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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Quality Assurance and Continuous Improvement Policy

1. Purpose

The purpose of this policy is to outline how {{org_field_name}} maintains high standards of care and support through a structured and evidence-based approach to quality assurance and continuous improvement. We are committed to delivering a consistently high-quality service that is person-led, safe, compassionate, and outcome-focused, in accordance with the Health and Social Care Standards (HSCS), the National Care Standards for Care at Home, and the SSSC Codes of Practice.

Our quality assurance framework ensures we remain accountable to the people we support, their families, regulatory bodies, and our wider community. We aim to demonstrate through practice, documentation, and outcomes that the care we provide is not only compliant but continually improving.

2. Scope

This policy applies to all staff and stakeholders of {{org_field_name}}, including:

• Registered and Deputy Managers
• Care Coordinators and Team Leaders
• Frontline care support workers
• Administrative personnel
• External partners and professionals where joint working is applicable

The policy covers all aspects of care delivery, governance, communication, leadership, compliance, service development, and engagement with the people we support.

3. Related Policies

This policy works alongside and complements the following:

• Governance and Management Policy
• Record Keeping and Documentation Policy
• Personal Planning and Outcomes Policy
• Supervision and Appraisal Policy
• Incident Reporting and Learning from Events Policy
• Complaints and Feedback Policy
• Staff Training and Development Policy
• Business Continuity and Contingency Policy

4. Policy Statement: Our Commitment to Quality

At {{org_field_name}}, we believe that quality is everyone’s responsibility. Quality assurance is embedded at every level of the organisation – from the day-to-day interactions between care workers and the people we support, to the strategic decisions made by the Registered Manager and Company Director.

We strive to meet the following principles:

• Outcome-focused care tailored to each individual’s needs, wishes, and preferences
• Inclusive decision-making involving people we support, their families, and staff
• Consistent self-evaluation and reflection
• Transparent reporting and accountability
• Proactive learning from feedback, incidents, and audits

5. How We Manage Quality and Improvement Efficiently

5.1. Using the Health and Social Care Standards as a Foundation

We use the HSCS principles of dignity, compassion, inclusion, responsive care, and wellbeing as the benchmark for all care planning and delivery. Every staff member is trained to understand the standards, and these are used in:

• Care reviews
• Supervision discussions
• Quality audits
• Service evaluations

Our care plans reflect personal outcomes aligned with HSCS Standard 1.15 and 2.17, and are reviewed regularly with the person and/or their representative.

5.2. Ongoing Self-Evaluation and Quality Frameworks

In line with Care Inspectorate quality frameworks, we ask ourselves three core questions:

• How are we doing?
• How do we know?
• What are we going to do next?

To answer these, we:

• Conduct quarterly internal audits (including file audits, medication, infection control, and spot checks)
• Use key performance indicators (KPIs) to monitor call times, missed visits, and complaint trends
• Engage in reflective learning and benchmarking with other providers when possible

We also utilise the Care Inspectorate’s self-evaluation resources and quality indicators to benchmark our performance.

5.3. Feedback-Driven Culture

We actively seek feedback from:

• The people we support
• Family members and informal carers
• Staff across all roles
• Partner agencies and commissioners

Feedback is gathered via:

• Scheduled satisfaction surveys
• Review meetings
• Suggestion boxes
• Informal conversations
• Compliments and complaints tracking

All feedback is logged, monitored, and actioned in our service improvement tracker.

5.4. Learning from Incidents and Complaints

When something goes wrong—or almost goes wrong—we treat it as an opportunity to learn and improve. Our robust procedures ensure:

• All incidents, near-misses, and complaints are recorded and reviewed
• Root cause analysis is completed where needed
• Learning is shared with relevant teams during supervision or debrief
• Trends are tracked and reported in monthly quality reports
• People we support are informed of outcomes and changes made as a result

This aligns with the SSSC Code 3.7 and 5.12, promoting openness, reflection, and action.

5.5. Monitoring Staff Competence and Practice

Staff quality is continuously monitored through:

• Regular supervision and appraisal cycles
• Observational visits of staff in people’s homes
• Service-user feedback forms tied to specific workers
• Scheduled and unannounced spot checks
• Auditing of documentation and MAR charts

Supervision includes reflective conversations about how staff apply the Health and Social Care Standards and the SSSC Codes of Practice in daily work.

5.6. Audit and Reporting Framework

Our Registered Manager is responsible for ensuring that monthly and quarterly audits are carried out across all service areas. This includes:

• Care documentation audits
• Medication administration audits
• Safeguarding and accident analysis
• Complaints and compliments reporting
• Staff performance monitoring

Audit outcomes are used to develop our Service Improvement Plan (SIP) which outlines actions, responsible persons, timescales, and measures of success. The SIP is reviewed quarterly and updated accordingly.

5.7. Staff Involvement in Quality Improvement

We recognise that frontline staff often have the most valuable insight into what is working well and what needs to change. We foster a culture where staff:

• Feel confident in raising concerns or improvement ideas
• Are involved in creating action plans
• Help test changes in practice (Plan-Do-Study-Act cycles)
• Share positive examples of practice with their peers

We hold regular team learning sessions that encourage open dialogue and collaborative thinking, aligned with the SSSC Employer Code 2.5 and 2.6.

5.8. Compliance and Continuous Learning

We ensure all aspects of our service are in full compliance with:

• The Regulation of Care (Scotland) Act 2001
• The Social Care and Social Work Improvement Scotland Regulations 2011
• GDPR and data protection requirements

We use findings from Care Inspectorate inspections, notifications, and national publications to inform training and updates to policies.

5.9. Communication and Transparency

Quality assurance findings and improvement plans are shared with:

• People we support (in accessible formats)
• Staff (via meetings and bulletins)
• External stakeholders (commissioners, family members, and the Care Inspectorate as appropriate)

Our quality reports are retained as part of our governance records and are made available upon request.

6. Roles and Responsibilities

• Registered Manager: Leads all quality assurance systems, coordinates audits, reviews performance, and submits notifications to the Care Inspectorate.
• Deputy Manager: Supports audit cycles, coordinates SIP actions, and promotes quality culture among care coordinators and staff.
• Care Staff: Are expected to engage with audits, contribute to reflective discussions, and follow best practice in line with their training.
• People We Support: Are partners in our improvement work and encouraged to share their views to shape service delivery.

7. Policy Review

This policy is reviewed annually or earlier if there are:

• Significant changes to legislation or regulatory standards
• Lessons learned from inspection or critical incidents
• Organisational changes affecting service delivery

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Responsible Person: {{org_field_registered_manager_first_name}}{{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.