National Care Standards Review

4. Accountability and enforcement - how will National Care Standards be used?

When the standards first came into force over ten years ago, they were used, alongside regulations, to make decisions about care services.

Now, as the way care services are regulated and inspected has changed, the standards are only one of the ways that the Care Inspectorate and Healthcare Improvement Scotland determine the quality of a care service or an independent healthcare service.

Some people we spoke with thought that providers applying to register a new care service should be required to set out how overarching standards would be promoted and upheld. This would help to ensure that providers are committed to high quality care which promotes peoples' rights. Overarching quality standards could be used as a test of compliance, similar to the Kitemark or other quality mark, which could be removed if a provider fails to comply.

We propose that the new overarching standards should sit above all existing standards, principles and codes of practice for health and social care. Every person using a health or care service will be entitled to care which meets these standards.

People will be able to use the overarching standards to ensure they know and understand their rights. This will help make sure they are receiving the care and support that upholds their rights and meets their needs.

We think that the Care Inspectorate and Healthcare Improvement Scotland should hold services they regulate to account for meeting these essential requirements and use the aspirational elements of the standards of help services improve where needed.

However, as we propose developing quality standards for health and social care, we need to consider how we would ensure those services which are not regulated by the Care Inspectorate and Healthcare Improvement Scotland meet them. One option could be that the commissioner of a service - such as the health and social care partnership - becomes responsible for holding the service to account. Alternatively, as the wider inspections of health services and local authority services, carried out by both Healthcare Improvement Scotland and the Care Inspectorate, become more commonplace, there could be scope for this route to be used as a means of holding non-regulated services to account.

We have also considered whether there is a role for the Care Inspectorate and Healthcare Improvement Scotland to take forward the suite of specific standards for particular aspects of care, circumstance or need. This would allow them to consult widely with partners, professionals and people using particular types of service to ensure they are firmly focused on best practice and meeting peoples' needs. These specific standards would set out in detail the essential components that a service regulated by the Care Inspectorate or Healthcare Improvement Scotland must demonstrate.

We would like your views.

Question 4

a. Do you think the Care Inspectorate and Healthcare Improvement Scotland should hold services they regulate to account for meeting the proposed overarching standards, the general standards and the suite of specific standards?

Yes No Don't know

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b. How should we ensure that services not regulated by the Care Inspectorate and Health Improvement Scotland comply with the new standards?

c. We suggest that the Care Inspectorate and Healthcare Improvement Scotland, consulting with others, should develop the suite of specific standards. Do you agree with this?

Yes No Don't Know

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