The Care Commission

The Scottish Commission for the Regulation of Care, known as The Care Commission has the responsibility for the regulation and inspection of all care services in Scotland which are registrable under the Regulation of Care (Scotland) Act 2001.

The Care Commission was established in April 2002 as an independent regulator set up under the Regulation of Care (Scotland) Act 2001. The key principles of the Commission are threefold; keeping people safe; promoting dignity and choice and supporting independence. [1]

Services Regulated

The Care Commission has the responsibility for the regulation of a range of services in Scotland providing care to children, adults and older people. The following is a full list of services regulated by the commission. [2]

• Adult placement services
• Care homes for people with drug and alcohol misuse problems
• Care homes for people with learning disabilities
• Care homes for people with mental health problems
• Care homes for older people
• Care homes for people with physical and sensory impairment
• Housing support services
• Services for people in criminal justice supported accommodation
• Short breaks and respite care
• Support services
• Adoption agencies
• Care homes for children and young people
• Childcare agencies
• Early education and childcare up to the age of 16
• Foster care and family placement services
• School care and family placement services
• School care accommodation services
• Care at home
• Hospice care
• Independent hospitals / Independent specialist clinics
• Nurse agencies

Scope and statistics

Care Commission annually regulate over 15,000 care services used by 320,000 people. The commission currently has 571 staff.[3]

Methods of regulation

The form of regulation carried out by the Care Commission is largely laid down in the Regulation of Care(Scotland) Act, 2001, and associated Statutory Instruments.

The regulation is carried out by means of RICE, which is an acronym for Registration, Inspection, Complaints investigation, and Enforcement.

Registration ensures that the service, before opening, must demonstrate that it will be provided in line with legal and good practice requirements, and in conformity with the National Care Standards.

Inspection monitors the quality of the service. Inspections are often unannounced, and usually result in recommendations or requirements on the service. The inspections are summarised in a report available on the internet through the website of the Care Commission.

Complaint investigations may be initiated by communication from service users, their relatives, or members of the public. The investigation can often, as in inspection, result in recommendations, requirements, and less often in enforcement action.

Enforcement occurs where a service has not complied with legal requirements despite these having been made clear to the service. It usually consists of additional conditions on further operation: where these are not met, the enforcement can ultimately lead to the closure of the service.

A changed approach

In 2008 the Care Commission changed its approach to inspection. While still based on the National Care Standards, the criteria for assessing quality were grouped and organised into "Quality Themes" and a major emphasis was placed on how well services involved people who use services in assessing the quality of the service provided. Services were expected to self assess themselves using this framework and are encouraged also to grade themselves. These changes are part of a wider project known as Regulation for Improvement. The changes to inspection also included increased emphasis on inspection officers participation in aspects of the service, eg attendance at meetings, observing activities in the service, as part of the inspection.

Quality grades for services are awarded on each Quality Theme on a six point scale - Unsatisfactory, Weak, Adequate, Good, Very Good and Excellent. Services are typically awarded grades on four Quality Themes; Quality of Care and Support, Quality of Environment, Quality of Staffing and Quality of Leadership and Managament.

The six point grading scale is also used by HMIE when assessing the quality of educational provision. The Care Commission however introduced specific rules about the application of the grading scale to ensure that less than adequate performance was always clearly flagged in the awarded grades.

The Care Commission also carries out joint inspections with HMIE inspectors.

The aim of the grading system was to provide a clearer indicator of quality and of how improvements could be made by giving a grade for the main elements of quality care. The changed approach has been welcomed, allowing a greater focus on the point of view of the service user, and allowing funding authorities to make clearer, quality based decisions about ongoing funding. See Bill Duncan's article in Journal of Care Services Management

Future changes

After the release of the Crerar Review, on the simplification of regulatory processes in Scotland, the Scottish Government in November 2008 announced :

"... there will be two new improvement and scrutiny organisations from April 2011 - a single body for healthcare services and another body for social work and social care services, including child protection and the integration of children's services. The new bodies will take on work in these areas currently done by:

Her Majesty's Inspectorate of Education (HMIE) NHS Quality Improvement Scotland (NHS QIS) Social Work Inspection Agency (SWIA) The Care Commission

With the exception of independent healthcare regulation, all of SWIA's and the Care Commission's work will be carried out by the new social work and social care services body, Social Care and Social Work Improvement Scotland (SCSWIS). HMIE's current work leading on the inspection of services to protect children and developing a model of inspection for children's services will transfer to SCSWIS. The work of NHS QIS, plus the regulation of independent healthcare currently carried out by the Care Commission, will transfer to the new healthcare body, Healthcare Improvement Scotland (HIS). "[[4]]

Since this announcement, the affected organisations including the Care Commission have been working closely together to ensure a smooth changeover to the new structures.

See also

• Commission for Social Care Inspection (Regulator in England)

External links

• The Care Commission
• List of the National Care Standards used by the Commission