Social care - Independent Review of Inspection, Scrutiny and Regulation: recommendation report

1. Foreword

In 2022, I accepted an invitation from Kevin Stewart MSP, Minister for Mental Wellbeing and Social Care, to become the Independent Chair of a Review of Inspection, Scrutiny, and Regulation of Social Care in Scotland (IRISR). I welcomed the appointment of Stuart Currie as Vice Chair, who has been a real asset to the Review and, amongst other things, has led on our extensive programme of engagement.

As a result of changes within government, I welcome the opportunity to present the findings of the Review to Maree Todd MSP, Minister for Mental Wellbeing, Social Care and Sport.

In undertaking this Review of Inspection, Scrutiny, and Regulation of Social Care in Scotland (IRISR), no assumptions were made about what the Review would find or would recommend. We recognised that the present system of inspection, scrutiny, and regulation has been in place for two decades and in that time there has been a great deal of incremental change in social care support. This includes partnership working, pressures in the system and, of overarching importance, recognition of the importance of the views and expectations of those receiving social care support services.

Organisations and individuals are working diligently whilst under considerable pressure in a social care landscape that is complex, congested and at times inconsistent in terms of accessibility and quality. The Review has heard that some positive changes have been made in inspection, scrutiny, and regulation however, recurring feedback from the frontline of service delivery asked where the difference was being made.

It is clear that the social care support sector often struggles to secure and retain a stable and sufficient workforce, the importance of which, in supporting improvement, is a theme that ran through all our discussions. Whilst workforce issues were not of themselves central to our remit, the Review believed this to be an issue of such underpinning importance that we do make comment in the following report.

The appetite for engagement and change has been striking. There is a palpable sense that the Review provides a real opportunity to support an inspection and regulatory system that works better for those using and providing social care support services and that puts human rights and fairness at the very centre. The difference will be made in protecting people, in ensuring that people receive the quality services they deserve, in services being helped to improve, and above all, in ensuring improved personal outcomes for those being supported and cared for.

While resourcing was considered important, there is a keen awareness of the need to understand how existing resources are used effectively to deliver the best possible outcomes for people. As our discussions have developed, contributors and participants have come forward with constructive ideas and views on how things can change and develop for the better.

In recent years, several reviews have identified the need for change across the social care and wider support landscape. This Review has drawn upon and builds upon the prior work and findings including ‘The Promise’, ‘The Independent Review of Adult Social Care in Scotland’, ‘Putting Learners at the Centre’ and ‘Trust and Respect’. The recommendations of this Review are set out across five themes and are firmly informed by the evidence that has been gathered. They are driven by a commitment to equality and human rights and by putting the cared for at the heart of our considerations.

An implementation gap has been identified and progress needs to be accelerated. The recommendations lay out clearly what the Review thinks needs to be done to close that gap. Here is an opportunity to take the recommendations and make the difference that people delivering support and being supported across the sector are looking for. Now is the time for action.

I would like to thank all those who contributed to the Review. People have been extremely generous with their time and their views. The Review has heard from people with lived experience of social care support services and their relatives, from service providers across social care, from those delivering regulation and scrutiny, and from professionals bringing a wide range of perspectives and contexts. I would like to thank those who served on the Independent Review Panel and the Practitioner and Stakeholder Panel, all of whom gave generously of their time and their frank, challenging and open contributions to our discussions.

I would also like to take this opportunity to thank the Review Secretariat for their diligence and Vice Chair, Stuart Currie, whose knowledge, experience and commitment has been extremely valuable throughout.

Dame Sue Bruce

Independent Chair