NATIONAL CARE STANDARDS COMMITTEE (NCSC) MEETING

Conference Room 11, Victoria Quay, Edinburgh,

10.30am, Monday 26 June 2006

Present: Adam Rennie (Chair), Irene Audain, Susan Brimelow (attending for Jacquie Roberts), Leigh Edwardson, Linda Gregson (attending for Marjory Barquist), Gerry Kennedy, Tom Lamplugh, Jim McDonald, Sarah Wedgwood, David Whiteoak, Steven Wilson (attending for Michael Bews).

1. Welcome and apologies

1.1 Adam Rennie welcomed everyone to the 19th meeting of the NCSC.

1.2 Adam welcomed Gerry Kennedy, who had replaced Pat Dawson as the RCN representative on the Committee.

1.3 Apologies had been received from Marjory Barquist, Michael Bews, Suzanne Munday, Janis Pelosi, Jacquie Roberts and Raymond Taylor.

2. Note of last meeting and matters arising

2.1 Matters arising from the last meeting were:

· National Standards for Dental Services. The Committee had been advised at the last meeting that the National Standards for Dental Services would be published in mid-May to coincide with National Smile Week. Unfortunately, this timescale had slipped as it had taken the Executive and NHS QIS longer than expected to agree the format and design of the document. The intention was now to publish the Standards by end July.

Action: Scottish Executive/ NHS QIS

· Disclosure Checks. As agreed, a paper on the Care Commission's mapping exercise of the National Care Standards with other standards had been circulated to the Committee in May. The Committee had no additional comments.

· National Care Standards for Independent Medical Consultant and GP Services. Update: Tom Lamplugh advised that, despite their best efforts, Accent Marketing and Research had been unable to recruit a sufficient number of individuals to take part in the user consultation on the standards. Consequently, the Executive had decided to terminate the contract with Accent. In view of this, the Working Group would be asked to take account of relevant user feedback from previous consultations on independent healthcare standards when finalising the document.

Next Steps: The Executive intended to write to the Working Group shortly with a report of the feedback from providers and, in view of this, suggested revisions to the Standards. The Working Group would also be asked to consider revisions in respect of child protection and the Shipman Report once the Executive had discussed what was required with policy colleagues. The Executive hoped to finalise the draft Standards over the summer at which point they would come back to the Committee before going forward to Ministers. Action: Scottish Executive

3. Paper 1: Urgent Revision to the National Care Standards for Adult Placement Services

3.1 Linda Gregson introduced Paper 1 which set out proposals for an urgent revision to the National Care Standards for Adult Placement Services. The regulation of these services by the Care Commission had commenced on 20 June 2006.

3.2 Linda advised that the basis for the proposal was to restrict the number of individuals that could be placed per adult placement carer at any one time. The proposal was that in most cases, individuals should be placed on a one to one basis, however, in certain circumstances, it should be possible to place two individuals with one carer e.g. where they are siblings or married. In emergency situations, it should also be possible that up to three individuals (but never any more than three) could be placed with one carer at any one time.

3.3 The original intention had been to include something in Regulations to restrict the carer: placement ratio. However, in practice this would have completely restricted the flexibility of the Care Commission and the adult placement service to agree that more than one person could be placed with a carer in the specific circumstances set out above. It was, therefore, agreed with policy colleagues and the Care Commission that we address this by including the proposal in the standards.

3.4 Linda advised that the proposed wording of the revision needed to be further discussed and finalised with policy colleagues. The wording should reflect the policy that the adult placement carer is an individual (either living on their own or in a family unit); that the carer can be looking after their own family as well as the person being placed with them; and that the person being cared for could be cared for along with up to a further two people.

3.5 The Committee agreed that the proposed revision was both required and urgent. The Committee was content to agree the revised wording in correspondence.

Action: Scottish Executive

4. Paper 2: Urgent Revision to the National Care Standards for Independent Healthcare Services

4.1 Susan Brimelow provided background as to why the proposed revision was considered necessary. She explained that the Care Commission's experience of regulating independent healthcare services to date had highlighted the need for a specific set of regulations for independent healthcare services. Whilst this suite of regulations was being developed, both the Executive and Commission had agreed that Regulation 15 (Regulation of Care (Requirements as to Care Services)(Scotland) Regulations 2002) should be strengthened with regard to clinical effectiveness and management of risk.

