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Thursday, 23 March 2017

First thematic report on inspections of Scotland's adult learning disability services

Written by The Editorial Team

The Care Inspectorate has today published the first ever thematic report on inspections of services for adults with learning disabilities in Scotland.

The report shows that the overwhelming majority of care is performing well, and in most cases continuing to improve. There are some outstanding examples of care which is designed to meet people's individual needs and choices, and allow them to live as independently as possible.

Key findings from the report include:

  • 93% of services provide care which inspectors found to be good, very good or excellent, with equally positive evaluations of the quality of staffing and the quality of management and leadership.
  • The quality of the environment in these services was found to be good, very good or excellent in over 88% of cases.
  • Over 45% of services were found to be operating at a levelconsidered by inspectors to be very good or excellent across all quality themes. This is a significant achievement and consistent with a sector which is performing at a high and sustained level of quality.
  • There was high-level awareness about The Keys to Life strategy and the key lessons from the report on the review into Winterbourne View. Many services were using these to inform their staff development, and the way care is planned and delivered.
  • Managers in care services were asked to report on how easy they found it to arrange and access healthcare for the people they support. In some cases, a significant minority of managers reported it being difficult to access healthcare and this was more likely to be in housing support and care at home services than in care homes.
  • Where inspectors saw strengths in services, overwhelmingly this related to the implementation of person-led care practices which promoted choice and protected the rights of those using services.
  • Strengths were consistently built on strong communication between staff and those using the service. This was evidenced by staff demonstrating active knowledge of an individual’s preferences and choices and being sensitive to their (sometimes changing) needs, with examples of relevant and up-to-date care plans.
  • Inspectors found many examples of outstanding care which empowered people to make decisions about their own care and support, and their lives. In many cases, staff working in these services went out of their way to deliver person-led care which was informed by a real understanding of the needs, wishes and choices of individuals. In a small number of cases, inspectors made recommendations or requirements to ensure that people experienced individual support that would secure their independence.

The results are the findings of focused inspection work by the Care Inspectorate over a two year period which examined the quality of care experienced by adults with learning disabilities and the impact of The Keys to Life Policy in care homes and care at home services.

The Keys to Life is designed to empower people with learning disabilities and ensure the right support is in place for them. The study examined how well care services respond to the care and support needs of people experiencing care, the extent to which person-led values are embedded in practice, and the extent to which services support the strategic outcomes in The Keys to Life policy.

Karen Reid (pictured), chief executive of the Care Inspectorate said: “People who experience care are entitled to expect high-quality care which meets their needs, upholds their rights, reflects their choices and allows them to live as happy and fulfilled a life as possible.

“Over the last decades, care and support for adults with a learning disability has been transformed beyond recognition. A significant shift from life-long institutionalised care towards living in communities on equal terms has improved the lives of many people with learning disabilities.

“At the same time, increasing awareness about the need for person-led care has ensured that people are at the heart of decisions about their live. These principles are evident in many care services."

The reports shows care services for adults with learning disabilities in Scotland generally perform very well. Scrutiny evidence shows that over 93% of care services used by adults with a learning disability provide good, very good, or excellent care, inspectors noted.

However, the report shows that a significant minority of care managers reported difficulty in accessing the right healthcare for the people they support. In some cases, inspectors required improvements in how care was planned and delivered, and asked managers to ensure that activities were better focused on people's individual choices and wishes.

Karen Reid added: “The Care Inspectorate’s combined scrutiny and improvement role means that we are able to identify quickly where poor practice exists and support it to improve.

"We expect care services and staff to always put the needs of people who use care at the heart of decisions, and make sure care is tailored to their individual needs. Local partnerships must work across the social care and health systems to ensure that everyone is able to get the health and social care support that is right for them."
The report is available here: