There are more than 40,000 adults living in residential care in Scotland. The majority of the care homes in Scotland are run by the private sector, with the rest being run by the voluntary sector and local authorities. While dealing with the important task of caring for some of society’s most vulnerable, residential care homes are subject to heavy regulation.
All care services in Scotland, including care homes for adults and the elderly, children’s nurseries and care at home are regulated and inspected by the Scottish Care Inspectorate.
The Role of the Care Inspectorate
The Care Inspectorate was set up in 2011 by the Scottish Government and took over the roles of the Care Commission, the Social Work Inspection Agency and Her Majesty’s Inspectorate of Education (HMIE).
There are currently 14,000 registered care services registered with the Care Inspectorate in Scotland. When registering care providers the Care Inspectorate considers:
- the identity of the care provider (i.e. is it an established care provider or a new business);
- the proposed registered manager who will be responsible for the day to day running of the service; and
- the policies and procedures which will be put in place to ensure the effective operation of the care facility.
The Care Inspectorate must be satisfied that the service provider has the necessary plans in place and the right quality of staff to operate a care service.
Inspections by the Care Inspectorate
The service provided and the risk allocated to the service by the Care Inspectorate will dictate the frequency and the amount of time that will be spent on inspections. However, inspections typically occur on an annual basis. Inspections can be either planned in advance or unannounced. The Care Inspectorate typically carry out 8,000 inspections a year. However, care services which are considered to be a higher risk will be carried out more frequently. In addition to regular inspections, the Care Inspectorate also investigate complaints or concerns raised about care services.
The inspector will talk to those using the service, staff and managers to assess the quality of the care, the environment, management and staffing. Following the inspection, the inspector will grade the care service from 1 (unsatisfactory) to 6 (excellent). Since the introduction of the new National Care Standards the way services are being inspected is changing. Inspections are increasingly looking at what it is like to use the service. You can find out more about the National Care Standards here.
Reports issued by the Care Inspectorate after the inspection will detail the grade and set out requirements or recommendations for improvement. Care providers must comply with the requirements set out in the report. However, it is sensible for care providers to also seek to adopt the recommendations detailed in the report where possible.
If the care service does not improve, the Care Inspectorate can seek to cancel the service’s registration through a court application. The Care Inspectorate can, in emergencies, ask the Sherriff Court for an order requiring the immediate closure of a care service.
The Care Inspectorate often carry out joint inspections by Healthcare Improvement Scotland. Healthcare Improvement Scotland is part of the National Health Service and is a special health board with a remit over the quality of healthcare in Scotland. They exist to help health and social care organisations improve services.
Integration of healthcare and social care is a key policy for the Scottish Government.
Joint inspections are designed to examine how well care services, social work services and health services work together to support adults living in social care. The reports make recommendations as to how the different services can work together.
Care Inspectorate and Covid-19
In light of the Covid-19 pandemic the Care Inspectorate has updated its notification requirements. During the pandemic:
- Services need to notify the Care Inspectorate of each individual case of Covid-19.
- Care homes must make a weekly staff absence notification each Tuesday disclosing staff self-isolating, shielding and not working due to stress caused by Covid-19. Care homes must also notify the care inspectorate as to whether any staff are in hospital.
- The care home should notify the care inspectorate as soon as they become aware of the death of a staff member.
A new notification on staffing levels during the pandemic has also been introduced, which is designed to identify providers who will require staffing assistance due to the number of those off sick due to the virus. Additional problems such as the absence of adequate Personal Protective Equipment can be noted as a part of this notification.
Understanding the role and requirements of the Care Inspectorate and the importance of meeting the standards it sets is essential for the operation of your care home. Failure to comply can have implications and the remedies for the resulting problems can be costly and require you to divert time and resources away from running your business.
In some extreme cases a criminal prosecution can be brought, not just in relation to the care provider (normally a limited company) but also against the senior management team and company directors.
Davidson Chalmers Stewart’s Healthcare Team understand the regulations affecting the care sector and the challenges facing the sector. If you need advice in relation to your residential care home, speak to a member of the Davidson Chalmers Stewart Healthcare Team, who will be happy to help.