Using CQC Quality Statements to Evidence Positive Risk-Taking, Least Restrictive Practice and Proportionate Decision-Making
Positive risk-taking is a key indicator of how CQC quality statements are applied in practice. Providers must demonstrate that individuals are supported to take appropriate risks while maintaining safety. These expectations begin at CQC registration, where providers must show how risk is assessed, managed and reviewed. The key test is whether decisions are proportionate, person-centred and consistently applied across all staff.
Moving from risk avoidance to risk enablement
Services often default to risk avoidance, limiting independence. CQC expects providers to demonstrate how risk is enabled safely, with clear decision-making processes and evidence of outcomes.
This requires structured assessment, consistent staff understanding and strong governance oversight.
Embedding positive risk-taking into daily practice
Risk-taking must be embedded in everyday care, with staff understanding how to support individuals safely while promoting independence.
Managers must ensure decisions are recorded, reviewed and consistently applied.
Many of these issues are closely linked to quality assurance processes and regulatory expectations across services. You can explore these connections in our CQC quality assurance and compliance hub for adult social care providers.
Operational example 1: supporting independent community access
Context: Baseline assessment shows a person is restricted from going out independently due to historical concerns about safety.
Support approach: The provider develops a positive risk-taking plan to support gradual independence.
Day-to-day delivery detail: At the start of each shift, staff review the individual’s risk plan and confirm current support level. The person is supported to leave the service for short, planned periods. Staff record observations in real time, noting behaviour, confidence and any risks. At handover, staff share updates and adjust support levels if required. Managers review records weekly.
What can go wrong: Staff may revert to restrictive practice or fail to record observations.
Early warning signs: Increased anxiety or inconsistent documentation.
Escalation and response: Staff escalate concerns to the shift lead within the same shift. The Registered Manager reviews within 24 hours and adjusts the plan if needed.
Consistency: All staff follow the same risk plan and recording process.
Governance link: Weekly review of risk plans and monthly audit of outcomes.
How effectiveness is evidenced: Increased independent activity, reduced restrictions and improved confidence measured through records, feedback and audits.
Operational example 2: reducing restrictive practices in daily routines
Context: Baseline review identifies routine restrictions that limit choice.
Support approach: The provider reviews and removes unnecessary restrictions.
Day-to-day delivery detail: Staff review routines at the start of each shift, involve the person in decisions and record choices. Changes are documented and shared at handover. Managers monitor implementation.
What can go wrong: Staff may continue restrictive practices out of habit.
Early warning signs: Lack of recorded choice or feedback indicating dissatisfaction.
Escalation and response: Immediate feedback and supervision.
Consistency: Reinforced through training and observation.
Governance link: Monthly audit of restrictive practices.
How effectiveness is evidenced: Reduced restrictions, improved choice and positive feedback.
Operational example 3: balancing safety and independence in complex care
Context: Complex needs require careful balance between safety and independence.
Support approach: The provider uses structured risk assessments and review processes.
Day-to-day delivery detail: Staff assess risks at the start of each shift, implement agreed strategies and record outcomes. Managers review data weekly and adjust plans.
What can go wrong: Overly cautious or overly risky decisions.
Early warning signs: Inconsistent outcomes or increased incidents.
Escalation and response: Immediate management review and adjustment.
Consistency: Standardised processes ensure alignment.
Governance link: Regular review of risk assessments and outcomes.
How effectiveness is evidenced: Balanced outcomes, reduced incidents and improved independence.
Commissioner expectation
Commissioner expectation: Commissioners expect providers to demonstrate proportionate risk-taking and least restrictive practice.
Regulator / Inspector expectation
Regulator / Inspector expectation: CQC will expect providers to show that risk decisions are person-centred and evidence-based.
Governance and oversight
Providers must implement structured audits of risk assessments, including monthly reviews and quarterly trend analysis. The Registered Manager reviews findings weekly, while senior leadership monitors outcomes.
Escalation thresholds include increased incidents or inconsistent practice. Actions are tracked and reviewed until resolved.
Evidence is triangulated through records, audits, feedback and outcomes.
When positive risk-taking is embedded into quality statements, providers can demonstrate safe, proportionate and person-centred care.