Assessment framework for local authority assurance

Working with the integrated care board (ICB), the local authority uses high quality, wide ranging data, including the wider determinants of health, to understand current and emerging population strengths and needs. This intelligence, combined with ongoing engagement with communities and providers, guides proactive planning to ensure the care market can meet future demand and aligns with the broader corporate vision. 

There is a highly effective approach to shaping and managing a diverse, sustainable care market, underpinned by up-to-date and reliable system-wide data. Commissioners are proactive in identifying and managing risk, using well established early warning systems that show sustained impact. Learning is routinely shared across the system. 

The importance of intersectionality in delivering care and support is recognised across the system and is a shared priority. There is a clear, shared vision for commissioning, and there are sustained positive outcomes. 

Commissioning leaders continually nurture strong and open relationships with external partners, including care providers, which are fully collaborative at a strategic level. There is continuous shared learning across the system, with a demonstrable and strong impact. 

The local authority and key partners, including care providers, share a clear vision for developing a skilled, stable and future ready care workforce. This is supported by reliable intelligence and long-term planning that reflects evolving care and support needs.  

Fee rates are agreed openly and transparently, using a rigorous approach to ensure they reflect the true and fair cost of care. Contracts are flexible to support learning and continuous improvement. Robust evaluation of quality and outcomes is based on what matters to people.   

There is a sustained approach to high-quality co-production in commissioning. It is systematically designed and evaluated with people who receive care and support, unpaid carers, and groups whose voices are seldom heard. People with lived experience inform and shape models of care that reflect the priorities of local people.  

The local authority and providers use strengths based, innovative approaches that build on system assets, develop the workforce and improve opportunities. This is supported by commissioners’ ongoing high quality learning and development. There is an open dialogue with providers, supporting them to raise issues early. 

Local need is met to an exceptionally high standard. Local need profiles inform sustained joint strategic approaches to commissioning to target interventions for those with specialist support needs, including for young people, and people with sensory support needs. 

There is a system-wide approach to ensuring quality and safety, which is understood and owned at all levels. Services are highly responsive, using real-time data and feedback from people to inform quality indicators. A feedback loop and continuous evaluation drives measurable service improvement, keeping services focused on what matters to people. 

Integrated commissioning uses highly effective shared data, and governance and delivery arrangements, and evaluation mechanisms are well established and have sustained impact.  

There is a clearly defined joint strategic approach to care provision based on a thorough understanding of the local population. High-quality data and information are used in partnership with the integrated care board (ICB) to address inequalities and take a preventative, proactive and joined-up approach to meeting need.  

Commissioning leaders oversee a clear, effective approach to market shaping and management activity in partnership with care providers. Their decisions are grounded in strong, triangulated data, including provider information, demand modelling, workforce trends and people’s lived experience, to support a vibrant and stable market. They also identify and address any data gaps proactively. 

The local authority has a good understanding of the needs of people who arrange and fund their own care and considers these needs in commissioning strategies and actions. It ensures that these people have access to a diverse range of quality services. 

Commissioning leaders nurture relationships with key external partners at a strategic level, including care providers and housing providers. They establish an effective culture of trust and openness, which is encouraged at an operational level, with good working relationships with providers. 

Staff and leaders take a proactive approach to developing the local care workforce, supported by a culture that values and invests in staff. Joint planning ensures the workforce is skilled and has the capacity to meet current and future needs, promoting excellence and retention.  

Fee rates reflect fair terms and conditions, with a transparent and consistent process for setting and reviewing fees. Negotiations support market sustainability and workforce retention in line with national expectations and requirements. 

Commissioners are committed to collaborative commissioning, co-producing equitable, outcome focused frameworks with providers. People and providers are treated as equal partners in shaping priorities and service models. Views from groups whose voices are seldom heard are actively sought and inform planning. Procurement supports strategic planning, with commissioning focused on people’s outcomes, enabling needs to be met through high-quality care. 

Local need is met through appropriate and sustainably resourced care, and there is targeted support for equity of access. The local authority ensures market sufficiency so that supply meets current and future needs. People have access to a diverse range of local, safe, effective, affordable and high-quality options to meet their needs, with genuine choice of provision. People are not placed out of area due to gaps in local provision; if they are, agreed plans are in place to support their return home where wanted, and these plans are followed through. 

