Guidance

Digital working in adult social care: What Good Looks Like

Updated 17 May 2023

Applies to England

What Good Looks Like for local authorities and care providers

When technology is embedded seamlessly into care and support it can be transformative, improving people’s quality of life and ensuring information is readily available to help staff provide the right care in the right place at the right time.  

This framework sets out what good digital working looks like for care providers and local authorities with responsibility for adult social care in England. It provides a series of common goals for these organisations to work towards that will help achieve the vision set out in People at the Heart of Care. It is an aspirational framework designed to be used by local authorities and care providers of all sizes and types of service, including both Care Quality Commission (CQC) registered and non-registered providers.

The guidance is aimed at individuals who have responsibility for digital transformation in local authorities and care provider organisations. This might include digital leads, directors of adult social services, commissioners and service managers. However, we recognise there isn’t a one-size-fits-all approach and roles may differ depending on where you work.

The content in the framework has been developed in collaboration with Partners in Care and Health (a partnership between the Local Government Association (LGA) and the Association of Directors of Adult Social Services (ADASS)), provider sector stakeholders and through a series of workshops and interviews with providers, local authorities and national membership organisations. We are grateful to everyone who participated in these discussions, shared feedback and helped to shape the guidance.  

Success measures

The What Good Looks Like (WGLL) framework for adult social care is part of a suite of guidance for digital working across health and social care, developed by NHS England and the Department of Health and Social Care (DHSC). It is structured around the following 7 success measures for digital working in adult social care services: 

1. Well led
2. Ensure smart foundations
3. Safe practice
4. Support workforce
5. Empower people
6. Improve care
7. Healthy populations

Figure 1 below contains a diagram showing an infographic of a wheel divided into 7 sections. Each section represents one of the 7 success measures for the What Good Looks Like framework. Surrounding the wheel are the 3 categories that define goals for digital transformation in health and social care: transform, digitise, connect.

Figure 1: the 7 measures for the WGLL framework, divided into 3 categories

Local authorities and care providers play an important role in supporting the objectives of their integrated care system (ICS). This guidance builds on the NHS England What Good Looks Like framework, which provides clear guidance across 7 success measures for health and care leaders to digitise, connect and transform services safely and securely. Nurses working in social care may also be interested in the publication Guidance for nursing on ‘What Good Looks Like’.

How we’re supporting you

We are developing an advice and guidance website, building on the current Digital Social Care website, which provides access to trusted information, case studies and guidance resources. Over time these resources will be expanded to include templates, standards and self-assessment tools which will focus on supporting all organisations, regardless of their starting point, to understand how they can work towards the principles covered by the 7 success measures.

Details on funding opportunities can also be found on the Digital Social Care website. This includes information to support you to identify and get in touch with the regional leads who work within your ICS. You can also explore how to connect with your ICS through local authorities or care provider associations.

Further support and resources for local authorities can be found through the Digital Transformation Team at Partners in Care and Health and the Knowledge Hub community forum for local authority officers.

The content in this framework will be updated based on feedback. If you have comments, please contact england.wgll@nhs.net.

The 7 success measures: the framework in detail

Throughout the sections below there are links to further resources and tools to support you in your digital journey. The framework can also be used alongside related guidance resources for digital working, such as the:

• adult social care digital skills framework
• CQC’s provider guidance on digital record systems
• local government digitalisation outcomes

Success measure 1 - Well led

Your organisation’s leaders fully understand the benefits of digital technology and have the confidence and capability to drive forward digital transformation, sharing and learning from best practice.

Having a clear vision and credible strategy for how to use digital technology ensures the transformative power of technology is felt throughout an organisation. This results in benefits for people who draw on social care, as you enhance the quality of care through the improved use of technologies and information or by being able to better support the workforce.  

