PARTNERS IN PROTECTION National Care Standards Commission A Perspective

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PARTNERS IN PROTECTIONNational Care Standards
CommissionA Perspective

• Presentation by
• Heather M. Wing OBE
• Director of Adult Services NCSC
• 8th November 2002

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Terminology used

• NMS national minimum standards
• Regulations the rules governing operation of
  services
• Methodology the processes by which the
  standards regulations are tested out
• NCSC National Care Standards Commission
• GSCC General Social Care Council
• SCIE Social Care Institute for Excellence
• NICE National Institute for Clinical Excellence
• CHI Commission for Health Improvement
• CHAI Commission for Health Audit Inspection
• CSCI Commission for Social Care Inspection

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Terminology Cont

• CRB Criminal Record Bureau
• POVAr Protection of Vulnerable Adults Register
• DH Department of Health
• SSI Social Services Inspectorate professional
  arm of DH

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NCSC - what it is, what it does

• Non departmental public body
• Independent - local, regional, national
• Regulatory - promotes monitors standards
  enforcement agency
• Powers drawn from Legislation
• Care Standards Act 2000
• Associated Regulations
• AND
• National Minimum Standards

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NCSC - what it is , what it does

• Commenced operation 1/4/02
• Responsible for the regulation of a range of
  services - 45, 000
• Care Homes providing personal care/nursing
• Care Homes providing adult placements
• Domiciliary Care Agencies
• Nurses Agencies
• Independent Health Care
• Range of childrens services

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NCSC - Role

• Protect vulnerable people from abuse
• Take action to root out those providers not
  providing good care
• Challenge poor practice
• Ensure legal requirements are met
• Promote Monitor national minimum standards
• Encourage improvement of standards over time
• Report on quality and availability of services
• Work in partnership to protect people

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Principles of Regulation

• Fair
• Reasonable
• Proportionate
• Targeted
• Transparent
• Accessible
• Realistic
• Consistent

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Regulatory Framework

• Care Standards Act 2000
• Regulations
• NCSC (Registration) Regulations 2001
• NCSC (Fees Frequency of Inspections)
  Regulations 2001
• Care Home Regulations 2001
• National Minimum Standards
• Care Homes for Older People
• Care Homes for Younger Adults Adult
  Placements
• Regulatory Methodology processes procedures

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NCSC Role - Regulation

• Registration -
• Inspection -
• Complaints Investigations -
• Enforcement -

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Law National Minimum Standards

• NCSC - statutory duty to carry out law to apply
  the NMS
• NCSC must take into account the NMS when making
  any regulatory decisions
• Applied wisely fairly - a force for good
• Law and NMS applied through National Methodology
• Person centred
• Evidence based information focused on outcomes

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Story so far since 1/4/02

• NCSC went live on 1/4/02
• 2000 staff transferred to NCSC from 230 Local and
  Health Authorities
• All ongoing business transferred
• Creation of new regulatory methodology building
  on past good practice
• Establishment of NCSC infrastructure
  accommodation, IT systems, Management structure

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Story so far cont

• Recruitment programme new inspectors
• Assistance to providers, service users staff to
  understand new NMS, legislation interpretation
• 17 days after went live Govt. announce 2 new
  super regulators CHAI and CSCI
• NCSC create separate Private Voluntary Health
  Care Division within NCSC as a result
• Considerable effort being expended to prepare for
  more changes to come

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Story so far cont

• Major problems with CRB checks capacity
  demand issues
• POVA register deferred
• Domiciliary Care Standards Regulations deferred
  likely publication 14th November
• Nurses Agencies Standards Regulations Ditto
• Managing the change process
• Retention of the practices processes that work

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Legislation Care Standards Act

• For the first time specifically references the
  protection of vulnerable adults
• Part V11 of the Care Standards Act 2002
  Protection of Children and Vulnerable Adults
• Sections 80, 81, 82, 83, 84, 85, 86, 87, 88,
  89, 90, 91, 92, 93, 94, 95, 96, 97

