- Principles and Practice
- The Quality Assurance Cycle
- Practice Standards – Quality Assurance
- Applying the Framework to Review Practice
- Practice Audits
- Thematic Audits
- Practitioner Events
- ICR/SCR Process
- Feedback and Engagement from Children and Families
- Learning and Changing
This page describes the principles and purpose of quality assurance activity across the Aberdeen City Multi-agency partnership. It also sets out the quality assurance process and the expectations of staff involved in this. Emphasis is placed upon learning and upon supporting colleagues across a wide range of partner agencies involved in improving outcomes for the children of Aberdeen City. It provides all partners within Children and Young People’s Services with a framework that can be used to evidence the quality of service delivery and contribute to ensuring children are safe and their wellbeing is promoted at all times.
It was important for the partnership to develop a multi-agency approach to quality assurance across all services and embedded a culture across the partnership that ensures our approach to service improvement and learning is consistent and strong.
Evaluating services for children and young people is overseen by a team of senior officers from Police Scotland; Aberdeen City Council; NHS Grampian and the third sector. The analysis of self-evaluation activities should ultimately identify areas that require development and contribute to the continuous improvement of services and supporting the implementation of Aberdeen City’s Child Protection Improvement Plan and Local Outcome Improvement Plan.
The Care Inspectorate “A quality framework for children and young people in need of care and protection – August 2019” will be used by the group to support self-evaluation. As detailed in this framework, it will help guide the Child Protection Committee; Community Planning Partnership and those with strategic responsibility to plan, deliver and evaluate services for children, young people and their families.
The framework is informed by the Local Outcome Improvement Plan, Aberdeen City Integrated Children’s Services Plan 2017-2020 and the Child Protection Improvement Programme 2019-2021, which all include safeguarding as a key priority and the development of effective frontline practice as a key commitment.
Details of the roles and responsibilities of all staff and managers within the Quality Assurance system in Aberdeen City can be viewed here.
Principles and Practice
The framework seeks to reflect the key principles that inform practice across all partner agencies in Aberdeen. The Quality Assurance framework aims to be:
- Child centred: the focus of quality assurance will be on the experience, progress and outcomes of children who come into contact with our services;
- Strengths based: quality assurance will focus upon strengths whilst identifying where practice can be improved. It will seek to offer high support and high challenge;
- Evidence based decision making: quality assurance will provide a clear rationale for decisions made when considering practice. Quality assurance must be transparent and fair to those whose practice is being assured;
- Outcome focused: the proper focus of quality assurance will be upon outcomes rather than on processes which are well understood through a robust performance management framework;
- Positive: our approach to quality assurance will be positive – looking at informing and encouraging improvement and supporting the development of staff and services;
- Reflective: our quality assurance framework is designed to promote reflective practice and shared learning.
The framework will also assist managers and team leaders to ensure:
- There is a positive culture of self-evaluation, leading to continuous improvement across services.
- All children, young people and their families’ outcomes are improved
- A consistency of methodology and co-ordination of multi-agency QA activities
- Staff have support and access to appropriate tools to support the QA agenda
- Services are regularly monitored, reviewed and evaluated
- We are committed to the ongoing development and improvement of the children and young people’s workforce
- More effective and more efficient systems and procedures
- Improved quality of services for users
- Better communication amongst staff and volunteers
- More creative thinking enabling new perspectives and ways of working
- Organisational learning
- Self-evaluation and continuous improvement
- Knowledge and learning are combined through the promotion of good practice, which will support:
The Quality Assurance Cycle
Self-evaluation should broadly answer three key questions:
- How good are we now? This question should help partners identify strengths within and across service delivery and begin to consider areas for improvement.
- How do we know? In considering this question, services should be gathering evidence and developing auditing/self-evaluation processes which illustrate how well the lives of children and young people are improving. There are a number of sources of evidence which can inform partners and services about the quality of their work.
- What do we plan to do next? This question should help to take forward what we have found so far and to develop a set of clear and tangible priorities for improvement.
Practice Standards – Quality Assurance
All staff providing services to children and young people are held accountable for making sure that their respective professional practice standards are met at all times. Practice standards are informed by statutory guidance, regulation and local policy e.g. the Scottish Social Services Council (SSSC) Practice Standards.
Our Quality Assurance activity seeks to ensure that the following overarching practice standards, applicable to all agencies and services, are adhered to as they act as building blocks in achieving effective frontline practice and positive outcomes for children:
- All children will have an up to date holistic assessment which reflects a clear picture of the child’s experience, wishes and feelings;
- All children will have a plan which explains their needs, personal views, planned outcomes and agreed actions;
- All assessments, plans and interventions will reflect an understanding of the wishes, feelings and needs of the child, and will be focused on enabling them to their outcomes to be improved upon;
- All assessments, plans and interventions will reflect an understanding of the wishes, feelings and needs of parents and carers, and will be focused on enabling them to fulfil their responsibilities to their children;
- As far as age and understanding allows, children will be involved in decisions that affect them and worked with by professionals who have the tools and training to directly engage children;
- Case records will have an up to date chronology of significant events, an accurate genogram and a case summary;
- Case recording will be up to date and will reflect the purpose of interventions and contacts;
- Every case file will include a relevant risk assessment on a child and will include a contingency plan;
- Every case will contain evidence of management oversight and regular supervision that is reflective, provides challenge and includes a rationale for decision making with clear actions;
- Every case will contain evidence of management oversight ensuring that tasks have been completed to the required quality standard.