It is essential that the leadership, management and governance of adult social care organisations support digital innovation, understand risks and effectively manage change. By engaging with good practice, learning from and proactively sharing with others across the sector, leaders can improve understanding of digital technology and make best use of evidence to invest in technologies. This will ensure services meet people’s needs - improving quality and safety of care, freeing up time or capacity and/or supporting people to live independently for longer. Participating in professional networks at local, regional or national level can help to facilitate this.

Achieving safe and effective digital transformation requires organisations to safely use data to inform and improve decision-making and planning, and to understand the ethical and legal issues that can arise through using digital technology, including issues of consent. Secure data sharing for direct care purposes is encouraged and organisations should seek appropriate advice on information governance when sharing data for secondary purposes. The rights, interests and preferences of people drawing on social care should always be at the heart of decision-making on when to use digital technologies. 

Local authorities should:

• have strong representation on the integrated care board, to positively influence the digital strategy of your local system and to accurately represent the needs of local care providers and the people they support
• ensure your internal decision-making and investment boards understand the potential for technology to make productivity and efficiency savings, based on comparable work in other local authorities
• explore the use of technology to support care market improvement, capacity and sustainability, including the use of commercial mechanisms to incentivise or encourage providers to digitise
• ensure staff at all levels have the knowledge, digital skills and capability to plan and deliver a digitally enabled social care service and that local authority leaders support the prioritisation of those skills as part of the leadership role
• co-produce digital plans to ensure they meet the needs of people using services, staff, care providers and all relevant parties in your organisation
• understand individual autonomy and privacy rights associated with the use of digital technology and respect that digital will not be appropriate for everyone
• ensure data sharing and use is done in line with data protection laws, and the common law duty of confidentiality, knowing when you can and cannot use care data for purposes such as research and service planning
• be aware of and comply with the national data opt-out and help the people you support to understand their rights in this area
• ensure plans sufficiently cover digital inclusion and consider factors such as your size, geography, demography and capability to provide positive outcomes for people and staff and to reduce health and care inequalities
• support your board level digital or technology leader to have sufficient knowledge of health and social care to represent the needs of the sector
• seek ongoing input from relevant frontline professionals, such as social workers, commissioners and occupational therapists, into the development, implementation and safe use of technology and data
• consider whether a specific role of Social Care Informatician, similar to the Chief Clinical Information Officer in the NHS could help to drive forward change

Care providers should:

• ensure your staff in leadership positions have the knowledge and skills to deliver digital transformation across the organisation and build digital confidence within your teams. Support can be found through the Digital Skills Training Database
• have clear investment plans to successfully embed the use of digital technology across your organisation to support person-centred care
• ensure leaders have a continued understanding of initial and ongoing infrastructure requirements in your care settings, and associated investment, including access to reliable connectivity and appropriate devices
• draw on accurate and timely data to understand the care needs and outcomes of the people you support, ensuring data sharing and use is done in line with data protection laws, and the common law duty of confidentiality when delivering direct care
• engage with and inform people on how and why their confidential information is used and the choices they have around this, sharing information on and complying with the national data opt-out, where appropriate
• engage with your ICS and take advantage of funding opportunities to test and scale technologies, sharing your experience with others in the sector and evaluating the benefits and impacts
• actively learn from other care providers when purchasing, implementing and using digital social care records (DSCRs) or other technologies, using resources such as the Adopting digital care records masterclass series

Success measure 2 - Ensure smart foundations  

Your organisation has modern and secure digital infrastructure, and staff have reliable access to comprehensive and up-to-date digital records.  

Access to secure connectivity, the right technology and the right digital and data processes is fundamental to the use of digital solutions to improve people’s care outcomes. By considering factors including your size, geography, demography and capability, you ensure your organisation is digitally well-equipped to provide positive outcomes for people who draw on care and staff. 

Information is securely communicated across health and social care settings through a secure email platform to support integrated and joined up approaches to care. Ensuring care professionals have access to critical information about an individual person, through a single DSCR, means they have the right information at their fingertips to provide the best possible care. As an organisation, you invest in digital systems so accurate information is readily available to support person-centred care.  

