Office workers sat around a desk with a laptop

The challenges of running a joint review…

One of the inspections I’m working on at the moment is around mental health. It’s a joint project between the Care and Social Services Inspectorate Wales (CSSIW), who I work for, and Healthcare Inspectorate Wales (HIW).

We’re looking into how Community Health Teams provide care, support and treatment to adults with mental health problems. As part of this review, we’re carrying out inspection visits at one Community Mental Health Team in each of the 7 health board areas in Wales. We’re carrying out interviews with senior officers at health boards and local authorities. And, we’re also consulting a wide range of stakeholders, including service users and their carers/families to hear their views about the services they receive.

If you’re interested, you can also get involved with the review (opens in new window).

So far, we’ve scoped, planned and completed four inspections visits and our joint working has been fairly harmonious so far, albeit challenging at times.

Our Inspection methodology consists of a blend of HIW and CSSIW routine methods. We’ve faced some challenges – such as whether to conduct announced or unannounced visits; reaching agreement on the use of language, i.e. “patient” versus “service user”; and how to capture evidence from inspections.

However, we’ve achieved an approach, including the design and production of assessment tools, which enable us to make a holistic evaluation of the quality of care, support and treatment, as well as its compliance with both mental health and social care legislation.

Inspection teams are led by HIW and comprise an equal number of HIW and CSSIW reviewers. This has created some challenges and highlighted differences in the way we work. For example, home visits to service users/carers versus office visits; the way we manage immediate concerns; and the level of detail included in preliminary verbal feedback.

However, we have agreed a joint approach and created mixed inspection teams. This has helped to achieve a good balance of evidence, through lively debate about the cases reviewed and the staff, service users and carers we’ve interviewed.  There is also the very positive spin-off that professionally we have learned a great deal from each other.

Although early days – we haven’t fully completed an inspection report yet – from my personal experience of participating in two of the inspection visits, I think, our joint approach is already producing an overarching evaluation of services that is “greater than the sum of its parts”. I am very confident that this will eventually be reflected in our overarching joint national report to be published next year.

About the author

Bobbi JonesBobbie Jones has worked as a local authority inspector for CSSIW since 2013. Prior to this, Bobbie worked as an inspector for HMI Probation after having spent a career of over 20 years in the National Probation Service.

Bobbie qualified as social worker in 1991 and has subsequently completed a Masters degree at Cambridge University in Criminology, Penology & Management.

Bobbie enjoys gardening, relaxing with a good book and playing with her grandchildren.

A teacher in a school

Inspection Wales Programme makes good progress

It’s sometimes said that external reviewers are like buses; they all turn up at the same time. And the challenge to the Inspection Wales partners, as the four principal external review bodies in Wales, is to demonstrably work together effectively to plan and deliver our work.  Such collaboration is essential to make the most of our respective, limited, resources, and to add most value to public bodies being reviewed and the people of Wales.

Front cover of the stocktake paperWe’ve now published a review of the progress [opens in new window] we’ve made in delivering our programme, an initiative to improve cooperation and collaboration between the four external review bodies in Wales.

The examples and case studies described within the paper demonstrate the extent to which the four review bodies are already planning and delivering work jointly, and show how, to again paraphrase another commonly used phrase, four heads are better than one.

The paper identifies long standing arrangements for collaboration, such as healthcare summits and quarterly meetings between the Heads of Inspection. It also outlines a recent new initiative from Estyn [opens in new window] and refinements to existing practices by CSSIW [opens in new window] which further demonstrate the commitment to information sharing by Inspection Wales partners. It provides details of joint working, particularly, but not exclusively, in the areas of education and health. For example, joint reviews by Estyn and the Wales Audit Office [opens in new window] of the four regional consortia for education improvement and joint reviews by HIW [opens in new window] and CSSIW of learning disabilities and Deprivation of Liberty safeguards.

Next steps for Inspection Wales

Over the next 18 months, Inspection Wales will further progress its first joint national thematic review on the topic of services for young people. Working across their respective remits in this way will enable Inspection Wales partners to take a more comprehensive look at the services provided to young people by different public bodies and report more holistically on young people’s experiences of services.

