Published: 20 August 2026 A weekly briefing highlighting key developments affecting adult social care providers. Each edition brings together developments that may influence governance, leadership and operational decision-making across adult social care. Factual information is drawn from official or authoritative sources, with commentary reflecting professional interpretation of the potential implications for providers. NICE opens consultation on aggressive behaviour in people receiving NHS or social care What has changed? On 19 August, NICE opened consultation on its draft updated guideline, Aggressive behaviour in people receiving NHS or social care: prevention and management, alongside a draft quality standard, Aggressive behaviour in people receiving NHS or social care. The guideline covers the prevention and management of aggressive behaviour in children, young people and adults receiving NHS or social care in any setting. NICE states that it aims to reduce aggressive behaviour and the use of restrictive practices. The draft quality standard covers preventing and managing aggressive behaviour in children, young people and adults receiving NHS or social care and identifies priority areas for quality improvement. It will update and replace the existing quality standard on violent and aggressive behaviours in people with mental health problems, published in 2017. Both consultations close at 5pm on 16 September 2026, with the final guideline and quality standard expected to be published on 28 January 2027. Why it matters The explicit inclusion of social care makes this relevant to providers across a range of settings. The draft proposals cover areas including prevention, individual risk management, involvement of people and carers in care planning, restrictive practices, sharing information across care settings, and support and learning following incidents. For providers supporting people who may experience distress or aggressive behaviour, this is an opportunity to consider how current arrangements compare with the proposed expectations before the final publications are issued. Importantly, social care organisations are within scope to contribute to the consultation process. Organisations commenting formally need to meet NICE's stakeholder requirements and register for the relevant consultation. For the draft guideline, NICE also accepts comments from individuals, although it encourages people to submit through a registered stakeholder organisation where possible. Registration for the guideline consultation does not automatically register an organisation for the quality standard consultation. Actions for providers Identify whether the draft guideline and quality standard are relevant to the people your services support. Review the consultation documents and, where appropriate, consider registering as a NICE stakeholder and contributing before 16 September. Review governance and oversight of restrictive practices, including recording, proportionality and review. Check whether post-incident processes identify learning and changes required to reduce future risk. Consider whether staff training is supported by competency assessment, supervision and observation of practice. Contributing to the consultations NICE is accepting comments until 5pm on Wednesday 16 September 2026. Draft guideline: Aggressive behaviour in people receiving NHS or social care: prevention and management View the consultation and response information: NICE draft guideline consultation Draft quality standard: Aggressive behaviour in people receiving NHS or social care View the consultation and response information: NICE draft quality standard consultation. CQC: latest local authority assessments highlight system and pathway risks What has changed? CQC has published its assessments of Lincolnshire County Council and North Lincolnshire Council against their responsibilities under Part 1 of the Care Act 2014. Lincolnshire was rated Requires Improvement, while North Lincolnshire was rated Good. The detail beneath the overall ratings provides useful intelligence. In Lincolnshire, care provision, integration and continuity, safe pathways, systems and transitions, and governance, management and sustainability were scored 2 out of 4. CQC reported mixed experiences of accessing adult social care and identified issues around areas including provision, equipment and adaptations, hospital discharge and transitions. North Lincolnshire achieved scores of 3 in areas including care provision, integration and continuity, partnerships and communities, governance, management and sustainability, and learning, improvement and innovation. However, there were also areas for development. Assessing needs, equity in experience and outcomes, safe pathways, systems and transitions, and safeguarding were each scored 2. CQC identified areas for improvement including assessment practice, recording, consistency in safeguarding practice and contingency planning. Why it matters These are assessments of local authorities rather than registered providers, but they provide useful intelligence about the wider systems in which providers operate. Delays in assessments and reviews, equipment, transitions, discharge arrangements, market capacity and safeguarding processes can all create additional risks for people receiving care and the providers supporting them. The findings also reinforce the importance of organisations understanding demand, identifying emerging risks and working effectively across organisational boundaries. For providers, there is a clear implication around information flowing effectively between providers, commissioners and other system partners. Actions for providers Review transition and discharge arrangements, particularly where responsibility passes between providers, local authorities and health services. Check that roles, escalation routes and contingency arrangements are clear. Track external delays affecting people's care, including assessments, reviews, equipment, funding decisions or changes to packages, and ensure resulting risks are documented and escalated. Review continuity and contingency arrangements for foreseeable disruption, including changes in people's needs, equipment problems, staffing pressures or interruptions to provision. Use provider intelligence proactively with commissioners. Capacity pressures, unmet demand, packages that are difficult to place and emerging quality risks can provide important early warning of wider system pressures. Review people's experience across pathways, particularly where several organisations are involved, rather than relying solely on assurance from internal processes. Leadership Reflection This week's developments put risk across organisational boundaries firmly on the agenda. CQC's findings show how assessment, provision, equipment, transitions, safeguarding and capacity can affect people's experiences across an entire pathway. NICE's consultation similarly places emphasis on prevention, individualised risk management, information sharing and learning when incidents occur. For leaders, this creates an important assurance question: Do our governance arrangements give us enough visibility of risks that sit between organisations, as well as those within our own service? Five Things I’d Be Thinking About This Week 1. NICE consultation Does the proposed guidance apply to any of our services, and do we have experience or evidence that could usefully contribute to the consultation? 2. Restrictive practice Can we clearly demonstrate when restrictive practices are being used, why they are necessary and proportionate, and how their use is reviewed? 3. System delays Are delays in assessments, reviews, equipment, funding or discharge creating additional risks for people we support and can we evidence our escalation? 4. Transitions and contingency planning When responsibility moves between teams or organisations, is it clear who is doing what and what happens if the planned pathway breaks down? 5. Winter readiness Are we connected into local winter planning around capacity, discharge, escalation, workforce resilience and infection prevention? (Its time to start thinking about winter). Sources National Institute for Health and Care Excellence (NICE) Aggressive behaviour in people receiving NHS or social care: prevention and management — draft guideline consultation Aggressive behaviour in people receiving NHS or social care — draft quality standard consultation Care Quality Commission Lincolnshire County Council: local authority assessment North Lincolnshire Council: local authority assessment — published 14 August 2026 NHS England Winter planning 2026/27 – expectations and assurance — published 17 July 2026 Editorial Note This briefing covers significant issues reviewed up to 20 August 2026 and has been written specifically with their relevance to care-home leaders in mind. The NICE consultation opened on 19 August 2026 and explicitly includes social care. The CQC findings relate to local-authority assessments rather than assessments of individual registered providers and are included because of their wider relevance to care-home leaders. The sections headed Why It Matters, Actions for Providers, Leadership Reflection and Five Things I'd Be Thinking About This Week represent professional interpretation of the published information. Every effort has been made to distinguish verified factual information from professional commentary. This briefing should not be regarded as legal or regulatory advice. Looking Ahead Future briefings will continue to focus on developments that have a direct and material impact on care-home leaders, including: CQC regulation and assessment; government adult social care policy; workforce and Fair Pay Agreement developments; NICE guidance relevant to older people and care homes; safeguarding, medicines and clinical governance; local-authority commissioning and market developments; hospital discharge where there are direct implications for providers; and emerging quality and safety issues affecting care homes. 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.

