Madrid city council plans and designs services in-house and monitors the quality of services contracted out to external providers. Long-term care has been a particularly fast-growing sector with about 50 different, mostly private, organisations delivering various services to about 200,000 citizens. Advances have been made to ensure higher quality in contractual matters, advertising of tenders, transparency, inclusion of social clauses and the improvement of award criteria.

Madrid City Council is convinced that assessing compliance with the involvement of the contracted providers and the participation of citizens is key to guarantee continuous improvement. Information obtained through the quality control system set up by the municipal Directorate General for Older People allows for a precise monitoring of the implementation of technical specifications defined in tender documents.