Assessing quality and performance

Page last updated: 21 May 2024


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.

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 and based on the strength of what we find, give a score of 1 to 4.

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.

We would then combine this new evidence with what we already hold on ‘processes’ to help us form a view of quality.

Example: combining evidence category scores to give a quality statement score

Evidence categoryScoreExisting or updated score
People's experiences3updated
Feedback from staff and leaders2updated
Total score for the combined evidence categories11 

We calculate this as a percentage so that we have more detailed information at evidence category and quality statement level.

To calculate the percentage, we divide the total (in this case 11) by the maximum possible score. This maximum score is the number of relevant evidence categories multiplied by the highest score for each category, which is 4. In this case, the maximum score is 16. Here, it gives a percentage score for the quality statement of 69% (this is 11 divided by 16).

We convert this back to a score. This makes it easier to understand and combine with other quality statement scores to calculate the related key question score.

We use these thresholds to convert percentages to scores:

  • 25 to 38% = 1
  • 39 to 62% = 2
  • 63 to 87% = 3
  • over 87% = 4

In this case, the percentage score of 69% converts to a score of 3.

We then use this score to give us an updated view of quality at key question level. In this case it is for the safe key question:

Example: combining quality statement scores to give a key question rating

Quality statementScoreExisting or updated score
Learning culture2existing
Safe systems, pathways and transitions3existing
Involving people to manage risks2existing
Safe environments3existing
Infection prevention and control3updated
Safe and effective staffing2existing
Medicines optimisation3existing
Total score for the safe key question21 

Again, we 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.