I have been writing each week about the five headline outcomes which form the main structure of the new Scottish National Health and Social care standards. These will be fully introduced from April 2018 and can be downloaded in their final form from the Scottish Government website. (https://beta.gov.scot/publications/health-social-care-standards-support-life/pages/2/)
The standards are being introduced after extensive consultation with services, with people using those services, and with the public, over several years. The five main ‘headline outcomes’ cover the outcome of receiving care which people are entitled to expect. These are:
- High-quality care and support that is right for me
- I am fully involved in all decisions about my care and support
- I have confidence in the people who support and care for me
- I have confidence in the organisation providing my support and care
- I experience a high-quality environment if the organisation provides the premises
Each of these five outcomes is discussed and specified using the five main principles of care, which were agreed after consultation: dignity and respect; compassion; be included; responsive care and support, and wellbeing.
General Features of the Standards
The health and social care standards are applicable across all services providing some element of care, whether or not these services are registered. The standards are saying that this is how care and support is expected to be provided in Scotland.
The standards are Human rights-based. No particular charter or convention on rights is specified. However, the language of expectations clearly refers to what people being cared for have a right to receive.
The language used is clearly person-centred. This can be seen in the use of the first person language throughout: ‘I am fully involved… ‘I have confidence…’
Most important, I think, is that a values orientation is adopted in the statements. Compassion, wellbeing, dignity and respect. These have always been central to care, and it is good to see the emphasis on values rather than on quantity, size and areas which were often seen as crucial elements of the standards previously. Of course, the requirements of legislation and best practice remain in place. As stated in the introduction of the standards, outcomes rather than inputs have the highest importance, ‘people’s care experiences are at the heart of a common understanding of quality’.
What do Services Need to do to Meet These Standards?
I believe good quality services will already be in a position of conforming to most of the requirements of the standards. Staff training in the importance of rights, outcomes and people’s aspirations and choices will be helpful. Some documentation may need to be changed, for example, information about the service, additional sections in the support plan to include aspirations, and statements about respecting people’s choices. Personal outcomes and aspirations should be clearly specified in advance, and progress towards these outcomes is assessed and recorded. All of these measures should also be included in the quality monitoring systems of the service, and any necessary change to meet the standards fully should be carried out and recorded.
I believe the standards are revolutionary, promising innovation and further steps forward in developing quality care provision. We trust that their implementation will overcome the present huge pressures of funding and staff resourcing which are evident across all health and social care sectors.