1. Summary in English

This report is part of the basis for the ongoing work to harmonise and improve the quality of the County Governors’ case handling in their supervision of the use of coercion and force towards persons with intellectual disabilities. The aim is to carry out more targeted inspections, and for inspections to contribute to improved legal protection and quality of care for service users.

In the report, we describe findings from the County Governors’ work with on-site inspections pursuant to Section 12-3 (1) of the Health and Care Services Act (hol). The report shows that there are variations in how inspections are planned, carried out, and followed up. This relates to preparations, collection of documentation, who is interviewed, the structure of reports, and the time spent finalising reports. We focus on the undesirable variation. We also aim to facilitate simplification and efficient work processes where possible.

We have assessed inspection practice against the current guidance from 2019 (2). Where the guidance is not followed, we have analysed whether this represents undesirable variation. We provide recommendations on how inspections to a greater extent can help ensure better legal protection for service users.

Specific recommendations are:

1. Update the written guidance with clearer requirements when prioritizing inspections, preparations, documentation, and interviews.
2. Ensure that post-inspection reports are short and concise, and are finalised as quickly as possible and within three weeks. Develop simpler report templates for inspections where no breaches of the law are identified.
3. Develop a standard for how frequently on-site inspections should be conducted, and ensure that everyone subject to decisions to use coercive measures decisions receives systematic follow-up with inspections.
4. Continue and further develop regular professional forums and annual courses for the County Governors to increase harmonisation and a shared understanding of the regulatory framework.