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Joint inspections of integrated services for adults

Published: 13 March 2015

Along with Healthcare Improvement Scotland, we carry out joint inspections of health and social work services for adults.  From April 2016 Integration Joint Boards have been in place made up of representatives from NHS boards, local authorities third and independent sectors and those who use health and social care services. The Public Bodies (Joint Working) (Scotland Act) 2014 and guidance aims to ensure the provision of seamless, consistent, efficient and high-quality services, which deliver very good outcomes for individuals and carers. Each local partnership had to produce a joint commissioning strategy and a joint integration plan, for adult services. From 2017 we carried out inspections of health and social care integration focussing on progress made in strategic planning and commissioning.

Following a review of progress in health and social care integration by a Ministerial Strategic Group we have been working together with Healthcare Improvement Scotland to develop an updated inspection methodology, including a set of quality indicators to inspect against. This methodology is to determine how effectively health and social work services work in partnership, including the third and independent sectors, to deliver very good outcomes across the whole adult population

The inspection teams are made up of inspectors and associate inspectors from both the Care Inspectorate and Healthcare Improvement Scotland and clinical advisers seconded from NHS boards. We plan to have inspection volunteers who are members of the public who use a care service, have used a care service in the past or are carers and Healthcare Improvement Scotland’s public partners on each of our inspections.

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Joint inspection of services for children and young people

Published: 13 March 2015

What do we do?

In 2017, the Scottish Government’s child protection improvement programme set out a vision for a child protection system in Scotland that places the wellbeing of children at the heart of everything it does. Scottish Ministers asked the Care Inspectorate to work with scrutiny partners to take a more focused look at children and young people in need of care and protection.

Our joint inspections therefore take account of the experiences and outcomes of such children and young people by looking at the services provided for them by community planning partnerships in each local authority area. This includes the work of health visitors, school nurses, teachers, doctors, social workers, police officers and lots of other people who work with children, young people and their families.

What is our approach?

When we engaged with children and young people about the focus of inspections, their most important message to us was that children and young people should be enabled to experience sincere human contact and enduring relationships. They want to be able to build trust through consistent relationships with adults and they want to be supported to maintain contact with those people who are most important in their lives. Our approach therefore looks carefully at how well the system is organised to ensure that they can experience continuity in their care and develop and sustain lasting relationships.

We believe that staff who are well trained and supported, and who feel valued and empowered, are more likely to be able to provide high quality services for children and young people. We will therefore explore how well staff are valued, supported and equipped to carry out their task. We know from our inspection findings that partners recognise the critical importance of achieving high standards in assessment and planning to ensure the safety of, and improve outcomes for, children and young people. However, we also know that performance in assessment and planning is not as consistently strong across the country as it needs to be and we will look at the extent to which robust quality assurance and high quality reflective supervision are in place.

Our inspections will also consider the appropriate use of legal measures to achieve security and stability in the lives of vulnerable children. Strong collaborative leadership is essential within the challenging context of providing high quality public services in an integrated landscape. Inspections will include a focus on the role played by staff who work in adult services in protecting children and young people and supporting sustained positive change for them and their families.

We will continue to evaluate the effectiveness of collaborative leadership, including leadership of the child protection committee and its relationship with chief officers, and we will identify any barriers that affect continued improved performance. We will look at how well leaders can demonstrate what difference they are, together, making to the lives of children in need of protection and those for whom they are corporate parents.

We started the current round of joint inspections of services for children in need of care and protection in August 2018 and will continue to review and revise the approach over the course of these inspections.

How do we do it?

Our inspections last for a number of months. We collect information about the area before we visit it. This helps us to understand what happens there and what is affecting the way that services are being provided.

During the inspection, a team of inspectors from the Care Inspectorate and other partner agencies visit the area over two separate weeks.

This gives us the chance to find out if children, young people and their families are getting the help that they need and if services are making a difference to their lives. To do this we:

  • speak with the staff
  • speak with children and young people and listen to their views
  • speak with parents and carers
  • read information about the children and young people.

What individual people tell us during inspection is confidential. Our reports do not include any information about them or their family, or anything that could identify them. However, we do have a duty to pass on information if there are concerns about someone’s safety.

