ccps membership meeting discovery point, dundee 12 june 2014
TRANSCRIPT
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