CCPS Membership Meeting

Discovery Point, Dundee12 June 2014

National care standards and inspection methodology

reviews

Helen HapperHead of Quality and Improvement

Care Inspectorate

Modernising our inspection methodology

Helen Happer Marie PatersonHead of Quality & Improvement Project lead,

methodology review

Why?

• Revision of national care standards – Human Rights based approach - using principles to inform and explain decision-making

• Influence of national policy on design and delivery of care in Scotland

• More tailored approach required for different service types/ needs

• Need a better interface between scrutiny at care service, corporate and strategic partnership levels

• Commitment to supporting the best possible experiences and outcomes for people who use care services

• Challenge of rising expectations and limited resources

Post Crerar

Whose views?• Current, future and past users of care services,

and their families• The public• Providers and commissioners of services• Front line staff in services• Care Inspectorate staff• Scottish Government• Scrutiny partners• Other bodies

Consultation to date

• E consultation - service providers (incl staff) and commissioners [1232]

• E consultation - public [570]• E consultation - CI staff [172]• Focus groups x 12 - providers and managers of

services [70]• Discussions with SG and scrutiny partners• Currently consulting with a range of service user

groups

Areas of consensus

• Widespread support for inspection• Essential to maintain standards & protect

vulnerable people• Provides reassurance, affirmation and

motivation to improve• Purpose should be improving experiences and

outcomes for people who use services • Needs to be manageable for all• Inspection should lead to improvement

Areas of ‘tension’

• scrutiny support • independence familiarity• time to improve risks of delay• report for public report for provider• predictability bespoke• intelligence led preconceived• rigour deliverability /

minimising intrusion

What did service providers tell us about how inspections feel for them?

What did inspectors tell us about how inspections feel for them?

Works well when….

Approach: supportive – improvement focused - shared goals – risk-based – proportionate – transparent

Attitude: open-minded - flexible - fair

Behaviour: dialogue -accessible - advice - smile! Knowledge: understands service, area of work

Activity: spend time with users of service

Focus attention on….

• Clarifying and communicating expectations – includes defining good practice

• Simplifying processes and increasing reliability of responses

• Improving consistency and transparency• Maximising time observing practice and

meeting people who use the service• Reporting clearly on people’s experiences and

the difference services are making to their lives

A new framework

• EFQM-based self-assessment and inspection framework – relationship between impact, outcomes and processes

• A suite of Quality Indicators, illustrations at Very Good & Weak for each

• A published judgement framework• Increased expectations of self-assessment and

evidence to support it• Shared tools for inspectors and providers to

support QA and improvement• Outcome-focused public report

Process.....

Direction setting Consultation

Framework dev’t Direction check

Consultation/review Enabler development

Review/direction check Testing

Implementation Consultation and review

Meanwhile…..

• Restructuring into specialist teams• New approach to inspection of childminding services/reporting• Shared inspection and capacity-building with Education Scotland -

early years• Improved information-sharing to inform strategic inspections• Review of key processes - enforcement and requirements follow-up,

registration• Developing our workforce• Strengthening quality assurance• Website development and The Hub• Review of annual returns• Creation of ‘expert’ groups to support capacity building• “Quality conversations” forums across the country• Publication of inspection frameworks

Update on the National Care Standards Review

Heather DallScottish Government National Care

Standards Review Team

National Care Standards Review Public Consultation

National Care Standards

•23 different sets •written for people using services •What people should expect from their care/service provider •Out of date originally written 2002

NCSServices for Adults

• Care homes for older people• Support services• Care homes for people with drug and alcohol

misuse problems• Care homes for people with learning disabilities• Care homes for people with mental health

problems• Adult placement services• Care homes for people with physical and sensory

impairment• Housing support services• Services for people in criminal justice supported

accommodation• Short breaks and respite care

Services for Children and Young People

• Adoption agencies• Care homes for children and young people

• Childcare agencies• Early education and childcare up to the

age of 16• Foster care and family placement services

• School care accommodation services

Services for Everybody

• Care at home• Hospice care• Independent hospitals• Independent specialist clinics• Nurse agencies• Independent medical consultant and GP

services• Dental services

Considerations – policy landscape

• The Children and Young People (S) Act• GIRFEC• Caring Together – carers strategy• 20:20 Vision and Quality strategy for NHS Scotland • Integration of Health and Social Care and outcomes • Changing policies and guidance

Review Teams activities:

• Pre-consultation events • Focus groups/reference groups• Liaising with HIS, MWC, SHRC• Linking with SG policy leads • 2 Project Board meetings

Project BoardCCPS Audit Scotland

Scottish Care MWC

HIS SHR

SSSC LA/NHS

SG policy leads CI

COSLA SHR

Carers Scotland Police

Project Board - activities • Updates on engagement activities and themes emerging

• Exploration of issues such as – aspirational v essential standards, use of HR based approach, who should write standards, issues of importance to sector – procurement/contracting, timing of NCS development and implementation

• Support setting up provider reference groups

• Sub group to look at specific issues

• Advice and contributions to paper

• Email responses on draft consultation paper

Current project team activities:• Awaiting Ministerial sign-off • Communication to ALL • Alternative formats• Consultation events for people who use

services and carers and other stakeholders• News articles • On line surveys

Areas for consultation

• Human Rights emphasis

• Apply to all health and social care services

• Structure/model

• Content

• Who should develop

Proposed model Over arching standards for all services – charter Human Rights Approach

Generic standards – reduce the 23 sets to a core set

Management and Leadership, Quality Assurance, Personalisation, Environment/safety, Well trained and compassionate staff, Keeping well

Specialist standards (pick and mix approach)

Nutrition for older people, oral health, size of bedrooms in care homes, educational opportunities for children, intermediate care, financial support (incapacity), palliative care, support with medicines

What next

• Consultation open until early September

• Externally analysed

• Project Board (end September)

• Decisions re action

• Communication

• Action Plan

• April 2015 stage 1 of development ??

A provider perspective on inspection – key issues and

concerns

Marcia RamsayDirector

Leonard Cheshire Disability Scotland

Discussion