An annual calendar of audits will be drawn from CPC, ICSB and coordinated by the Quality Assurance and Audit Lead. The calendar will be proposed at the first CPC and ICSB meeting of the calendar year for implementation in the period April to March. It is the responsibility of CPC and ICSB to determine the QA activity. This may be delegated to a relevant sub-committee such as GIRFEC group and CPC performance and quality assurance sub-committee.
This multi- agency calendar does not substitute for single agency QA activity such as:
- Supervision audits: the quality of supervision is crucial to frontline practice. This will be assured through quarterly supervision audits;
- Dip Sample: team managers complete regular dip sampling audits to ensure that actions are completed;
- Observations of practice: in addition to assuring the quality of frontline practice, observation enables assessment of key decision making in meetings and the quality of shared working;
- Learning from Compliments and Complaints: these are a valuable source of information and can identify strengths within practice as well as areas where things could be improved.
Child protection trends or themes emerging from single agency quality assurance processes may be raised with the Child Protection Committee’s Performance & Quality Assurance sub-committee or, in relation to corporate parenting, with the Integrated Children’s Services Board GIRFEC group.
Applying the Framework to Review Practice
The Multi-agency Quality Assurance Calendar will be drawn from the following:
Evaluating services for children and young people is overseen by a team of senior officers from Police Scotland, Aberdeen City Council, NHS Grampian, SCRA and the third sector through Aberdeen City’s Child Protection Committee and Integrated Children’s Services Board. The analysis of self-evaluation activities should ultimately identify areas that require development and contribute to the continuous improvement of services and supporting the implementation of both the Local Outcome Improvement Plan and Aberdeen City’s Child Protection Improvement Plan.
A programme of practice audits is identified by the multi agency QA team in conjunction with the CPC and ICSB. Cases are then identified randomly and allocated to the team of auditors. This should also include members from all partner agencies; Aberdeen City Council (Children’s Social Work and Education), NHS, Police and Third Sector and will be referred to as the Multi-Agency Quality Assurance Team.
In auditing cases auditors seek to apply the principles laid down within the Quality Assurance Framework and with reference to the Care Inspectorate guidance (see A quality framework for children and young people in need of care and protection – August 2019). Auditors consider the quality of practice and the impact that this has had upon outcomes for the child. Auditors provide evidence to support their decision making which means that judgements are transparent. This enables learning and allows for challenge to the audit process.
Auditors make judgements of practice based upon the Care Inspectorate grades of: Excellent, Very Good, Good, Adequate, Weak, Unsatisfactory. When we write inspection reports, we use the six-point scale to describe the quality we see:
6 Excellent Outstanding or sector leading
5 Very good Major strengths
4 Good Important strengths, with some areas for improvement
3 Adequate Strengths just outweigh weaknesses
2 Weak Important weaknesses – priority action required
1 Unsatisfactory Major weaknesses – urgent remedial action required
An evaluation of excellent describes performance which is sector leading and supports experiences and outcomes for people which are of outstandingly high quality. There is a demonstrable track record of innovative, effective practice and/or very high-quality performance across a wide range of its activities and from which others could learn. We can be confident that excellent performance is sustainable and that it will be maintained.
An evaluation of very good will apply to performance that demonstrates major strengths in supporting positive outcomes for people. There are very few areas for improvement. Those that do exist will have minimal adverse impact on people’s experiences and outcomes. While opportunities are taken to strive for excellence within a culture of continuous improvement, performance evaluated as very good does not require significant adjustment.
An evaluation of good applies to performance where there is a number of important strengths which, taken together, clearly outweigh areas for improvement. The strengths will have a significant positive impact on people’s experiences and outcomes. However, improvements are required to maximise wellbeing and ensure that people consistently have experiences and outcomes which are as positive as possible.
An evaluation of adequate applies where there are some strengths but these just outweigh weaknesses. Strengths may still have a positive impact but the likelihood of achieving positive experiences and outcomes for people is reduced significantly because key areas of performance need to improve. Performance which is evaluated as adequate may be tolerable in particular circumstances, such as where a service or partnership is not yet fully established, or in the midst of major transition. However, continued performance at adequate level is not acceptable. Improvements must be made by building on strengths while addressing those elements that are not contributing to positive experiences and outcomes for people.
An evaluation of weak will apply to performance in which strengths can be identified but these are outweighed or compromised by significant weaknesses. The weaknesses, either individually or when added together, substantially affect peoples’ experiences or outcomes. Without improvement as a matter of priority, the welfare or safety of people may be compromised, or their critical needs not met. Weak performance requires action in the form of structured and planned improvement by the provider or partnership with a mechanism to demonstrate clearly that sustainable improvements have been made.
