Positive Risk-Taking in Adult Social Care: What CQC Inspectors Look For

Positive risk-taking is a key principle within person-centred adult social care. People receiving support should be able to make choices, pursue independence and live meaningful lives, even when those choices involve some degree of risk. However, providers must demonstrate that risk decisions are thoughtful, documented and reviewed. Services reviewing broader guidance around CQC risk and safeguarding expectations alongside the wider regulatory framework within the CQC quality statements should therefore be able to evidence balanced decision-making. Inspectors typically look for services that empower people while maintaining clear oversight, ensuring that independence is supported safely rather than restricted unnecessarily.

A consistent approach to quality assurance is supported by the CQC governance and compliance knowledge hub for adult social care providers.

Understanding positive risk-taking

Positive risk-taking means supporting individuals to pursue goals or activities that carry some level of risk while ensuring that safeguards are in place. In practice, this requires careful assessment, collaborative planning and ongoing review.

CQC generally expects providers to avoid both extremes. Excessive restriction can limit independence and quality of life, while poorly managed risk can expose people to harm. The challenge for services is therefore to demonstrate thoughtful, proportionate decision-making.

How inspectors assess risk decision-making

During inspection, CQC often examines how services document risk assessments, how staff understand those risks and how decisions are reviewed. Inspectors may ask staff to explain why a particular activity is supported and what measures are in place to manage associated risks.

Strong evidence usually includes clear care planning, documented conversations with the individual and family where appropriate, and leadership oversight ensuring risk management remains proportionate.

Operational example 1: supporting independent travel

Context: A supported living tenant wanted to travel independently to a local college. Staff initially had concerns due to the person’s anxiety and previous disorientation when travelling.

Support approach: The service developed a step-by-step travel plan including familiarisation visits, visual prompts and gradual reduction of staff support.

Day-to-day delivery detail: Staff accompanied the tenant during early journeys, practised recognising landmarks and provided a mobile phone with emergency contacts.

How effectiveness was evidenced: Over time the tenant travelled independently and reported increased confidence. Care records and reviews demonstrated how structured support enabled independence safely.

Operational example 2: encouraging community participation

Context: A residential home supported a resident who wished to continue visiting a local café despite mobility difficulties.

Support approach: The service carried out a risk assessment considering route safety, mobility aids and staff supervision.

Day-to-day delivery detail: Staff accompanied the resident initially, monitored fatigue levels and gradually supported the resident to visit with reduced supervision.

How effectiveness was evidenced: The resident maintained social connections and wellbeing while risks were carefully managed through planning and monitoring.

Operational example 3: balancing independence with medication safety

Context: A person receiving domiciliary care wished to manage their own medication despite previous missed doses.

Support approach: The provider introduced a monitored dosette system combined with reminders and regular reviews.

Day-to-day delivery detail: Staff checked adherence discreetly and discussed routines during weekly reviews to ensure safety.

How effectiveness was evidenced: Medication adherence improved while the individual retained autonomy over their routine.

Commissioner expectation

Commissioner expectation: Commissioners generally expect providers to support independence while ensuring that risks are assessed, documented and reviewed. Services should demonstrate that risk decisions are person-centred and aligned with agreed care outcomes.

Regulator / Inspector expectation

Regulator / Inspector expectation: CQC inspectors typically expect evidence that positive risk-taking is deliberate and proportionate. Services should show how decisions are documented, how risks are reviewed and how staff are supported to balance autonomy with safety.

Embedding positive risk-taking in practice

Providers who evidence positive risk-taking effectively often integrate risk discussions into care planning, supervision and review processes. Staff understand that risk is not something to eliminate entirely but something to manage carefully in partnership with the individual.

When services approach risk thoughtfully, they demonstrate to CQC that people receiving care are not only protected from harm but also supported to live fulfilling, independent lives.

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