Local authorities should: 

• work with your wider ICS to facilitate a fully shared care record across health and social care
• prioritise interoperability and national good practice standards on data sharing to support direct care in your purchasing and commissioning decisions
• consider the role of digital solutions when supporting the local authority workforce or responding to capacity, efficiency or capability challenges
• encourage commissioned providers to provide accurate and timely data to central collections, and utilise central data sources where possible
• ensure it is possible to interface and match your internal records, using the NHS number as a unique identifier through a secure data environment for health and social care, to enable the appropriate parts of people’s records to be available to other departments, including finance, housing and children’s social care
• work with your ICSs to support care providers to adopt DSCRs and to test and scale technologies that support the quality and safety of care
• understand the connectivity needs of providers in your local area, and support them to explore options to access sufficiently fast broadband to match their digital transformation needs
• be aware of the upcoming transition from analogue to digital telephone networks, and assess telecare users’ current equipment for digital compatibility, working with suppliers to test reliability and develop contingency plans as detailed in the Telecare stakeholder action plan
• use secure email platforms to communicate health and care information

Care providers should: 

• have access to a reliable internet connection of suitable speed to enable safe and consistent digital working for staff
• understand and plan for the right levels of broadband connectivity to support use of digital technology throughout your premises
• ensure robust and complete wifi networks provide connectivity for all users in all areas of your care settings, including access for people drawing on social care to support their independence and wellbeing
• equip staff with a mobile device that has sufficient connectivity to enable usage of DSCRs or other care technologies in domiciliary care settings or where broadband coverage is limited in residential settings
• have confidence, skills and knowledge to identify, recommend and use appropriate digital technology to deliver high-quality care. This includes the use of software and devices (for example smart phones, laptops and tablets) to ensure care workers have access to the information they need
• follow secure email policies and make use of NHSmail for secure communications with NHS partners and for services such as proxy access to medication re-ordering
• where available, sign up to GP Connect to gain secure access for approved staff to view appropriate primary care information for the people you support
• make use of resources such as the assured supplier list and Digital Social Care when purchasing technology, to be confident that digital solutions meet baseline standards for security and interoperability
• use secure cloud data storage, when relevant, to support the increase in data that may not be supported by your computer hard drive
• work with partners to ensure there is safe and secure transition to digital solutions, including appropriate archiving and retention of records
• follow good practice and use shared data standards in social care to share information quickly and securely, using resources such as the Social care data catalogue
• plan and prepare for changes required in residential settings ahead of the analogue to digital telephone switchover - this might include care alarms, phone systems, CCTV and security alarms if these are analogue-based

Success measure 3 - Safe practice

Good data and cyber security means organisations can safely use and share information which can improve care and support for people. 

As an organisation, you take informed steps to protect people’s health and care information against cyber threats and data breaches and to give care workers the knowledge and confidence to appropriately use and share information. You are assured that all suppliers you use for software or care technology follow robust cyber security and data handling processes. This helps to ensure people’s data is handled in a way that is safe and secure.  

Safe digital practice requires staff to be competent in avoiding breaches of data at a level appropriate to their role. By upskilling staff and sharing knowledge on cyber security and information governance, you build confidence in sharing information for individual care whilst protecting people’s confidentiality. This is supported by clear policies and processes, including business continuity plans, to respond to data breaches and cyber security issues. Organisations create and promote a non-blame culture where staff feel safe to raise concerns about data breaches.  

It is essential to stay up-to-date with digital safety standards and regulatory, policy and legislative changes relating to data security. Where a cyber security or data breach does occur, you report this to the relevant authority as required and use learning to continuously improve mitigation and recovery plans. 

