Consultation on code of practice on quality, concerns and closure of care and support services

The Social Services and Well-being (Wales) Act 2014 (the 2014 act) gives the Welsh Ministers the power under section 145 to issue codes of practice requiring local authorities to act in accordance with requirements in the code of practice when exercising their social services functions. Local authorities must also have regard to any guidance set out in the code of practice.

Section 169 of the 2014 act and sections 2,12 and 19 of the National Health Service (Wales) Act 2006 (the 2006 act) give the Welsh Ministers the power to issue guidance to local health boards and NHS trusts. Local health boards and NHS Trusts will be directed to exercise their relevant functions in accordance with the requirements contained within the code of practice.

Commissioning social care services to meet the care and support needs of the eligible local population is a local authority social services function. The National Framework for the Commissioning of Care and Support in Wales code of practice came into force on 1 September 2024 and applies to the commissioning of care and support services by local authorities, local health boards and NHS trusts in Wales. It lays out principles and standards for commissioning practices and contracting arrangements, including appropriate monitoring mechanisms to enable statutory partners to assure themselves of compliance.

The Welsh Government has worked with Commissioning Care Wales (CCW) and sector stakeholders to develop a 'Code of practice on quality assurance and performance management, escalating concerns, and closure of regulated care and support services'. It is complementary to the National Framework and focusses on care and support services regulated under the 2016 act. It replaces the statutory guidance on ‘Escalating concerns with, and closures of care homes providing services for adults’ issued in 2009.

As Minister for Children and Social Care, I want all regulated care and support services provided in Wales to be of the highest quality, to be focussed on improvement, and to provide the best possible outcomes for the adults and children benefiting from those services. These services, wherever they are provided, are essential in ensuring that people have the care and support they need in an environment which understands their needs, supports their well-being and helps them to achieve their personal outcomes.

We all have role to play in making that aspiration a reality – whether at national or local government level, as regulators, and, of course as providers of these vital services.

Local authorities and NHS bodies commission regulated care and support services to meet the needs of adults and children in their local areas. In doing so they have a responsibility to assure the quality of the regulated services they commission and to performance manage them effectively and proportionately.

The proposed code of practice which we are consulting on encourages an approach which is focussed on outcomes for people, working collaboratively, and a culture of learning and improvement. It aims to achieve greater consistency of practice across Wales.

I look forward to receiving your views.

Dawn Bowden MS
Minister for Children and Social Care

This public consultation seeks views on the draft 'Code of practice on quality assurance and performance management, escalating concerns, and closure of regulated care and support services' (the draft code). Local authorities are both service providers and commissioners of regulated care and support services. Local authorities also undertake collaborative, joint, or integrated commissioning with local health boards and NHS trusts in Wales.

Local health boards and NHS trusts commission regulated care and support services and may provide regulated care and support services such as care homes with nursing, and domiciliary support services.

For the purposes of the draft code, local authorities, local health boards and NHS trusts are referred to as "Commissioners".

In the draft code a requirement is expressed as “must” or “must not”. Guidance, where local authorities have discretion, is expressed as “may” or “should” or “should not”.

To ensure that the code of practice has comparable force in relation to local authorities, local health boards and NHS trusts, the Welsh Ministers will direct local health boards and NHS trusts in Wales under the 2006 act to exercise their relevant functions in accordance with the requirements contained in the code.

The draft code will be supported by a toolkit comprising good practice templates and examples. Many of the templates have been adapted from those developed by stakeholders for local use. The toolkit will be accessed via the National Framework for the Commissioning of Care and Support community hub and will be maintained by the National Office for Care and Support. The toolkit is not part of this public consultation.

This section of the draft code highlights the importance of a system-wide way of working focussing on outcomes for people when assuring the quality of commissioned services. It confirms the importance of quality assurance within a wider quality management system and a culture of continuous learning and improvement.

It describes an effective quality management cycle. It states the importance of working collaboratively with service providers and other stakeholders to ensure the quality of commissioned regulated care and support services.

It provides guidance on contractual documentation. It encourages commissioners to work proactively to assure the quality of commissioned regulated services to prevent the unnecessary instigation of escalating concerns. It includes requirements to have effective processes in place to gather, record and review stakeholder feedback and to assess risks posed to the well-being and safety of individuals using the service.