There will be a further blog in the near future about the joint work Inspection Wales partners are doing on youth services in Wales. There will also be a further blog about the forthcoming joint HIW and Wales Audit Office review of governance at Betsi Cadwalder University Health Board.

Inspection Wales partners will also continue to engage with the Welsh Government as it develops its plans for local government reform, as set out in the January 2017 White Paper on local government reform.

About the author

Emma Giles, Inspection Wales Programme Board ManagerDr Emma Giles took over as Inspection Wales Programme Manager in March 2017. Prior to this, Emma was a performance audit lead with the Wales Audit Office.
Emma is an outdoor enthusiast who likes mountain biking and walking.

Her PhD in Criminology looked at how offenders and criminal justice staff understood fairness, and what these differing perceptions of fairness meant for relationships between staff and offenders.

 

 

A female carer helping a lady make cupcake cakes

Choice and voice: a joint approach

The collaborative approach to a joint inspection between Healthcare Inspectorate Wales (HIW) and Care and Social Services Inspectorate Wales (CSSIW) led to a successful report launch involving service users and carers, and a big push on social media on launch day.

Publishing our findings in June, we – the two inspectorates – challenged local authorities and health boards to improve the planning and delivery of services for people with learning disabilities.

Together we delivered a lengthy national inspection programme in six local authorities and local health boards, to see how services were planned and delivered for people in those areas.

We met with advocacy and involvement groups, including All Wales People First [opens in new window] and the All Wales Forum of Parents and Carers [opens in new window], and we produced an all-Wales report, which we launched at an event at iSmooth [open in new window], a Mencap Cymru [opens in new window] social enterprise in Ammanford.

This was thoroughly appropriate for this particular report, and gave the report more meaning than if it was a generic conference venue.

Many members of staff at iSmooth have learning disabilities and it was important that the venue was relevant to the types of issues discussed in the report, about the support available for people with learning disabilities.

Kevin Barker, inspector and CSSIW lead on the inspection said the process demonstrated a commitment to do what we expect others to do: work together to achieve a better result.

“Actions will always speak louder than words,” he said.

Online reaction

Words spoke loudly on the day of the report launch, with tweets between 28-29 June on the English-language @CSSIW Twitter channel [opens in new window] reaching more than 8,000 people.

Of those people who saw the tweets, 2.2% of them either clicked on them, clicked on links in them or expanded the images.

The most popular tweet from the launch which was seen by more than 2,240 people was the video of Wayne Crocker, Director at Mencap Cymru. It was retweeted 7 times and had 7 likes, by partners such as Mencap Cymru.

Meanwhile, tweets on CSSIW’s Welsh-language @Arolygu_gofal Twitter channel [opens in new window] reached 2,000 people over the two days. Of those people the tweets reached , 0.8% of them either clicked on the them or clicked on the link.

For the @HIW_Wales Twitter channel [opens in new window], which retweeted CSSIW’s tweets across the two days, their tweets reached 283 people, of which on average 0.4% of them engaged with them.

Valuable learning experience

Working together on such an important inspection programme has been a valuable learning experience for both organisations, commented Alun Jones, director of inspection, regulation and investigation for HIW [opens in new window].

“The resulting national inspection report and the individual local authority/health board reports are richer and more powerful for having input from both inspectorates,” he said.

“Our work has allowed us to shine a light on the way in which organisations work together to plan and deliver learning disability services.

“We have made a number of important recommendations which call for more effective joint working for the benefit of people with learning disabilities and their carers.”

Digging deeper

Richer more powerful reports were made possible by digging deeper with our inspection approach, explained HIW review manager, Emma Philander.

“From my point of view I feel that the highest quality care and support for adults with learning disabilities ensures that it meets the holistic needs of the person,” she said.

“By HIW and CSSIW working jointly it meant that we could better assess whether services were meeting people’s holistic needs, both from a health and social care perspective.

“Working together meant we could unpick the complexities of how health staff and social care staff were working together and the impact this had on people with learning disabilities.

