Joint inspections of adult support and protection

Background

Phase 1 of our programme of joint inspections of adult support and protection took place during 2020-2023. Twenty-five joint inspections were carried out, and individual partnership reports were published. An overview, summarising the findings in these reports was also published, and is available here. This shaped our subsequent phase 2 approach.

Phase 2

In June 2023, the Scottish Government asked the Care Inspectorate to lead further joint inspection work with our inspection partners including, Healthcare Improvement Scotland and His Majesty’s Inspectorate of Constabulary in Scotland. This commenced on 1 August 2023 and is scheduled to conclude in July 2025, and blends scrutiny activity with improvement support. There has been close collaboration with adult protection partnerships throughout.

The programme provides assurance on the quality of adult support and protection services in Scotland and promotes improvement activity through the development of a quality indicator framework and supported self-evaluation. Phase 2 of the programme comprises four workstreams.

Workstream 1

The joint inspection of the six adult support and protection partnerships first inspected in 2017.

The first year of our phase 2 programme included reviewing the progress of the six adult protection partnerships that were subject to adult support and protection inspections in 2017/18. The joint inspection team used the inspection methodology employed in Phase 1. These inspections focused on key processes and strategic leadership.

This programme of inspections was completed in May 2024 and included the North Ayrshire, Highland, Dundee, Aberdeenshire, East Dunbartonshire and Midlothian partnerships. Individual reports of the inspections have been published and can be accessed using the links above.

A joint inspection of adult support and protection overview report took account of the key findings from these six reports. This was published and can be accessed here.

Workstream 2

Development of a multi-agency quality improvement framework (QIF) for adult support and protection partnerships in Scotland.

Design of the QIF was undertaken in collaboration with The Scottish Government National Implementation Group self-evaluation subgroup. Four consultation workshop events took place, to which representatives from all health and social care partnerships across Scotland were invited. This included events in Glasgow, Edinburgh, and Dundee, as well as one online session. These were held to provide an opportunity for the sector to comment on, refine, and enhance the draft framework. The sessions were attended by approximately eighty-four delegates representing almost all Health and Social Care Partnerships and the feedback gathered was then used to inform the final document.

A working group was established that included joint inspection partners and representation from the national implementation group.
The working group took careful consideration of the views from people with lived experience to ensure it was trauma informed.
A communication plan was designed and implemented and four well attended engagement sessions were arranged
The joint inspection team undertook a ‘you said, we did’ exercise with the national implementation self-evaluation subgroup to review the key themes from the four engagement sessions. We refined the QIF following their feedback.
The QIF was published on 15 October and can be accessed here.
This document will be promoted widely across the sector after its launch at a series of national events.
This includes a formal launch at the Aspire event that took place on 28 November 2024
This framework will support partnerships multi-agency self-evaluation of their adult support and protection arrangements and is designed to lead to improvement in services.

Workstream 3

This review of progress activity provides assurance of improvement in those partnerships where areas of weakness outweighed strengths in phase 1. This programme involves the South Ayrshire, Moray, West Lothian, Edinburgh, Orkney, and Western Isles partnerships.

Our file reading tool had previously been updated to reflect the changes in methodology and take account of the Scottish Government revised code of practice for adult support and protection (July 2022).

Completed workstream 3 progress reviews include South Ayrshire, West Lothian, Edinburgh and Moray. Individual reports will be published in due course for all six partnerships.

In these progress reviews we are using the following evaluations to measure progress.

Minimal progress: Improvement is minimal. The partnership’s overall approach to improvement is not comprehensive or put into practice. Its deployment and implementation are limited. It has not embedded improvements or they are still at the planning stage. It does not communicate improvements effectively and they are not well understood by staff. It does not assess and review the effectiveness of its improvement progress.   

Some progress: Evidence of some improvement.  The partnership’s approach to improvement is moderate.  Its implementation and deployment of improvements are structured.  It is beginning to embed improvements in practice.  It communicates improvements partially and staff understand them reasonably well.   It has limited measures to evaluate and review impact and outcomes for adults at risk of harm.  It periodically assesses and reviews its improvement methodology. 

Significant progress: Significant improvement. The partnership’s approach to improvement is comprehensive and embedded. Its deployment of improvements is well structured, implemented and effective. It communicates improvements purposefully, and staff understand them fully. It has effective measures to evaluate and review impact and outcomes for adults at risk of harm. It continually assesses and refines its improvement methodology.

The joint inspection team will also be re-visiting the Renfrewshire partnership to complete their phase 1 inspection that was interrupted by Covid-19 restrictions coming into force in March 2020.

Workstream 4

The joint inspection of adult support and protection team aims to work with volunteer partnerships, using the quality improvement framework developed in workstream 2, to undertake a programme of supported self-evaluation. Our focus will be on quality illustration 5.7 and those cases where it is difficult to determine the three-point criteria. During phase 1 activity some partnerships had promising initiatives aimed at developing their early intervention, prevention, and trauma informed approaches to this complex group of adults at risk of harm. We will work jointly with partnerships to assess the strengths of these initiatives.

This is an opportunity for partnerships to work alongside the joint inspection team to develop and implement the methodology. We will share learning and promote a deeper understanding about self-evaluation approaches and its impact on improvement work.

We have invited all adult support and protection partnerships to formally express a confirmed interest in this opportunity week commencing Monday 11 November 2024. We will look to confirm the partnerships selected prior to the end of December 2024 and commence work with them in January 2025.

A communication and engagement plan will be put in place once we have identified the partnerships we will be working with.