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Care Inspectorate Grades – Everything You Need to Know

Neoma Toersen

Writer for Health and Social Care

The Care Inspectorate grades are used by the Care Inspectorate Scotland. The Care Inspectorate plays a vital role in ensuring the excellence of social care services across the country and they use their own set of guidelines and grading systems to do so. Using their comprehensive grading system, the regulator will evaluate various aspects of a care service and use their findings to rate them. As a result, valuable insights will be provided on the performance of services and the rating will influence their reputation.

With over 30 years of experience digitising care services across the world, we at The Access Group know what your care service needs to do to boost compliance and ensure that the highest quality of care is provided to service users. We’ve put together this article for Scottish service providers to elaborate on the grading criteria and offer tips on how to achieve better grades. We have also put together examples using the inspection reports available at Care Inspectorate Scotland.

The Inspection Framework Structure

The framework sets out key questions about the difference a care service makes to someone’s well-being and the quality of the foundations that impact that. The frameworks do a great job of reflecting the Health and Social Care Standards and providing care services with more transparency on what the Care Inspectorate expects. The key questions include:

  • How well do you support the well-being of people?
  • How good is your leadership?
  • How good is the staff team?
  • How good is the setting?
  • How well is the care and support planned?
  • What is your overall capacity for improvement?

Under every key question, there will be four quality indicators that cover the specific areas of practice. Each quality indicator will give a rough idea of what ‘very good’ and ‘weak’ quality would look like in the form of illustrations. These have been designed to help people understand the level of quality that is expected. Please note, that while these would have been drawn up using the Health and Social Care Standards, the illustrations will not consist of a checklist or definitive descriptions.

The inspection Framework structure - image of an old woman being supported

Care Inspectorate Grading System

Understanding the care inspectorate grading system used by the Care Inspectorate Scotland will help you understand the key areas that are crucial to the well-being of individuals receiving care, which can boost your compliance as a result. The areas you must understand include the quality of care and support, the environment, safe staffing levels and good leadership/management.

During their inspection, the Care Inspectorate will use the six-point scale to provide an overall evaluation for each of the key questions. The scale rates a service from excellent (6) to unsatisfactory (1). This will be recorded using the specific quality indicators that they inspect. The same scale will be used to rate the quality indicators within a key question.

The Six-Point Scale

The Care Inspectorate uses the following six-point scale to describe the quality they see when inspecting care services.

6

Excellent

Outstanding or sector-leading

5

Very Good

Major Strengths

4

Good

Important strengths, with some areas of improvement

3

Adequate

Strengths just outweigh weaknesses

2

Weak

Important weaknesses – priority action required

1

Unsatisfactory

Major weaknesses – urgent remedial action required

Excellent – This evaluation describes the performance which is sector-leading and supports outstandingly high-quality experiences and outcomes for people. The track record of modern, effective practice and/or very high-quality performance is self-evident across a wide range of activities from which other services could learn from. The Care Inspectorate believes a service with an excellent rating safeguards a balanced and well-maintained performance.  

Very Good – Care services with this rating will show signs of performance that demonstrate major strengths in supporting positive outcomes for service users. There will be very few areas that need to be improved. Areas that do will have minimal unfavourable impacts on the experiences and outcomes of people. While there may be opportunities to strive for further improvement, services with a very good rating will not require major change.

Good – This evaluation applies to performance where many important strengths outweigh the areas that require improvement. The impact of the strengths will be significantly positive on the experiences and outcomes of people. However, the areas that need improvement are essential for maximising wellbeing and once they have been worked on, they will ensure that people are having consistent positive experiences and outcomes.

Adequate – Care services with this rating will show signs of some strengths, however, they only just outweigh their weaknesses. While the strengths may have a positive impact on people’s experiences and outcomes, the likelihood of achieving this is significantly reduced due to the key areas of performance that require improvement. Adequately rated services may be tolerable in certain situations, but continued performance at this level isn’t acceptable and improvements must be made.

Weak – This evaluation describes a care service that exhibits some strengths, but these are outweighed by significant weaknesses. Whether it’s on their own or when they’re added together, these weaknesses can substantially affect the experiences and outcomes of individuals. If improvement isn’t made a priority, the safety and welfare of people may be compromised and their needs won’t be met. A structured action plan is required by the provider or partnership of a weak-performing care service.

Unsatisfactory – Care services with this rating will show major weaknesses in critical areas of performance which require immediate remedial action to improve people’s experiences and outcomes. The safety or welfare of people will likely be compromised by risks that can’t be tolerated. Those responsible for carrying out the compulsory actions for improvement must do so as a matter of urgency. This is to ensure people are protected and that their wellbeing will be improved without delay.

Grading Examples

Here are some examples of how the evaluation of key areas can lead to an ‘excellent’ or ‘weak’/‘unsatisfactory’ rating during a Care Inspectorate inspection.

  1. Quality of Care and Support:

Excellent – Personalised care plans addressing individual needs and positive testimonials.

Weak/Unsatisfactory – No individualised care plans and negative feedback from service users.

  1. Quality of Environment:

Excellent – Innovative facilities promoting well-being and adherence to safety standards.

Weak/Unsatisfactory – Safety hazards unaddressed and poor cleanliness and hygiene.

  1. Quality of Staffing:

Excellent: Ongoing staff training and positive feedback from staff and service users.

Weak/Unsatisfactory – Insufficient staffing or inadequately trained personnel.

  1. Quality of Leadership and Management:

Excellent – Proactive leadership and continuous improvement initiatives.

Weak/Unsatisfactory – Lack of clear leadership direction and a poor response to challenges.

Tips to Achieve a Higher Rating

There are some basic things you can do to help you achieve a higher rating. Doing the following will help you identify areas where you’re performing well and where you may require improvement.

  • Regular self-assessment – Using Care Compliance software, conduct regular self-assessments against the Care Inspectorates standards to identify areas for improvement.
  • Invest in staff training – Prioritise ongoing and engaging care training to ensure your care staff are well-equipped to provide the highest quality of care to service users.
  • Embrace innovation – Implement innovative approaches throughout your care service that have been designed to enhance the quality of care and support provided.
  • Listen to feedback – Actively seeking and responding to feedback from service users, their families and staff can have a significantly positive impact on your care service.
  • Commit to continuous improvement – Remain innovative by demonstrating a commitment to learning and evolving to meet changing needs and standards.

Nurse studying file for care inspectorate grades

Boost Compliance with Care Software           

Achieving a higher grade in the Care Inspectorate Scotland’s grading system will require a complete commitment to excellence in all aspects of social care services. By understanding the criteria, learning from examples and embracing the culture of continuous improvement, your care service will be able to provide the best possible care and support to those who need it.

With the right digital platform, such as Access Care Compliance, you can increase your chances of achieving regulatory compliance and can use their tools to estimate your rating. Access Care Compliance is already being used by care providers across Scotland and is configurable to the differing requirements of the Care Inspectorate. If you manage cross-border services (e.g. in Scotland and England), you can use this platform in both nations.

The Access Group has over 30 years of experience working with services in the care sector. Over the years, we’ve learned what care services should and shouldn’t be doing to achieve compliance. This knowledge has created the foundation of our software, which has been developed to give you the freedom to do more and to succeed. If are interested in learning more about our Care Compliance software, please contact us to talk to one of our experts or to get booked in for a demo.