Assessing quality and performance
Example: how we reach a rating
To assess quality against a particular quality statement, operational colleagues will look at the relevant evidence categories. In this example, we are just looking at the 'infection prevention and control' quality statement.
Infection prevention and control: "We assess and manage the risk of infection. We detect and control the risk of it spreading and share any concerns with appropriate agencies promptly."
For this service, the key evidence categories for this quality statement are:
- People's experiences
- Feedback from staff and leaders
- Observation
- Processes
We would look at individual pieces of evidence under each evidence category.
For example, in the ‘people's experience’ evidence category, we may look at:
- patient surveys
- complaints and compliments
To gather evidence in the ‘feedback from staff and leaders’ and ‘observation’ categories, we might schedule:
- an inspection to look at the care environment
- a call to speak with staff at the service.
To gather evidence in the ‘processes’ category, we might ask the service to share:
- infection control-related induction and training arrangements
- cleaning, hygiene, and infection control policies and records
We consider all this evidence to produce a balanced judgement. Based on that judgement, we apply the appropriate score to the quality statement.
How we use quality statement scores to give a key question rating
We will use our published evidence categories to guide what we look at during assessments. This is then used to create individual quality statement scores.
We then use this quality statement score to give us an updated view of quality at key question level. In this example, it is for the safe key question:
Example: combining quality statement scores to give a rating for the safe key question
| Quality statement | Score | Existing or updated score |
|---|---|---|
| Learning culture | 2 | existing |
| Safe systems, pathways and transitions | 3 | existing |
| Safeguarding | 3 | existing |
| Involving people to manage risks | 2 | existing |
| Safe environments | 3 | existing |
| Infection prevention and control | 3 | updated |
| Safe and effective staffing | 2 | existing |
| Medicines optimisation | 3 | existing |
| Total score for the safe key question | 21 |
To calculate a percentage score, we divide the total (in this case 21) by the maximum possible score. For the safe key question, this is 8 quality statements multiplied by the highest score for each statement, which is 4. So the maximum score is 32. Here, it gives a percentage score for the key question of 65.6% (this is 21 divided by 32).
At key question level we translate this percentage into a rating rather than a score, using these thresholds:
- 25 to 38% = inadequate
- 39 to 62% = requires improvement
- 63 to 87% = good
- over 87% = outstanding
Therefore, the rating for the safe key question in this case is good.