Blog: Supporting self-evaluation in care homes for older people

By Kevin Mitchell, Executive Director of Scrutiny and Assurance

Inspections are vital to provide assurance and support improvement, but so is robust, evidence-based self-evaluation undertaken on a regular basis as part of wider quality assurance approach can be even more powerful in supporting continuous improvement.

From 30 July this year, Care Inspectorate inspectors working with care homes for older people will be using a new quality framework as a core part of the inspection. This sets out the key questions and quality indicators, and provides illustrations of the quality we expect to see in care homes for older people. The primary purpose of the quality framework is to support self-evaluation, but our staff using it in this way is a clear and transparent way of showing what we will be looking for on our inspections. Therefore, the framework is an important tool for supporting care homes for older people to evaluate their own quality and Inspectors and care homes can use the same set of quality indicators to evaluate quality and plan improvements where necessary.

Whist this is a new approach in care settings, it is not a new approach for the Care Inspectorate. For many years, scrutiny and improvement bodies across social work, education, community justice and beyond have used such quality frameworks effectively to help assess the outcomes achieved by services, and the things that enable positive outcomes to be achieved and where improvement is needed . It is the approach we already use when we are looking at the co-ordination of social services, either in a health and social care partnership, or a community planning partnership.

Over the last year, we have adapted this approach in the Care Inspectorate for use within the context of single care services, and used the Scottish Government’s health and social care standards to illustrate the quality we are looking at. While these national standards are applicable for people using a wide variety of services, this framework is specific to care homes for older people (and we have commenced the process of developing similar frameworks for use in other settings).

The new inspections, using this framework, will feel familiar to people who have experienced recent inspections from the Care Inspectorate, with continued emphasis on evaluating the impact of care and support on people’s experiences, the difference services are making to people’s lives and outcomes. Inspectors will also look at some of the key enablers of high quality care, like the skills mix in the care home, and how people’s needs are assessed and planned for.

Although we will use it for inspection, the new framework is primarily designed for self-evaluation. Our experience is that self-evaluation, done well, is a powerful to tool to understand what is working well, what needs to improve, and to help start the improvement journey.

Self-evaluation is an important part of any quality assurance process, and over the year ahead we will be supporting care services to build their knowledge about and capacity in self-evaluation. There are three key self-evaluation questions that any provider should regularly ask: ‘how good are we now?’, ‘how do we know that?’ and ‘what do we plan to do next?’.

The first question helps providers to understand how good they currently are, and how they are making an impact on the lives of older people in their care home. The second questions is about collecting and interrogating the evidence for this. A key part of this evidence will not just be reviewing performance measures, but speaking directly with people experiencing care and their families to hear their views and insights into the quality they experience. The third question is about the starting point for planning measurable changes based on the evidence from the self-evaluation process. It links directly to key improvement approaches like the Model for Improvement, and increasingly, we are providing practical advice on our knowledge, innovation and improvement website, the Hub, for services to plan and measure improvements in their own care and support.

Of course, just as inspectors do not look at every separate quality indicator on every inspection, self-evaluation is best when done regularly and is focused on specific areas. The quality framework for care homes for older people will help services, and inspectors, identify core areas of practice on which to focus. On our inspections, for example, we will always look at the experiences of people’s social care, healthcare, and whether they are treated with compassion, dignity and respect, and also how people’s needs are assessed and care planned for. Where necessary, we will look in more detail at the leadership and staffing within a care home, and at the setting itself and how connected people can choose to be with the local community.

You can keep up to date with the changes and find more details about them on our new-inspections page