“It meant we could dig deeper with our inspection approach and hold both the local authority and health boards to account to improve services for people with learning disabilities.

“I feel that both organisations learned from each other’s approaches and we look forward to building on this and collaborating more in the future.”

Policy and legislation manager for HIW, Nia Roberts, agreed.

“One of the other good things about this work was that we looked at health boards and local authorities at different levels,” she explained.

“We saw how colleagues from health and social services worked together on the front line to provide care and support to individuals with learning disabilities.

“We also asked senior representatives from health boards and local authorities to explain how they plan and commission to meet the needs of all people with a learning disability in their area. This involved scrutiny by both CSSIW and HIW.

“Given the provisions of the Social Services and Well-being (Wales) Act, this was important work, which was enriched by having both inspectorates involved.”

CSSIW project lead Kevin Barker concurred.

“There were many benefits from the joint work between CSSIW and HIW in this inspection, not least the range and quality of the evidence that it delivered,” he said.

“People with learning disabilities and their family carers often need help and support from both health and social services. They expect a joined up approach from the people and agencies involved and so do the inspectorates.”

You can read the joint inspection report on the CSSIW website [opens in new window].

People walking past marquee's at the Royal Welsh Show

Find out more about Inspection Wales at the Royal Welsh Show

Livestock, farming and forestry aren’t usually part of the work of the Inspection Wales programme. But we’re excited to announce that Inspection Wales will be out in force at this year’s Royal Welsh Show [opens in new window] in Builth Wells, 18-21 July.

Exhibiting together for the first time since the show’s inception, inspectors and corporate staff from Healthcare Inspectorate Wales [opens in new window] (HIW), Estyn [opens in new window], Wales Audit Office [opens in new window] and Care and Social Services Inspectorate Wales [opens in new window] (CSSIW) will be talking to visitors about the work they do both individually and together to help public services in Wales improve.

Together, we’ll be asking people how much they know about our work and gathering feedback to help inform our future communication. There’ll also be lots to see and do on our stand. We’ll be showcasing some of our joint working through case studies, displaying our latest projects and there’ll even be a small area for children.

The Estyn team are looking forward to meeting parents, teachers and learners who may be interested to hear about the way inspections of schools and other education and training providers are changing from September 2017.

Healthcare Inspectorate Wales are attending the show for the first time this year and will be raising awareness of the work within the inspectorate and seeking views on people’s experiences of healthcare services. They launched their new website last month and the team are looking forward to meeting visitors and asking for their views.

At the CSSIW stand, people will be invited to meet with inspectors and find out how to get involved in the inspectorate’s work.  Visitors can also learn more about inspection, registration, enforcement and seek advice on choosing care services.

The Wales Audit Office are returning for their second year and looking forward to having conversations with the public about the valuable role they play in holding public services to account and supporting improvement.

So, whether you’re visiting the show with family, friends or colleagues, come and meet the friendly staff at the Inspection Wales stand and learn more about our work.

Aerial view of the Senedd building

Our work helps you make informed decisions

Briefing for new Assembly Members

One of the things those of who work in the world of external review frequently get asked is, ‘what do you do?’. We know what we do is important, makes a difference, and the evidence we provide helps change things for the better, but perhaps a short briefing paper would help those of us not quite so immersed in our world understand? We thought so.

This is particularly important for the new Assembly, with the elections held on 5 May, as many of the Assembly Members will be new, and may not be familiar with our work. And they will be making decisions about public services right from the start of their new roles. Solid evidence helps people make good decisions.

Hence we prepared a short briefing paper, Audit, Inspection and Regulation in Wales [PDF 216KB opens in new window]. It provides a summary of who we are and what we do.

We hope it will be helpful, and encourage people to use our work to inform themselves. After all, you need to know we exist and the types of reports we write before you make decisions on services.

Our Inspection Wales partners work will help you answer questions like:

  • Is my council, or hospital well run?
  • Are schools in Wales getting better?
  • How did that happen? E.g. Cardiff Airport, Welsh Drainage Board
  • What do they spend all that money on?
  • What are the big problems we face in Wales?
  • And detailed information on specific topics such as: Are Welsh Operating Theatres getting better?
  • Are services helping older people stay independent?