4.2 Linda advised that the amendment to Regulation 15 had come into force on 20 June 2006. Copies of the amendment were circulated to members at the meeting. She advised that the original proposal included a requirement for providers to provide care and treatment which reflects published research based evidence and guidelines issued by appropriate professionals and expert bodies as to good practice. However, Scottish Executive solicitors had advised that such a requirement was not specific enough to be included in regulations. It had, therefore, been agreed to propose an amendment to the National Care Standards for Independent Healthcare Services instead.

4.3 Adam advised that the proposed revision would apply to the National Care Standards for Independent Hospitals, Independent Specialist Clinics and Hospice Care. The revision would also be included in the Doctors Standards as these were still in draft. With regard to the Dental Standards, it was noted that these were due to be published shortly and it would, therefore, be difficult to include this amendment without significantly delaying publication. Both the Executive and NHS QIS thought that the Dental Standards would not need to be revised as the wording of Standard 8 sufficiently covered this issue. However, it was agreed to further consider this issue once the wording of the revision had been finalised.

4.4 The Committee agreed that the proposed revision was both required and urgent. Linda advised that the wording of the revision still needed to be discussed with policy colleagues and the Care Commission. Once finalised, the proposed revision would be sent to the Committee for consideration and, if possible, agreed in correspondence. However, it was noted that it may be necessary for this proposal to come back to the Committee for further consideration.

Action: Scottish Executive

5. Paper 3: Proposed Revisions to the National Care Standards for Care Homes for Older People

5.1 Linda introduced Paper 3 which set out proposed revisions to the National Care Standards for Care Homes for Older People. The proposals were being brought forward in response to the Office of Fair Trading Report on Care Homes for Older People, published in 2005.

5.2 The Committee agreed to the proposed revisions in principle. It was noted that, before going out to public consultation, the proposals were subject to change following further discussion with policy colleagues. It was agreed that the proposed revisions would come back to the Committee for further consideration once a consultation had been carried out.

Action: Scottish Executive

6. Paper 4: Review of the National Care Standards

6.1 Tom Lamplugh introduced Paper 4, which built on previous discussions and attempted to clarify the aim, methodology and timing of a review of the National Care Standards.

6.2 Of the two options, the Committee favoured Option 1- a focussed review of the National Care Standards. However, in terms of timing, some members expressed concern that it was too soon to carry out such a review as not all sets of standards had been published and/or inspected against. Following discussion, it was agreed that a sufficient number of standards had had an opportunity to bed down and complete a full inspection cycle for a review to be carried out at this stage.

6.3 The Committee also expressed concern in relation to the suggested scope of the review, which would focus on the six sets of standards for care homes. Tom explained that this group of standards had been chosen as they all had been fully inspected against and presented a broad cross-section of readily accessible user groups. However, the Committee was concerned that concentrating solely on care homes, despite the range of available users groups, would limit the potential for read-across to other sets of standards/sectors. Members felt that there was value in extending the scope of the review beyond care homes to include standards such as early education and childcare and independent hospitals, both of which had been fully inspected against and had distinct and accessible user groups.

6.4 With regard to the draft research specification, the Committee was content with the proposed aims and objectives. It was noted that Point 8: Coherency should be extended to include duplication and overlap between the standards and regulations.

6.5 With this in mind, the Committee agreed to Option 1- a focussed review of the National Care Standards. However, it was agreed that the scope of the review should extend beyond care homes. Tom agreed to prepare a further paper for the next meeting setting out a revised group of standards upon which to base the review. Action: Tom Lamplugh

7. Future Meetings

7.1 Adam advised that the Secretariat would shortly be scheduling further meetings for the period September to November. A note of the dates would be sent out to the Committee along with the note of meeting.

Action: Secretariat

7.2 Adam advised that the Committee's remaining workplan included the Review of the National Care Standards (discussed above) and to sign off the National Care Standards for Independent Medical Consultant and GP Services. He also advised that there was a possibility that the Committee would be asked to develop standards for private ambulance services. If so, this could involve extending the Committee's membership.

8. AOCB

8.1 There was none.

National Care Standards Committee Secretariat

June 2006