After our inspection, we publish a report on our website about what we found for the area. Our inspection reports set out what works well and what could improve. We expect the community planning partnership to take action on any recommendations we make for improvements.

For more information about what happens during an inspection click here for The Guide.

How can you get involved?

What you think really matters. If we are inspecting your area, and you have experience of services, you may want to speak to us about the help that you have been getting.

We will offer a range of ways for you to give us feedback. As well as a survey we will arrange one-to-one discussions and group meetings. Our one-to-one discussions can take place in person, or we can contact you by phone or other ways such as Facetime or Skype.

If you give us information anonymously, we may not be able to get in contact with you if you raise concerns about your own safety or the safety of anyone else. If you have such concerns we would encourage you to contact your local authority and ask for their child protection or adult protection service. You can also contact Childline on 0800 1111. If we have any concerns about the safety of individuals we will share this with protection agencies.

Our inspection team also includes young inspection volunteers. These are young people aged 18 – 26 with experience of care services who help us with our inspections. If you are a young person, you can choose to speak with one of them and you can have a person to support you when you meet them. If you are a young person and want to know more about young inspection volunteers or how to get involved, click here to find out more.

 

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Education Scotland

Published: 13 March 2015

The Care Inspectorate and Education Scotland have recently reviewed their collaborative working approaches for carrying out inspections in the early years and school care accommodation sectors. The previous methodology was developed by our predecessor bodies, the Care Commission and HMIE. It is important to update the methodology to better meet the requirements of the Public Services Reform (Scotland) Act 2010.

Our new arrangements for working together will seek to maintain high levels of efficiency and effectiveness and to streamline the paperwork we request from providers. 

Changes include joint questionnaires and joint self-assessment and reporting formats. There will be a care inspector as part of the inspection teams for nursery classes in primary schools.

Children and Young People (Scotland) Act: Early Learning and Childcare

Education Scotland and the Care Inspectorate will work together to support the development and expansion of early learning and childcare. 

We will continue with our current programmes of both individual and shared inspection and evaluation of services for children aged 3 to school age. In relation to the new entitlement for specified groups of 2 year olds to early learning and childcare, our shared activities will focus on building capacity in partnership with the local authorities and organisations such as the National Day Nurseries Association, Play Scotland  and the Scottish Childminding Association (SCMA), as well as providers themselves.

Our collective aim is to assist in ensuring that the increased provision will be of a high quality with the focus on achieving the best possible outcomes for children and that commissioners and providers are committed to delivering flexible choices for parents. 

The Care Inspectorate will continue to inspect all daycare and childminding services for children in line with current legislation.

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Statistics and analysis

Published: 13 March 2015

We collect a wide range of statistical information about Scotland's care services.  We collect this to help us regulate services.  We also use this information to produce statistical overviews of the service types we regulate.  

We include data in our annual report and accounts, annual childcare statistics and the periodic, state-of-the-nation reports we produce.

Use the following links to find the publication you are looking for:

Childcare Statistics

Quarterly Statistical Summary Report

You can find our reports in our publications and statistics area.

Childcare Statistics

The Childcare Statistics detail the provision and use of registered daycare of children and childminding services in Scotland.  These are updated on an annual basis.  Below are links to the annual reports since 2010.

Care Inspectorate Quarterly Statistical Summary Report

The Quarterly Statistical Summary Report publication presents data on the number of registered care services, care service registrations and cancellations, complaints against care services received, registered and completed and quality theme grades all by care service type and or service sector. 

Full reports are available for download in Adobe Portable Document Format (.pdf) and Microsoft Excel (.xlsx) format.  In addition, the data tables are available in non-proprietary Comma Separated Values (CSV) format, individually.  The provision of the data in these formats is intended to facilitate its analysis and re-use.

All content is available under the Open Government License, unless otherwise stated.  More information on this license is available at https://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Our Intelligence Team compile and manage the information within the Quarterly Statistical Summary Report.

For help using this or any queries relating to its content or use then please email us This email address is being protected from spambots. You need JavaScript enabled to view it.