So, our various reports add to the sum total of knowledge against which you can make your own decisions about individual schools, care homes and wider public services.

This briefing paper sets the background to our work, and points to further resources. We hope everyone who reads it will find it helpful.

Silver whistle

Inspection Wales partners’ role in whistleblowing in Wales

Who should I blow the whistle to if I work in Wales?

One of the objectives of the Inspection Wales Programme is working together efficiently. A key way is to ‘share and learn’ about our internal approaches to a number of things we all do.

One example of this is whistleblowing: three of our four partners are ‘prescribed persons’ under the Public Interest Disclosure Act 1998 (PIDA ) [opens in new window], and all of us have people, whether employees of Welsh public bodies or members of the public, bringing us concerns. If the concerns are from members of workers, then they may (depending on what the concerns are) be classed as whistleblowing.

Whistleblowing is when a worker reports serious concerns about wrongdoing or malpractice in the workplace to someone.

All partners have mechanisms for dealing with concerns, and you can find them on our websites. But we realise it is not always easy to find who a potential whistleblower should contact in Wales. Hence our subtitle: who should I blow the whistle to if I work in Wales?

To help, we have prepared a short, simple guide to our respective responsibilities [opens in new window].

In a nutshell, if you have a concern about the NHS, Social Care, Education or value for money, fraud and corruption in relation to the provision of public services in Wales, this leaflet will help you decide which of our partners you should approach, and what you can expect to happen.

You can contact us even if you are not a worker and we will treat any such concerns seriously, but the specific protections under PIDA will not apply.

We cannot guarantee that we will keep your concern confidential or that we will investigate all concerns raised with us in detail, but we do take all approaches seriously and feed them into our collective intelligence to help us guide our work.

We hope this leaflet is helpful, and we intend it to supplement wider and more in-depth guidance on partners. More advice on our partners’ approaches:

There are also a number of external sources of advice, including the charity Public Concern at Work [Opens in new window].

Inspection Wales progress report cover on a white desk

Is joint working working? Collaboration between audit and inspection bodies in Wales … the story so far.

Four years ago, the heads of the 4 main audit and inspection bodies in Wales signed an agreement to formalise joint working between the bodies.

It was a logical move by the Wales Audit Office (led by the Auditor General for Wales), the Care and Social Services Inspectorate Wales (CSSIW), Her Majesty’s Chief Inspector for Education and Training in Wales (Estyn) and Healthcare Inspectorate Wales (HIW).

The agreement strengthened links between the 4 organisations and provided a solid foundation for better collaboration, knowledge sharing and business planning. The key objective? To improve outcomes for the people of Wales.

But have we achieved what we set out to achieve?

Well, when I took up my new role as Inspection Wales Programme Manager in February 2015, it was the first thing I wanted to find out.

So have we?

Yes, I believe we have. But, (until now) we haven’t told many people about it.

We’ve produced a report on our progress so far, which provides some detailed findings if you’re interested in reading more. But, I will summarise here.

Relationships

They’re hard to measure, but I can testify that relationships between our four organisations are strong and exist at many levels across the businesses. There needs to be a level of trust to work together outside organisational comfort zones, and we do have this. I’m not saying that everything is perfect, and in some areas these relationships are still developing, but we have strong foundations in place.

Building blocks

We needed to agree how we do things together. That was not as easy as it could be because we all work to different laws and reporting arrangements. We’ve already published our remit paper, which explains all this in detail. Hence, we needed to work through basic processes like sharing information, and how we handle serious concerns about an organisation.

Joint working

We have done a lot of things together, but, we haven’t always told everyone that we did it together! Our stocktake report contains many examples, and some of these will be familiar pieces of work to you, but you might not have known they were joint.

We know we need to get better at sharing and our joint working achievements. That’s partly why we’ve set up this blog site. I’ll be writing more posts in the coming weeks and months, but you will also find posts from other people who are equally passionate about working together.