There are some managers who seem to know absolutely everything about their service. Ask about a resident and they know the full history; ask about a complaint and they can tell you where it is up to; ask why agency usage went up three weeks ago and they will usually know that too. That level of knowledge is reassuring, but it can also hide a problem if too much of the service starts to depend on one person carrying all of that information, judgement and follow-through. I have been in services where nothing dramatic happened when the manager was away, but you could still feel the difference. Things took a little longer to move, people were less confident about what they could decide for themselves, and some issues simply sat there because “the manager normally deals with that”. The stronger and more capable the manager, the easier it is for everyone else to lean on them, and over time that can create a situation where the person is not just leading the service but quietly holding far too much of it together. It usually happens for understandable reasons. If you know the service well, it is quicker to make the call yourself, sort the complaint yourself, or deal with the awkward conversation rather than spend twice as long talking somebody else through it. I can guarantee at some point we have all done it. The problem is that every time the same person steps in, somebody else misses the chance to develop. That is where succession planning becomes relevant for me. Not as something that suddenly becomes important when somebody hands in their notice, but as part of everyday leadership. If we think someone has the potential to step up in future, there should be more behind that than a vague sense that they are “one to watch”. We should be clear about what they already do well, what they have not yet had enough exposure to and what experience they need next. That might mean leading a quality review, chairing part of a governance meeting, managing a complaint from start to finish, taking ownership of an improvement plan or spending time with a more experienced manager in another service. None of that is complicated, but it does need to be intentional and planned. Otherwise, people can sit in deputy or senior roles for years being described as “not quite ready” without anyone being particularly clear what ready actually looks like. There is also a big difference between giving someone more work and actually developing them. We are generally quite good at the first one. A deputy can end up with the rota, training follow-up, supervisions, incident checks and half the operational headaches in the building but still have very little exposure to the parts of leadership that require judgement. That is not really succession planning. If someone is being prepared for a bigger role, they need to be involved in the difficult bits as well: safeguarding discussions, complaints, quality reviews, risk decisions, governance conversations and the situations where there is no perfect answer and someone still has to make a sensible decision. They need to be asked what they think before being told what the answer is. They need the opportunity to make decisions within their role, explain their reasoning and, occasionally, get something slightly wrong and learn from it, as that’s often when you learn the biggest lessons. You cannot transfer judgement in a few months because someone has resigned. You can explain systems, contacts, meetings and priorities, but confidence and professional judgement only develop through experience. I also believe succession planning needs to go wider than the registered manager role. In some services, there is just as much dependency on the deputy, the clinical lead, the administrator who knows every system, or the senior carer everybody turns to when something does not feel right. If one of those people left tomorrow, would you know where the gap would appear? That is much more useful to consider, than simply asking whether there is a succession plan. Who are we actually developing? What experience are they getting? What are they still not being exposed to? Where is knowledge concentrated in one person? And what would become vulnerable if that person was no longer there? There is a retention point here too. Good people are more likely to stay where they can see that somebody is investing in their development and where progression does not depend on waiting for the person above them to resign. If the only development offer is “maybe one day you can have the manager’s job”, that is not much of a plan. People need opportunities to grow before there is a vacancy, and organisations need to understand that developing someone does not mean they have to become a carbon copy of the person currently in post. Not everyone wants the next job either, and that is fine. Someone can be an excellent deputy, clinical lead or senior without secretly longing to inherit the registered manager’s inbox, but their development in their current role remains just as important. Succession planning should be about capability and choice, not pushing good people into roles they never really wanted. Personally, this is why succession planning belongs in governance conversations, not just workforce ones. A service can be performing well and still be surprisingly fragile if too much knowledge, confidence and decision-making sits with one person. The assurance comes from knowing that when a good manager takes leave, moves on or is simply unavailable, the service does not lose its grip because other people understand what matters, what needs to move and where they can make decisions. That doesn’t just happen. It must be developed while things are going well, not discovered as a priority once the leaving card has already been bought. We shouldn’t be asking who would step in if someone left, succession planning in social care means we should be preparing people before they are needed. Need support developing your next leaders? I support managers and senior leaders through practical coaching and mentoring, with a focus on confidence, judgement, governance and leading well in the real situations they are dealing with. If succession planning, leadership development or strengthening management capability is on your agenda, get in touch.

Published: 13 August 2026 A weekly briefing highlighting key developments affecting adult social care providers. Each edition brings together developments that may influence governance, leadership and operational decision-making across adult social care. Factual information is drawn from official or authoritative sources, with commentary reflecting professional interpretation of the potential implications for providers. This Week's Focus Hot Weather With high temperatures presenting an increased risk to older people, this week's briefing focuses first on the practical implications for care homes. The UK Health Security Agency (UKHSA) identifies older people and people with conditions including dementia, diabetes, kidney disease, Parkinson's disease, cardiovascular or respiratory conditions and mobility problems among those at greater risk during hot weather. People living in care homes are specifically recognised as being at higher risk. For care homes, the response needs to consider individual resident risk, hydration, the care environment, medicines, staffing and whether arrangements are effectively reducing risk. The detailed UKHSA guidance for social care managers is established guidance rather than something introduced this week. However, the current Heat-Health Alert action card for health and social care providers was updated on 21 May 2026 using new evidence, and the current Adverse Weather and Health Plan 2026 to 2027 was added to GOV.UK in March 2026. What Has Changed? There is no new statutory requirement for care homes arising from the hot-weather guidance this week. The current UKHSA framework provides national guidance on how health and social care providers should prepare for and respond to hot weather. The Heat-Health Alert action card sets out suggested actions for providers at green, yellow, amber and red alert levels. UKHSA's detailed guidance for social care managers advises services to: identify people at greater risk of heat-related illness; ensure staff are familiar with hot-weather and business continuity plans; monitor hydration and significant changes from what is normal for the person; ensure relevant staff know how to check and record room temperatures; consider whether additional staffing or support may be required; regularly check indoor and outdoor temperatures during the hottest periods; and seek appropriate healthcare advice where medicines may increase an individual's vulnerability during extreme heat. Why It Matters Care homes support a population particularly vulnerable to the effects of high temperatures. For managers, the important consideration is whether existing arrangements recognise individual levels of risk rather than relying on a standard response across the service. Some residents may be unable to recognise or communicate thirst. Others may be more vulnerable because of their health conditions, medicines or mobility. The physical environment