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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Working with External Providers and Agencies Policy

1. Purpose

The purpose of this policy is to establish a structured, collaborative, and efficient approach to working with external providers and agencies in home care. {{org_field_name}} is committed to ensuring that all third-party collaborations enhance the quality of care, maintain regulatory compliance, and prioritise service user safety, dignity, and well-being. This policy also makes clear that the use of external providers does not remove {{org_field_name}}’s responsibility for oversight, quality assurance, safe coordination of care and compliance with the Fundamental Standards.

This policy sets out the processes, standards, and responsibilities required when engaging with external healthcare professionals, specialist service providers, contractors, and partner organisations to deliver seamless, high-quality care in service users’ homes.

2. Scope

This policy applies to:

• All employees, including care staff, care coordinators, and management.
• External providers, including healthcare professionals, specialist therapy services, equipment suppliers, and social care agencies.
• Service users and their families, ensuring informed decision-making and seamless service integration.
• Regulatory bodies, ensuring full compliance with statutory guidelines and Care Quality Commission (CQC) Fundamental Standards.

It covers:

• Establishing agreements with external providers.
• Standards and expectations for external agencies.
• Roles and responsibilities in collaborative care delivery.
• Information sharing, confidentiality, and data protection.
• Quality assurance and monitoring.
• Conflict resolution and safeguarding measures.

• Due diligence and approval of external providers.
• Allocation of accountability where care is shared, delegated or transferred.
• Incident reporting, duty of candour and safeguarding escalation involving external providers.
• Complaints handling and dispute resolution involving partner organisations.
• Risk assessment, contingency arrangements and service continuity.
• Audit trails, documentation and governance oversight.

3. Legal and Regulatory Framework

This policy is to be read alongside the following legislation, regulations and guidance, as amended from time to time:

• Health and Social Care Act 2008.
• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in particular:
  • Regulation 9 – Person-centred care
  • Regulation 10 – Dignity and respect
  • Regulation 11 – Need for consent
  • Regulation 12 – Safe care and treatment
  • Regulation 13 – Safeguarding service users from abuse and improper treatment
  • Regulation 16 – Receiving and acting on complaints
  • Regulation 17 – Good governance
  • Regulation 18 – Staffing
  • Regulation 19 – Fit and proper persons employed
  • Regulation 20 – Duty of candour
• Care Quality Commission (Registration) Regulations 2009, including requirements relating to notifications and statement of purpose where relevant.
• Care Act 2014, including duties relating to wellbeing, cooperation, integration and adult safeguarding.
• Mental Capacity Act 2005 and associated Code of Practice, where decisions about care, treatment, information sharing or best interests arise.
• UK GDPR and the Data Protection Act 2018.
• Equality Act 2010.
• Safeguarding Vulnerable Groups Act 2006.
• Human Rights Act 1998.
• Current CQC guidance on the Fundamental Standards and CQC assessment framework.

{{org_field_name}} recognises that the use of external providers, agencies and partner organisations does not remove or reduce the registered provider’s legal duty to ensure that people receive safe, person-centred, coordinated and high-quality care. Where care or support is arranged, shared, delegated or delivered with another organisation or professional, {{org_field_name}} remains responsible for maintaining oversight, assessing risks, sharing information appropriately, responding to concerns, and taking timely action where standards are not met.

4. Establishing Agreements with External Providers

Before entering into any arrangement with an external provider, agency, contractor or partner organisation, {{org_field_name}} will complete and record a due diligence assessment proportionate to the nature, risk and scope of the services to be provided.

The due diligence process will include, where applicable:

• confirmation of the provider’s legal identity, contact details and relevant business status;
• confirmation of CQC registration status, regulated activity status, or other relevant regulatory/professional registration where required;
• verification of professional qualifications, registrations, competencies and experience relevant to the service being delivered;
• confirmation of safer recruitment arrangements, including DBS status where required by role;
• review of safeguarding arrangements, whistleblowing arrangements, complaints arrangements and incident reporting processes;
• review of insurance cover, including public liability, employer’s liability and professional indemnity where applicable;
• review of policies relevant to the service, including safeguarding, medicines, infection prevention and control, information governance, consent, equality and risk management;
• confirmation that staff supplied are suitably trained, supervised and competent for the tasks delegated or commissioned;
• assessment of capacity, reliability, business continuity and contingency arrangements;
• confirmation of arrangements for communication, escalation, record keeping, handover, and emergency response.

