Inspections overview
- Inspection types
- Inspection teams
- Inspection methodology
- Inspection activities
- Inspection reports
- Quality assurance
- Inspection governance
- Covid-19
Inspection types
Our specific inspection focus and programme at any one time is agreed with the Scottish Government and published in the Care Inspectorate’s Scrutiny, Assurance and Improvement Plan. We take a number of different approaches to inspection, designed to meet different scrutiny objectives. These include, but are not limited to:
Inspections and joint Inspections: inspections of individual local authorities or partnerships in relation to key priority areas. Local authorities are identified for inspection based on a combination of risk assessment and rotation of scrutiny activity.
Progress reviews: return visits to a local authority or partnership to check progress following a previous inspection and set of recommendations. Progress reviews are usually (but not always) carried out where the original inspection identified significant areas for improvement.
Thematic reviews/inspections: inspections carried out in a limited number of local authority or partnership areas to explore a particular area of policy or practice that is of national interest. These reviews may or may not evaluate the performance of individual authorities or partnerships but are primarily designed to explore the national picture relating to a given theme and make national recommendations.
Supported self-evaluations: we are always keen to support and encourage self-evaluation. We may at times work proactively with identified local authorities and partnerships to support and validate their self-evaluation of particular areas of activity.
Inquiries: this approach uses an abbreviated approach to explore a particular theme or issue across the country. It is usually designed as a discrete piece of work, carried out over a relatively short time to produce a quick report that provides insight into the key issues relating to the theme.
Inspection teams
Our inspection teams have an inspection lead with responsibility for effectively delivering and concluding the individual inspection. The lead is supported by a deputy lead and a team of inspectors drawn from the Care Inspectorate and relevant partner scrutiny bodies. Our inspections may be supported by associate assessors and people with lived experience (inspection volunteers). The administration and organisation of inspection activities is managed by a team of strategic support officers.
The size of an inspection team will be determined by the scope, methodology and planned length of the inspection. Sometimes, additional resources may be allocated for specific parts of the inspection. However, most inspections will have a core team of between six and 10 members.
How resources are deployed across the different activities of the inspection, and the timing of activities, is captured on a plan that we call the inspection footprint.
Inspection methodology
For each set of inspections, we develop a quality framework (QIF). The quality framework outlines what we expect the quality of the service provided to be. The frameworks we use in our strategic inspection work are based on the EFQM (European Foundation for Quality Management) excellence model, widely used by organisations for managing change and improving performance. The Health and Social Care Standards are woven throughout the quality indicators.
Overall, the QIF provides a model to support inspection. We examine:
- performance and the outcomes that services achieve for the children and adults who use them
- the processes that support service delivery
- the vision, leadership, management and planning of services.
The quality frameworks are also available to local authorities & partnerships for them to use for self-evaluation purposes.
Inspection activities
The activities carried out by inspection teams to gather information can differ across inspections. However, there are some activities which have been proven to consistently provide good information and are therefore used regularly as part of inspections. These include:
Information and communication
The local authority or partnership can expect to receive full information about the inspection.
Most inspections provide a written guidance document of some sort, explaining the various stages and activities of the inspection, along with timescales.
In most inspections, we ask the local authority or partnership to nominate a local co-ordinator to manage and co-ordinate the various activities for them.
Throughout the course of the inspection, there are pre-planned meetings between key members of the inspection team and the local authority or partnership. These may be called professional or partnership discussions. Their key functions are: for the inspection team to feedback on findings so far; for the local authority or partnership to reflect on those findings; for the parties to discuss arrangements and plans for the next phase of the inspection.
Self-evaluation
It is a priority for the Care Inspectorate to support local authorities and partnerships to evaluate their own progress. Most of our inspections ask the local authority or partnership to provide a position statement and supporting evidence at the beginning of the inspection to help inform the inspection team’s understanding and formulate lines of enquiry.
Talking to children and adults who use services
Understanding the experience of people who use social work and social care services is fundamental to inspection, and we use a range of methods to gather the views of both people and unpaid carers. These are likely to include surveys, interviews, events, focus groups, and a range of activities developed to support specific inspections.
