The examples below provide insight into how other Good or Outstanding rated services are succeeding in this area of inspection.
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Supporting independence through positive risk-taking
The service extended positive risk management beyond the home, enabling people to access meaningful opportunities in their local community while gradually building their independence. Staff used innovative, person-centred approaches to help people achieve goals that mattered to them, creating sustainable opportunities rather than one-off experiences. In one example, staff worked in genuine co-production with a person using pictorial prompts, accessible communication and their detailed knowledge of the individual's preferences to develop a personalised risk management plan. Together with the person's family and professionals, they focused on what was important to the individual rather than the risks alone. As a result, the person was able to access the local community independently, demonstrating how positive risk-taking can enable people to live the life they choose safely and confidently.
Read more about this service here.
Care provider: Catherine Tam Agency
Date published: July 2026
Using technology to promote safety
The service used technology alongside personalised care planning to reduce risks while maintaining people's independence. Movement sensors were used in ways that reflected individual needs, alerting staff when someone got out of bed or a chair, crossed the threshold of their bedroom or opened a door. This enabled staff to respond promptly when support was needed without unnecessarily restricting people's freedom. Relatives understood how the equipment helped keep their family members safe, with one explaining, "My relative has a sensor by the bed; if they get up, the alarm goes off." The service also made timely referrals to external professionals when additional equipment or specialist advice was needed, ensuring people received the right support to remain safe.
Read more about the service here.
Care provider: Brook House Care Home
Date published: July 2026
Building independence through small, achievable goals
Keyworkers supported people to achieve their goals by breaking them down into small, manageable steps that enabled risks to be addressed gradually and safely. This personalised, strengths-based approach helped people build confidence at a pace that was right for them while maintaining appropriate safeguards. As a result, people achieved meaningful milestones, including taking part in new community activities, developing independent living skills and reconnecting with important family routines. By focusing on gradual progress rather than limitations, the service empowered people to increase their independence and achieve outcomes that mattered to them.
Read more about this service here.
Care provider: The Old Orchard
Date published: June 2026
Risk assessed, person centred distress support
Staff demonstrated they were aware of people’s individual needs and helped ensure people were safe. They told us that risk assessments provided guidance on what action they should take to reduce risks and maintain people’s safety. Staff were encouraged to report new risks so that appropriate action could be taken to ensure the safety of people. A staff member told us, “We keep people safe without taking away their independence, there are tasks that some people like to do for themselves.”
Effective systems were in place to ensure risks to people’s health and safety were assessed and person-centred care plans were implemented. People assessed as needing a specific number of staff to support them safely received this level of support. Where required, care plans included guidance and strategies for staff on people’s individual warning signs and how to manage distress in a person-centred way. For example, staff were guided to use distraction and redirection strategies to support a person who experienced distress.
Read more about this service here.
Care provider: Goldcrest Healthcare Service (Birmingham)
Date published: November 2024
Positive risk taking with personalised care
People were empowered to take positive risks, to ensure they had greater choice and control of their lives. The positive risk-taking approach demonstrated by the service showed they respected people's right for independence and their right to take risks.
The registered manager told us about 1 person with swallowing difficulties who had been advised to eat a soft diet only. However, the person, who had capacity to make decisions for themselves had wanted to continue to eat the foods they enjoyed. To ensure the person was able to do this safely all relevant professionals were made aware of the persons choice and control measures were put in place to reduce the risk of choking.
To ensure the person’s voice continued to be heard a consistent live-in care team was put in place so that staff could build trusting relationships and understand the persons needs fully. The staff team for this person completed relevant training in areas that were vital to supporting them to stay safe. This meant the person was able to stay at home with their family. The registered manager commented, “Investing in our team’s learning and development is invaluable. It allows us to offer comprehensive healthcare services, supporting clients like [person] to remain in their homes and participate in family life. The ongoing collaboration with specialist teams and continuous training ensures that our staff are well-equipped to meet the evolving needs of our clients and the future of providing healthcare at home services.”
Read more about this service here.
Care provider: Beda Homecare Ltd trading as Home Instead Bedford
Date published: October 2024
Collaborative, positive risk assessments
The registered manager had completed detailed risk assessments covering the areas of risk people may face and putting measures in place to mitigate those risks as far as possible. There was a focus on supporting people to take risks in a positive way fully enabling them to be independent and make their own choices. These risk assessments gave guidance for staff to help people keep people safe whilst supporting them in a positive way to do what they wanted to do.