A written agreement, contract or service level agreement must be in place before services commence, unless there is a documented emergency justification authorised by a senior manager. The agreement must clearly set out:

• the scope of services to be provided;
• roles, responsibilities and lines of accountability;
• standards of care and expected outcomes;
• requirements relating to person-centred care, dignity, consent, safeguarding and confidentiality;
• requirements for timely information sharing, record keeping and reporting;
• requirements for incident reporting, notifiable safety incidents and duty of candour cooperation;
• escalation arrangements for urgent concerns, deterioration, missed visits, medication concerns, equipment failure, safeguarding concerns or service failure;
• monitoring, review and audit arrangements;
• arrangements for complaint handling and cooperation with investigations;
• termination, suspension and contingency arrangements where standards are not met.

No external arrangement will be approved unless {{org_field_name}} is satisfied that the external provider can support compliance with the Fundamental Standards and can deliver care safely, consistently and in a manner that respects the rights, preferences and wellbeing of the service user.

5. Standards and Expectations for External Agencies

All external providers and agencies engaged by or working alongside {{org_field_name}} must:

• deliver services in a way that supports compliance with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the CQC Fundamental Standards;
• provide care and support that is safe, person-centred, dignified, respectful and responsive to individual needs;
• work in partnership with {{org_field_name}}, the service user, families where appropriate, and other relevant professionals to support continuity and coordination of care;
• maintain clear, accurate, contemporaneous and secure records of all care, treatment, interventions, contacts, concerns and escalations;
• communicate promptly any change in the service user’s needs, condition, risks, capacity, wellbeing or presentation;
• report accidents, incidents, near misses, safeguarding concerns, complaints and service failures without delay and cooperate fully with investigations;
• comply with lawful information-sharing requirements, confidentiality duties and data protection law;
• ensure that staff deployed are suitably recruited, trained, supervised, competent and fit for the role they perform;
• follow agreed procedures for medicines, infection prevention and control, moving and handling, lone working, emergency response and business continuity where relevant;
• cooperate with audits, quality checks, competency reviews, meetings, reviews and service investigations conducted by {{org_field_name}} or relevant authorities;
• raise concerns immediately where they believe a service user may be at risk of harm, neglect, abuse, discrimination, unsafe care or avoidable deterioration.

Failure to meet these requirements may result in additional monitoring, corrective action, suspension of referrals, safeguarding escalation, contractual action or termination of the arrangement.

6. Roles and Responsibilities in Collaborative Care Delivery

{{org_field_name}}’s responsibilities

{{org_field_name}} will:

• ensure that any external involvement is assessed, planned and documented in a way that supports safe, coordinated, person-centred care;
• ensure the service user, and where appropriate their representative, understands the role of the external provider and any impact on care delivery;
• maintain oversight of all externally supported or jointly delivered care arrangements;
• ensure care plans, risk assessments and communication records clearly identify who is responsible for each aspect of care;
• monitor the quality, reliability and safety of services delivered by external providers;
• take timely action where concerns arise, including escalation, review, safeguarding referral, temporary suspension or termination of the arrangement;
• ensure lessons are learned from incidents, complaints, concerns and service failures;
• keep clear records of decisions, approvals, reviews, incidents and actions relating to external providers.

Managers and supervisors

Managers and delegated supervisors will:

• approve external provider arrangements only after due diligence is complete;
• ensure staff understand the agreed interface between internal and external responsibilities;
• review performance, incidents, complaints and feedback relating to the external provider;
• ensure concerns are escalated in line with this policy and other relevant organisational procedures.