Reviewing records
Reading the records of children and adults who use services (also known as file reading) is a rich source of evidence for the inspection teams and is a part of many inspections. It provides understanding of how processes work and gives a picture of how staff interact with people using services.
Support networks
As well as reading records, many inspections include further examination of the care and support journeys experienced by children and adults by meeting with the staff and other significant people who have been part of that journey. This means that inspectors are able to further explore questions that have arisen from reading case records.
Staff surveys
Many inspections include surveys issued to staff. The inspection team often requests the help of the local authority or partnership in distributing the survey and encouraging staff to respond. The arrangements for issuing the survey, and which staff should receive it, will be discussed with the inspection co-ordinator by the inspection lead and strategic support officer.
Interviews and focus groups with key stakeholders
Most inspections involve focus groups or interviews with key stakeholders, including staff, managers, senior leaders, representatives of other statutory and third sector organisations. Often this takes place towards the end of an inspection as it gives the inspection team a good opportunity to discuss themes and issues that have emerged during other inspection activities.
Inspection reports
Inspection teams use regular team meetings to identify and explore themes that emerge from inspection activities. We make sure that potential findings are triangulated and corroborated through a range of activities before accepting them.
Inspection reports for each strand of inspection activity are tailored to the requirements of that inspection, so there are differences between the reports produced by each strategic inspection team. There will also be differences in the reports produced by each team when they are working on different inspection themes.
However, in general, strategic inspection reports can be expected to contain:
- a summary of key findings and/or strengths and areas for improvement
- an analysis of the inspection findings based on the relevant quality framework
- some form of evaluation of the local authority or partnership’s performance – which may or may not have grades attached
- recommendations for action and/or improvement.
Quality assurance
We aim to achieve a high quality for all our work and want it to have maximum value for all our stakeholders and help to improve the experience of people who use services. To help us achieve this, each inspection programme has a range of quality assurance arrangements:
Each programme has arrangements for review of the inspection approach and methodology which take account of the learning from each inspection while balancing the need for consistency. A key source of learning is from post inspection questionnaires and feedback from inspection leads and team members. All strategic scrutiny teams are represented on a forum to discuss potential improvements to inspection methodology from experiences across the different workstreams and promote consistency wherever possible. When reading the records of people who use services during inspection, a proportion of the sample is double read to ensure consistency of evaluations and we provide training for all record readers.
At the reporting stage of our inspections, inspection leads present their inspection team’s findings and draft report to a ‘quality and consistency’ panel with representation from each partner scrutiny body for discussion and comment. Reports are then issued to the area inspected for an accuracy check before final editing and publication.
Information governance
Our approach to processing personal data is set out in full in our organisational privacy notice.
Covid-19
The Covid-19 pandemic has had a huge impact on social work and social care services across the country. Because of this, most of our strategic inspection work was paused between March 2020 and spring 2021. Since then, strategic inspections have recommenced with some adjustments to reflect the ongoing risks posed by covid-19 and the pressure on local authority and partnership services.
We continue to be responsive to the trends of the pandemic as we plan for and deliver inspection activities. We have also incorporated learning from the pandemic period in relation to our use of technology, and expect to be using a blend of onsite and distance approaches to carry out inspections moving forward.
Joint inspection of services for children and young people
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.
Joint inspections
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.
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.
Related links:
Joint inspections of integrated services for adults
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.
Joint inspections of services for adults
Our approach
The Public Bodies (Joint Working) (Scotland) Act 2014 sets the legislative framework for integrating adult health and social care.
Integrating health and social care services is important to ensure that people have quick access to the range of services and support they need, that their care feels seamless to them and that they experience good outcomes and high standards of support. This is particularly vital for the increasing numbers of people with multiple, complex, long-term conditions in Scotland.
Since April 2017, the Care Inspectorate and Healthcare Improvement Scotland have had joint statutory responsibility to inspect and support improvement in the strategic planning and commissioning of integrated approaches.
In 2019, the Ministerial Strategic Group (MSG) for Health and Community Care asked us to further develop our joint inspections to focus on how integration impacts on people’s outcomes, to consider the performance of the whole health and social care partnership and to ensure a balanced focus across health and social care provision.
