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Health Visitor CAS Standards

Introduction to West of Scotland Care Assurance System (CAS)

Delivering high quality and appropriate care is of paramount importance.  We as nurses and the organisation overall must account for the quality of care it delivers  and that care should be evidence based and appropriate to the needs of the individual or family.

Measuring the quality of nursing care delivered by individuals and teams is not easy. This performance assessment framework will also contribute to the individual organisation’s vision, purpose and values incorporating local and national drivers that support the Healthcare Quality Strategy for Scotland (Scottish Government, 2010). 

6 key dimensions of Safe, Person- centred, Efficient, Effective, Equitable, Timeous, and built around the following priorities;

  • Caring and compassionate staff and services
  • Clear communication and explanation about conditions and treatment
  • Effective collaboration between clinicians, patients and others
  • A clean and safe care environment
  • Continuity of care
  • Clinical excellence

The framework is designed to encapsulate the key tenets of: Scottish Patient Safety Programme, Person Centred Health and care collaborative, GIRFEC, Healthcare Environment Inspection and healthcare associated infection.

Whilst responsibility for achieving the required standards lies with the Senior Nurse/Team leader and his or her Team, the Professional Nursing Lead will support the Senior Nurse / Team Leader to ensure continuous improvement within their Teams.

This system is based on a model used within Salford Royal NHS Foundation Trust and each standard has been framed using the four domains within the Leading Better Care Role Framework (2008).

  • Safe and effective patient care
  • Enhancing the patients experience of care
  • Managing and developing the performance of the team
  • Contributing to the organisations objectives


The Care Assurance system (CAS) designed to support nurses in practice to understand how they deliver care, identify what works well and where further improvements are needed.

Assessment Process

The Health Visiting CAS has been designed to be used in a flexible way to meet the Governance requirements of each Health Board area. The following is a guide for use:

  1. The CAS lead/team will identify a date to undertake the assessment. This will be discussed with the Clinical Team Leader in advance.
  2. The assessment will cover four identified standards.
  3. To assist with the process, templates have been developed and are included within the CAS Assessment Pack.
  4. Evidence will be collected using a variety of methods. These include :
    • Discussion with Clinical Team Leaders, Staff and families
    • Observation of environment and clinical practice
    • Documentation audit and review
    • Training records
  5.  For each Standard Element the method and source should be recorded under Evidence Type.
  6. Compliance should also be recorded for each element. This may be done by adopting a percentage rating or RAG Status with rationale recorded within the Further Action
  7. Where further action is required to improve a particular Standard or Element, this should be recorded with the Action Plan with an identified timeframe. For example:
    • Red ( Below 60%) – One month
    • Amber ( 60 – 80%) – Three months
    • Green ( 80+) – Six months

Tri Board Health Visiting CAS Steering Group

January 2017

Recommended Links:

Full Health Visitor Standards