Employees and care staff

Employees must:

• work cooperatively and professionally with external providers while maintaining professional boundaries;
• share relevant information accurately and promptly in accordance with agreed procedures;
• report any concern about competence, conduct, delays, missed care, unsafe practice, communication failures or poor outcomes involving an external provider;
• not assume that an external provider has taken action unless that action has been confirmed and recorded where appropriate.

External provider responsibilities

External providers must:

• operate within their competence, contractual remit and legal/professional responsibilities;
• provide timely reports, handovers and updates;
• escalate concerns immediately;
• cooperate with reviews, audits, investigations and safeguarding processes.

Service user and family involvement

Service users must, wherever possible, be involved in decisions about external support, referrals, joint working, information sharing and changes to care arrangements. Their wishes, preferences, communication needs, equality needs, protected characteristics, cultural needs and desired outcomes must be respected.

7. Information Sharing, Confidentiality, and Data Protection

{{org_field_name}} will ensure that information shared with external providers is relevant, necessary, accurate, timely, secure and proportionate to the purpose for which it is shared.

Information may be shared with external providers where:

• the service user has given valid consent; and/or
• there is another lawful basis under UK GDPR and the Data Protection Act 2018; and/or
• sharing is necessary to protect the vital interests, safety or welfare of the service user or another person; and/or
• sharing is required for safeguarding, legal, regulatory or professional reasons.

Where there is doubt about a person’s capacity to consent to information sharing or decisions about external involvement, staff must act in line with the Mental Capacity Act 2005 and any best-interests decision-making process.

The following controls must be in place where relevant:

• an information sharing agreement or contractual confidentiality clause;
• clear specification of what information may be shared, with whom, for what purpose, and by what method;
• secure systems for transfer, storage and access to records;
• role-based access to confidential information;
• clear arrangements for reporting data breaches, confidentiality breaches or cyber incidents;
• periodic review and audit of information-sharing practice.

Staff must record significant information-sharing decisions, including the rationale for sharing without consent where this is lawful and necessary.

8. Quality Assurance and Monitoring

{{org_field_name}} will maintain effective governance systems to assess, monitor and improve the quality and safety of services delivered by external providers and agencies.

Monitoring arrangements will include, where relevant:

• initial and periodic due diligence review;
• review of incidents, accidents, safeguarding concerns and near misses;
• review of complaints, compliments and service user feedback;
• review of missed visits, late visits, communication failures and handover issues;
• review of competency, training compliance and professional registration status where relevant;
• review of records, care documentation and information-sharing quality;
• contract review meetings, case review meetings and multidisciplinary discussions;
• trend analysis to identify recurring themes, risks or learning;
• action plans, follow-up checks and escalation where concerns are identified.

The findings of monitoring activity must be documented and reported through the organisation’s governance processes. Where concerns are identified, {{org_field_name}} will specify required improvements, timescales, responsible persons and review dates. Persistent or serious non-compliance may result in suspension of work, safeguarding escalation, referral to relevant authorities or termination of the agreement.

8.1 Risk Assessment, Continuity and Contingency Planning

Where external providers contribute to the delivery of care, {{org_field_name}} will assess the risks associated with reliance on that provider, including missed visits, delayed response, communication breakdown, equipment failure, workforce shortages, transport problems, medication delays, digital failure and emergency unavailability.

For higher-risk arrangements, a documented contingency plan must be in place. This will set out:

• trigger points for escalation;
• who must be informed and how quickly;
• interim cover arrangements;
• emergency contact details;
• out-of-hours arrangements;
• when the arrangement must be suspended or replaced;
• how the service user and, where appropriate, family or representatives will be informed.

Contingency planning must be proportionate to the service user’s level of need and the potential impact of service disruption.

8.2 Records, Documentation and Audit Trail

{{org_field_name}} will maintain a clear audit trail of all arrangements with external providers, including:

• due diligence checks and approvals;
• contracts, SLAs and information-sharing agreements;
• care planning decisions and allocation of responsibilities;
• correspondence, referrals, handovers and key communications;
• incidents, complaints, safeguarding concerns and escalations;
• review meetings, audits, findings and action plans;
• decisions to suspend, restrict or terminate an arrangement.