In response to the MSG recommendation, the Care Inspectorate and Healthcare Improvement Scotland have reviewed our joint inspection methodology to answer the following question:
“How effectively is the partnership working together, strategically and operationally, to deliver seamless services that achieve good health and wellbeing outcomes for adults?”
In order to address the question over the broad spectrum of adult health and social care services, we will conduct a rolling programme of themed inspections, looking at how integration of services positively supports people’s experiences and outcomes. It’s important to note that these thematic inspections are not considering the quality of specialist care for each care group but are simply a means of identifying groups of people with similar or shared experiences through which to understand if health and social care integration arrangements are resulting in good outcomes. In this way, we’re looking at integration through the lens of different care groups which, taken together, will in time build a picture of what is happening more broadly in health and social care integration and how this is experienced by people and the outcomes achieved.
How we do it
Our inspections last for a number of months. We work closely with the partnership to co-ordinate our inspection activities.
We have a range of ways to gather information that will help us to assess how integrated services in the area are helping to improve outcomes for people and their unpaid carers. These include:
- asking for information from the partnership
- speaking to people who use health and social care services and their unpaid carers
- speaking with staff, managers and leaders across the partnership
- reading people’s records.
We communicate regularly with the partnership and keep them up to date with our findings.
After the inspection, we publish a report about our findings on the Care Inspectorate’s and Healthcare Improvement Scotland’s websites. The report explains what we have found, identifies strengths and points out areas that could be improved. We agree an Improvement plan with the partnership to address those areas.
Getting involved
The voices of people who use health and social care services and of their unpaid carers are at the centre of our inspection. We will use as many opportunities as we can to get people involved and talk to them about their experiences of health and social care services.
We have developed an engagement framework to support all our engagement activity. The framework sets out 12 statements about positive outcomes and experiences that we will speak with people about.
More information
You can find full information about joint adult inspections:
- The Partnership guide sets out the inspection process step by step and provides all the information that partnerships need to manage their part in the inspection.
- The Quality Improvement Framework (QIF) explains the criteria we use to evaluate quality in our inspections
- The Engagement framework provides a set of “I” statements to help us consider the experience of people who use health and social care services and their unpaid carers. It underpins all the engagement with people and unpaid carers that takes place during the inspection.
- Our joint inspection reports can be found here.
- The record review template and record review guidance supports our reading of health, social work and social care records. The current version is used to read the records of people living with mental illness.
Joint inspections of services for children and young people
Joint inspections of services for children and young people subject to compulsory supervision orders living at home with their parents
As part of our strategic scrutiny plan this year we will work with scrutiny partners to take a more focused look at the experiences and outcomes of children and young people subject to compulsory supervision orders living at home with their parents.
Our joint inspections will look at the services provided for them by health workers (for example, school nurses, health visitors and doctors), social workers, police officers and lots of other people who work with them and their families.
We will be starting this programme of scrutiny in summer 2025 and we will complete up to four inspections with this focus by April 2026. On the 8 July 2025 we hosted a webinar to share our plans. We will continue to review and revise the approach over the course of these inspections.
Watch our webinar below:
More information about our approach:
Previous joint inspections
- Joint inspections of services for children and young people at risk of harm 2021-2025.
- Joint inspections of services for children and young people in need of care and protection: review of findings from the inspection programme 2018-2020
- Joint inspections of services for children and young people: a report on the findings of inspections 2014-16
Joint inspections of services for children and young people at risk of harm
At the request of Scottish Ministers, between 2021 and 2025 the Care Inspectorate led on joint inspections of services for children and young people at risk of harm.
The remit of these joint inspections was to consider the effectiveness of services for children and young people up to the age of 18 at risk of harm. The inspections looked at the differences community planning partnerships are making to the lives of children and young people at risk of harm and their families.
These joint inspections aimed to provide assurance on the extent to which services, working together, could demonstrate that:
- Children and young people are safer because risks have been identified early and responded to effectively.
- Children and young people’s lives improve with high-quality planning and support, ensuring they experience sustained, loving and nurturing relationships to keep them safe from further harm.
- Children and young people and families are meaningfully and appropriately involved in decisions about their lives. They influence service planning, delivery and improvement.
- Collaborative strategic leadership, planning and operational management ensure high standards of service delivery.
We will shortly be producing an overview report. You can access individual inspection reports here.