Care Inspectorate Quarterly Statistical Summary Report - Quarter 2 (2024/25)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 1 (2024/25)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 4 (2023/24)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 3 (2023/24)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 2 (2023/24)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 1 (2023/24)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 4 (2022/23)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 3 (2022/23)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 2 (2022/23)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 1 (2022/23)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 4 (2021/22)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 3 (2021/22)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 2 (2021/22)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 1 (2021/22)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 4 (2020/21)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 3 (2020/21)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 2 (2020/21)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 1 (2020/21)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 4 (2019/20)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 3 (2019/20)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 2 (2019/20)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 1 (2019/20)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 4 (2018/19)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 3 (2018/19)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 2 (2018/19)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 1 (2018/19)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 4 (2017/18)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 3 (2017/18) - Revised

Care Inspectorate Quarterly Statistical Summary Report - Quarter 3 (2017/18)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 2 (2017/18)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 1 (2017/18)

Care Inspectorate Quarterly Statistical Summary Report - Quarter 4 (2016/17)

 

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Joint inspections

Published: 13 March 2015

The joint inspections are undertaken by the Care Inspectorate’s strategic inspection team who sit within the Scrutiny and Assurance Directorate. Please click here to find out more information.  

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Inspections

Published: 06 October 2014

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..

 

 

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Enforcements

Published: 06 October 2014

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.

 

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Notifications and record keeping

Published: 06 October 2014

Large Scale Investigation Notifications

Since 2014, adult protection codes of practice have required that the Care Inspectorate is alerted to the occurrence of large scale investigations.

This is an expectation that is directed at Local Authorities and now, by extension, HSCPs.

Please notify us on the commencement of a large scale investigation here.

Please notify us of the completion of a large scale investigation here.

Notifications and record keeping 

By law all services must tell us immediately if certain events take place. 

  • Accidents, incidents or injuries
  • Outbreak of infectious disease
  • Death of person using a care service 
  • Allegations of abuse
  • Significant equipment breakdown
  • Allegation of misconduct by a provider or employee
  • Criminal convictions resulting in unfitness of a manager
  • A provider becoming unfit
  • Absence of manager
  • Planned refurbishment/alteration/extension of premises
  • Change of registration details
  • Person living at the registered premises

We have produced comprehensive guidance on the records you must keep and the notifications you must make (click on the links below).

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Unannounced inspections

Published: 06 October 2014

Unannounced inspections

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Annual returns

Published: 06 October 2014

Each year, we ask service providers to complete an annual return to help us plan, inform and carry out our inspections and improvement work. 

We also publish a number of annual statistical publications and share some of the information with other organisations, such as the Scottish Social Services Council and the Scottish Government.

The intelligence we gather through annual returns helps us target our improvement activity and support within social care. It is a great source of baseline data across a variety of health and wellbeing indicators which we use to identify, drive and track improvement, for example infection control, nutrition and the recruitment and retention of staff.  The data also helps us to identify trends and topics by both geographical area or service type, so that we can see where best to focus our improvement support work, for example, improvement workshops or new resources and guidance for care services across the sector.

This year's annual returns will be made available to service providers for completion between 6 January and 2 March 2025. The closing date includes an extension of two weeks on our usual six-week deadline.

All service types must complete their annual returns electronically, using our eForms system. We would encourage services to check their eForms account to make sure that their email address is up to date to ensure they are notified when the annual returns go live.

Even inactive services must submit an annual return.

We no longer automatically downgrade services for failing to submit an annual return. This is because we do not believe that non-submission is necessarily a reflection of poor quality of service. We will, however, continue to publish details about submission or non-submission of annual returns within inspection reports. We also reserve the right to make a formal requirement relating to submission of an annual return, or in cases of serious or persistent non-compliance, to issue an improvement notice under s62 of the Public Services Reform (Scotland) Act 2010, requiring its submission.

Please note that where the manager of the service has changed, you must formally notify the Care Inspectorate of the correct details. This can be done using our online digital portal.  

Related documents

If you have any questions about the annual returns, please read our frequently asked questions.

Find out what has changed in the 2024 annual return. 

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