Chamber and committees

In 2009-10, 30 Improvement Notices were not complied with and in 2010-11, six were not complied with. Statistics on the number re-issued are not routinely collected.

If a care home does not comply with an Improvement Notice, the Care Inspectorate must consider what appropriate action to take. Each Improvement Notice is unique to the service to which it is issued, however options available to the Care Inspectorate include issuing a proposal to cancel registration or, where progress has been made but not completed, allowing additional time for the Improvement Notice to be complied with. At every stage, the Care Inspectorate takes a risk-based judgement on the impact on the health and well-being of the people who use the service.

Local authorities and health boards are fully engaged at the point of consideration of taking any enforcement action. This allows the Care Inspectorate to consider what actions they need to take regarding people who use the service and to consider any support, such as training, they can provide to assist towards improvement.

Statistics on average and maximum lengths of time between inspecting a care home and issuing an improvement notice are not collected. However, service providers are given full oral feedback on any concerns arising as a consequence of inspection or complaint shortly after the inspection visits. Where emergency conditions of registration are imposed, these become effective immediately.

Statistics on average or maximum length of time between the Care Inspectorate issuing an improvement notice and carrying out a follow-up inspection are not collected as each notice is unique to the service it is served on.

Each improvement has a time specified within the notice that should be a reasonable time to allow the improvement to be made. The Care Inspectorate inspects at the earliest date possible after the time period specified in the Improvement Notice has passed. There may be a number of inspections arising from an Improvement Notice and public reports made available following these. The Care inspectorate would expect an action plan in response to the Improvement Notice and this would be taken into account when planning any inspection to validate compliance.

The Care Inspectorate can also make application to the sheriff for cancellation of the registration of a care service on the basis that unless the order is made “there will be a serious risk to the life, health or wellbeing of persons”. The sheriff has the power to make an interim order, which may include an order suspending registration pending a full hearing. If necessary, the Care Inspectorate can also impose an emergency condition of registration, which becomes effective immediately and remains in place until removed or successfully challenged on appeal.

The Care Inspectorate does not collect data on emergency hospital admissions from care homes. The Care Inspectorate will, however, investigate in circumstances where an emergency hospital admission resulted in a complaint which identified concerns about the care practices leading up to that admission. Further, if the admission was notified to the Care Inspectorate as a significant incident in line with the legal requirements on notifications by providers the Care Inspectorate would consider whether additional enquiries were necessary.

More widely, as part of the intelligence-led approach, the Care Inspectorate is currently examining what data, including statistics on overall levels of emergency admissions, should form part of the systematic evidence base that informs the decisions it takes on the planning and handling of inspections.

The Care Inspectorate can cancel registration of a care service in a number of scenarios. It has the power to withdraw registration from care homes where it has served an Improvement Notice and this has not been complied with within the period specified in the notice. It can also cancel registration of a service where the person providing the registered care service ceases to provide the service.

The Care Inspectorate also has expedited powers, to apply to the sheriff (under s65 of the Public Sector Reform (Scotland) Act 2010) for cancellation of the registration of a care service (including care homes) on the basis that unless the order is made “there will be a serious risk to the life, health or wellbeing of persons”. The sheriff has the power to make an interim order, which may include an order suspending registration pending a full hearing.

If necessary, the Care Inspectorate can also impose an emergency condition of registration, which becomes effective immediately and remains in place until removed or successfully challenged on appeal.

NHS boards are responsible for planning, providing and securing the provision of NHS services for its population and for ensuring the quality of that care.

Where NHS boards contract with the independent healthcare sector to provide NHS services these contracts need to specify the same quality standards that would apply in the NHS. This means that suitable governance arrangements need to be in place so that the Chair, Chief Executive and other board members have the necessary assurances in place to ensure that risks are identified and managed and planned outcomes are delivered.

Healthcare Improvement Scotland is responsible for supporting, ensuring and monitoring the quality of healthcare provided or secured by the health services. They have the power to scrutinise any NHS service and this can be carried out in a number of ways including peer review, evaluation panels, clinical case review and the inspection model used by the Healthcare Environment Inspectorate. Any planned inspection of NHS services undertaken by Healthcare Improvement Scotland must be in accordance with their Inspection Plan which they are required to agree with Scottish Ministers.

In addition, the Public Services Reform (Scotland) Act 2010 requires Healthcare Improvement Scotland and the Care Inspectorate to co-operate and co-ordinate their activities for the purpose of improving the exercise of their scrutiny functions. The current development work on the new Standards of Care for Dementia is a good example of how this collaborate approach could support service monitoring and improvement.

Personal assistants (PAs) are not a regulated service under the Public Service Reform (Scotland) Act 2010. There are currently no plans to regulate PAs through the Care Inspectorate. The Scottish Government considers that the route to adequate protection of personal employers should be through effective inspection of social work services to ensure they are prepared to meet their duty of care.

Yes. The PVG scheme strikes a balance between proportionate protection and robust regulation and makes it easier for individual employers to determine who they might safely employ.

The Care Inspectorate does not collect data on emergency hospital admissions from care homes.