A quality framework for care homes for adults and older people
The primary purpose of this quality framework is to support services to evaluate their own performance. It is then used by inspectors to provide independent assurance about the quality of care and support. By setting out what we expect to see in a high-quality service, we can also help support improvement.
We have also produced a set of self-evaluation tools to support services to assess how well they are doing against key areas from our quality framework and highlight where they need to support improved outcomes for people.
- Quality framework for care homes for adults and older people
- Self-evaluation tools and guidance for care homes for adults and older people
Within the framework we have included a scrutiny toolbox, which provides examples of the scrutiny actions we may use in evaluating the quality of provision. The resources below are key practice documents that we think will help care services in their own improvement journey. These are listed under each relevant key question.
Key question 1. How well do we support people’s wellbeing?
Quality Indicator 1.1: People experience compassion, dignity and respect
Key improvement resources
Guidance for care providers in Scotland using CCTV
Guidance on human rights charter for technology and digital in social care
Health and Social Care Standards
Mental health strategy for Scotland
Mental Welfare Commission resources
National trauma training programme
Older people in care homes-Sex, sexuality and intimate relationships
Proud to care: LGBT and dementia
Rights, respect and recovery: alcohol and drug treatment strategy
Psychology and psychological interventions in dementia
Transforming psychological trauma: a knowledge and skills framework for the Scottish workforce
Quality Indicator 1.2: People get the most out of life
Adult protection and social care
Care home guidance for people with learning disabilities who have dementia
Care workers compendium of digital resources
Dementia learning and promoting excellence
Dementia resources for the deaf community
Disability Rights UK – doing sports differently
General standards for neurological care and support 2019
Guidance for delivering meaningful activity
Information on supporting people with complex needs and sight loss
Information resources on person-centred practice
Jenny’s diary – supporting conversations about dementia with people who have a learning disability
Let's get active, connected and included resource
Mental Health Foundation – Recovery information
Scottish recovery network – peer support resources
See Hear – strategic framework for meeting the needs of people with a sensory impairment
Quality Indicator 1.3: People’s health and wellbeing benefits from their care and support
Key improvement resources
Blood monitoring of type 2 diabetes
Care Experience Improvement Model (CEIM)
Eating and drinking well in care: good practice guidance for older people
Falls prevention for people with learning disabilities
Guidance for care of people prescribed clozapine in care homes
Guidance for social care services for supporting people living with HIV in Scotland
Guide for those caring for a vegan or vegetarian
Guide for vegetarians and vegans who require texture-modified diet
Healthcare framework for adults living in care homes
Hospital passport: for people with a learning disability coming into hospital
Intermediate care including reablement
Mental Welfare Commission good practice guides: covert medication
My health passport: resource for autistic people who might need hospital treatment
Notifications about controlled drugs: guidance for providers, 2015
Palliative and end of life care resources
Physical deterioration and escalation tool for care settings
Pressure ulcers measurement toolkit
Promoting continence for people living with dementia and long-term conditions
Safe administration of medication: modules 1-3 (Scottish Social Services Council)
Safe swallowing practice note (care homes)
Scottish commission for learning disability healthy eating healthy living pack
Sexual health framework 2015-2020
Standards for prevention and management of pressure ulcers
Supporting better oral care in care homes
Trauma informed practice – National trauma training plan and resources
Quality Indicator 1.4: People experience meaningful contact that meets their outcomes, needs and wishes
Key improvement resources
Care Inspectorate information on supporting meaningful connection
Consenting adults: Capacity, rights and sexual relationships
Health and Social Care Standards for visiting and staying connected: Guidance for providers
Open with care - supporting meaningful contact in care homes: guidance
Supporting people to keep in touch when care homes are not accepting visitors
Supporting personal relationships
Restoring relationships toolkit
Quality Indicator 1.5: People's health and wellbeing is supported and safeguarded by infection prevention and control practices
Key improvement resources
Covid-19 – living with dementia in care homes
Healthcare associated infection (HAI) standards
National infection prevention and control manual
Norovirus – guidance for care homes
Norovirus - guidance for care homes poster
Preventing infection in social care settings (app)
Safe management of the care environment
Key question 2. How good is our leadership?