Local authorities should: 

• meet the requirements of the UK General Data Protection Regulation (GDPR), the Data Protection Act 2018 and comply with the common law duty of confidentiality, providing transparency and public engagement on how personal data is used
• have a Caldicott Guardian, a senior member of staff who will be consulted whenever the sharing of data may raise legal or ethical challenges, and an appointed data protection officer
• be clear and transparent about the purpose and use of data, whether that is for individual care, research, service improvement or commissioning purposes and ensure you follow appropriate standards based on the specific use of the data
• work with providers to ensure robust resilience plans are in place, and there is confidence in responding to cyber and information governance incidents across the sector
• support the sector in safe practice and cyber security, and use contracting and commercial mechanisms to incentivise commissioned care providers to complete the Data Security and Protection Toolkit (DSPT), recognising that care providers are at different levels of digital maturity
• embed good cyber security practices, and complete the DSPT if processing health and care data

Care providers should: 

• meet the requirements of the UK GDPR, the Data Protection Act 2018 and comply with the common law duty of confidentiality
• ensure appropriate cyber security and information governance functions are in place including data protection officers
• understand, follow and improve your data protection and cyber security arrangements, including plans for staff training. This may be through the Digital Social Care data protection and cyber security guidance tools and advice services or equivalent
• develop and test business continuity plans for data and cyber security as part of wider business planning
• make use of the assured supplier list to ensure your DSCR solutions have the appropriate safety and security systems and that procedures are maintained and enforced in accordance with industry practice
• complete the DSPT annually, to a minimum level of ‘standards met’ if you are CQC registered. For non-CQC registered providers you should use the DSPT to check and improve your data and cyber security arrangements
• make use of available free support and guidance through the Better Security, Better Care programme

Success measure 4 - Support workforce

Supporting your workforce means developing a skilled, capable workforce who can confidently identify, recommend and use appropriate technology safely and effectively for people drawing on social care.

As an organisation, you embed a clear vision for digital working and support your staff - in all roles and at all levels - to review and develop their digital skills and provide access to appropriate development opportunities.   

You develop ways of working that focus on informing and raising awareness of digital technology and communicating the benefits. Myth-busting, reassurance, confidence-building and a learning culture are promoted.

Staff are given the time and commitment to develop digital confidence and capability, and are equipped to use technologies to access the information they need safely. Staff are also engaged in testing and embedding new technologies to ensure they are fit for purpose and support effective delivery of quality care.  

Digital leadership skills are embedded and become a ‘normal’ part of every leader’s role as you understand that technology benefits people drawing on your service, your organisation and workforce.  

Local authorities should:

• ensure staff are supported to develop the right data and digital skills across your organisation, with training and support tailored for those working in social work, occupational therapy, direct support roles, commissioning, analytical, strategic and administrative roles
• embed digital technology in frontline practice, including social work referrals, assessments and reviews
• support care providers and partners to upskill their own staff, and share any opportunities to increase the digital skills and confidence across the sector
• understand the importance of your data and analytical workforce, empowering them with suitable development opportunities and investment

Care providers should:

• ensure staff understand, and have the required skills and confidence to use, appropriate digital technology as part of their role
• build a positive learning environment and develop a plan for digital skills training (including information governance, information sharing and cyber security) using resources such as the adult social care digital skills framework
• use appropriate solutions to support all staff to build their skills and digital confidence, including support and training for digital leaders
• ensure digital skills are included in induction and appraisal processes for all staff, including agency staff
• create opportunities for peer-to-peer digital learning - this may include developing some staff as ‘digital champions’
• work together with your local authority and/or ICS, membership organisations and other relevant partners to learn about and promote digital learning opportunities to your staff

Success measure 5 - Empower people

A person-centred approach to the design and use of digital technologies can improve people’s quality of life and wellbeing and support independence.  

Technology can be used by an individual, their carer or their care provider to support quality of life and the provision of high-quality, safe and personalised care. It can play an important role in supporting people’s mental health and wellbeing, helping maintain independence, supporting people to remain connected to their loved ones or communities, or through online access to entertainment, hobbies and learning.  

By co-producing the development and delivery of your digital strategy with the people your organisation supports, you can ensure people who draw on care, their families and care networks are equal partners in shaping digital services.  

