Setting Standards in Scotland

This item was received as a response to comments we made in News Views, reporting on the plans for standard-setting in Scotland and accounts of the impact of regulatory visits on childminders in England.

Click here to read the original news items (January 2008 issue).

I am the project manager responsible for the introduction of the grading system in Scotland which you have covered in the above article.

You raise a valid point about the risk that grading systems are often applied using very complex “rule books” and that this can become a complex bureaucratic exercise. Too often, in my personal view, that approach simply ends in testing inputs and processes rather than quality. Quality for care services, if it means anything, must relate to what is being delivered to users. We are trying to avoid this input/process focused approach and are trying to focus our gradings as far as possible on outcomes for users. We are also placing a very heavy emphasis on real self assessment by services and the involvement of service users in that process.

I note that you refer to the issue of “averaging”. I do not wish to comment on any other grading system but all gradings systems have to address the problem of how to aggregate performance across a number of areas in order to achieve the final grades. Some sort of approach which averages performance in some way is almost unavoidable in doing this.

My perception is that stakeholders want both a simple easy guide to the quality of performance of a service and also to be able to see the detail of more specific areas of performance. The headline grades for a service can be thought of as providing the former while the detail of performance is available in inspection reports.

The subject of aggregating performance to calculate grades is a complex one. In my view users and carers generally do not want areas of poorer performance hidden by areas of better performance in calculating the final grades. For some providers you will appreciate that the view may be the other way round !

We have taken the view that the top grades in a system must be hard to achieve; otherwise they have no value. That is not the same, of course, as saying that inspectors must never award top grades to a particular type of service.

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