can also vary within the same home, with some bedrooms and communal areas becoming more difficult to keep cool. UKHSA advises residential settings to have a cool room or area that can be maintained below 26°C and to monitor indoor and outdoor temperatures during hot periods. Hot-weather arrangements should therefore give managers confidence that higher-risk residents are identified, appropriate monitoring is taking place and staff know when concerns need to be escalated. Actions for Providers Review which residents are at greatest risk during hot weather and ensure this is reflected in individual care planning. Check that staff know how to recognise dehydration, heat exhaustion, heatstroke and significant deterioration. Review hydration and monitoring arrangements for residents who cannot independently recognise or communicate thirst. Ensure staff can check and record room temperatures and know what action to take where concerns are identified. Consider whether particular rooms or parts of the building repeatedly become difficult to keep cool. Ensure medicines are considered as part of individual risk assessment and seek appropriate clinical or pharmacy advice where concerns arise. Medicines should not be stopped or altered without appropriate professional advice. Consider whether staffing arrangements provide sufficient capacity for additional monitoring and support during periods of significant heat. Ensure significant concerns, incidents or environmental risks are escalated through the service's usual governance arrangements. Operational Watch Hospital Discharge Reporting Changes from 30 August NHS England updated its Acute discharge situation report: technical specification on 12 August 2026. The specification confirms that, from 30 August 2026, the Acute Discharge Situation Report will include additional metrics on delayed discharges and delayed bed days by discharge pathway. NHS England says these measures are intended to provide greater visibility of delays across pathways and support local and national improvement activity aimed at reducing unnecessary time spent in hospital after a person is ready for discharge. The responsibility for submitting this data sits with relevant NHS trusts rather than care homes. NHS England does, however, expect trusts to work with partners across the system, including local authorities, in compiling and using the information. The specification includes care-home-related discharge pathways. These include returning to an existing care home, returning with short-term rehabilitation or increased support, intermediate care delivered in a care-home bed, and, in defined circumstances, a new care-home admission. Why It Matters There is no new reporting requirement for care homes arising from this change. However, the reporting framework distinguishes between different reasons why discharge may be delayed. These include residential or nursing home arrangements still being made, residential or nursing home capacity not being available, and circumstances where an agreed provider requests further action or information before accepting the person. The practical implication for care-home managers is therefore the importance of being clear about why an admission or return cannot proceed. Managers regularly have to balance timely discharge with their responsibility to establish whether a person's needs can be safely met. There may be legitimate reasons why an admission or return cannot proceed immediately, including incomplete information, unresolved changes in need, medication or equipment arrangements, safeguarding concerns or insufficient safe capacity. Providers should remain confident in making safe admission decisions while ensuring that the reasons for those decisions, and any additional information or action requested, are clear and documented. Actions for Providers Review whether admission and hospital-return processes clearly identify the information required to determine whether a person's needs can be safely met. Ensure requests for further clinical information, medication, equipment or clarification are proportionate and documented. Make sure capacity decisions reflect what the service can safely deliver rather than simply whether a bed is physically available. Ensure escalation routes are clear when essential information or arrangements are preventing an admission or return. Review recurring problems with hospital discharge through governance processes rather than treating each occurrence as an isolated operational issue. Consider whether hospital readmissions identify patterns relating to discharge quality, communication or changes in residents' needs. Leadership Reflection Hot weather and hospital discharge may appear to be very different operational issues, but both require managers to balance responsiveness with safe, individualised care. During periods of high temperature, having a plan is only part of the assurance. Leaders need confidence that individual risks are recognised, staff know what action to take and concerns are escalated appropriately. The same applies to hospital discharge. Timely admission or return to a care home is important, but this should not override the need for sufficient information, appropriate equipment, medication arrangements and confidence that the service can safely meet the person's needs. For leaders, the focus should remain on whether systems support staff to make safe decisions and whether those decisions can be clearly evidenced. Five Things I'd Be Thinking About This Week Do we know which residents are at greatest risk during periods of high temperature? Are our hot-weather arrangements working for individual residents, rather than simply demonstrating that we have a plan? Do we know which areas of our home are most difficult to keep cool and what action we will take when temperatures increase? If we delay an admission or hospital return because we do not have sufficient information or safe capacity, is the rationale clearly documented? Are staff confident about when to escalate concerns, whether those relate to a resident deteriorating during hot weather or concerns about a proposed hospital discharge? Sources This briefing is based on the following primary official sources: UK Health Security Agency — Supporting vulnerable people before and during hot weather: social care managers Published: 19 December 2024Last updated: 8 July 2025Applies to England.https://www.gov.uk/guidance/supporting-vulnerable-people-before-and-during-hot-weather-social-care-managers UK Health Security Agency and Centre for Climate and Health Security — Heat-Health Alert action card for health and social care providers Published: 18 February 2025 Last updated: 21 May 2026 Applies to England. The 21 May update states that the guidance was updated using new evidence.https://www.gov.uk/guidance/heat-health-alert-action-card-for-health-and-social-care-providers UK Health Security Agency and Centre for Climate and Health Security — Adverse Weather and Health Plan Published: 27 April 2023 Last updated: 22 April 2026 The Adverse Weather and Health Plan 2026 to 2027 was added to the publication page on 25 March 2026.https://www.gov.uk/government/publications/adverse-weather-and-health-plan NHS England — Acute discharge situation report: technical specification Published: 30 April 2024 Last updated: 12 August 2026 The current specification confirms that additional delayed-discharge and delayed-bed-day metrics by pathway will apply from 30 August 2026.https://www.england.nhs.uk/long-read/acute-discharge-situation-report-technical-specification/ Editorial Note This briefing covers significant issues reviewed up to 13 August 2026 and has been written specifically with their relevance to care-home leaders in mind. The hot-weather guidance referenced is established UKHSA guidance and is included because of its current operational relevance. It is not presented as a new statutory or regulatory requirement introduced this week. The NHS England Acute discharge situation report: technical specification was last updated on 12 August 2026. The current specification confirms that additional metrics on delayed discharges and delayed bed days by discharge pathway will apply from 30 August 2026. The sections headed Why It Matters, Actions for Providers, Leadership Reflection and Five Things I'd Be Thinking About This Week represent professional interpretation of the published information. Every effort has been made to distinguish verified factual information from professional commentary. This briefing should not be regarded as legal or regulatory advice. Looking Ahead Future briefings will continue to focus on developments that have a direct and material impact on care-home leaders, including: CQC regulation and assessment; government adult social care policy; workforce and Fair Pay Agreement developments; NICE guidance relevant to older people and care homes; safeguarding, medicines and clinical governance; local-authority commissioning and market developments; hospital discharge where there are direct implications for providers; and emerging quality and safety issues affecting care homes. . 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.