Staff were fully aware of the risks people faced and knew how to support them in the safest way possible. Staff told us the registered manager updated risk assessments based on their feedback and what they felt worked well for people. People and their relatives were regularly involved in discussions about care plans and risk assessments. One relative said, ‘‘We always have discussions about how staff can help [family member] be safe and the risk assessments are very thorough.’’
Read more about this service here.
Care provider: The Limes
Date published: August 2024
Proactive, Person-Centred Risk Management
The service assessed potential risks to people to ensure adequate support was in place to maintain their safety. Staff had access to detailed risk assessments and management plans which provided guidance on the level of support each person required to remain safe. The service had adopted a proportionate and balanced approach to risk management and respected the choices people made about their care and support. People and their relatives confirmed the service involved them in completing risk management plans and staff supported them to safely manage risks.
Staff were knowledgeable about individual risks and how to support people. Staff told us of potential risks and the level of support each person required to maintain safety. Staff said for example, the service in partnership with health and social care professions implemented continuous monitoring to manage a risk of falling to promote safety for one person. However, for another person, who displayed behaviours that challenged the service, the service had reduced their closed monitoring due to a successful positive behaviour support approach in place. A staff member informed us, they used distractive methods to support one person who displayed both verbal and physical behaviours that challenge staff to ensure they were calm and happy before supporting them with personal care. Staff involved people in managing everyday risks such as when accessing the local community in crossing roads and within the home environment including washing of dishes in the kitchen.
Read more about this service here.
Care provider: The Drive
Date published: May 2024
Individual risk assessments documented; acoustic monitoring
People’s care and clinical records included information around individual risks and support staff needed to provide. For example, risks around mobility, falls and equipment use, skin integrity, health conditions, eating and drinking were assessed. The service used an acoustic monitoring system which was effective in minimising disturbance for people during welfare checks, especially at night, but also helped staff to offer assistance when needed to reduce the risk of falls.
Read more about this service here.
Care provider: Kingsbury Court
Date published: December 2023
Using an internal team of positive behaviour specialists
The provider had employed an internal team of positive behaviour specialists that worked closely with people and their families to ensure support was safe and achieved excellent outcomes for people.
For example, people had dramatically increased their day to day freedoms, by staff understanding the purpose of behaviours and supporting people to communicate any distress in different ways. Senior managers and leaders continued to be visible in settings and staff were confident they could speak to any leaders about any ideas or concerns.
The CQC received excellent feedback from people and relatives about the support provided. Where any concerns were raised these had been addressed openly and positively by leaders through engaging with people and relatives.
Read more about this service here.
Care provider: Avenues South East
Date published: November 2022
Working closely to manage risks around consensual relationships
Areas of vulnerability were identified and carefully assessed on an individual basis. Supportive and sensitive work was undertaken by carers and staff to support people to increase their awareness, knowledge and safety skills.
When a person told their carer they would like to have an intimate personal relationship in future, the carer undertook regular work with the person to help them understand about consent and consensual relationships, to help reduce the risk of the person's vulnerability being exploited and reduce the risk of potential abuse.
Care provider: Shared Lives Service - West Northamptonshire Council
Date published: November 2022
Technologies to build confidence when travelling independently
In their inspection, the CQC saw numerous examples of people using public transport with assistive technology to help them remain safe. This included technology to summon assistance if needed, to track people's location with their agreement and examples of arrangements for people to build confidence by travelling independently and being met at their destination. This meant people had more freedom and independence whilst remaining safe at all times.
Care provider: Shared Lives Service - West Northamptonshire Council
Date published: November 2022
Using NICE guidance to manage risks
This service implemented specialised risk assessments based on NICE guidance for oral health, falls, pressure ulcers, diabetes, epilepsy and more. Implementing the people's experience in adult social care services guidance also supported risk assessments to be person-centred, recognising each person individually.
See also: NICE social care quick guides
Improving oral health for adults in care homes
Helping to prevent pressure ulcers
Care provider: Anonymous
Date published: January 2022
How we developed Positive behavioural support skills
In this three-minute audio clip from the Care Exchange podcast, Joseph Hughes explains how they identified the appropriate training and developed expertise.
You can listen to the full podcast here and access our latest episodes of The Care Exchange here.
You can read more about this service here.
Care provider: City Care Partnership
Date published: March 2021