Records must be accurate, complete, contemporaneous, legible, secure and retained in line with legal and organisational requirements.

8.3 Duty of Candour and Incident Cooperation

{{org_field_name}} will act in an open and transparent way with service users and relevant persons in line with the duty of candour.

Where an incident involving an external provider results in, or may have resulted in, harm or risk of harm to a service user, {{org_field_name}} will:

• ensure the immediate safety and wellbeing of the service user;
• establish the known facts promptly;
• liaise with the external provider without delay;
• determine whether the incident meets internal reporting, safeguarding, commissioning, insurance, professional or CQC notification thresholds;
• communicate openly and honestly with the service user and/or relevant person as required;
• provide an apology where appropriate in line with the duty of candour;
• document all actions taken and learning identified.

External providers must cooperate fully with incident review, fact-finding, safeguarding enquiries and duty of candour processes.

8.4 Suspension, Restriction or Termination of External Arrangements

{{org_field_name}} may suspend, restrict or terminate an arrangement with an external provider where there is evidence of:

• unsafe care or treatment;
• safeguarding concerns;
• serious or repeated communication failures;
• repeated missed visits or service unreliability;
• unqualified, unregistered or otherwise unsuitable staff being deployed;
• failure to cooperate with investigations, audits or agreed improvements;
• significant confidentiality or data protection breaches;
• conduct likely to place service users, staff or the organisation at risk.

The decision and rationale must be documented, and alternative arrangements for the service user’s care must be considered and implemented without avoidable delay.

9. Concerns, Conflict Resolution, Complaints and Safeguarding

Any concern relating to an external provider must be taken seriously and responded to promptly. Concerns may include poor communication, missed care, unsafe practice, unprofessional conduct, poor record keeping, medication concerns, boundary issues, discrimination, confidentiality breaches, safeguarding concerns or failure to follow agreed care plans.

Where a concern is identified, {{org_field_name}} will:

1. take immediate action to protect the service user where there is any risk of harm;
2. record the concern factually and contemporaneously;
3. inform the relevant manager without delay;
4. notify the external provider and request an urgent response where appropriate;
5. consider whether the matter amounts to a safeguarding concern, serious incident, complaint, contractual breach, disciplinary matter or notifiable safety incident;
6. escalate to the local authority, CQC, police, professional regulator, commissioning body or safeguarding team where required;
7. keep the service user and, where appropriate, their representative informed in line with the duty of candour and organisational policy;
8. agree and monitor corrective actions;
9. review the ongoing suitability of the external arrangement.

Professional disagreements must never delay safeguarding action or immediate safety measures. Where there is unresolved disagreement between organisations, staff must escalate through management channels while ensuring that interim actions are taken to protect the person.

Complaints involving external providers will be managed in line with {{org_field_name}}’s complaints procedure. Where another organisation is involved, {{org_field_name}} will cooperate with that organisation while maintaining oversight of the complaint outcome insofar as it affects the safety, wellbeing or experience of the service user.

10. Review, Audit and Assurance

This policy will be reviewed at least annually and sooner where required due to:

• changes in legislation, regulation, guidance or CQC expectations;
• learning from complaints, incidents, safeguarding concerns, audits or inspections;
• changes to service delivery models, referral pathways or external partnership arrangements;
• identified weaknesses in implementation or governance.

Compliance with this policy will be tested through audits, spot checks, incident review, supervision, quality assurance activity and governance review. Action arising from audit or review will be documented, assigned and monitored to completion.

11. Conclusion

{{org_field_name}} is committed to working with external providers and agencies in a way that is safe, lawful, well-governed and focused on the needs and outcomes of each service user. Effective partnership working must support, and never compromise, safe care, dignity, accountability, continuity and quality. All staff and external partners are expected to follow this policy and to act promptly where concerns arise.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.