Leadership When It Matters Most There are incidents from years ago that I still remember clearly. I've lost sleep thinking about some of the families involved. I've replayed conversations in my mind and wondered whether there was anything more that could have been done. I suspect many leaders in health and social care will recognise that feeling. The responsibility doesn't end when you leave work; it stays with you. That's why, when people ask me about investigations, my mind doesn't immediately go to reports, evidence or regulatory processes. It goes to the first 24 hours. Of course not every incident will result in external scrutiny, but every significant incident deserves a thoughtful, compassionate and well-governed response. During my career, I've been involved in several incidents that resulted in Coroner's inquests, Local Authority scrutiny, CQC involvement and, on occasions, media interest. Every one was different, and every organisation responded within its own circumstances, but what remained constant was the significance of those first few hours. People often assume the investigation is where learning begins. I don't believe it is. Learning begins the moment the incident happens. In those first 24 hours, organisations reveal far more about themselves than any investigation report will. They reveal their leadership, culture and whether governance is something that exists on paper or something that genuinely supports people when they need it most. The First 24 Hours Are About People The first priority is always people. This means responding to any immediate risks, supporting families facing unimaginable circumstances and recognising that the member of staff involved may also be experiencing one of the most difficult days of their professional life. Compassion and professionalism are not mutually exclusive; they should underpin every decision that follows. Duty of Candour Is More Than a Conversation Where the statutory Duty of Candour applies, organisations should act promptly, openly and compassionately in accordance with Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Being open does not mean having every answer immediately. It means responding honestly and allowing the facts to guide what follows. It means communicating what is known at that point in time, acknowledging what remains uncertain and explaining what will happen next, whilst taking account of any legal, regulatory or investigative considerations. There are occasions where organisations must balance openness with police investigations, Coroner's processes, legal advice, confidentiality and the integrity of the investigation itself. Good judgement means understanding the difference between openness and speculation. Supporting Staff Without Compromising the Investigation One aspect that can easily be overlooked is the wellbeing of the staff involved. Many will be distressed or worried about the consequences for the person they supported, the family and their own professional future. Some may require immediate emotional support, while others may need access to occupational health, employee assistance programmes, professional representation or independent advice. Supporting staff is not the same as interviewing them. Looking after their wellbeing should be separate from establishing the facts. Leaders should ensure staff know what support is available, understand the processes that will follow and feel able to speak openly without fear of assumptions or premature judgement. Looking after staff and protecting the integrity of an investigation are not competing priorities; both are essential. Establish the Facts The first 24 hours are rarely calm. Decisions often need to be made quickly and with incomplete information. This is where good governance provides structure. A coordinated response is essential. Identify who is leading, create an accurate chronology while events are fresh and preserve records and other relevant evidence. Make appropriate notifications, including to CQC, meet safeguarding responsibilities and ensure relevant agencies are informed in accordance with legislation, local procedures and the circumstances of the incident. This may include working with healthcare professionals, the police or other agencies where appropriate. Seek advice from HR, legal advisers, insurers or professional bodies where appropriate. Most importantly, avoid assumptions. Facts first. Conclusions later. One of the biggest mistakes organisations can make is trying to answer questions before they know what actually happened. Start Learning Immediately One question should be asked as early as possible. Could this happen again tomorrow? If the answer is yes, learning cannot wait until the investigation report is complete. Good organisations don't simply investigate an individual incident. They ask whether the same risks, systems, competency gaps or communication issues exist elsewhere across the organisation. This is where Regulation 17, Good Governance, becomes more than a regulatory requirement. It is about using information to understand risk, take action and continually improve. The Moment Governance Becomes Real By the time you're speaking to a family, notifying the regulator or preparing information for the Coroner, your governance arrangements have already been tested. The decisions made in those first few hours can shape everything that follows. We spend a great deal of time preparing for inspections. Perhaps we should spend just as much time asking ourselves: if something serious happened tomorrow, would our governance arrangements give us the confidence to lead with compassion, integrity and professionalism from the very first hour? We don't prepare for the first 24 hours because we expect the worst to happen. We prepare because every person we support deserves an organisation that's ready if it does. The reflections in this article are drawn from my professional experience of leading through significant incidents in health and social care. Every incident is unique, and organisations should always follow their own policies, seek appropriate legal and professional advice where necessary, and comply with applicable legislation, regulatory requirements and local procedures. If your organisation would benefit from support following a significant incident, or you want to strengthen your governance and assurance before one occurs, I'd be happy to help.

Published: 6 August 2026 A weekly briefing highlighting key developments affecting adult social care providers. Each edition brings together developments that may influence governance, leadership, workforce and operational decision-making across adult social care. Factual information is drawn from official or authoritative sources, with commentary reflecting professional interpretation of the potential implications for providers. This Week's Focus Beyond Recruitment: What the Workforce Strategy Means for Adult Social Care Leaders Two years after the launch of the Workforce Strategy for Adult Social Care in England, Skills for Care reports that three quarters of the strategy's 56 recommendations and commitments are complete or in progress. The strategy was developed collaboratively with the sector to provide a long-term direction for: attracting and retaining staff; developing skills and capability; and transforming how adult social care is delivered. While national progress is encouraging, the key question for providers is whether that direction is translating into measurable improvements in workforce stability, capability and leadership within their own organisations. What Has Changed? Skills for Care's two-year progress update confirms: the strategy continues to focus on three priorities: attract and retain, train and develop, and transform; three quarters of the 56 recommendations and commitments are complete or in progress; the strategy is supporting workforce planning, influencing policy and strengthening collective action across the sector. The update does not introduce new statutory requirements for providers. It does, however, provide an opportunity for organisations to review whether their own workforce planning aligns with the longer-term direction of adult social care. Why It Matters Workforce remains one of the most significant strategic challenges facing adult social care providers. Skills for Care's latest workforce intelligence reports that: vacancy rates have reduced to 6.1%, the lowest level for ten years; and the workforce has grown for the fourth consecutive year, with approximately 22,000 additional filled posts compared with the previous year. While these trends are positive, workforce pressures remain significant. Effective workforce oversight should include an understanding of: whether recruitment attracts people with the right values and behaviours; why staff leave and whether retention initiatives are effective; whether learning and development opportunities support career progression; how competence is assessed following training; whether managers receive appropriate leadership support; where future leadership, nursing and specialist workforce gaps may emerge; and whether workforce intelligence is informing organisational decision-making. The Workforce Strategy also reflects the changing nature of adult social care, including greater emphasis on integrated working, prevention, technology, personalised care and digital capability. For providers, the question is no longer whether a national workforce strategy exists. It is whether organisational workforce planning is keeping pace with it. Actions for Providers Review whether the organisation has a genuine workforce strategy rather than simply a recruitment plan. Bring together information on vacancies, turnover, sickness, agency use, retention, exit interviews, competence and leadership capacity. Examine workforce risks at service and role level rather than relying solely on organisation-wide averages. Ensure competency assessment includes observation of practice and evidence that learning is applied safely and consistently. Review whether career pathways are visible to staff and reflected