The Care Inspectorate is the national regulator for care services in Scotland – just as the CQC is the national regulator for care services in England. Below you will find an infographic that describes the role of the Care Inspectorate with detailed explanation below that.
It’s aim is to register, inspect and rate services using a proportionate and targeted approach which drives high quality care, support and treatment.
Service providers are involved in shaping improvement through completing Annual Returns which provide valuable data. The data enables the Care Inspectorate to target organisational improvement with a view to supporting health and social care providers.
What is the role of the Care Inspectorate?
Below is an infographic that explains the role of the Care Inspectorate in Scotland. Right click while holding down the CTRL key and scroll to enlarge it. You can also download the infographic as a pdf.
What is the Care Inspectorate?
The Care Inspectorate, previously Social Care and Social Work Improvement Scotland (SCSWIS), was set up in 2011 by the Scottish Government as a single regulatory body for social work and social care services. Today it regulates around 14,000 services in Scotland. Of the home care services, 14 (1.2%) are run by a health board, 180 (15.2%) by a local authority, 481 (40.7%) are private and 508 (42.9%) are voluntary or not-for-profit (figures as at 30 June 2023).
All care services must, by law be registered with the Care Inspectorate.
Providers complete an annual return. The data collected supports the Inspectorate to plan, inform and carry out inspections with a view to targeting areas of improvement. This helps the Inspectorate to identify trends and topics that need to be improved both geographically or by service type.
What are the aims of the Care Inspectorate?
The Care Inspectorate registers new services and inspects them grading them on a 6 point scale. It investigates complaints and, using a targeted approach, pays closer attention to services requiring improvement. An approach is taken that is proportionate to the size and issues within an organisation and enforcement action is taken when necessary to drive improvement.
What criteria does the Care Inspectorate use for inspections?
The inspection framework is well established and since April 2018 the Health and Social Care Standards have been used across Scotland. Similar to the CQC Fundamental Standards, these standards set out the standards of care that people can expect from care and support services.
The standards are underpinned by five principles:
- Dignity and respect
- Responsive care
- Support and well-being
What are the Care Inspectorate ratings?
When care services are inspected they are graded on a six point scale from Excellent to Unsatisfactory:
- Grade 6 – Excellent
- Grade 5 – Very good
- Grade 4 – Good
- Grade 3 – Adequate
- Grade 2 – Weak
- Grade 1 – Unsatisfactory
For the second quarter of 2023 just 0.3% of services inspected were deemed to be Unsatisfactory, 2.8% Weak, 13.3% Adequate and 83.6% Good, Very Good or Excellent.
What are the Health and Social Care Standards?
The Health and Social Care Standards are based on service user’s experiences and provide clear guidance on what they can expect from the services they receive in relatiom to their care, support and treatment. The focus is on high quality, outcome based person centred care.
- I experience high quality care and support that is right for me
- I am fully involved in all decisions about my care and support
- I have confidence in the people who support and care for me
- I have confidence in the organisation providing my care and support
- I experience a high quality environment if the organisation provides the premises
What are the Core Assurances?
The Inspectorate has a set of core assurances that guide their work and ensure the quality and safety of care services. These core assurances include:
- Quality of Care: Ensuring that individuals receiving care and support experience high-quality care that is person-centered and meets their needs and preferences.
- Rights and Choices: Upholding the rights of individuals who use care services, including their right to make choices about their care and support.
- Safety: Ensuring that care services are safe for individuals who use them, with appropriate safeguards in place to protect their well-being.
- Staffing: Ensuring that care services have an appropriate number of skilled and trained staff to provide safe and effective care.
- Leadership and Management: Assessing the leadership and management of care services to ensure they are effective in delivering high-quality care and improving outcomes for individuals.
- Effectiveness: Evaluating the effectiveness of care services in achieving positive outcomes for individuals and their families.
- Efficiency: Assessing whether care services are delivered efficiently and make the best use of resources to provide value for money.
- Improvement: Supporting and encouraging care services to continuously improve and learn from best practices.
- Communication and Engagement: Promoting effective communication and engagement with individuals who use care services, their families, and the wider community.
- Inclusivity and Equality: Ensuring that care services promote inclusivity and equality, respecting the diverse needs and backgrounds of individuals.