Quality Indicator 2.1: Vision and values inform practice
Key improvement resources
- Guidance for providers and applicants on aims and objectives
- Scottish Social Services Council - supervision guidance
- Scottish Social Services Council - steps into leadership
- TURAS Leadership and Management Programmes
Quality Indicator 2.2: Quality assurance and improvement is led well
Key improvement resources
- How we support improvement
- SCLD – Using scrutiny to drive outcomes and associated resources
- Adults with incapacity: template policy for adult services
- Duty of candour guidance
- EFQM excellence model
- Leadership development activities – Scottish Social Services Council
- The Public Services Reform (The Scottish Public Services Ombudsman) (Healthcare Whistleblowing) Order 2020
- Learning from adverse events through reporting and review: A national framework for Scotland 2019
- NES quality improvement learning and tools
- Improvement support booklet 2.2
- Care Experience Improvement Model (CEIM)
- Clinical and care governance framework
- Governance for quality social care in Scotland
Quality Indicator 2.3: Leaders collaborate to support people
Key improvement resources
- Information Commissioner’s guide to data protection, including GDPR
- National wellbeing hub for staff
- Partnerships and Co – conversation openers
- Scottish Social Services Council - steps into leadership
- SSSC staff guidance, wellbeing and learning resources
Quality Indicator 2.4: Staff are led well
Key improvement resources
- Achieving effective supervision
- Everyday leadership from the frontline
- Guidance on development of policy and procedure
- Leadership development activities – Scottish Social Services Council
- Steps into leadership - SSSC
Key question 3. How good is our staff team?
Quality Indicator 3.1: Staff have been well recruited
Key improvement resources
National health and social care workforce plan: part two
Knowledge and skills framework for Health and Care staffing in Scotland
Scottish Code of Practice for the international recruitment of health and social care personnel
SSSC / Care Inspectorate - safer recruitment through better recruitment
SSSC / NES social care induction framework
Values-based recruitment toolkit
Quality Indicator 3.2: Staff have the right knowledge, competence and development to support people
Key improvement resources
Achieving effective supervision – IRISS insight
Codes of practice for social service workers and employers (SSSC)
Common core skills and national occupational standards (SSSC)
Employer responsibilities–supporting staff with registration
Framework for continuous learning (SSSC)
Frequently asked questions about SSSC registration
Prepping for practice – induction guidance 3.2
Professional standards of practice and behaviour for nurses, midwives and nursing associates
Scottish Social Services Council - supervision guidance
Quality Indicator 3.3: Staffing arrangements are right and staff work well together
Key improvement resources
Guidance for providers on the assessment of staffing
Health and Care (Staffing) (Scotland) Act 2019
Information and resources on safe staffing
Safe Staffing programme information
The changing functional needs and dependency of people living in care homes
Key question 4. How good is our setting?
Quality Indicator 4.1: People benefit from high quality facilities
Key improvement resources
Care Inspectorate: building better care homes
Design guide for care homes for adults
King’s Fund Care home assessment tool
Living in the community: housing design for adults with autism
Practical fire safety guidance
Psychologically informed environments
Rights, Risks and Limits to Freedom Good Practice Guide
Safe management of the care environment
Quality Indicator 4.2: The setting promotes people’s independence
Key improvement resources
Care Inspectorate - Building better care homes
Dementia-friendly environments
Dementia-friendly health and social care environments
Good practice in the design of homes and living spaces for people with dementia and sight loss
Learning disabilities and behaviour that challenges: service design and delivery
The King’s Fund Developing supportive design for people with dementia
Quality Indicator 4.3: People can be connected and involved in the wider community
Key improvement resources
Care...about physical activity
Dementia: developing community links
The care home and community engagement toolkit
The keys to life. Scotland’s learning disability strategy
Key question 5. How well is our care planned?
Quality Indicator 5.1: Assessment and personal planning reflects people’s outcomes and wishes
Key improvement resources
Understanding personal outcomes
Talking points – joint improvement team
Outcome-focussed conversations – Joint Improvement Team
HIS guidance on anticipatory care planning
Scottish Independent Advocacy Alliance – companion guidelines
Making it real – how to do personalised care and support
Guide for providers on personal planning
Mental Welfare Commission guidance:
Power of attorney guide for staff in hospitals and care homes
Working with the Adults with Incapacity Act – for people working in adult care settings
Quality Indicator 5.2: Carers, friends and family members are encouraged to be involved
Key improvement resources
Carers Trust: the triangle of care
Mental Welfare Commission – carers and confidentiality good practice guide
Joint adults and older people quality framework and self-evaluation toolkit
We held a webinar on 9 March 2022 for people working in care homes for adults and older people. The webinar explained the changes made within the updated Quality framework for care homes for adults and older people, and also introduced staff to the self-evaluation toolkit which had emerged from the learnings of our previous work on Covid-19 Self-evaluation toolkit for key question 7 and from discussions with services and inspectors.
Quality improvement programmes and topics
Quality improvement activity led by the Care Inspectorate, including recent practice resources and initiatives
Care homes for adults
Care homes can provide all aspects of a person’s accommodation, support, nursing and personal care or support
Care homes for older people
Care homes can provide all aspects of a person’s accommodation, support, nursing and personal care or support