Staffing schedules

Published: 18 January 2019

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.

Downloads: 18552

Medicine waste in care homes

Published: 18 December 2018

The Care Inspectorate worked with colleagues in NHS Tayside, Scottish Care, Community Pharmacy Tayside and other Pharmacy organisations to reduce inappropriate medicine waste in care homes. Co-production between these organisations resulted in all agreeing a new protocol to ensure only appropriate waste was collected. The project has been successful and we have received positive qualitative feedback from care home managers and pharmacy staff. 

Medicine Waste Protocol

Letter sent to care homes in September 2016

Watch our clip below to find out more.

If you need any help or advice in relation to this project please feel free to contact either your community pharmacist or any one of the following individuals:

Dr David Marshall
Care Inspectorate - Health Improvement Adviser (Pharmacy)
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Diane Robertson
NHS Tayside - Community Pharmacy Development
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Ivan Cornford
Scottish Care - Local Integration Lead (Angus)
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Downloads: 19133

Early learning and childcare profiles

Published: 23 May 2018

Early learning and childcare profiles, by local authority

We have created early learning and childcare local profiles to assist local authority planning for the expansion of early learning and childcare in Scotland. 

These profiles are a valuable source of information about daycare of children services in local authority areas. They include information about: number of services and capacity; funded places; trends in children registered; registered children by age; service quality; sessions and opening times; SIMD and urban/rural classification; staffing and vacancies; population estimates and projections; and an early learning and childcare service list of the area.

The profiles focus on those services that provide early learning and childcare (children and family centres, nurseries and playgroups) while our early learning and childcare statistics publication also provides information about out of school care, holiday playschemes and creches.

We welcome any feedback, queries and ideas for improvement for these profiles; please email This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Early Learning and Childcare Profiles, as at 31 December 2016

Early Learning and Childcare Profiles, as at 31 December 2017

Early Learning and Childcare Profiles, as at 31 December 2018

 

  

Downloads: 17702

Duty of Candour

Published: 29 March 2018

The new duty of candour came into effect on 1 April.  It affects all health, social work and care services except childminders. It means that services must take specific steps to carry out their duty of candour when a serious adverse event happens.  They will need to let the people affected know, offer to meet with them, and apologise.  This is an important part of being open with people who experience care, and also learning from things that go wrong.

Starting from April 2019, care services and social work services must, by law, produce a short annual report showing the learning from their duty of candour incidents that year, publish it, and notify us that it has been published.  That means the first annual report services produce will cover the period April 2018 to April 2019.

Regulations and guidance about the duty of candour process have been issued by the Scottish Government and you can find it here.  It has also issued a guidance letter, which you can read here.  An online learning module is available now.  This explains more about the duty of candour and helps services and their staff understand their obligations.  We strongly encourage services and their staff to undertake this module here.

We have included a question in our notification forms, “does this incident trigger the duty of candour?” This allows us to collect data on how the duty is being implemented and help embed awareness.

The first annual duty of candour reports will be due after April 2019 and it is important that services plan ahead.  Even if there are no incidents to which the duty applied, a short report will still be required, as it must contain information about staff training on the duty of candour.

For social work services, we will ask local authority chief social work officers to notify us that they have published a duty of candour report after 6 April 2019.

For care services, we will amend future annual returns, to ask services if they have published a duty of candour report.

From April 2019, we may ask to review services’ duty of candour reports or examine them as part of our overall scrutiny of care services.

Our role in developing the reporting and monitoring

The Scottish Government asked the Care Inspectorate to chair a small working group looking at how the reporting should take place, and what kind of monitoring should happen.

The group comprised key representatives from health and social care and was chaired by the Executive Director of Strategy and Improvement at the Care Inspectorate. It concluded its work in February 2017.

It made a series of recommendations and you can read the report here.  For regulated services, the group recommended that the Care Inspectorate and Healthcare Improvement Services should try to integrate the reporting and monitoring into existing notification processes, to make it simple for providers.

The group recommended that health boards and social work departments should be free to select the best way to record information, and provided a series of template reports showing how annual reports should be made.

