Staffing schedules

The Care Inspectorate has traditionally issued a staffing schedule to relevant service types at the point of registration. This is a historical practice that has continued from previous regulatory bodies. The issuing of staffing schedules has been reviewed over the years, but the practice of some service types having a staffing schedule remains. We have recognised that the majority of staffing schedules in place do not reflect the changing needs of people who currently use the service. In a time of great change across the care sector, we want to promote innovation and also ensure people experiencs high-quality care and support that is tailored to their needs, rights and choices. High-quality staffing that responds dynamically to people’s needs is essential for this.

We recognise that staffing schedules are prescriptive and that they merely set a minimum standard based on numbers and general assumptions around the needs of the residents at the point of registration, which may have changed significantly since then. The staffing schedules are based on the assumption that services operating at full occupancy. They do not take account of changes in residents’ dependency and capabilities, either among long-standing residents or new people coming to live in the home.

Consequently, we have taken the decision to move away from issuing staffing schedules to enable providers to apply judgement and flexibility in demonstrating how they meet the requirements of the relevant regulation (SSI 210 (15) Staffing) which states that:

‘A provider must, having regard to the size and nature of the care services, the statement of aims and objectives and the number and needs of service users… ensure that at all times suitably qualified and competent persons are working in the care service in such numbers as are appropriate for the health, welfare and safety of service users.’

We will however retain the discretion to impose conditions about staffing, or any other matter, on any individual care service where that is necessary to ensure people experience high quality care.

The legal framework under which services operate is quite clear that the responsibility for assessing staffing according to need lies with the provider of a care service. The Scottish Regulators’ Strategic Code of Practice requires us to be proportionate in our approach and we believe that the safety, health and wellbeing of people who experience care can be enhanced without the issuing of fixed staffing notices at the point of registration.

The removal of staffing schedules will also remove reference to the management arrangements, however Scottish Statutory Instrument (SSI) 210: Regulation 17 (1) (c) – Appointment of Manager states: “A provider who is not, or does not intend to be, in full time day-to-day charge of the care service must appoint an individual to manage the service”. We expect this regulation to be complied with and to see the management arrangements detailed in the aims and objectives for each individual service.

With the removal of staffing schedules, our scrutiny methodology will help provide assurance that the provider has systems in place to assess people’s dependency, regularly and as their needs change. Providers will be required to maintain a daily record of the staffing level and skill mix which results from a dynamic process in relation to the assessment of need and capability.

Quality Indicator 3.3 in the new quality framework for care homes for older people states: ‘Staffing levels are right and staff work well together’. Inspectors can and will evaluate providers systems and processes against this indicator to ensure that there are positive outcomes for people who receive services. We strongly encourage providers to ensure this is part of their self-evaluation and quality assurance systems also.

This approach reflects the Care Inspectorate’s broader shift towards outcomes-focused regulation which seeks to ensure that care and support is responsive to people’s individual needs. Providers of care and support have a clear responsibility to provide effective staffing, and we will continue to ensure through our scrutiny work that this is happening.

From 1 September 2018 we will no longer issue staffing schedules for new registrations. A letter and variation template will be sent to all existing providers for services who have staffing schedules. Between January and 31 March 2019 we will process variations for all providers who return a completed variation template.

It may take some time to complete variations for all relevant registered services. We are therefore unable to give a timescale for completion of individual applications; however, we will endeavour to complete variations as quickly as possible.