within supervision, appraisal and development planning. Consider future workforce requirements, including succession planning, leadership development, nursing capacity, specialist skills and digital capability. Regulatory Watch Current CQC Assessment Priorities Although there have been no major new national regulatory announcements this week, CQC's current assessment priorities remain highly relevant for providers. CQC continues to prioritise assessments for: services where there are urgent or emerging risks; services identified as very high risk that have not yet been assessed; services registered for more than one year that have not yet received an assessment; and services with ratings more than six years old. CQC introduced a more proportionate assessment approach for eligible Good-rated adult social care services. For eligible services, assessments place greater emphasis on: people's experiences and outcomes; observation of care; and targeted, risk-based review of records. Why It Matters A proportionate assessment is not a lower standard. For leaders, it reinforces the importance of maintaining assurance continuously rather than relying on inspection preparation. Effective governance should provide a reliable and consistent picture of: what people experience; where risks are emerging; whether staff are competent; whether improvement actions have been effective and sustained; and whether information from different sources tells a consistent story. These expectations align closely with the principles of Regulation 17 (Good Governance), which requires providers to maintain effective systems to assess, monitor and improve the quality and safety of services. Adult Social Care Negotiating Body Recruitment remains open for the independent Chair of the new Adult Social Care Negotiating Body, which will support the introduction of Fair Pay Agreements for adult social care. The Department of Health and Social Care has confirmed that the Negotiating Body will bring together employer and trade union representatives to negotiate pay, terms and conditions and wider employment matters. The Government has also committed funding to support implementation of the first Fair Pay Agreement. Why It Matters While this does not create immediate operational requirements, providers should begin considering how future nationally negotiated arrangements could influence: workforce costs; recruitment and retention; commissioning and fee negotiations; career progression; and long-term financial planning. Leadership Reflection National strategies and regulatory developments provide direction. Their value is determined by whether they improve what happens within organisations. The Workforce Strategy may demonstrate national progress, but providers still need to determine whether staff experience stronger leadership, clearer development opportunities and better professional support. Similarly, CQC's assessment approach reinforces the importance of governance that demonstrates the reality of care rather than simply evidencing completed activity. Leaders should be able to answer one question with confidence: How do we know people are receiving safe, effective and person-centred care today? Inspection readiness should be the outcome of good governance, not the objective. Five Things I'd Be Thinking About This Week Do we have a workforce strategy, or primarily a recruitment plan? Can we identify which services and roles carry the greatest workforce challenge? Does our workforce information lead to meaningful action? Would our day-to-day governance provide CQC with a credible picture of quality? Are we considering how future workforce reforms may affect our organisation over the coming years? Sources This briefing is based on information published by: Skills for Care – Workforce Strategy for Adult Social Care in England. Skills for Care – Workforce Strategy recommendations and commitments. Skills for Care – The State of the Adult Social Care Sector and Workforce in England (or the relevant monthly workforce statistics publication used for workforce figures). Care Quality Commission – Priorities for delivering more assessments and tackling aged ratings. Care Quality Commission – Assessment and evidence guidance for providers. Department of Health and Social Care – Care workers to be represented in Fair Pay Agreements. Department of Health and Social Care – Adult Social Care Negotiating Body public appointment information. Editorial Note This briefing covers significant developments and current sector issues reviewed up to 6 August 2026. The Workforce Strategy two-year progress update forms the principal focus of this edition. The CQC assessment priorities described in this briefing represent the current regulatory position and are included as contextual information rather than new regulatory requirements introduced during this reporting period. The sections headed Why It Matters, Actions for Providers, Leadership Reflection and Five Things I'd Be Thinking About This Week represent the author's professional interpretation of the available evidence. Every effort has been made to ensure factual accuracy at the time of publication. Professional commentary reflects the author's interpretation of published information and should not be regarded as legal or regulatory advice. Looking Ahead Future briefings will monitor: progress against the Workforce Strategy; emerging workforce intelligence; CQC assessment activity and regulatory developments; establishment of the Adult Social Care Negotiating Body; developments relating to Fair Pay Agreements; the forthcoming NMC consultation on the Code and revalidation; and wider policy, workforce and governance developments affecting adult social care. If there is a regulatory update, guidance document or section issue you would like featured in a future edition of the Adult Social Care Briefing, I'd be pleased to hear from you.

Is Your Governance Telling You the Truth? Listen to Episode 1 Most organisations have audits, policies, dashboards and action plans. But are they really providing assurance? In the first episode of Beyond the Audit, I explore why governance is about much more than paperwork. We look at the difference between audit and assurance, the questions every leader should be asking, and why the best governance systems help us understand what is really happening for the people we support. In this episode Why governance is about understanding, not just measuring. The difference between audit and assurance. Four questions that strengthen governance. Why evidence matters more than activity. How better conversations lead to better care. If you enjoyed this episode, follow Beyond the Audit on Spotify and explore more articles and practical insights throughout the Insights section of this website.

Information is everywhere. Insight is much harder to find. We often assume that collecting more information will give us greater assurance. In practice, the opposite is often true. It's a topic I return to time and time again because I continue to see it so often. The organisations I work with don't lack information, but making sense of it all is often the harder part. Most hold huge amounts of information. Incident reports, audits, complaints, safeguarding concerns, quality indicators, workforce data, competency assessments and resident feedback are all collected for good reasons. Individually, each provides a valuable insight into how a service is performing. The problem is that they often exist in isolation. This is where a single source of truth can make a real difference. A single source of truth is not simply one system. It is a way of ensuring that everyone is working from consistent, reliable information that connects across the organisation. It allows leaders to understand not just what is happening, but why it is happening and what it means. In many services, information is still reviewed separately. An increase in falls may be discussed in one meeting, complaints in another, safeguarding elsewhere, and workforce pressures somewhere else entirely. Viewed independently, none of these issues may appear significant. Viewed together, they may all point to the same underlying problem. The same applies across almost every area of governance. Different reports may contain conflicting figures. The same action may appear on multiple trackers. Policies, risk assessments and care documentation may exist in different versions. Training records may show attendance while competency assessments tell a different story. Audits may identify recurring themes that are difficult to track over time because information sits across multiple spreadsheets or systems. On their own, none of these examples are unusual. Most providers will recognise at least some of them. The challenge comes when they begin to combine. Once those pieces are brought together, valuable patterns begin to emerge that are difficult to see in isolation. Emerging risks become easier to identify. Learning can be shared more effectively and resources can be directed where they are most needed. Importantly, leaders spend less time questioning the accuracy of information and more time understanding what it is telling them and then acting on it. Resident voice also becomes far more meaningful when viewed alongside governance information. Numbers tell us what happened. Residents, relatives and colleagues often explain why it happened, how it affected them and what could be improved. Bringing those perspectives together creates a much richer understanding of quality than either could provide alone. A single source of truth is not about removing professional judgement. It is about giving people confidence that the information they are using is accurate, connected and capable of supporting good decisions. As health and social care becomes increasingly complex, more information isn't better information. A single source of truth is about connecting what we already know, so it can be understood, trusted and acted upon Information only matters when it leads to understanding. Understanding only matters when it leads to improvement.

