Scotland's new national care standards focus on people's experience
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A presentation to the European Social Network conference in Seville 2018. It describes Scotland's approach to new care standards which set out what people should experience from care and support.
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Scotland's new national care standards focus on people's experience
- 1. From compliance to outcomes for people experiencing care: Scotland’s new national care standards Rami Okasha Executive Director of Strategy and Improvement, Care Inspectorate, Scotland @ramiokasha Dr Fiona Wardell Standards and Indicators Lead Healthcare Improvement Scotland
- 2. 23 different standards for inspections in social care & private healthcare Minimum technical standards A new approach 2001: One set of standards for all health & social care 2018: Focused on people’s experience
- 3. Social care Healthcare Social work Early learning and childcare The scope
- 4. The minimum standard for a care service. The quality that I am entitled to experience. 2001 2018 Human rights and wellbeing1
- 5. Frontline delivery Commissioning care Assessing needs Service planning Standards across the whole system2 2001
- 6. Frontline delivery Commissioning care Assessing needs Service planning Standards across the whole system2 2018
- 7. Person-led • Staff will treat you politely. • Staff call you by your preferred name. • If you need help, your request will be dealt with as soon as possible. • I get the most out of life because people have an enabling attitude. • I experience warmth, kindness and compassion. • I am recognised as an expert in my own needs and wishes. 3 2001 2018
- 9. The outcome focus Care home room size 12.5 m2 3.5 m2 for toilet 4 I have enough physical space to meet my needs and wishes. 2001 2018
- 10. Guidance describes inputs which lead to good care Quality is measured through the lens of a person’s experience
- 11. How did we develop them?
- 12. Started with a set of principles Consultation with 2000 people
- 13. c. 150 statements 5 main standards One set of standards www.NewCareStandards.scot 5 principles
- 14. Compassion Responsive care & support Wellbeing Be included Dignity and respect “Safety is what my carer says when they want me to stop doing something” Part of “wellbeing” Safety?
- 15. Five standards I experience high quality care and support that is right for me. I am fully involved in all decisions about my care and support. I have confidence in the people who support and care for me. I have confidence in the organisation providing my care and support. I experience a high quality environment if the organisation provides the premises.
- 16. Does this comply with the rules? To what extent are people getting the right care and support to meet their needs and wishes? This changes question for inspectors Enforcer Enabler
- 17. What are you doing wrong? Are you doing this right? Are the outcomes good? Are key processes in place? Combined self-evaluation / inspection frameworks Focus on supporting improvement Evidence what you are doing works well.
- 18. Key successes Underpin all new guidance and standards Shared ownership across health and social care Standards support improvement Revised scrutiny arrangements Workforce development and qualifications Agreed logic model showing outcomes we want and changes needed to get there
- 19. Challenges Public understanding and awareness Understanding strongest in regulated care Relationship between standards & quality assurance Their role outside delivery (planning, assessment, commissioning)
Editor's Notes
- And these are the headings of the 5 general Standards. All starting with ‘I’, being written in the first person locates quality firmly through the lens of the person experiencing care, rather than by specifically describing or prescribing what care professionals should do to make this happen. This is empowering for people who may be in unfamiliar or distressing environments and is designed to ensure care professionals reflect on their practice from the perspective of the person. This person-led approach is designed to help people and organisations to work together to support people to direct their own care. So the first Standard talks about experiencing high quality care and support ‘that is right for me’. The 2nd Standard focusses on the importance of people being fully involved in their care and support. This is more than just being consulted or having a say, with 2.1 stating that ‘I can control my own care and support if this is what I want.’ Standard 3 reflects that the quality of relationships you have with staff and volunteers is at the heart of high quality care. Statement 3.1 states: ‘I experience people speaking and listening to me in a way that is courteous and respectful, with my care and support being the main focus of people’s attention.’ 3.3 highlights that relationships need to be a 2 way dialogue and negotiation, while 3.7 also talks about the importance of relationships between staff and volunteers: ‘I experience a warm atmosphere because people have good working relationships.’ Standard 4 addresses the need for all organisations responsible for providing care to work together, as set out in 4.17 and 4.18, as it is often the ‘messy joins’ between different services and different sectors that can result in problems. The increasing expectation that leaders and managers actively involve people in how an organisation provides care is also articulated. While Standards 1 to 4 apply to all care settings, Standard 5 only applies where the organisation proving care is also responsible for the premises.