assess risks and impact on service users to determine commissioning based on the risk and safety of adults using the service. The position in relation to the contract should also be considered at this time if it hasn’t already been considered.
The purpose of a quality assurance strategy is to rigorously test whether improvements have been attained and can be sustained. This may include involving a range of staff with the right knowledge, skills, and experience to assess the viability of the improvements and might be the same staff involved in fact-finding so that they can provide a comparative narrative.
Obtaining feedback from adults and carers can act as a further measure to assess whether there has been any noted difference in the service delivery. This may be obtained from holding a follow-up meeting with adults in care settings, or from a sample of telephone calls to those adults who said that they had experienced a poor service, to see if their view has changed. Support from Healthwatch may be appropriate to help seek an independent assurance.
Where there are ongoing concerns and resolution does not look likely to occur and risks remain high, the QASIG subgroup must be notified so that a decision can be made as to whether it is escalated to the Strategic Provider Concerns Group.
Further meetings to update stakeholders will be made if and when necessary. Where there are wide reaching, complex concerns, and there is high risk, it is likely that update meetings are needed more frequently. Where there are serious delays by the provider to implement improvements, a further meeting should always be held to consider the level of risk and appropriate action. Focus should be on risk and the impact on adults using the service. It is important to distinguish between what is safeguarding and what are commissioning responsibilities, and if further incidents have occurred.
If there is a consensus from all involved parties that improvements have been evidenced and sustained, the provider concerns process will formally come to an end. The relevant parties, including the provider and the CQC, will be notified in writing by the Chair.
If, at any point, a safeguarding provider concern indicates that the emergency planning procedure needs to be invoked, an urgent meeting should be held. This should involve the relevant Heads of Service, including Contracts and Commissioning.
The criteria for invoking the West Sussex Joint Care and Nursing Closure Response Plan is as follows.
An emergency closure, whether temporary or permanent, will apply in the following circumstances (this list is not exhaustive):
A planned closure, whether temporary or permanent, will apply in the following circumstances (this list is not exhaustive):