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Legislation CSA

• Protection of Vulnerable Adults Register POVAr
• Section 81 of the Care Standards Act 2000
  requirement for Secretary of State to keep a list
  of people deemed unsuitable to care for
  vulnerable people
• Section 82/3 duty of registered persons to
  refer care workers to the list
• Section 84 registration authority i.e. may
  refer to the list

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Legislation CSA

• Creation of the GSCC (General Social Care
  Council) to regulate care workers
  establishment of register of workers, production
  of codes of conduct, qualifications training
  programmes
• Section 54 71 Care Standards Act 2000

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Legislation the Regulations

• Care Home Regulations 2001 example
• the registered person shall make arrangements by
  training staff or by other measures to prevent
  service users being harmed or suffering abuse or
  being placed at harm or abuse
• Regulation 13 (6)

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Legislation Cont-

• Care Home Regulations 2001 - Regulation 21 Staff
  Views as to the Conduct of the home states-
• This regulations applies to any matter relating
  to the conduct of the care home so far as it may
  affect the health or welfare of service users
• Regulation 24 - Review of Quality of Care
• Requires registered person to set up a system to
  periodically review the quality of care look to
  ways of improving this
• Regulation 26 - Visits by Registered Provider
  where an organisation /partnership
• Requires the provider or his representative to
  carry out monthly visits, to speak to service
  users/their representatives, staff, look at
  records events, complaints records, prepare a
  written report send copy to NCSC

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National Minimum StandardsCare Homes for Older
People

• Standard 18
• The registered person ensures that service
  users are safeguarded from physical, financial,
  or material, psychological, or sexual abuse,
  neglect, discriminatory, abuse or selfharm,
  inhuman, or degrading treatment, through
  deliberate intent, negligence or ignorance, in
  accordance with written policies.

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Partners in protection

• Prevention or abuse and protection of vulnerable
  people Collective responsibility of all
  involved
• Those involved include
• Providers of care
• NCSC
• Police
• Health Care Professionals
• Local Authorities care managers, social workers
  etc
• Other regulators
• Visitors to the care services including
  friends/families
• Service users

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Partnership what does this mean?

• Understanding of respective roles
  responsibilities
• Trust and respect
• Awareness of limitations of each others roles
• Willingness to share / exchange information
• Putting user first rather than processes
• Regular formal informal dialogue
• Absence of blame culture but prepared to
  challenge

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Tools to Protect Vulnerable People

• New regulatory framework
• Establishment of POVA
• Baseline set by implementation of No Secrets
  Disclosure Act (Whistleblowing)
• Established partnership working protocols based
  on No Secrets
• Establishment of GSCC to register care workers
• Training of care providers, managers, staff
  inspectors

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Issues relating to Protection

• New organisation due to change again
• Impact on local, regional national protocols
  for adult protection
• Establishing effective networks
• Delays in implementing POVAr
• Deferment in full CRB checks for some care staff
• Understanding about NCSC role and function
• New legislation much challenge to
  interpretation

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Suggestions AP National Agenda

• Ensure that focus on structures, processes
  change, does not divert from primary focus i.e.
  protection of vulnerable people
• Establish a national forum for Adult Protection
  bringing key people together
• Make whistleblowing a safe acceptable process
• Develop advocacy schemes accessible to all
• Ensure that complaints processes work
• Recognise collective responsibilities

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Suggestions AP National Agenda

• Involve service users in any AP agenda not lip
  - service real involvement
• Take action where abuse is identified be brave
  and withstand challenges
• Tell it as it is and not be fobbed off
• Listen to what service users others tell us
• National Training Programme AP for all workers
  involved

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Conclusions

• Adult Protection is now on the agenda
• Nationally recognised as a key issue
• However still a mind set which sees AP as less
  of a priority than the protection of children
  equal importance
• Resources, systems, issues danger relegation to
  any other business on the agenda
• Need to have champions nationally locally to
  ensure high on the agenda service users depend
  on us all

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