As an organisation, you ensure people understand the benefits and opportunities associated with the use of digital technology in social care, acknowledging and respecting individual choice around whether a person wishes to use technology as part of their care. People are supported to feel confident selecting and using the most appropriate tools to support their independence and wellbeing and you empower individuals and their carers to securely access and contribute to their DSCR.  

People understand their rights and the ethical issues that can arise around the use of digital technology and data and are confident in the ability of your organisation to protect their rights when implementing technology and using health and care data.

Local authorities should: 

• consider how digital technology can help meet Care Act 2014 requirements to promote improved wellbeing, contribute to the prevention of care and support needs and provide information and advice
• support staff to understand the importance of personalisation and co-production with people, embedding these principles across your organisation, for example through using the Think Local Act Personal ‘Making it Real’ statements or Technology for our Ageing Population: Panel for Innovation Principles
• ensure people understand the technology solutions available to them and understand their rights and the ethical risks that can arise, involving and supporting people to make informed decisions in their care and offering alternatives where technology is not the preferred option
• be confident to identify, recommend and use appropriate digital tools to help support people’s independence, safety and wellbeing
• work with partners across your ICS on initiatives that support integrated health and care records, and that support people to access, personalise and contribute to their data
• support people to provide information through digital routes, designing services to allow people to complete assessments digitally, and reduce duplication of core information
• ensure there are varied methods of communication with people, including digital and non-digital means, to ensure their involvement, complying with the Accessible Information Standard as required

Care providers should: 

• co-produce and personalise care plans with people, actively involving family, friends and carers to support person-centred care, and offering choice and control in how care is delivered, including virtually or in person
• empower the people you support to use digital technologies that may improve their wellbeing, their communications and independence
• ensure people have the option to access and jointly manage their DSCR and information, allowing them to take their own record throughout their care journey
• encourage appropriate access for families, friends and carers to securely view a person’s DSCR. All solutions on the assured supplier list include this functionality
• use digital technology to support people to stay connected to family, friends and their community
• make use of the #CareAbout Me standard by the Professional Records Standard Body or the This is me philosophy by the Alzheimer Society, or other equivalent best practice

Success measure 6 - Improve care

Effective use of digital technology, data and processes can support the delivery of outstanding quality and personalised care and support at the right place and at the right time. 

The use of digital technology should enhance the quality of social care, free up time for meaningful human interaction and create stronger connections between people who draw on care, their friends, family and care networks. 

As an organisation, you use technology to improve the provision of care and support for people to have choice, control and independence. This means embedding technology to support services and using insight from data to continuously drive improvements in care quality and safety. This includes improving equity to ensure people have access to high-quality care no matter who or where they are. You have a digital shared care record and work with local and regional partners to support and achieve this, ensuring that direct care information can safely be shared across health and social care as part of an integrated system. 

Local authorities should: 

• work within your ICS to jointly communicate and provide a seamless service for your local community, improving continuity of care and outcomes for people using digital technology solutions across health and social care
• understand the difference across services and care pathways based on location and capacity within your communities, and use digital solutions within your plans to address variations in quality, type or availability of services
• draw on timely and accurate data to inform commissioning, understand the needs and requirements of local populations and manage health and social care services more effectively
• consider, or re-examine alongside other interventions, the role technology enabled care (TEC) can provide in maintaining independence of people in their own homes as care needs are reviewed, and how other preventative devices may need to be linked in, for example a compatible smoke detector where a person has deteriorating mobility and there is an increased fire risk
• when seeking evidence of quality, safety, innovation and continuous improvement, ask organisations providing TEC products and services if they have signed up to the Quality Standards Framework, a scheme run by TEC Quality (a subsidiary of the TEC Services Association) and the only TEC service that has United Kingdom Accreditation Service (UKAS) status
• embed digital technology as part of enablement and reablement services, as well as wider initiatives that promote independence
• aim to improve ease of access to social care services through multi-channel accessibility to ensure people are aware of support available to them
• work as a wider ICS on the clinical and professional risk management standards, adhering to and promoting the Data Alliance Partnership Board standards