It sets out an approach to improvement action where this is required including the role of service providers in this process. This section of the draft code includes an example quality assurance and decision process in annex A.

This section of the draft code provides guidance on the criteria for escalating concerns as well as the structure and processes that should be in place to manage and make decisions about escalating concerns. The focus is on improving the quality of the regulated care and support service and safeguarding individuals and, where possible, preventing avoidable service closure or decommissioning (contract termination). It includes information on suspension of placements. It includes an example escalating concerns process in annex B.

This section of the draft code deals with decommissioning, which in this context is defined as “the withdrawal from or closure of an internal or external service and funding arrangement by ceasing payment of grants or the ending of a contract or service level agreement”.

The draft code describes the circumstances in which decommissioning may be considered appropriate. It focuses on the importance of ensuring continuity of service to meet people’s needs, maintaining the skills, experience and knowledge of the workforce, communication and notifications. It includes an example of a decommissioning flowchart in annex C.

This section of the draft code deals with the closure of regulated care and support services which may be voluntary or enforced. Closures may arise because a service provider has voluntarily decided to close one or more of its services or exit the market entirely. Alternatively, the closure may be due to enforcement action by Care Inspectorate Wales or other regulators (including the Health and Safety Executive), financial viability, or a crisis or emergency beyond the service provider’s control.

The draft code sets out the recommended structures and arrangements to be put into place as well as emphasising the need for clear roles and responsibilities and effective communication to manage and support the safe closure of a regulated service. It includes an example of a closure flowchart in annex D.

Question 1

To what extent do you agree or disagree with the requirements placed on local authorities, local health boards and NHS trusts within the quality management and performance management section of the code of practice? 

Question 2

To what extent do you agree or disagree with the requirements placed on local authorities, local health boards and NHS trusts within the escalating concerns section of the code of practice? 

Question 3

To what extent do you agree or disagree with the requirements placed on local authorities, local health boards and NHS trusts within the decommissioning section of the code of practice? 

Question 4

To what extent do you agree or disagree with the requirements placed on local authorities, local health boards and NHS trusts within the closure of regulated services section of the code of practice?

Question 5

We would like to know your views on the effects the draft 'Code of practice on quality assurance and performance management, escalating concerns, and closure of regulated care and support services' would have on the Welsh language, specifically on opportunities for people to use Welsh and on treating the Welsh language no less favourably than English.

What effects, if any, do you think there would be on the Welsh language? How could positive effects be increased, or negative effects be mitigated?

Question 6

How do you believe the draft 'Code of practice on quality assurance and performance management, escalating concerns, and closure of regulated care and support services' could be formulated or changed so as to have positive effects or increased positive effects on opportunities for people to use the Welsh Language? 

Question 7

Do you have any related issues which have not been addressed in this consultation?

Please submit your responses by 30 June 2025, in any of the following ways:

• complete our online form
• download, complete our response form and email CareHomeTeam@gov.wales
• download, complete our response form and post to:

Care Home Team
Social Services Improvement Division
Welsh Government
Cathays Park
Cardiff
CF10 3NQ

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Data Protection Officer

Data Protection Officer
Welsh Government
Cathays Park
Cardiff
CF10 3NQ

Email: data.protectionofficer@gov.wales

Information Commissioner’s Office

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The Welsh Government will be data controller for any personal data you provide as part of your response to the consultation. Welsh ministers have statutory powers they will rely on to process this personal data which will enable them to make informed decisions about how they exercise their public functions. Any response you send us will be seen in full by Welsh Government staff dealing with the issues which this consultation is about or planning future consultations. Where the Welsh Government undertakes further analysis of consultation responses then this work may be commissioned to be carried out by an accredited third party (e.g. a research organisation or a consultancy company). Any such work will only be undertaken under contract. Welsh Government’s standard terms and conditions for such contracts set out strict requirements for the processing and safekeeping of personal data. In order to show that the consultation was carried out properly, the Welsh Government intends to publish a summary of the responses to this document. We may also publish responses in full. Normally, the name and address (or part of the address) of the person or organisation who sent the response are published with the response. If you do not want your name or address published, please tell us this in writing when you send your response. We will then redact them before publishing.

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Number: WG51604

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