By Heather Edwards, Interim Head of Improvement Support

The Care Inspectorate is in a unique position in that we provide scrutiny and assurance and we have a formal responsibility for furthering improvements in the quality of care people experience. Our scrutiny work drives continuous improvement and acts as a diagnostic tool on which we can plan our improvement support activity which is integral to the Care Inspectorate’s core purpose and a key function.

Our first Improvement Strategy 2017-2019 set out our crucial role in supporting improvement as well as checking that these changes have a positive impact on outcomes for people. This strategy went beyond the traditional way of setting targets, recommendations or requirements and brings a systematic approach to realising improvement in the quality of care.

We are now building on the work from that strategy as we continue to embed the Health and Social Care Standards and the dynamic process of self-evaluation that leads to a culture of continuous improvement. So, I am delighted to introduce the refreshed Improvement Strategy 2019-2022, which supports our new Corporate Plan 2019-2022 and contributes to realising our vision and common purpose of world-class care for everyone in Scotland.

This strategy demonstrates how we have successfully strengthened our improvement support role and function across the Care Inspectorate and celebrates the difference that has been made, ultimately, to the lives of people experiencing care. It provides an insight into what our improvement support offer will be over the next three years and how we will identify where improvements are required.

Growing improvement capacity

The strategy describes how we will build the skills, confidence and capacity for improvement support with our own staff and across the social care and early learning and childcare sectors in Scotland. The key aspect of this refreshed improvement strategy is how we aim to continue to support care services, providers and partnerships to develop their improvement skills in order to make lasting improvements. At the same time, we are supporting and spreading innovation and involving those who experience care and support throughout the process in order to see the best outcomes for people who experience care.

This strategy has three over-arching aims.

  1. Grow improvement support
    We continue to build improvement capability and capacity both within the Care Inspectorate, with social care providers and partnership areas.
  2. Growing innovation
    We test out, support and spread innovative practice. At the same time, we influence policy across social care to support the development of world class care and provide models of care which are fit for the future.
  3. Grow involvement
    We involve people who experience care and support to shape and direct improvement support to where it matters most for people and the communities they live in.

Health and Social Care Standards

The Health and Social Care Standards are at the heart of all our work and provide a human rights, person-led focus through which the outcomes of improvement support can be measured. These standards, which have a strong focus on what matters most to people, will continue to enable us to build a culture and understanding of improvement within the Care Inspectorate and across the social care sector. The standards also challenge us to explore different opportunities for improvement activity and the testing of innovative models of care.

Embedding a culture of self-evaluation

Self-evaluation is central to continuous improvement. One of our key strategic objectives in our Corporate Plan is to promote quality self-evaluation with providers and partnerships and to work collaboratively with them to develop effective tools to support the self-evaluation process. Through the activities of this strategy we will, using an improvement support approach, carry out this work. The new quality frameworks, based on the standards, can be used by services to self-evaluate and to identify areas for improvement.

Self-evaluation is a reflective process through which providers of care services can get to know what they do well and identify where they need to improve, and the best way to do that. It is a dynamic and continuous process rather than a one-off activity. It is forward looking, leading to the development of improvement plans and the relevant actions to test change ideas for improvement to see what works best, which leads to implementing good practice and supporting innovation in care. Self-evaluation is a very important marker of quality assurance. If you would like to know more about self-evaluation, please read our guide to this The Hub website.

Improvement is everyone’s responsibility

Improvement support is not the responsibility or remit of just one team within the Care Inspectorate but of the organisation as a whole. As a result of the work we are doing, our workforce is growing in confidence and knowledge in improvement approaches to support the care sector. This is a great strength of the Care Inspectorate and its approach to improvement support, it is part of everyone’s role, crosses directorates and everyone has a part to play. This refreshed improvement strategy gives a focus on how we as an organisation will provide improvement support across the Care Inspectorate. Improvement support is a key component of our new business model and has a significant role to play across registration, inspection, complaints and enforcement. Over the next three years the improvement support aspect of our work will strengthen not only to support improvement in regulated care services but also in strategic inspections.

Intelligence-led improvement support

The Care Inspectorate firmly believes that effective use of intelligence is the foundation for our scrutiny, assurance and improvement support approaches – enabling our work to be intelligence-led, risk-based, targeted and proportionate.
Almost uniquely among health and social care regulators, the Care Inspectorate is responsible for investigating complaints about registered care services. Complaints are one of the most important ways we can support rapid improvement in care quality. Complaints activity can also provide us with important intelligence in order to know where to target our improvement support.

Our current business and digital transformation programmes give us an opportunity to develop our business model in which improvement support can be clearly identified as a core function of what we do and is aligned with our core purpose. This will provide good intelligence and enable us to look at the themes emerging from our scrutiny and assurance activity. Understanding the intelligence that we gather will allow us to provide the right intervention at the right time with the maximum effect and impact.

Involving people

Just as there has been a shift in our approach to scrutiny and assurance to focus on outcomes for people through the assessment of quality in services being based upon people’s personal experiences, we need to ensure the same principles are followed for improvement support. We will strengthen the links to the Involving People team to explore ways of engaging with people who experience care as well as with our inspection volunteers to help realise the aspirations of the Involvement Strategy.

We will actively encourage people to get involved in influencing and shaping our improvement support programmes. Improvement, by the very nature of the process, requires us and all our partners to work differently and to be united and optimistic in our approach. In order to see success, the experience, knowledge and input of everyone involved must be valued and respected while working on the principles of co-production and collaboration such as “we all teach, and all learn”.

Improvement alliances

Collaboration is key to successful improvement and this has been demonstrated many times throughout our improvement support work, and particularly through programmes such as Care About Physical Activity Programme (CAPA) where the strength of relationships with partners and stakeholders is critical to success. Over the past two years we have further built and nurtured relationships with other improvement bodies and organisations, such as the iHub in Healthcare Improvement Scotland (HIS), in order to maximise our collective improvement support efforts and develop, share and spread good practice. Working collaboratively with local communities and local subject matter experts where we cannot directly provide that much needed expertise, is also essential to support sustainable positive change. The cornerstone to supporting improvement is developing and nurturing relationships with all stakeholders.

I am confident that as a result of the implementation of the improvement strategy our capacity, ability and opportunity to support improvement will grow. In turn this will help us ensure people in Scotland are experiencing world-class care.

  • You can read the full Improvement Strategy 2019-2022 on the Care Inspectorate website.
  • If you would like to learn more about how we support improvement, please visit The Hub website where you will find a suite of improvement resources, guidance and other materials.