We look forward to sharing more with you about our audit and inspection missions to let the people in Wales know whether they are getting what they need and deserve.

About the author

Mandy Townsend on holiday sat in a boat

Mandy Townsend started work as the Inspection Wales Programme Manager in February 2015 and is seconded to the part-time role for two years.

Mandy, who is based in North Wales, spends the rest of her week in her original role as a Health Performance Auditor at the Wales Audit Office.

Views on report into independence of older people in Wales

The Auditor General for Wales, this week, released a report ‘Supporting the Independence of Older People: Are Councils Doing Enough?

The report examines whether councils are working effectively to support the independence of older people. While the Welsh public sector recognises the challenges of an ageing population, the report found that some key barriers are inhibiting the shift in focus that is needed to reduce demand for health and social care services and support older people to live independently.

This study was conducted by the Wales Audit Office and the Care and Social Services Inspectorate, who are part of Inspection Wales, along with the Older People’s Commissioner for Wales.

In this series of videos, the Auditor General for Wales, the Chief Inspector of Care and Social Services Inspectorate Wales and the Older People’s Commissioner for Wales answer the following questions on the report:
Clearly there are financial challenges to delivering these services, what can local government do to ensure that services are available for those who need it most?

Given the findings of today’s report what recommendations would you make to both councils and Welsh Government to help improve the services they offer to older people in Wales?

Huw Vaughan Thomas, Auditor General for Wales

Imelda Richardson, Chief Inspector of Care and Social Services Inspectorate Wales

Sarah Rochira, Older People’s Commissioner for Wales

If you would like to view a copy of the report you can do so via the Wales Audit Office website

Collaboration in action

A joint report on the independence of older people released today provides a great example of how the Inspection Wales Programme is developing approaches to collaborative working.

This study was conducted by the Wales Audit Office and the Care and Social Services Inspectorate, who are part of Inspection Wales, along with the Older People’s Commissioner for Wales.

In this blog post, representatives from all three organisations outline the advantages of working together on this report and how collaboration is helping them deliver better outcomes.  

Huw Vaughan Thomas, Auditor General for Wales

HVt generic twitter

Working together. Everyone talks about it and the benefits it brings. You know the picture. Better use of resources, wider knowledge to draw on, specialist expertise, greater experience to broaden understanding and practically, more hands make light work of the difficult task. As an idea it is difficult to argue against but can still be very difficult to do. Different working styles, different expectations and different objectives all have to be balanced if it is to be successful. It also helps if you get on and like each other.

Thinking of the pluses and minuses of working together, I am pleased to say that the Wales Audit Office study on the independence of older people, which was published on October 15th 2015, is built on an effective working together experience. Colleagues in the Care and Social Services Inspectorate in Wales and the Office of the Older Peoples Commissioner in Wales positively assisted the Auditor General to deliver this study.

The support provided, advice given, help in shaping the methodology, delivering fieldwork, distributing surveys, promoting the work and reviewing findings has led to a comprehensive review which produced a detailed picture of how councils support the independence of older people.

Without the enthusiasm and willingness of CSSIW and the Commissioner to support this work the study would not have been as a comprehensive in its coverage or made the impact it has. One thing is for sure, the benefits of joint working is plain for all to see and is something we need to continue to build on and is something we can and need to do more of.
Imelda Richardson, Chief Inspector of Care and Social Services Inspectorate Wales

Imelda Richardson image for twitter and facebook

We work closely with Wales’ other inspectorates and we’re proud to champion a joint working approach, as demonstrated by working with Estyn to create a joint inspection framework for early years services. We have a number of agreements in place on how we work with other regulators, inspectorates, and local authorities involved in improving the quality of social care and social services in Wales.

For this report we were able to share knowledge from our inspection activity in all 22 Welsh local authorities, and collaborate with partners to better focus on the wellbeing of our older population. We were happy to play a supporting role for this report and share our knowledge and experience about the needs of older people.

Our work is an important part of Wales’ social care sector, and joint working allows us to be a stronger voice for improving care for people in Wales than if we operated in isolation.

