Regulation in the Context of Supported Housing

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Regulation in the Context of Supported Housing

• Seamus McErlean
• RQIA
• 9th April 2008

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Role of RQIA

• Regulate and review the quality of health and
  social care services across all sectors
• Powers to review and inspect including clinical
  and social care governance arrangements
• Common system of regulation based on minimum
  standards set by DHSSPS
• Provide information to the public and
  organisations about standards to ensure
  continuous improvements
• Facilitate the promotion of best practice and its
  implementation

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Role of RQIA (cont)

• Undertake specific investigations where serious
  persistent concerns are identified
• Report on quality of provision and availability
  of services
• Liaise with professional regulatory bodies where
  performance of individuals raises concerns
• Communication with services users/public/media
• ENCOURAGE QUALITY IMPROVEMENT

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Monitor and Regulate

• Residential Care Homes
• Nursing Homes
• Childrens Homes
• Independent Clinics
• Independent Hospitals
• Independent Medical Agencies
• Nursing/Special Agencies
• HSS Boards
• HSC Trusts

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Monitor and Regulate

• Domiciliary Care Agencies
• Day Care Settings
• Residential Family Centres
• Adult placement Schemes
• Early Years/Children Under 12
• Voluntary Adoption Agencies
• Fostering Agencies

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Legislation

• The Health and Personal Social Services (Quality,
  Improvement and Regulation) (Northern Ireland)
  Order 2003
• The Domiciliary Care Regulations (Northern
  Ireland) 2007

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Definitions

• Domiciliary Care Agency - Article 2(2)
• an undertaking which consists of or includes
  arranging the provision of prescribed services in
  their own homes for persons who by reason of
  illness, infirmity, disability or family
  circumstances are unable to provide any such
  service for themselves without assistance

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Exception

• an undertaking is excepted from the definition
  of domiciliary care agency, if the undertaking is
  carried on by an individual who -
• a) carries it on otherwise than in partnership
  with others
• b) is not employed by an organisation to carry it
  on and
• c) does not employ any other person for the
  purpose of the undertaking

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Definitions

• Prescribed services are
• personal care and
• assessment of the need for such care

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Definitions

• Personal Care
• includes the provision of appropriate assistance
  in counteracting or alleviating the effects of
  any of the matters mentioned in paragraph (1) (a)
  - (d) and, in particular, includes -
• action taken to promote rehabilitation
• assistance with physical or social needs and
• counselling

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Paragraphs 1 (a) - (d)

• old age and infirmity
• disablement
• past or present dependence on alcohol or drugs
  or
• past or present mental disorder

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Registration Procedure Completion of
Application Form (Responsible Person and
Manager) Access NI References x 2 Health
check/verification Financial vetting Other
documentation Interview - responsible person

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• Where do standards come from?
• Statutory sources legislation, case law,
  regulation
• Moral and ethical values
• Organisational (including governmental) policy,
  rules and guidelines
• Professional sources (expressed through common
  practice, professional associations, codes of
  practice, research and academic texts, etc)

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From Inputs to Outcomes
The Bakery
Flour, yeast, water
Inputs
Mixing, baking
Processes
Number of loaves
Outputs
Do people like the taste?
Outcomes
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From Inputs to Outcomes
Health Social Care
Staffing, equipment
Inputs
Policies, procedures
Processes
Number of service users
Outputs
Users experience
Outcomes
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The Inspection

• Legislation minimum of 1 inspection per year
• Announced or Unannounced
• Power of entry
• 6 weeks notice setting out agenda, times etc
• Request for documentation/evidence in advance

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Inspection Considers

• Service users, representatives, staff, other
  professionals
• Records
• Environment
• Policies and Procedures
• Pharmacy (as appropriate)
• Estates (as appropriate)
• Internal Audit (as appropriate)

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Inspection Considers

• Statement of Purpose
• Previous Inspection Reports
• Matters arising from previous inspections
• Self Evaluation
• Complaints
• Annual Quality Review
• Themes

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Themes

• Providing a safe service
• Users are valued by the service
• Staff development and training
• Open and effective communication
• Promoting, protecting and improving care
• Leadership and accountability

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Post Inspection

• Initial verbal feedback on outcomes of the
  inspection and matters requiring action
• Initial agreement on action strategy and
  timescales
• Requirements and recommendations
• Draft report prepared by inspector
• 2 weeks for comment
• Final report comments in Appendix
• Open document RQIA and facility

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Contact Details

• RQIA
• 9th Floor, Riverside Tower
• 5 Lanyon Place
• Belfast BT1 3BT
• Tel [phone]
• Seamus.McErlean_at_rqia.org.uk
• Amanda Jackson
• Dermot Parsons