Inspections

Infection prevention and control (IPC) standards published

Healthcare Improvement Scotland has published new IPC standards that apply to health and adult social care settings

The standards will act as a key component in the drive to reduce the risk of infections in health and social care in Scotland. They will support services to quality assure their IPC practice and approaches, and the IPC principles set out in the National Infection Prevention and Control Manual.

The Care Inspectorate will take account of the standards in our inspection and regulation of adult and older people’s care services including care homes.

The standards can be found here. 

Our approach to inspection and self-evaluation

In consultation with the social care sector, we have developed a self-evaluation and quality framework model based on the Scottish Government’s Health and Social Care Standards.  We have used this model to develop a suite of quality frameworks for different service types.

Our inspectors use quality frameworks to evaluate the quality of care during inspections and improvement planning. 

All our frameworks are available to download from the publications and statistics area or on The Hub.

The frameworks replace our previous practice of inspecting against themes and statements.  Inspectors will look select a number of quality indicators from a number of key questions to look at. 

Framework structure

The frameworks better reflect the Health and Social Care Standards and provides more transparency about what we expect. 

They set out key questions about the difference a care service makes to people’s wellbeing, and the quality of the elements that contribute to that. These include:

• How well do we support people’s wellbeing?
• How good is our leadership
• How good is our staff team?
• How good is our setting?
• How well is our care and support planned?

Under each key question, there are three or four quality indicators, covering specific areas of practice. Each quality indicator has illustrations of what ‘very good’ quality would look like, and what ‘weak’ quality would look like. These illustrations are drawn from the Health and Social Care Standards but are not checklists or definitive descriptions. They are designed to help people understand the level of quality we are looking for.

A sixth question, ‘What is our overall capacity for improvement?’ is included in the framework to help care services in planning their improvement journey.

Each quality indicator includes a scrutiny and improvement toolbox.  This includes examples of how we might evidence the quality of care provided.  It also contains links to practice documents that will help services in their own improvement journey.

Key questions added as a result of Covid-19

In order to robustly assess  arrangements to respond to the Covid-19 pandemic, our inspections are placing particular focus on infection prevention and control, wellbeing and staffing in care settings. 

We have developed a key question to augment our frameworks. We have done this to meet the duties placed on us by the Coronavirus (Scotland) (No. 2) Act and subsequent guidance that we must evaluate infection prevention and control and staffing.  

This means carry out targeted inspections that are short, focused and carried out with colleagues from Health Improvement Scotland and Health Protection Scotland, to assess care and support during the Covid-19 pandemic. We will continue to put the wellbeing for people experiencing care at the heart of our inspections.  

This additional key question has been added to our frameworks for:

• Care homes for children and young people and school care accommodation (special residential schools)
• Mainstream boarding schools and school hostels
• Secure accommodation

Self-evaluation

The quality frameworks help services evaluate themselves. Self-evaluation is central to continuous improvement.  It enables care settings to reflect on what they are doing so they can recognise what they do well and identify what they need to do better.  We have published a guide to self-evaluation to support services in their improvement journey and a range of toolkits to support services undertake self-evaluation.

Where can I find out more?

The quality frameworks and key question 7's (KQ7s), and our inspection leaflet gives more information. 

Alternatively, you can contact your inspector, call us on 0345 600 9527 or email This email address is being protected from spambots. You need JavaScript enabled to view it..

Enforcements

Enforcement is an essential and powerful element of the Care Inspectorates' core responsibilities and it is central to our aim of protecting service users and bringing about an improvement in the quality of care services.

We have two different types of notices that can be served against care services.

Condition Notices

A condition notice is served when the Care Inspectorate needs to change the conditions of registration of a service in order for it to operate.  If a provider wants to change their conditions of registration, they can apply for a variation.  An application for variation is not treated as “enforcement”.  Read more about variations here.

Improvement Notice

An improvement notice might be served when we have sufficient concerns about a service.  The provider must make the required improvements within a given timescale.  If not, we may pursue the cancellation of that service.  Cancelling a service is rare and we work hard with services to ensure that this is the last resort.

Urgent Proceedings 

If we believe that there is a serious and immediate risk to life, health or wellbeing, we can apply to the Sheriff Court for emergency cancellation of a service's registration or apply for changes to their conditions.

Click here to view/download the Enforcement Policy.

Read more in our Requiring care services in Scotland to improve leaflet.

• Professional
• Enforcement