1. CCPS Membership Meeting Discovery Point, Dundee 12 June 2014

2. N ational care standards and inspection methodology reviews Helen Happer Head of Quality and Improvement Care Inspectorate

3. Modernising our inspection methodology Helen HapperMarie Paterson Head of Quality & ImprovementProject lead, methodology review

4. 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

5. Post Crerar proportionateTargeted OUTCOME FOCUSED Evidence Based

6. 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

7. 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

8. 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

9. 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

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

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

14. 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

15. 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

16. 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

17. Process..... Direction setting Consultation Framework dev’t Direction check Consultation/review Enabler development Review/direction check Testing Implementation Consultation and review

18. 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

19. Update on the National Care Standards Review Heather Dall Scottish Government National Care Standards Review Team

20. National Care Standards Review Public Consultation

21. 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

22. NCS Services 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

23. 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

24. Review Teams activities: Pre-consultation events Focus groups/reference groups Liaising with HIS, MWC, SHRC Linking with SG policy leads 2 Project Board meetings

25. Project Board CCPS Audit Scotland Scottish Care MWC HIS SHR SSSC LA/NHS SG policy leads CI COSLA SHR Carers Scotland Police

26. 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

27. 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

28. Areas for consultation Human Rights emphasis Apply to all health and social care services Structure/model Content Who should develop

29. 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

30. 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 ??

31. A provider perspective on inspection – key issues and concerns Marcia Ramsay Director Leonard Cheshire Disability Scotland

32. Discussion