Taking on board ideas around best practice and taking a cross-cutting view across social care allows us to improve our own practice and share ideas more widely across other organisations, and can only have a positive impact on the people of Wales who rely on or help support social care in this country.

I look forward to further collaborative work with partner organisations in the coming years.

Sarah Rochira, Older People’s Commissioner for Wales

Sarah Rochira

As Older People’s Commissioner, I have welcomed the opportunity to work with the Wales Audit Office (WAO) and other partners to produce this report. The report follows on from my participation in the WAO Shared Learning Seminars in July 2015, and I am pleased that this work has strengthened links with the Auditor General and colleagues. Collaboration across the public sector in Wales is needed more than ever, and I am pleased that the WAO and others reinforce my key statements and recognise the importance of maintaining the independence of older people.

Given the challenging financial outlook, service providers in Wales must now work together to provide high-quality services that reflect the needs of older people. Older people’s needs are not confined to health and social care services, and providers based in transport, education, housing and leisure sectors, for example, must deliver cost-effective services that help to maintain the independence of older people.

A collaborative, joined-up and long-term approach, based on the integration and prevention agendas, is now urgently required to remove key barriers and maintain the health and wellbeing of older people. Joint working is crucial in addressing both the national wellbeing goals within the Wellbeing of Future Generations Act and also the aims within the Ageing Well in Wales Programme.

I look forward to working further with the WAO and other partners to make clear the importance of taking a preventative approach and to ensure that public service providers can better utilise older people’s wealth of knowledge and experience, increase their contribution to communities across Wales and help older people across Wales to maintain their health and independence.

If you would like to find out more about the report ‘Supporting the Independence of Older People: Are Councils Doing Enough?’ the report can be downloaded from the Wales Audit Office website.

The power of working together: Why audit and inspection bodies in Wales need to connect more

Mandy Townsend

Hi. I’m Mandy Townsend and I’ve got an exciting new job I want to tell you about.

Working as the new Inspection Wales Programme Manager doesn’t sound very stimulating does it? But, believe me, it’s a really great role which is designed to help people in Wales.

How do I do that?

I bring together the main bodies in Wales that exist to help make sure public services are delivering what they should be. I help them work together, share information and coordinate their work as efficiently and effectively as possible. This work is called the ‘Inspection Wales Programme.’

The 4 audit and inspection bodies I’m talking about are the Wales Audit Office (led by the Auditor General for Wales), the Care and Social Services Inspectorate Wales (CSSIW), Estyn (Her Majesty’s Inspectorate for Education and Training in Wales) and Healthcare Inspectorate Wales (HIW).

Most of our work is very separate because each body has different purposes and different laws which govern what they have to do. But some of our work can have a common focus. For instance, we all have a role to play in checking particular public services; and there are other areas where 2 or 3 of us share responsibility in various combinations for scrutinising aspects of services.

While we know how our work relates to each other, most people don’t. So, we’ve written a short paper to explain it.

Personally, I like this visual summary:

Graphic showing the 4 inspection bodies linked together

You can see the linkages between the work of the 4 audit and inspection bodies and it means that joint working helps us all be more efficient.

Why?

There are many reasons for this – avoiding duplication of effort is one of them. It’s not just public bodies that don’t want us examining the same thing twice, importantly we don’t want to either, it is a waste of our time and energy. We could be using our limited resources to do something else.

But, the main reason, for me at least, is that when we work together we are more powerful. If we all contribute to the same thing and report (good or bad) on it, people take notice, and things change.

That’s why we want to work together as well as we can. After all, the reason we all come to work is to improve services for the people of Wales – to make things better.  If the Inspection Wales Programme can help our partners do this more efficiently, then it’s a success.

And that is why my job is exciting.

About the Author:
Mandy Townsend on holiday sat in a boatMandy Townsend started work as the Inspection Wales Programme Manager in February 2015 and is seconded to the part-time role for two years.
Mandy, who is based in North Wales, spends the rest of her week in her original role as a Health Performance Auditor at the Wales Audit Office.