In order to support excellent practice in services for individuals with a learning disability, the Care Inspectorate will further develop its approach to how it delivers scrutiny and improvement work in services providing support to adults with a learning disability during 2015/16.  

This will build on the awareness work that the Care Inspectorate undertook during 2014/15 with care homes for adults with a learning disability around the Keys to Life strategy and the Winterbourne View recommendations. 

During this year, our inspectors raised awareness of these important documents by asking a number of key questions about the strategy and the report of care home managers. The purpose of this work was to support services to implement the recommendations. 

From April 2015, the Care Inspectorate will be conducting an Inspection Focus Area around the Keys to Life as part of planned scrutiny and improvement. This will focus on people's experience and outcomes and how their rights are promoted and protected. This will take place across services for adults with a learning disability.  

Separately, a small cohort of 36 care homes for adults with a learning disability will be inspected in a new way as part of our review of scrutiny and improvement. 

The Inspection Focus Area

Our future work around the Inspection Focus Area will take the form of inspectors asking a series of improvement focussed questions to generate and identify good practice and to report on where key principles relating to Keys to Life have been met, including enabling a safe and open culture and equal access to healthcare. 

This will start during the self assessment. At the subsequent inspection, inspectors will follow-up any outstanding requirements and then the focus will be on Keys to Life against all four quality themes, using these quality statements:  

Care and support 

1.1 and 1.5 We respond to service user care and support needs using person centred values 

Environment (care homes only)

2.1 and 2.3 The environment allows service users to have as positive a quality of life as possible


3.1 and 3.4 We ensure that everyone working in the service has an ethos of respect towards service users and each other

Management and leadership 

4.1 and 4.3 To encourage good quality care, we promote leadership values throughout our workforce 

The inspection will draw evaluations (grades) in the usual way, using the scale from unsatisfactory - excellent. 

We will ask you to complete the self assessment which will be available from mid February 2015 and we will notify you through the eform system when it is available. This must be completed by the end of March 2015 as the information will be used to inform our inspections of your services. 

Please focus on updating your self assessment, paying specific attention to the quality statements highlighted for next year, as well the additional questions in your self assessment about equality and access to health care. 

We are adding a new section to the self assessment however, the rest of the self assessment will remain as is and will be pre-populated with existing information you have supplied us. 

New type of inspections - a test of change 

The Care Inspectorate is currently testing new types of inspection to support our proportionate, risk-based approach and see if different inspection types can better support improved outcomes for people using care services. In approximately 36 care homes for adults with a learning disability which are evaluated as being good, very good or excellent, we propose to conduct shorter, thematic inspections. These will not hinge on particular quality statements, but will examine more broadly they way that the care home is implementing the Keys to Life policy under each of the four quality themes (care and support, staffing, environment, management and leadership). The inspection will follow up on any outstanding requirements, and the reports will be much shorter and more accessible. We will not draw evaluations (grades) for these inspections. If, however, the inspector is concerned by any aspect of the care they see during the inspection, they may revert to a more traditional inspection.  

We appreciate that care services taking part in this test of change will want further detailed information about them, and we will ensure this is provided in due course.  

If you have any questions then please do not hesitate to get in touch with your inspector.