These core assurances are essential for the Care Inspectorate’s mission to improve the quality and safety of care services in Scotland and to protect the rights and well-being of those who use them. Inspections and assessments are based on these core assurances to ensure that care services meet the required standards and make recommendations for improvement where necessary.
How does self-evaluation work for providers?
There is an emphasis on self-evaluation of services by providers to drive continuous improvement, and this is an ongoing process. Self-evaluation relates back to the Core Assurances. Providers are empowered to self-evaluate and reflect on their own performance to support continual improvement, this establishes a baseline for improvement and improves outcomes for service users.
The Inspectorate does not routinely ask for evidence of improvement or action plans, this is wholly the responsibility of the provider although the Inspectorate may ask for the above as part of their ‘scrutiny’ of a service.
Providers are expected to ask themselves the following questions and provide evidence to reflect their processes:
- How well do we support people’s well-being?
- How good is our leadership?
- How good is our staff team?
- How good is our setting?
- How well is our care planned?
What sort of evidence does the Care Inspectorate ask for?
Sources of evidence can include the following:
- Performance data – these would include assessments and risk calculations, for instance using the Waterlow Score or Braden Scale, tasks, observations, incident and concern reports, reviews, training records, carer’s journals, client journals, capacity planning and rostering documentation along with evidence of invoicing and payroll.
A good all-in-one digital care records system like CareLineLive will help providers gather this information on a daily basis so it is then available for inspections at the click of a button.
- Views of people experiencing care – many of the same sources as detailed above can be utilised alongside service user feedback, staff feedback and feedback from related professionals. Care plan reviews and quality assurance documentation may also be helpful. The views of the wider care circle, including friends and family, may also be consulted – again CareLineLive has a feature in place to enable communications with the care circle. Observations of the care may also take place.
- Views of staff – again these may be documented in the information listed above as well as private and group feedback.
- Views of other stakeholders and professionals – these will be gathered from incident and concern reporting, risk reporting and the risk register as well as related professionals feedback and the client journal
The Care Inspectorate will want to review documents that show how decisions are made and to ensure that service users are involved in the evaluation process.
Documentation needs to show a professional level of risk assessment, that goals and outcomes are being measured and that good governance and leadership is in place.
Finally the Care Inspectorate will want to see evidence that improvements are ongoing. Case studies may document this alongside improvement data and the formal documentation listed above.
What does the Care Inspectorate look for when registering new providers?
Registration is online and potential providers provide specific evidence that relates to the service type.
Checks for registration include:
- Whether the provider is fit to provide the service
- Whether the manager is fit to manage the service
- That the proposed premises are fit to be used for that purpose (dependent on the service type)
- That the service will make all the proper provisions for the health, welfare, independence, choice, privacy and dignity of everyone using the service.
- Financial viability
What criteria do registered providers have to meet in Scotland?
There are a number of laws and regulations that care service providers have to comply with both at registration and beyond. All services must continuously meet the requirements of:
- The Public Services Reform (Scotland) Act 2010
- The Social Care and Social Work Improvement Scotland (Registration) Regulations 2011 (SSI 2011/28)
- The Social Care and Social Work Improvement Scotland (Applications) Order 2011 (SSI 2011/29)
- The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/210)
- The Health and Social Care Standards
- Be conversant with self-evaluation for improvement – your guide
- Be conversant with the quality frameworks
Who are the care service regulators in other parts of the UK?
Care services in England are regulated by the Care Quality Commission. In Wales by the Care Inspectorate Wales, in Northern Ireland but the Regulation and Quality Improvement Authority and in Jersey by the Jersey Care Commission.
In Ireland home care is not regulated to the same extent as the UK and there are campaigns to regulate services. There is a provider list for providers that want to deliver care through HSE. Providers must comply with the Tender 2018 Service Specifications which were developed in line with the Health Information and Quality Authority (HIQA) National Standards for Safer Better Healthcare. These set out the key principles of quality and safety that should be applied in any health care service setting. All service providers have an obligation to meet the national standards.
How does CareLineLive help home care providers?
CareLineLive is all-in-one home care management software with numerous features to support the day-to-day running of a home care business.
The assessments, eMAR, body maps and concern and incident reporting allow for excellent person-centred care planning.
The built-in reports give ample opportunities to provide evidence for regulatory purposes and these are collected on an on-going basis so that when an inspection happens the information is readily available.
The carer app facilitates real time information flow from carers out in the field so that managers can deal with issues, reviews and updates in real time.