The Scottish Government responded to the report and you can read its response here.  For more information on the duty of candour, there is lots of helpful information on the Scottish Government website here.

 

Downloads: 147789

National Preventive Mechanism

Published: 20 December 2017

Care Inspectorate Colour

 NPM Logo 2 Colour

 

 

 

 

  

The Care Inspectorate is a member of the National Preventive Mechanism (NPM), a group of organisations designated to monitor the treatment and conditions of those people who have been deprived of their liberty.

The NPM’s Eighth Annual Report was published on 20 February 2018. It gives an overview of members’ work monitoring detention across the UK from 1 April 2016 to 31 March 2017 and the NPM’s joint, thematic work on transitions and pathways between different detention settings. 

The NPM was established pursuant to the Optional Protocol to the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (OPCAT). OPCAT is an international human rights treaty designed to strengthen the protection of people deprived of their liberty, including requiring each state party to set up a national level body (known as a National Preventive Mechanism) that can support efforts to prevent their ill treatment. The aim of an NPM is to prevent torture and other cruel, inhuman or degrading treatment or punishment from taking place.

Central to OPCAT is the idea that a system of regular, independent visits to places of detention can serve as an important safeguard against abuses, and prevent torture and ill-treatment in places that by their very nature fall outside the public gaze.

Specific requirements of an NPM

To comply with OPCAT, members of the National Preventive Mechanism, such as the Care Inspectorate, must have certain powers. These include the power to:

  • inspect all places of detention
  • access all information relating to detainees
  • interview detainees in private
  • choose where to visit and who to speak to
  • make recommendations based on human rights norms to relevant authorities
  • make proposals and observations on existing or draft legislation.

The Care Inspectorate has these powers in respect of secure care for children. We also work closely with HM Inspectorate of Prisons in Scotland and support some of their inspections.

They recently published Isolation in Detention guidance. The guidance provides a framework that NPM members will apply when examining the issue and making recommendations, and aims to improve consistency of approach. It allows NPM members to identify and promote good and improved practice.

The UK’s National Preventive Mechanism

The UK ratified OPCAT in 2003, expressing its commitment to prevent torture and ill-treatment in places of detention.

The UK’s National Preventive Mechanism was formally designated in 2009 and is now made up of 21 member organisations whose official functions include monitoring and inspecting places of detention.

Across the UK, different detention settings are visited or inspected by different NPM members. The UK NPM is coordinated by HM Inspectorate of Prisons and decision-making is guided by a steering group, which is made up of representatives from NPM members in the four nations.

Each NPM member has a different mandate, powers and geographical remit, and sets its own priorities for detention monitoring as well as contributing to joint NPM priorities.

The Care Inspectorate is actively involved in the UK NPM work, including involvement in three of its four sub-groups:

  • Mental Health Network
  • Children and Young People’s sub-group
  • Scottish sub-group.

Scotland

The Scottish members of NPM are:

The Scottish sub-group coordinates NPM activities in Scotland, provides support to NPM members, raises the profile of the work of the NPM and improves liaison with the Scottish Government. It is chaired by the Scottish member of the Steering Group, currently the Mental Welfare Commission for Scotland.

     

 

Downloads: 23883

Link inspectors and relationship managers

Published: 14 December 2017

The Care Inspectorate provides a designated link team for local authorities and strategic partnerships. This is because there are multiple services of different types and a need for regular planned contact to discuss emerging issues across the breadth of their work.  Link teams consist of a strategic inspector, who is responsible for scrutiny carried out at authority or strategic partnership level; a relationship manager for adult care services and complaints about care services; and a relationship manager for children’s care services and registration.  

Relationship managers also provide a designated point of contact for larger providers who operate multiple services.  

Managers responsible for services for children also link to each of the six regional collaboratives that have now been established across the country.  

Named strategic link inspectors and relationship managers can be found here.  

Find information on the link inspector role for council and partnership staff here

You can get information about the link inspector for a particular local authority area by e-mailing the strategic support team at This email address is being protected from spambots. You need JavaScript enabled to view it.