Care providers should: 

• promote a learning culture to identify how and where digital technology can be incorporated into your care and support offer to improve people’s outcomes
• work with local authorities to use care technology to maintain peoples’ mobility, independence, pursue their hobbies and interests, connect with friends, family and carers and to support them to live their life
• work in partnership with your ICS to understand the funding options available for technologies that support an individual’s quality of life - including technologies that can improve care quality and safety, reduce avoidable admissions to hospital or support people to live independently in their own home - building a robust evidence base on the impact of these technologies
• actively use DSCRs to inform service improvements and support the delivery of high quality, personalised care
• share learning and evidence which demonstrates the impact of a new digital solution on the people you support, staff and your organisation
• use available data to support quality monitoring, learning and improvement

Success measure 7 - Healthy populations

Having good data to understand and plan for the needs of the population (whether at a community level or individual level) means that we can reduce inequalities and improve outcomes for all people. 

Support can be targeted where it is needed most by using data insights to drive improvements to the health and wellbeing of the populations we serve. By working with partners and people who draw on social care, and their carers, we can improve services based on a holistic understanding of current and future need.

Building an evidence base of what works well through collaboration with educational and academic establishments, health partners and suppliers across the sector is crucial to effectively embedding and scaling digital solutions that improve the quality and safety of care.  

It is essential that personal data is used appropriately and safely for research, service improvement or commissioning purposes. Organisations drive data innovation in line with legal requirements and information governance guidance, offering transparency and individual choice around use of data for purposes other than direct care and seeking advice where necessary.  

Local authorities should: 

• use guidance such as that found on the information governance portal to decide the correct and lawful way to use data, taking account of GDPR and other relevant legal obligations
• work with providers and your ICS to improve wellbeing and equalities for communities through the appropriate use of data, understanding the resources and logistics required to collect data and supporting smaller providers to facilitate such intelligence sharing
• have a shared data solution across your local authority to support real-world evidencing, for direct care purposes, across adult and children’s social care, public health and housing services, for example
• invest time and resources into quantitative and qualitative analysis that helps you to achieve your strategic aims - supporting your data and analysis teams to explore new ways of using data to inform decision-making
• work to promote and encourage data intelligence within the voluntary and community sector, ensuring there is equality across the sector and providers are not disadvantaged by size or geographical location
• access national good practice, and peer local authority support, to support your planning, for example through LGA and ADASS regional teams
• work to share data safely and appropriately with other partners, including the voluntary and community sector and local communities themselves, so they can support the development of solutions for their local areas
• understand the importance of data analytics and data science using real data from pilots, research or local services to help build evidence to support investments, plans and strategy for local service and system delivery
• embrace research opportunities to support the acceleration of digital adoption in social care, for example through the Acceleration Award from the National Institute for Health and Care Research
• understand and promote the use of technology, apps and platforms that help people manage their own health and wellbeing using resources provided by the:
  • Digital Technology Assessment Criteria
  • National Institute for Health and Care Excellence
  • National Institute for Health and Care Research
• be aware of and comply with the national data opt-out to help the people you support to understand their rights in this area

Care providers should: 

• use guidance such as that found on the information governance portal to decide upon the correct and lawful way to use data, taking account of GDPR and other relevant legal obligations
• use data management and data analysis to monitor the health and wellbeing of the people you support, and use this insight to identify appropriate solutions or preventative support to improve people’s outcomes
• use data to detect potential issues, to enable more responsive care and to maintain health and wellbeing to improve outcomes for people you support
• use data to improve the wellbeing of people you support to ensure that they can live the life they choose, including people at the latter stage of life
• use data management and analytics to support the training and needs of your workforce
• use data and analytics to identify areas of service improvement, support service quality and safety, and to assess your service against regulatory requirements
• work with partners in the local health and care system, including the local authority where appropriate, to share and receive information about the people in your care to improve population health management, commissioning and care outcomes, for example in relation to equality, diversity and inclusion