Rami Okasha examines how new inspections will affect the social care sector

New ways of inspecting care homes are due to start in July, reflecting Scotland’s new Health and Social Care Standards. When the new standards were published in 2017, the Care Inspectorate hailed these as being radical, modern and really focused on supporting people’s power, control, human rights and wellbeing.

The standards set out what people should experience from care and support, regardless of setting, and are not designed just for inspection of care services. They are relevant across planning, commissioning, assessment and delivery. This represents a big step-change from before.

The Care Inspectorate promised there would be no big-bang approach to changes to inspections, but that we would use the standards to modernise all the work we do. Since then, we have been consulting with people who experience and provide care to revise how we inspect care and how we help it to get better where that is needed. The changes are really focused on the Care Inspectorate’s move from being an enforcer of rules to an enabler of quality.

Inspectors have been using the new standards in our work since April 2018, and from July we are starting to roll out a new model of inspection for care settings. We are starting with care homes for older people, and will be continuing this roll-out into other settings in the year ahead.

So what’s changed?

First of all, some things have not changed – inspectors will still be interested in experiences and outcomes for people, and spend significant time speaking with and observing care.

The biggest change is that we have published a new quality framework for care homes for older people. This is for self-evaluation, inspection, and to support improvement. The framework is adapted from approaches widely used in quality management, and the illustrations are drawn from the Health and Social Care Standards.

The framework uses a series of key questions to try to understand the impact on people experiencing care and support:

How well do we support people’s wellbeing?
How good is our leadership?
How good is our staff team?
How good is our setting?
How well is our care and support planned?

Each of the key questions has a number of quality indicators associated with it, and each key question has two illustrations to show what a care home might look like at different levels of quality.

Inspectors will look at a range of quality indicators on an inspection, and use the illustrations to help them evaluate quality on the six-point scale of unsatisfactory, weak, adequate, good, very good and excellent. Inspectors will provide an overall evaluation for the key questions that they inspect, and also detailed evaluations for each of the quality indicators. The precise key questions and quality indicators that inspectors look at will depend on the specific care service, but we will always look at people’s wellbeing and how care is planned.

A toolbox to support improvement

The framework also contains a detailed scrutiny and improvement toolbox. This shows how inspectors will undertake their role in trying to evidence performance in respect of specific quality indicators. Providing this information transparently will help staff and residents in care services to understand what an inspection will involve: we really want people to understand the work we do on an inspection. The framework also contains an improvement section for each quality indicator. As well as providing an illustration of very good quality practice, we have linked some of the key improvement resources that will help care homes reflect and plan that particular aspect of their work. This will be regularly updated on The Hub website.

What happens next?

These new inspections will start in July 2018 for care homes for older people. We are already working with people experiencing and providing care to develop similar frameworks for other settings. We want to involve lots of people in that, and will test new approaches before deploying them in different settings.

You can keep up to date with the changes and find more details about them on our New Inspections page on the Care Inspectorate website.

Rami Okasha is executive director of strategy & improvement at the Care Inspectorate