Published: 30 July 2026 A weekly briefing highlighting the key developments affecting adult social care providers The Adult Social Care Briefing is published every Thursday and highlights significant developments affecting adult social care providers. Each edition explains what has changed, why it matters and the practical actions providers may wish to consider. The aim is to provide a concise, practical update that supports governance, leadership and operational decision-making. This Week's Headline This week, the Government signalled that adult social care reform is a central priority. In a speech delivered on 29 July 2026, Prime Minister Andy Burnham outlined plans to accelerate Baroness Casey's independent review of adult social care, alongside the Government's continued ambition to develop a National Care Service and reform the adult social care workforce. The announcement is significant because it sets out the Government's direction of travel. Government Signals Plans to Accelerate Adult Social Care Reform What has changed? On 29 July 2026, Prime Minister Andy Burnham set out the Government's priorities for adult social care reform. The Prime Minister confirmed that: the Government intends to accelerate the work of the independent Casey Commission, chaired by Baroness Louise Casey; the Prime Minister reiterated the Government's ambition to develop a National Care Service; the Government also announced its intention to begin work on reforms to the adult social care workforce, including future consideration of pay, career progression and closer alignment with the NHS workforce; and the Casey Commission has separately announced plans for a national engagement programme, including the Big Conversation on Care, to inform its work. Why it matters Adult social care reform has been debated for many years. This announcement is significant because it confirms that reform has become a stated Government priority. For providers, however, the immediate position remains unchanged. Any practical implications will depend on future Government proposals, consultation and, where required, legislation. Actions for providers Continue delivering safe, effective and person-centred care in line with current legal and regulatory requirements. Monitor announcements from the Government, the Department of Health and Social Care and the Casey Commission. Avoid making decisions based on anticipated reforms until detailed proposals have been published. Continue strengthening governance, quality assurance and workforce oversight using existing organisational priorities. Leadership Reflection While this week's announcement is significant and long overdue, for providers, the priority remains unchanged. Continue delivering safe, effective and person-centred care, maintain effective oversight of quality and risk, and ensure governance arrangements provide assurance that people are receiving the care they need. As further detail emerges, organisations will have opportunities to consider the implications for their own services. Until then, providers should continue working within the current legal and regulatory framework while monitoring official developments. Five Things I'd Be Thinking About This Week Can we demonstrate the quality and outcomes of the care we provide? Do we have a clear understanding of our greatest organisational risks? Are our governance arrangements providing assurance and supporting continuous improvement? Are we monitoring official developments rather than responding to speculation? If reform progresses, can we evidence the impact our services have on the people we support? Sources This briefing is based on information published by: Prime Minister Andy Burnham's speech on adult social care reform, 29 July 2026. Reuters – reporting on the Prime Minister's announcement regarding adult social care reform, published 29 July 2026. Casey Commission – Baroness Casey warns social care reform will fail without public consent, published July 2026. Department of Health and Social Care – published information relating to adult social care reform and the Casey Commission. Editorial Note This briefing covers developments identified between 24 and 30 July 2026. The section headed What has changed reports information published by official and other authoritative sources. The sections headed Why it matters, Actions for providers, Leadership Reflection, Five Things I'd Be Thinking About This Week and Looking Ahead represent professional commentary based on the information available at the time of publication. Looking Ahead Future briefings will monitor: any revised timetable or further publications from the Casey Commission; details of opportunities for people who draw on care and support, providers and the workforce to contribute; formal Government proposals for adult social care reform; any accompanying funding, workforce or commissioning announcements; and any legislation or regulatory changes arising from the reform programme. 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.

Published: 23 July 2026 A weekly briefing highlighting the key developments affecting adult social care providers The Adult Social Care Briefing is published every Thursday and highlights significant developments affecting adult social care providers. Each edition explains what has changed, why it matters and the practical actions providers may wish to consider. The aim is to provide a concise, practical update that supports governance, leadership and operational decision-making. This Week’s Headline This week has brought significant developments in workforce policy alongside changes in political and regulatory leadership. The Government has published its response to the consultation on the adult social care Fair Pay Agreement process and expanded the Care Workforce Pathway to include ten additional role categories. The Care Quality Commission has appointed Emily Miles as its new Chief Executive, while Yvette Cooper MP has been appointed Secretary of State for Health and Social Care. Together, these developments point to a period of change across adult social care. Some establish processes that will affect the sector in future, while others place new leaders in nationally important roles. For providers, the priority is to understand what has been confirmed, consider the potential implications and avoid drawing conclusions before further policy or regulatory announcements are made. Adult Social Care Workforce Reform What has changed? On 16 July 2026, the Department of Health and Social Care published the Government’s response to its consultation on the Fair Pay Agreement process for the adult social care workforce in England. The Government confirmed that an Adult Social Care Negotiating Body will be established as an advisory non-departmental public body operating at arm’s length from ministers. It will be overseen by an independent chair and include equal numbers of worker and employer representatives. Worker representation will be coordinated by the Trades Union Congress, while employer representation will be coordinated by the Care Provider Alliance. The negotiating body’s statutory remit will include pay and terms and conditions. It may also consider wider employment matters, including training, career progression, people and culture policies and additional benefits. The Government’s published timetable states that: regulations will be laid in 2026; the negotiating body, chair and members will be appointed during 2026–27; negotiations for the 2028–29 financial year will begin around April 2027; and the first Fair Pay Agreement will come into effect in April 2028. The maximum funding available to councils to cover increased costs resulting from the first agreement has been set at £500 million for the first year. The detailed pay rates and employment terms have not yet been negotiated. Also on 16 July, the Government expanded the Care Workforce Pathway by adding ten role categories. The pathway now covers 18 categories: 11 direct roles and seven supporting roles. The Government states that it incorporates nearly all adult social care roles that are not regulated health or social-work roles. The new categories are: activity co-ordinator; care technologist; nominated individual; corporate management; learning and development practitioner; quality assurance lead; administration; catering; domestic maintenance. Why it matters The Fair Pay Agreement announcement confirms how the negotiation process will operate, but it does not introduce an immediate requirement for providers to change pay or employment terms. The eventual agreement may have implications for workforce costs, commissioning arrangements, recruitment, retention and service sustainability. Providers should not assume what the final pay settlement will be or whether the £500 million funding envelope will meet every additional cost across the sector. The expanded Care Workforce Pathway provides a national reference point for a broader range of direct-care, leadership, governance and supporting roles. Providers may find it useful when reviewing job descriptions, workforce development, succession planning and career progression. It does not replace providers’ responsibility to define roles clearly and assess whether people are competent to carry out their responsibilities. Actions for providers Consider including the Fair Pay Agreement within medium-term workforce and financial planning, without making assumptions about pay rates that have not yet been negotiated. Review existing roles and job descriptions against the expanded Care Workforce Pathway, including quality, learning and development, administrative and supporting roles. Ensure workforce, operational and financial leaders review these developments together rather than treating them as separate HR matters. New Leadership at CQC What has changed? On 16 July 2026, the Care Quality Commission announced that Emily Miles had been appointed as its Chief Executive. She will join CQC from her role as Director General for Food, Farming and Biosecurity at the Department for Environment, Food and Rural Affairs and is expected to take up the role in the autumn. She previously served as Chief Executive of the Food Standards Agency. CQC’s interim Chief Executive, Dr Arun Chopra, will return to his substantive role as Chief Inspector of Mental Health. Why it matters The appointment comes at an important time for CQC as the organisation continues its programme of improvement following the independent review of its operational effectiveness. For adult social care providers, leadership at CQC matters because it helps shape the organisation’s strategic direction, priorities and relationships with providers over the coming years. While the appointment itself does not change providers’ current regulatory responsibilities, many organisations will be interested to see how CQC’s improvement programme develops under its new Chief Executive. Actions for providers Continue working against current CQC regulations, quality statements and published guidance. Do not delay identified improvement activity while waiting for possible future changes in CQC’s approach. Monitor CQC’s official publications for confirmed developments in its assessment and regulatory processes. New Secretary of State for Health and Social Care What has changed? On 20 July 2026, the Prime Minister’s Office announced that Yvette Cooper MP had been appointed Secretary of State for Health and Social Care. The Secretary of State is responsible for the work of the Department of Health and Social Care, including oversight of social care policy. Before this appointment, Yvette Cooper served as Secretary of State for Foreign, Commonwealth and Development Affairs between September 2025 and July 2026. Why it matters The appointment places a new Secretary of State in the department responsible for adult social care policy. The appointment itself does not confirm any change to adult social care funding, legislation or policy priorities. Its significance for providers will become clearer through future ministerial statements, spending decisions, legislation and official policy publications. Actions for providers Monitor official Department of Health and Social Care announcements for confirmed changes affecting adult social care. Avoid making business or operational decisions based on speculation about future government priorities. Ensure relevant national developments are considered through existing governance, workforce and financial-planning arrangements. Leadership Reflection Reading this week’s developments together, one thing stands out. Adult social care is entering a period of change, but not every announcement creates an immediate requirement for providers. The Fair Pay Agreement now has a confirmed structure and timetable, but the detailed settlement has not yet been negotiated. The Care Workforce Pathway has been expanded, but providers will still need to decide how it can support their own workforce arrangements. CQC and the Department of Health and Social Care have new leaders, but it would be premature to assume what those appointments will mean for future regulation or policy. Effective governance is not about reacting to every headline. It is about understanding what has genuinely changed, identifying what remains uncertain and deciding what proportionate action is required. Five Things I’d Be Thinking About This Week How might the Fair Pay Agreement affect longer-term workforce and financial planning? Do our job descriptions and development arrangements reflect the expanded Care Workforce Pathway? Are supporting roles included in our competency, supervision and succession-planning arrangements? Who is responsible for monitoring confirmed CQC and government developments? Can we demonstrate how national announcements are assessed and translated into proportionate organisational action? Sources This briefing is based on information published by: Department of Health and Social Care – Fair Pay Agreement Process in Adult Social Care: Government Response (updated 16 July 2026). Department of Health and Social Care – Care Workforce Pathway for Adult Social Care (updated 16 July 2026). Care Quality Commission – Emily Miles Appointed Chief Executive of the Care Quality Commission (published 16 July 2026). Prime Minister’s Office, 10 Downing Street – Ministerial Appointments: July 2026 (published 20 July 2026 and updated 22 July 2026). Department of Health and Social Care – Secretary of State for Health and Social Care (checked 23 July 2026). Editorial Note This briefing combines information from official national publications with my commentary on the potential implications for adult social care providers. The factual information is drawn from the sources listed above. The sections headed Why it matters, Actions for providers and Leadership Reflection represent professional interpretation and do not introduce additional statutory or regulatory requirements. It is intended to support governance, leadership and operational decision-making and should be read alongside the original publications. Looking Ahead Next week’s briefing will continue to monitor developments across regulation, workforce, government policy, clinical safety, safeguarding and the wider adult social care sector, highlighting the issues most likely to affect 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.

