scswis and the new regulatory regime jacquie roberts interim chief executive social care and social...

SCSWIS and the New Regulatory Regime

Jacquie Roberts

Interim Chief Executive

Social Care and Social Work Improvement Scotland

Public Services Reform (Scotland) Act 2010

Creation of:

Social Care and Social Work Improvement Scotland : Part 4

Creation of:

Healthcare Improvement Scotland : Part 5

SCSWIS

HIS:

Regulation of private health services

HMIE Child ProtectionMulti-Agency Inspections

Care Commission

SWIA

• Commencement 1 April 2011• Chair appointed November 2010• Interim Chief Executive appointed December

2010• Board appointed March 2011

Vision

SCSWIS believes that people in Scotland should experience a better quality of life as a result of accessible, excellent services which are designed and delivered to reflect their individual needs and promote their rights

Purpose

To provide high quality scrutiny and assurance – which means:

• Efficient and effective regulation and inspection• Supporting improvement• Signposting good practice• Being a catalyst for innovation

Three Year Change Programme

Progressive integration of functions

X Progressive alignment of functions

SCSWIS CASH BUDGET / TARGETS____ SG Plans ___ Actual

36.1

33.370

31.234

28.834

27.369

36.1

32.827

26

28

30

32

34

36

2010-11 2011-12 2012-13 2013-14 2014-15

£m

Three Year Strategic Change Programme

• Build effective new relationships – working with partners to co-ordinate and integrate key scrutiny processes

• Develop and implement a business information and intelligence strategy

• Develop our people : relevant skills and knowledge

• Build a new organisational culture : customer focused – effective – high performing

Three Step Changes

1. Integrated Children’s Services Inspections Year 1 – Karen Anderson

2. Scrutiny improvement: doing the core business well Year 1 – Gill Ottley

3. Integrated Adult Services Inspections Year 2 – David Cumming

Changes from April 2011

• New organisational structure• New alignment to local authority and health board

areas• National complaints function• National registration function• National enquiries team• Unannounced inspections whenever possible• Integrated inspection ‘clusters’ – more joining up of

former functions

What Information is SCSWIS Starting With?

• Findings from SWIA

• Findings from the Care Commission

Findings from SWIA

Strategic Commissioning

• Was not sufficiently focused on outcomes or best value

• Better developed for some groups than others

• Some councils were successful in building commissioning around engagement with people who use services and strategic partners, including service providers

• Some councils made procurement decisions, including re-tendering, without taking sufficient account of the impact on peoples lives

• Many councils did not have a clear rationale about their role as a provider or purchaser and took a short-term view of commissioning

Source: SWIA 2005-2011

Findings from SWIA

Older People’s Services

• Seventeen councils showed a decrease in the levels of

home care in a single year to 2009

• Intensive home care continues to increase overall, but with

uneven progress at council level (range 4.9-34.0 per 1000

aged 65+)

• Usage of care homes is declining overall (2% over the last

five years) Source: SWIA 2005-2011

Findings from SWIA

Services and Supports for Adults

• Levels of intensive home care remained low in some areas and services

needed to improve the responsiveness of home care services

• In most councils, resources for adult services were under pressure at a

time of increased needs and service pressures

• Eligibility criteria for services and support were tightened in many parts

of the country but this was not well monitored or reported

• Support for people with dementia needed to get more priority in most

areasSource: SWIA 2005-2011

Findings from SWIA

Slower Progress has been made on:

• Personalised approaches and measuring outcomes

• Increased carers’ assessment

• Risk assessment and risk management

• Strategic planning and commissioning

• Governance in partnerships

Source: SWIA 2005-2011

Findings from the Care Commission Inspections

  2009-2010 2010-2011

  All Grades 1 or 2

All Grades 5 or 6

All Grades 1 or 2

All Grades 5 or 6

Care at Home only

1 (0.7%) 42 (29.1%) 1 (<1%) 55 (33%)

Care at Home combined with Housing Support

8 (1.5%) 157 (29.1%) 4 (<1%) 176 (32%)

Care Homes for Adults 33 (2.4%) 285 (21%) 15 (>1%) 263 (20%)

Findings from the Care Commission

There are good outcomes when we find:

• Good care planning and management• Safe systems for medication• Good management of unexpected staff absence• Support is relationship-based, not activity-based• Person-centred support is enhanced• People who have no close family support are

safeguarded

Messages for SCSWISKey Messages• Poor performers in all sectors• Monitoring performance is a challenge for all of us• Re-ablement needs more attention• Independent providers need to be round strategic

commissioning tableKey Challenges• Matching resources to risk• Getting service users and families to use regulation• Avoiding getting in the way of innovation

How can SCSWIS work with you to lead and develop improvement and

innovation?

How best can SCSWIS engage with the wider stakeholder group?

What would work best for you?