Audit template
Commissioned vs Delivered Care
Compares contracted hours with delivered hours and explains the variance. This template runs monthly in MyCareCompliance and carries 8 mapped checks across 7 CQC quality statements.
Last reviewed: September 2026. This guidance reflects CQC information available at the date above — always refer to cqc.org.uk for current regulatory requirements.
What the audit covers
Every question in the Commissioned vs Delivered Care is mapped to a CQC quality statement and the underlying regulation, so a failed check tells you exactly which part of the single assessment framework is at risk. This is an optional template you can switch on when it applies to your service.
- Runs monthly — optional template
- Part of the Operations & service delivery audit category
- Maps to 5 regulations: Regulation 18 — Staffing, Regulation 12 — Safe care and treatment, Regulation 13 — Safeguarding service users from abuse and improper treatment, Regulation 9 — Person-centred care, Regulation 17 — Good governance
- Failed checks become tracked improvement actions with an owner, due date and evidence
The 8 checks
Safe and effective staffing
Safe — 1 check- Regulation 18 — StaffingCommissioned vs Delivered Care
Are staff rotas scheduled to deliver the full commissioned time, including adequate travel time between visits?
What we look for: Review rotas for 5 staff members across a week. Look for overlapping calls or back-to-back scheduling with zero travel time. A fail is where scheduled travel time is insufficient, forcing staff to cut visits short.
Evidence: Staff rotas, Scheduled call times, Travel time allocations on scheduling system
Safe systems, pathways and transitions
Safe — 1 check- Regulation 12 — Safe care and treatmentCommissioned vs Delivered Care
Is there a robust system for monitoring, reporting, and responding to late or missed calls in real-time?
What we look for: Check how the service monitors ECM for delayed visits. Evaluate the response to a recent late/missed call. Failure to identify a missed call promptly or lacking a clear escalation process constitutes a fail.
Evidence: Missed call logs, ECM live dashboard, On-call records, Incident reports
Safeguarding
Safe — 1 check- Regulation 13 — Safeguarding service users from abuse and improper treatmentCommissioned vs Delivered Care
Are instances of significant call clipping or non-delivery investigated to rule out potential financial abuse or neglect?
What we look for: Review the process for addressing falsification of timesheets or repeated short visits. Good practice involves investigating these as potential safeguarding issues. Ignoring severe call clipping is a fail.
Evidence: Safeguarding logs, Investigation reports, Disciplinary records, QA audits
Assessing needs
Effective — 1 check- Regulation 9 — Person-centred careCommissioned vs Delivered Care
Do initial care plans and assessments accurately reflect the exact hours, call times, and tasks commissioned by the local authority or funding body?
What we look for: Sample 5 recent care packages. Verify that the care plan matches the commissioned specification precisely. Discrepancies without documented rationale or commissioner agreement would be a fail.
Evidence: Commissioning documents (e.g. PAMMS/brokerage forms), Initial assessment records, Initial care plans
Monitoring and improving outcomes
Effective — 1 check- Regulation 9 — Person-centred careCommissioned vs Delivered Care
Where actual delivery consistently falls short of or exceeds commissioned hours, is a reassessment triggered with the funding body?
What we look for: Identify cases where service users consistently require less or more time than commissioned. Check if the manager has proactively contacted the commissioner to adjust the package. Failure to request reassessment when needs change is a fail.
Evidence: Care review notes, Emails to social workers/commissioners, Reassessment requests
Care provision, integration and continuity
Responsive — 1 check- Regulation 9 — Person-centred careCommissioned vs Delivered Care
Does Electronic Call Monitoring (ECM) or timesheet data confirm that actual care delivered matches the commissioned call durations?
What we look for: Compare commissioned hours against actual delivered hours for a sample of 10 service users. Look for systemic 'call clipping'. Consistent delivery of significantly less time than commissioned without review is a fail.
Evidence: ECM reports, Call log data, Timesheets, Exceptions reports
Governance, management and sustainability
Well-led — 2 checks- Regulation 17 — Good governanceCommissioned vs Delivered Care
Are service users and funding bodies billed accurately based on the actual care delivered, rather than solely on commissioned hours?
What we look for: Sample a recent billing cycle. Verify that invoices are adjusted for missed or significantly shortened calls in line with local authority contracts. Charging for care not provided is a critical fail.
Evidence: Invoices, Billing schedules, Credit notes, Commissioner communication
- Regulation 17 — Good governanceCommissioned vs Delivered Care
Do governance and quality assurance frameworks include regular, formal audits of commissioned versus delivered care?
What we look for: Review the provider's own internal audits. They should routinely compare planned vs actual delivery and set actions for improvement. Absence of this specific management oversight is a fail.
Evidence: Monthly manager audits, KPI reports, Quality assurance meeting minutes, Action plans
See it running for your service
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