Published: 16 July 2026 A weekly briefing highlighting the key developments affecting adult social care providers The Adult Social Care Briefing is published every Thursday and highlights significant developments affecting adult social care providers. Each edition explains what has changed, why it matters and the practical actions providers may wish to consider. The aim is to provide a concise, practical update that supports governance, leadership and operational decision-making. This Week's Headline This week has seen two significant national publications that provide valuable insight into the challenges facing adult social care. The Care Quality Commission (CQC) has published a report bringing together findings from its first national programme of local authority assessments, while the Association of Directors of Adult Social Services (ADASS) has published its Spring Survey 2026, reporting continuing financial and operational pressures across adult social care in England. Taken together, these publications provide valuable context for providers, commissioners and leaders seeking to understand the wider pressures affecting adult social care and the environment in which services are delivered. Local Authority Performance What has changed? The Care Quality Commission has published Local Authority Assessments 2023–2026: Emerging Themes and Findings, bringing together learning from its first national programme of local authority assessments under Part 1 of the Care Act 2014. The report identifies recurring themes relating to leadership, safeguarding, prevention, commissioning, partnership working, support for unpaid carers, transitions from children's to adult services and how local authorities deliver their adult social care responsibilities. Why it matters Although the report focuses on local authorities rather than individual providers, it provides valuable insight into the wider system in which providers operate. Many of the themes identified, including partnership working, safeguarding and commissioning, influence the environment in which care providers deliver services and support people. Actions for providers Consider how local authority processes affect the people you support, particularly where assessments, reviews or funding decisions are delayed. Consider adding any risks arising from external organisations to your service risk management processes. Work proactively with commissioners and partner organisations to resolve issues that affect people's experience and continuity of care. Pressures Across Adult Social Care What has changed? The Association of Directors of Adult Social Services (ADASS) has published its Spring Survey 2026, reporting continuing financial and operational pressures across adult social care. The survey reports: Adult social care overspends of £715 million during 2025/26. More than 400,000 people waiting for an assessment, care and support, a direct payment or a review. Continuing financial pressures and increasing demand across adult social care. Why it matters The survey provides important context for providers. While many of these pressures sit outside the direct control of care providers, they influence the wider health and social care system in which services operate. Understanding these wider pressures can help organisations plan proactively, assess organisational risks and prepare for future challenges. Actions for providers Review organisational risks arising from wider system pressures. Ensure business continuity arrangements remain current. Consider how external pressures could affect future workforce planning, occupancy and service delivery. Leadership Reflection Reading this week's publications together, one thing stands out. Much of what influences adult social care sits outside the direct control of providers. Commissioning decisions, increasing demand, pressures on local authorities and wider system challenges all shape the environment in which services operate. That doesn't mean providers are powerless. It means effective leadership is about understanding those pressures, recognising where they may affect the people you support and responding in a way that continues to deliver safe and effective care. Keeping an eye on the wider picture won't remove those challenges, but it can help organisations plan ahead, strengthen relationships with partners and make informed decisions if circumstances change. Which of this week's developments is most likely to influence your organisation over the next 12 months, and how are you preparing for it? Five Things I'd Be Thinking About This Week How might wider system pressures affect the people we support? Are we identifying external risks that could affect the quality of care we provide? Do we have effective working relationships with commissioners and partner organisations? Are we considering how changes outside our organisation may influence future planning? What can we do today to strengthen organisational resilience for the year ahead? Sources This briefing is based on information published by: Care Quality Commission (CQC) – Local Authority Assessments 2023–2026: Emerging Themes and Findings (published 14 July 2026). Association of Directors of Adult Social Services (ADASS) – Spring Survey 2026 (published 15 July 2026). Editorial Note This briefing combines publicly available information from national organisations with my own professional commentary on the potential implications for adult social care providers. It is intended to support governance, leadership and operational decision-making and should be read alongside the original publications. Looking Ahead Next week's briefing will continue to monitor developments across the wider adult social care sector, highlighting the issues most likely to affect 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.