The local authority works with providers and partners to strengthen service quality and safety, using clear mechanisms to monitor progress, address risks and ensure market sustainability. Strategic partnerships ensure purchasing supports long-term adult social care goals. A consistent approach to quality is maintained through a responsive improvement cycle informed by performance data, feedback, staff insight and clear complaints processes that feed directly into service improvement.

An understanding of the strengths and needs for local care and support inform planning, but this is less thorough for groups of people whose voices are seldom heard or people with protected equality characteristics. Commissioning decisions are not routinely overseen by leaders, and there is a lack of ambition in the breadth and quality of data gathered to fully understand these needs.   

Market shaping activity is often ineffective, with gaps in data and inconsistent use of insights leading to instability across the market. There is no coherent approach to ensuring sufficient capacity, diversity or stability in provision. Commissioners respond to risks inconsistently and sometimes too slowly, which negatively affects people’s experiences and outcomes. 

Commissioning leaders have started to build a collaborative approach to working with external partners at a strategic level, but it is not yet embedded, with discretionary approaches taken to building relationships with partners at an operational level.  

Leaders show commitment and ambition to workforce planning to ensure a skilled and sustainable workforce, but this has not yet translated into an embedded approach. A culture of valuing the care workforce is not reflected in commissioning arrangements, and commissioners do not consistently reflect fair terms, conditions, and pay for the workforce in provider fee rates. 

Coproduction in commissioning is fragmented. Although some views from people are considered, there is no consistent, equitable embedded approach, and groups who are seldom heard are not always included. Commissioning and contract notifications are issued too late for providers to plan effectively, creating instability and challenges in recruitment and resource allocation. 

There is not always sufficient care and support to meet demand or diverse needs. Gaps in provision mean some people are placed out of area, and those wishing to return often lack clear plans. People report mixed levels of choice. The range of commissioned services lacks diversity and innovation, is not always aligned with best practice, and does not consistently focus on outcomes or promoting independence. 

There is a mixed picture of quality across services; people’s experiences and outcomes are mixed. Although there are mechanisms for gathering performance intelligence and feedback from people with lived experience, this is not consistently used to inform service improvements. 

Commissioning is not consistently integrated, and this limits impact on people’s experiences and outcomes. Partners do not always deliver person-led services in joined up settings, and coordination across teams is variable. Contracts, voluntary and community sector engagement and housing partnerships are in place, but they are not yet working together effectively to support integrated pathways or deliver shared outcomes. 

Limited available information is used to understand local care and support needs, and it is not clear how this informs planning and commissioning activity. Commissioning arrangements are not overseen by leaders and there is an inconsistent, fragmented oversight of, and approach to, care provision.   

Market shaping activity is ineffective, with limited understanding of the pressures faced by local providers and poor-quality data to inform decisions. There is little planning for future demand, contributing to significant market instability. Commissioners also lack a clear grasp of local costs, further undermining effective market oversight. 

There is very little to no collaboration with external partners in market shaping and commissioning, and the local authority lacks an effective approach to provider engagement. Interaction is largely confined to routine contract monitoring, with no joint problem-solving or innovation. The culture is inward-facing, focused on compliance rather than learning, and any learning gained is not shared. 

Staff and leaders take little to no role in ensuring there is a sufficient and skilled care workforce that is recognised and valued. This affects both the quality of care and market stability. 

There is little evidence of coproduction in commissioning, with minimal effort to proactively engage people. The views of groups whose voices are seldom heard are neither sought nor acted upon. Commissioning is procurement-led, focused on processes and outputs rather than outcomes or impact, with no drive for learning, best practice or innovation. 

Little effort is made to ensure choice and diversity of provision for local people and meet local need. There are significant gaps in provision, which leads to poor outcomes and experiences for people. A significant number of people receive support out of area because of lack of choice or availability locally. 

There are ineffectual mechanisms to ensure safety and quality standards in local services. Commissioners do not to react in a timely or appropriate way to providers’ concerns, and do not take effective action when risk is identified. 

No consideration has been paid to opportunities for integrated commissioning, leading to fragmented, inefficient services.