Inside CQC: Supported Living and Integrated Care Systems

Debbie Ivanova, Director for People with a Learning Disability and Autistic People at the CQC, updates on Supported Living and Integrated Care Systems.

A year ago, we published our new strategy. We set out our ambitions under four themes, with people and communities at the fore, so now feels a good time to see how things have developed.

Sadly, our update to the review of restrictive practice, ‘Out of Sight, Who Cares?’, sits amid a growing number of publications, including ‘Safeguarding Adult Reviews’ and the ‘Learning from Deaths of People with a Learning Disability (LeDeR)’ programme, that highlight how the needs of people with a learning disability and autistic people are not being met. Too many times, people are not getting access to the right care.

Whilst we acknowledge providers are delivering good and outstanding care, we continue to expose poor practice and want to see improvements in quality of care in supported living. The model of care we’re looking for across all sectors is described in ‘Right Support, Right Care, Right Culture’, ensuring people’s needs always frame the support and care given. We will not register services unless they meet this model and will protect people and communities through our regulatory remit. This year, we have made 167 enforcement decisions, including cancellation, imposing positive conditions and restricting admissions – a 25% increase on 2021.

Supported Living

The Supported Living Improvement Coalition is led by people with experience of supported living services. Established in response to our increasing concerns about the variation in people’s experience of supported living services, the coalition meets regularly to explore key themes and understand what can be done to improve services. The actions are taken forward by providers, local authorities, housing associations and other key partners. The coalition’s themes for future work are:

  • Citizenship and community.
  • Ensuring and protecting people’s rights.
  • Person-centred choice and control.
  • The importance of good partnership working to create a supportive system.

They told us what good support and care looks like: ‘It starts with the person and working out what they need and want; building a plan around their needs and aspirations, the choice to live alone, supporting people to have a life, to be connected, to grow, to develop … whatever the person needs and what is right for them.’

By year end, we want the coalition to be led independently from the CQC, by the very people who are part of it. I encourage you to join the group. The coalition is open to people like you, from advocacy groups, care providers, clinical commissioning groups, local authorities and housing developers – you can join or advocate with consent, on behalf of someone who has experience of supported living. Email SupportedLivingImprovementCoalition@cqc.org.uk to get involved.

ICS and Local Authority Assurance

The needs of people, including those with a learning disability and autistic people, will be central to how we review local authorities’ provision of social care, and to our assessment of Integrated Care Systems, starting from April 2023. We are developing and testing our approach in collaboration with local authorities, system leaders, providers and people who use services. In spring, we ran co-production workshops to inform and influence our approach. Recently, a follow-up session shared the themes from those workshops and how we’re responding. Watch this on our YouTube channel, where we also outline the current thinking in our approach and you can see a briefing.

The collective action of all of us connected to adult social care – people who use services, families and carers, providers and commissioners, and CQC in our regulatory role – will bring about the greatest improvements for people with disabilities and autistic people. To collaborate, join our co-production events, share feedback on Citizen Lab and keep up to date with our regulatory model on our YouTube channel, which includes accessible podcasts. There is more work for us to do to ensure every person has the care they deserve, tailored to their needs.


Debbie Ivanova is Director for People with a Learning Disability and Autistic People at the Care Quality Commission. Twitter: @CQCProf

About Debbie Ivanova

Debbie Ivanova is Director for People with a Learning Disability and Autistic People at the Care Quality Commission.

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Inside CQC: Update on regulatory activity

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