When a medication error is reported, the immediate priority is always the person receiving care. Are they safe? Does the GP, prescriber or emergency services need to be contacted? Has the immediate risk been managed? Have those who need to know been informed? Those first actions are critical because they focus on the person, not the process. Once the immediate risk has been managed, the medication error investigation begins. This is where organisations have the greatest opportunity to learn. It's also where some of the most important questions remain unanswered. The incident is recorded. Notifications are made. The investigation identifies that a medication wasn't administered, the wrong dose was given or a signature was missed. The conclusion often recommends additional training, a reminder to follow the medicines policy or a competency assessment. The investigation is then closed. Sometimes that's the right conclusion. Quite often, it isn't. Sometimes I finish reading an investigation and realise I still don't really know what happened. I know the outcome, but I'm left wondering how the organisation reached its conclusions. Was all the available evidence considered? Were all the people involved spoken with? Were alternative explanations explored? Or did the investigation stop at the first answer that seemed to fit? A completed investigation isn't necessarily a good investigation. Medication errors rarely have a single cause. More often, they're the point at which several factors come together. A member of staff may have been interrupted during the medicines round. A resident may have returned from hospital with multiple medicines changes. The pharmacy may have dispensed the wrong item or supplied medicines late. A prescription may have been amended but not communicated effectively. The MAR or eMAR may not have reflected the most up-to-date information. Documentation may have been incomplete. Several members of staff may have been involved, making it difficult to establish exactly what happened. Sometimes, despite a thorough medication error investigation, it simply isn't possible to identify every detail with certainty. That doesn't mean the investigation has failed. The purpose of an investigation isn't to create certainty where it doesn't exist. It's to understand everything that may have contributed to the incident and identify what needs to change. We often talk about finding the root cause, as though every medication error has one simple explanation waiting to be uncovered. Adult social care rarely works like that. People are living with increasingly complex health conditions. Medication regimes are becoming more complicated. Staff administer medicines while responding to interruptions, supporting residents, answering questions from colleagues and dealing with the unexpected. GPs occasionally make prescribing errors, pharmacies sometimes make dispensing errors, documentation isn't always consistent. Technology removes some risks but introduces others. When several of these factors align, the opportunity for error increases. That's why one of the most important questions isn't, "Who made the mistake?" It's, "What made this mistake possible?" One focuses on an individual; the other focuses on understanding the conditions that allowed the error to happen. Of course, accountability matters, and where practice falls below the expected standard, that should always be addressed fairly and consistently. The difficulty comes when accountability becomes the only outcome. If the investigation ends with identifying the individual involved, there's a real risk the organisation learns very little about why the incident happened in the first place. A learning culture isn't about avoiding difficult conversations or removing personal responsibility. It's about recognising that most incidents have more than one contributing factor. It encourages people to report concerns, near misses and mistakes because they know the organisation wants to understand what happened, not simply decide who was at fault. Near misses are just as important. In many organisations they provide the greatest opportunity to improve because nobody has come to harm. If people don't feel confident reporting them, leaders lose valuable intelligence about where systems are becoming fragile. By the time harm occurs, those warning signs have often been there for some time. A good investigation also looks beyond the immediate incident. Has something similar happened before? Is this becoming a pattern? Are certain medicines, times of day or processes involved more frequently? Were previous actions actually effective? Could the resident or their family help explain what happened? Has learning been shared across the organisation, or has it remained within one service? Assurance isn't demonstrated by the number of investigations completed. It's demonstrated by being able to show that investigations have improved practice, reduced risk and strengthened the systems designed to keep people safe. The quality of a medicines investigation often tells you as much about an organisation as the medication error itself. It tells you whether people feel able to speak up, whether leaders are curious enough to ask difficult questions and whether learning is genuinely embedded in everyday practice. Good investigations don't just explain the past. They help prevent the next incident. Every medication error deserves to be taken seriously. Not because every error causes harm. Not because someone always needs to be blamed. But because every error tells us something about the way an organisation works. The next time a medication error is discussed in your governance meeting, don't just ask what happened. Ask what the incident is trying to tell you about your organisation.

Published: 9 July 2026 A weekly briefing highlighting the key developments affecting adult social care providers The Adult Social Care Briefing is published every Thursday and highlights significant developments affecting adult social care providers. Each edition explains what has changed, why it matters and the practical actions providers may wish to consider. The aim is to provide a concise, practical update that supports governance, leadership and operational decision-making. This Week's Headline This week's published developments highlight continuing themes around workforce wellbeing, restrictive practice and organisational oversight. Although these updates originate from different national organisations, together they provide useful insight into current issues affecting adult social care and the importance of effective governance, leadership and person-centred care. This briefing summarises the week's developments together with professional commentary on their potential implications for adult social care providers. Workforce Wellbeing and Leadership What has changed? The Department of Health and Social Care has published the findings from the second Adult Social Care Workforce Survey, undertaken in England between August and October 2025. Care England has also published a summary of the findings for providers. The survey highlights issues relating to workforce wellbeing, experiences of violence and abuse, staff retention and delegated clinical activities undertaken by care staff. Why it matters The findings reinforce the importance of supporting and retaining the adult social care workforce. Providers may wish to consider workforce wellbeing alongside quality and safety information when reviewing organisational performance and identifying opportunities for improvement. Actions for providers Review workforce wellbeing alongside quality and safety indicators. Monitor trends in turnover, sickness absence and agency use. Ensure delegated clinical activities are supported by appropriate competency assessment, supervision and governance arrangements. Safeguarding and Restrictive Practice What has changed? The Care Quality Commission has published its Independent Care (Education) and Treatment Reviews (IC(E)TRs) Annual Report 2024–2025, highlighting the contribution of independent reviews in supporting people with learning disabilities and autistic people to move away from long-term segregation where appropriate. Why it matters The report highlights the importance of person-centred care, regular review, advocacy and ensuring restrictive practices remain lawful, proportionate and subject to ongoing review. Providers may also wish to consider how safeguarding, Mental Capacity Act practice and restrictive interventions are reviewed through existing governance arrangements. Actions for providers Review restrictive practice arrangements. Ensure best-interest decisions remain current and appropriately documented. Check advocacy arrangements are effective and people's views are reflected in decision-making. Governance and Assurance What has changed? Taken together, this week's publications demonstrate the value of reviewing information from different sources when assessing service quality and organisational performance. Why it matters No single dataset provides a complete picture of quality. Complaints, incidents, safeguarding concerns, workforce information, audit findings and feedback from people using services can all contribute to organisational assurance. Considering these sources together may help providers identify emerging risks, monitor improvement activity and strengthen governance arrangements. Actions for providers Review complaints, incidents, safeguarding concerns and workforce information for emerging themes. Ensure governance reports identify trends as well as individual events. Check that improvement plans include evidence of measurable outcomes and ongoing review. Governance Question of the Week Can your organisation demonstrate how information from incidents, safeguarding, workforce data, audits and feedback is used to identify emerging risks and support continuous improvement? Five Actions for Providers This Week Review workforce wellbeing alongside governance and quality information. Check oversight of delegated clinical activities and competency assessments. Review restrictive practice, Mental Capacity Act and advocacy arrangements. Consider whether governance reports effectively triangulate information from multiple sources. Discuss this week's developments at your next governance or quality meeting and record any agreed actions. Sources This briefing is based on information published by: Department of Health and Social Care (DHSC) – Work-related Quality of Life of the Adult Social Care Workforce in England in 2025 (published 2 July 2026). Care England – What the New Adult Social Care Workforce Survey Means for You (published 3 July 2026). Care Quality Commission (CQC) – Independent Care (Education) and Treatment Reviews (IC(E)TRs) Annual Report 2024–2025. Department of Health and Social Care (DHSC) – Announcement of new NHS staff standards to tackle racism, violence and sexual harassment (published 6 July 2026). While this announcement applies to NHS organisations, it reflects the wider focus on workforce culture, staff safety and organisational leadership across health and care. National Institute for Health and Care Excellence (NICE) – Adult Social Care Guidance and Quality Standards. This briefing summarises publicly available information together with professional commentary on the potential implications for adult social care providers. Readers should refer to the original publications for the full detail and any subsequent updates. Looking Ahead Next week's briefing will review the most significant developments affecting adult social care providers and consider the practical implications for governance, regulation, workforce, safeguarding and quality. 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.