An evaluation of unsatisfactory will apply when there are major weaknesses in critical aspects of performance which require immediate remedial action to improve experiences and outcomes for people. It is likely that people’s welfare or safety will be compromised by risks which cannot be tolerated. Those accountable for carrying out the necessary actions for improvement must do so as a matter of urgency, to ensure that people are protected, and their wellbeing improves without delay.
Auditors complete their audits on an audit tool which is embedded within ICS. As well as considering case recording auditors meet with the allocated social worker and other relevant practitioners where appropriate, including the Team Manager, Independent Reviewing Officer, or Child Protection Case Conference Chair, if one is involved in the case. These meetings promote reflective discussion and are central to the principle of learning from audit. They enable a fuller understanding of the child’s journey and ensure that audit has an immediate impact in bringing about change to address practice issues.
In addition, auditors make contact with families or children whose case files are being audited to gather their views of services they have received. Such feedback provides additional understanding of practice thus contributing to quality assurance.
After each audit has been completed it is sent to the Quality Assurance and Audit Lead who moderates each audit, considering the evidence provided by the auditor in support of the judgements made about the quality of practice. During the moderation process judgements may be adjusted up or down depending upon the evidence on the case file. If this occurs the Quality Assurance and Audit Lead provides feedback to the auditor to ensure that the rationale for the change is understood and to inform future audit practice.
After moderation audits are returned to the CPC or ICSB as appropriate for progressing identified practice and learning issues.
In addition to the regular schedule of practice audits the Quality Assurance Lead also co-ordinates thematic audits where concerns have been identified through case file audits, performance data, complaints, or other sources of learning. The thematic audits are completed by a small group of auditors working together. Auditors are chosen from the Multi-Agency Quality Assurance Team.
Thematic audits consider a minimum of 12 cases and are completed in two days. It is proposed that there be two annual audits, one from ICSB one from CPC. Underpinning the Quality Assurance and Performance Framework is an understanding that continual improvement depends on a culture of reflection in action and reflection following action (Single and Multi-agency supervision/ consultation/ discussion).
Evaluating services for children and young people is overseen by the Multi-Agency Quality Assurance Team. The analysis of self-evaluation activities should ultimately identify areas that require development, and contribute to the continuous improvement of services and supporting the implementation of Aberdeen City’s Child Protection Improvement Plan and Local Outcome Improvement Plan.
This will allow the sharing of experiences of front line professionals and support an understanding of issues that impact upon practice as part of ongoing self-evaluation activity.
Initial Case Review (ICR) and Significant Case Review (SCR) are undertaken where there has been a death or near death of a child in accordance with the SCR and ICR Procedure; learning points from practice are thereafter shared.
Observations of practice provide a good opportunity to gain a robust understanding of the quality of practice. Observations should only be undertaken with the explicit and informed consent of the child and their family. Following observations of practice, the observer has an opportunity to speak with the child or their family about their experience of the services they have received and their impact. What has been observed is also discussed with the professional team around the child in order to understand their views, to promote reflective discussion and to inform learning.
Observation of meetings also provide an opportunity to assess the quality of shared working and decision making within Aberdeen City and to understand how different staff, teams and agencies are working with children and families.
Feedback and Engagement of Children and Families
Engaging children and their families in quality assurance is a key plank in gaining an understanding of practice and how this practice is achieving positive outcomes for children. Feedback is a crucial element of all quality assurance activity so that the lived experiences of children and families and their experiences of services feed directly into how we understand and learn about the quality and impact of practice.
Learning and Changing
Following all audit activity co-ordinated by the Multi –Agency Quality Assurance Team, the Quality Assurance and Audit Lead prepares a report or briefing analysing what has been learnt. These reports are shared within the commissioning ‘body’ (COG, ICSB or CPC) and with the Multi-Agency Childrens Services L&D Lead Officer.
Performance Clinics and Practitioner events will ensure that learning is disseminated so that all learning from audits is communicated to all colleagues across Children’s Services.
Audit reports include details on the number of audits completed, the focus of the audits and the overall quality of the cases. Reports reflect the evidence auditors have considered and include recommendations and an action plan of steps to be taken in order to build upon the positive practice that has been identified through audits. Recommendations may include changes to policy or practice guidance, improved use of knowledge and research to inform practice, or the provision of training or tools to support frontline practice. Recommendations inform a programme of multi agency learning and development. Learning from audit informs workforce development, service improvement plans and personal development plans.
The success of service delivery in Aberdeen City is measured by improving the outcomes for children and their families. This needs the commitment and support of all managers and their teams across all partners to ensure that quality assurance activity is embedded with a clear feedback and remedial action process.
This framework will support the production of an annual report to the Community Planning Partnership, COG, CPC and the ICSB. The annual report will provide assurance of the impact of self-evaluation and how Aberdeen City is improving outcomes for children, young people and their families.
It is important that Quality Assurance activity is coordinated in a manner that supports rather than disrupts the delivery of services to children, young people and their families. The senior officer team will therefore agree with the GIRFEC Group, CPC and the ICSB a programme of self-evaluation based on identified priority areas (see Sample QA Audit Calendar 2019/2020). This programme will be supplemented by a quarterly report from the Business Intelligence Unit on a suite of quantitative data.