We’re currently recruiting for new inspectors. In our latest blog, Sharon Walker explains what it’s like to know that you help to improve care and safety for patients
The primary goal of inspection is to promote high quality health and care services for the people of Scotland. As a senior inspector with Healthcare Improvement Scotland, I’m able to help make improvements happen by using a variety of tools to assess the strengths and weaknesses in a service or organisation.
The importance of relationships
Inspection is about team work. Inspection programmes are often planned in advance to identify what works well in an area, what isn’t working well and what is needed to achieve national drivers for optimum health and wellbeing across Scotland. The inspection teams are made of a variety of skills – some of us are nurses, some have worked as allied health professionals and others have enhanced knowledge of medicine, quality assurance and improvement methodology. By tapping into these skills, we are far more likely to help services to achieve high quality sustainable health and social care.
From experience, to help affect change it’s better to work with services – hierarchical domination usually ends in mistrust. It takes time to build these relationships and to find the right way to bring people with you on the journey to realise improvements. Listening to what works well in the service and what doesn’t helps to establish trust; it’s a two-way process whereby strategies can be openly discussed and agreed. Moreover, offering the right support at the right time helps services to improve outcomes for people.
It’s this engagement with care providers and the public that I like best. Meeting staff on the front line delivering care, talking to people receiving care about their experiences gives me a sense of achievement, knowing that I have included the most essential people in the inspection process.
Then there’s the report! This is the step that pulls all the evidence together in a relatively short summary – it’s an area which requires careful consideration to ensure key evidence of the inspection findings are included. After all, this is the part that demonstrates how good the service is and what needs to improve.
Sadly, some services do not always provide satisfactory levels of care despite targeted support – outcomes for people accessing care can at times be poor and require immediate interventions. Being able to understand the governance which supports the inspection methodology allows us to take the necessary steps to mitigate risks in services and find a way forward that is right for the service to improve and to keep patients safe. It’s important for us to report our findings accurately and clearly, so that the public can fully understand a services’ strength, plus where and how it needs to improve.
Partnership working and getting the balance right
As a senior inspector, I am predominantly involved in partnership working with other bodies such as the Care Inspectorate and Her Majesties Inspectorate of Constabulary in Scotland (HMICS) to carry out joint inspections of services provided across Scotland. As a result, I have developed my knowledge of joint inspection methodology and legislation which supports this aspect of quality assurance.
For example, the programme I am supporting at the moment is Adult Support and Protection, other joint programmes I have supported are services for Children and Young People and Adults.
The joint approach to inspection requires the team to consider the operational strengths and challenges associated with delivering health and social care, alongside knowledge of strategic commissioning and decommissioning of resources, plus the challenges associated with achieving equality – particularly in hard to reach areas and communities which have co-morbidities and higher crime rates.
Planning is essential. Being involved in the planning of inspections for me is important as I can help influence how my skills can be best used to gather evidence from inspections.
Once a nurse, always a nurse
Over the years, I have developed my experience of quality assurance and improvement, but occasionally I still feel like I am wearing two hats. Before I was an inspector, I was and still am a registered nurse, and this background helps me to strike the right balance between nursing and helping to bring about improvement. I am fortunate to have operational and strategic leadership experience which allows me to focus on specific aspects of inspection methodology such as quality of staffing, safe delivery of care and leadership and management. My colleagues in the Care Inspectorate and HMICS bring additional skills, all of which help to ensure inspections are carried out effectively.
As an inspector, I have travelled to some of the most beautiful parts of Scotland and met some truly amazing people who work tirelessly to bring about change. It’s hugely rewarding to add to what they do and to work with them to improve the quality of care.
Sharon Walker is a senior inspector with Healthcare Improvement Scotland
We’re currently recruiting for new inspectors, to find out more and to apply, visit our recruitment page.