Local inspections

Information about the findings from ten local inspections.

Local inspection reports

Background

The Healthcare Commission, the Commission for Social Care Inspection (CSCI) and the Audit Commission are carrying out a whole systems inspection of the way in which the NHS and local authorities are working together with their partners to improve the lives of older people and meet their needs. This work will be supported by King's College London, who have been contracted to get the views of older people and their carers. All three inspectorates plus King's College London will work jointly on the inspection and will produce a single, joint report for the community as a whole.

Ten local joint inspections are being undertaken in selected communities in England, four starting in January and six in April.  The January inspections are scheduled to be completed by April 2005, and April inspections by July. These will also inform a national report which will be published at the end of 2005. Further inspections will follow the national report and will be targeted in response to performance screening as part of a wider inspection framework.

The inspections will include subsequent developments in policy that affect older people.

Introduction

The joint inspection will cover a range of agencies and services in the local community providing services to older people.  A local community has been defined as a geographical area within one strategic health authority and includes a local authority and the health and social care organisations within it. The views of independent providers and voluntary organisations will be reflected.

Specific organisations are to be inspected at high level within each of the first four communities. Only some of these will be covered in subsequent fieldwork.

Download Organisations to be inspected (PDF, 53K) (opens new window)

A preliminary inspection of evidence will be undertaken, largely based on material provided before arrival on site, and will cover the health and wellbeing aspects of older people living in local communities. Initial findings from this preliminary work will be presented and discussed at a meeting with the organisations. The focus for more detailed work will then be agreed. At this point a specific focus, such as strokes, falls or mental health, and the organisations will be selected.

We will assess

• the progress in implementing NSF standards and subsequent policy development in older peoples services
• the performance of the local authority in commissioning and delivering services to promote independence and choice for older people and carers
• older people's and carer's views of service improvement and gaps

This work also aims to support the organisations in further progressing and improving services to older people. In doing so we will identify notable practice and areas for development.

Scope

Criteria against which progress will be measured, using a whole systems approach, have been developed jointly by the three inspectorates following extensive consultation, and includes the advice of older people:

Download Joint criteria for inspection (PDF, 65K) (opens new window)

They will form the basis of the inspection and will include:

• a review of implementation of the NSF for older people
• the issues which CSCI would normally expect to examine in an inspection
• the issues which Audit Commission is likely to include in the older people's strand of the corporate element of Comprehensive Performance Assessment (CPA) from 2005

Timescale and personnel

Broadly the process for the first four is as follows:

Throughout this period, a team of researchers from King's College London, will work alongside the inspectors, carrying out consultations and interviews with older people and carers within the area. Their findings will provide specific information on the experiences and views of older people within this specific community, inform the group interviews and feed into the report.

A number of staff from the Healthcare commission, Commission for Social Care Inspection (CSCI) and the Audit Commission will be involved with this inspection, with support from professional and older people advisors and King's College London staff.

Selection of communities

We aimed to select communities using a sampling framework that addressed the need for urban/rural, ethnicity, socio-economic and age ranges to be analysed to get a good sample to inform the national report. However, we were restricted by the need to ensure that we did not review three star social services or excellent performing councils. We worked with the Audit Commission, CSCI and Healthcare Commission to look at inspection programmes for 2004/2005 so that we were not overburdening organisations with too much inspection. The four communities selected were those where CSCI had planned an inspection of older peoples services for around the same time as the reviews. The joint older peoples inspection will replace these CSCI inspections of older peoples services.

The next six communities will be selected using a similar process although we will try to redress the need to get a varied sample of communities for the national report. The next six communities will be announced January 2005.

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