Downloads: 13617

eForms guidance

Published: 13 December 2017

Before using the eForms system for the first time, we recommend that you clear your browser’s cache and cookies. For instructions on how to do this, click here.

We recommend that you keep your browser versions up to date to ensure your security settings are maintained.

If you are using Internet Explorer, please note that version 10 or lower is no longer supported. You should update your browser if you are using an older version (you may need to update your operating system to do this). Alternatively you can use a different browser, such as Chrome or Firefox.

Please see the video below for more information.

Further information on: 

 

Click here to continue to eForms login

Downloads: 155300

Continuing care for young people

Published: 17 October 2017

We have been supporting the Staying Put agenda since 2013 and our role as corporate parents under the Children and Young people (Scotland) Act 2014 includes supporting young people moving from care to adulthood and independence.

We have updated our rules for adult placement services, with changes to fees and combined service status. These changes support young people to remain in their family placement and support providers.

Where a fostering service and an adult placement service operate as one service solely in order to support young people who have been cared for in the family on a fostering basis and who now wish to remain with the same family on a continuing care basis, this will be treated as one service, for the purposes of fees. The level for application and continuation fee will be set at the fostering agency service level. (‘Solely in order to support young people who have been cared for in the family on a fostering basis’ means that the adult placement service does not provide throughcare or aftercare.)

This supports the legislation which states that the accommodation and service should be the same for the young person as they move from being a looked after child to continuing care. On this basis, we are able to treat the services as one. This will mean one fee and one inspection, with a single report published under both categories on our website.

The updated guidance for care services, which includes the policy statement and guidance for staff is available here.

Downloads: 13247

Health and Social Care Standards

Published: 29 September 2017

On 1 April 2018, Scotland's Health and Social Care Standards came into effect, replacing the National Care Standards.  The Care Inspectorate is required, by law, to consider the Health and Social Care Standards when making decisions during our inspections and other scrutiny and improvement work.

We encourage services to refer to these when planning and delivering care.

Over time, the Care Inspectorate is testing and evaluating different ways to carry out its inspections of care services against the new Standards, starting with care homes for older people in summer 2018.  

As part of implementing the new Health and Social Care Standards, the Care Inspectorate reviewed the adult to child ratios in early learning and childcare (ELC) settings and issued guidance.  This reflects the ratios that existed under the previous National Care Standards, with some additional advice included within the guidance.  The guidance will be reviewed in May 2019. 

Care Inspectorate report on Health and Social Care Standards implementation

Downloads: 124444

Registration requirements for residential services and care workers for children and young people as they move into adulthood

Published: 20 July 2017

Joint statement by the Scottish Social Services Council (SSSC) and the Care Inspectorate.

We’ve had some questions about the registration requirements for workers and services providing continuing care for young people over the age of 16 and under 26 years following the Children and Young People (Scotland) Act, Part 11 Continuing Care. We have considered the issue and decided not to change anything.

The Continuing Care legislation supports continuing care for young people beyond the age of 16 and into young adulthood and this may mean for some residential childcare services they are not only caring for children and young people but also for young adults.

The introduction of Continuing Care has raised questions about how staff and services should be registered with the SSSC and the Care Inspectorate, given that young people will move from childhood to adulthood, while being supported by the same workers and services.

The agreed approach is that there will be no registration changes to either the services registered by the Care Inspectorate or the individual workers registered with SSSC in respect of residential services. So, care homes for children and young people and school care accommodation services will continue to be registered with the Care Inspectorate as residential childcare services. Those working in these settings will also continue to be registered on the parts of the SSSC Register for childcare and residential school care so there will not be any changes to their registration.

Both the SSSC and the Care Inspectorate will expect services and staff providing care and support to young people under Continuing Care to have the skills and knowledge and the services to develop policies to reflect the specific needs of the group for which they are providing care and support.

This approach ensures that the appropriate degree of robust regulation is maintained without placing any extra requirement on workers or services, and supports the development of innovative services for young people to get the best support into their adult life. Legislative arrangements for the registration of foster care agencies and adult placement agencies are separate to this and the Care Inspectorate will issue guidance shortly on this point.

Downloads: 12493

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