Adult Social Care Briefing
Published 10 September 2026
This Week’s Headline
Health Bill Moves to the House of Lords
The Health Bill completed its Commons stages this week and moved to the House of Lords.
DHSC also published an impact assessment and equality impact assessment on 9 September covering proposals relating to visiting and the involvement of other people in care decisions.
What Has Changed?
The Bill would amend the Care Act 2014 so that local authorities, when carrying out relevant functions, would have regard to:
the importance of people being able to involve others in decisions and those people receiving appropriate information and support;
appropriate opportunities to receive visitors; and
for people living in care homes, appropriate opportunities to take trips outside the home.
The Bill also proposes a duty on Integrated Care Boards to promote appropriate opportunities for people receiving accommodation through relevant ICB arrangements to receive visitors.
For providers, Regulation 9A remains the existing direct regulatory requirement relating to visiting and accompanying in care homes.
The new development is therefore the proposed extension of these considerations into wider local authority and ICB responsibilities.
Why It Matters
The proposals reinforce the importance of maintaining relationships, supporting involvement in decisions and enabling people to remain connected with life outside the home. They are also relevant from a commissioning perspective because these issues would sit more explicitly within the responsibilities of local authorities and ICBs if the Bill is enacted in its current form.
Actions for Providers
Review whether important relationships and community connections are reflected in care planning.
Check that any restrictions on visiting or leaving the home are individualised, proportionate and regularly reviewed.
Make sure relatives, representatives and advocates are appropriately involved in decision-making.
Use Mental Capacity Act processes where a person may lack capacity for a specific decision.
Continue to monitor the Bill as it progresses through Parliament.
CQC
CQC Inspection Highlights Gaps Between Recorded Care and Practice
CQC published the outcome of its first inspection of Brushwood House in Liverpool on 9 September 2026. The service was rated Inadequate overall and across all five key questions and placed in special measures. CQC identified breaches relating to safe care and treatment, medicines management, staffing, dignity and respect, consent, person-centred care, nutrition and hydration, safeguarding and governance.
What Has Changed?
There has been no change to regulation.
The inspection findings included:
call bells going unanswered for up to 20 minutes;
a resident record showing that breakfast had been eaten when inspectors found the meal untouched;
one person having been without prescribed medication for more than three weeks;
medicines being hidden in food without appropriate processes being followed;
people with identified choking risks not always receiving food and drink at the required texture;
required repositioning not consistently taking place and records being incomplete;
medicines belonging to different people not always being stored separately and securely; and
audio-enabled CCTV being used in communal areas without appropriate safeguards.
Why It Matters
The findings demonstrate the importance of validating information within care records and audits against actual care delivery. They also show how concerns across medicines, nutrition, staffing, consent and record-keeping can indicate wider weaknesses in governance and oversight.
Actions for Providers
Include resident-level trace audits within routine quality assurance.
Compare care plans and records with direct observation and staff knowledge.
Review covert medicines arrangements, including capacity and best-interest decision-making.
Check that texture-modified diet and fluid requirements are consistent across care plans, staff guidance and kitchen information.
Review call-bell response monitoring where delays are identified.
Check governance arrangements where CCTV or audio monitoring is used.
Validate high audit scores against incidents, complaints, observations and other quality intelligence.
Digital Governance
Government Publishes AI Risk Management Toolkit
The Department for Science, Innovation and Technology published an AI Risk Management Toolkit on 8 September 2026.
The toolkit is intended to support organisations involved in designing, operating, procuring or delivering products that use artificial intelligence.
What Has Changed?
The toolkit provides a structured approach to identifying, assessing, treating and monitoring AI-related risks. It covers areas including risk ownership, risk appetite, likelihood, impact, controls and monitoring. The toolkit does not create a new CQC requirement or adult social care statutory obligation.
Why It Matters
AI is increasingly being used within organisational systems and by individual staff.
For adult social care providers, this creates potential governance issues where AI is used in areas such as care planning, assessments, complaints, incidents, investigations, safeguarding, recruitment and quality assurance. The key issue is ensuring that use of AI sits within existing information governance, risk and assurance arrangements.
Actions for Providers
Identify where AI tools are currently being used within the organisation.
Include AI within information governance, procurement and supplier assurance processes.
Set clear organisational rules for staff using public AI tools, including how personal, confidential and commercially sensitive information should be handled.
Define where human review is required before AI-generated information is used.
Be particularly cautious where outputs could influence care, safeguarding, risk or employment decisions.
Ensure accountability remains with the organisation and the person making the decision.
Leadership Reflection
This week’s developments highlight the importance of testing whether systems and records accurately reflect what is happening in practice.
The CQC inspection findings show that completed records and established systems do not, on their own, provide assurance about the quality of care being delivered.
The same principle applies to wider governance. Policies, audits, digital systems and management information are useful only if leaders can be confident that they reflect people’s actual experience.
Five Things I’d Be Thinking About This Week
Do our care records accurately reflect the care people are actually receiving?
Are important relationships and community connections properly reflected in care planning?
Do our quality assurance processes include enough direct observation and resident-level sampling?
Do we know where AI is currently being used across the organisation?
If our audits and records say everything is fine, what are we doing to validate that independently?
Sources
Health Bill — HL Bill 52, as brought from the Commons UK Parliament9 September 2026 Health Bill Parliamentary documents
Health Bill: promoting visiting - impact assessment Department of Health and Social Care9 September 2026Health Bill: promoting visiting - impact assessment
Health Bill: promoting visiting - equality impact assessment Department of Health and Social Care9 September 2026Health Bill: promoting visiting - equality impact assessment
Regulation 9A: Visiting and accompanying in care homes, hospitals and hospices Care Quality Commission Current regulatory guidance CQC Regulation 9A guidance
CQC takes action to protect people at Liverpool care home Care Quality Commission9 September 2026 CQC Brushwood House publication
AI Risk Management Toolkit Department for Science, Innovation and Technology8 September 2026 AI Risk Management Toolkit
AI Risk Management Toolkit: guidance Department for Science, Innovation and Technology8 September 2026 AI Risk Management Toolkit guidance
The reasonable adjustment digital flag action checklist: what you need to do to achieve compliance NHS England Current implementation guidance NHS England Reasonable Adjustment Digital Flag action checklist
Editorial Note
This briefing covers material developments reviewed between 4 and 10 September 2026. The Health Bill remains proposed legislation and the provisions discussed may change as it progresses through Parliament. The Brushwood House findings relate to one CQC inspection and do not represent a change to regulation or evidence about the wider sector. The AI Risk Management Toolkit is cross-sector government guidance and does not create a new adult social care regulatory requirement. The Why It Matters, Actions for Providers, Leadership Reflection and Five Things I’d Be Thinking About This Week sections contain professional interpretation and practical considerations based on the verified source information.
Looking Ahead
Reasonable Adjustment Digital Flag — 30 September 2026
NHS England states that NHS and other publicly funded health and social care services within scope must fully implement the Reasonable Adjustment Digital Flag information standard by 30 September 2026. Providers within scope should ensure that processes are in place to identify, record, flag, share, meet, review and update reasonable adjustment needs and that the required digital capability is being addressed. The Health Bill will continue through the House of Lords. I will return to it when there is a substantive development affecting adult social care providers.
If there is a regulatory update, guidance document or sector issue you would like featured in a future edition of the Adult Social Care Briefing, I'd be pleased to hear from you.
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