NATIONAL CARE STANDARDS COMMITTEE MEETING
Rosebery House, Edinburgh, Wednesday 2 October 2002
Note of the Meeting
Present : Adam Rennie (Chair), Janie Allen, Pek Yeong Berry, Lorraine Briggs, Doreen Campbell, Val Cox, Margaret Davidson, Pat Dawson, Sally Evans, Linda Gregson, Jacqueline Hughes, Mary McCann, Andy Smith, Chris Stadames (for Jacquie Roberts), David Whiteoak (for Gordon Masterton), Carole Wilkinson, Rab Mowatt (committee secretary).
1. Apologies
Apologies were received from: Chrissie Carmouche, Theresa Fyffe, Harry Garland, R Houtman, John MacKenzie, Gordon Masterton (David Whiteoak deputising) Jim McDonald, Janis Pelosi, Margaret Watt, Children in Scotland and Parent Network Scotland. The BMA indicated that they would be unable to provide a representative to sit on the Committee.
2. Welcome and Introductions
2.1 Adam Rennie welcomed everyone to the first meeting of the newly reconvened NCSC. Membership of this Committee would require a significant time commitment and Adam would aim to be disciplined about the timing of the meetings to ensure the best use of members' time. There was recognition that some members would be new to the work of the Committee while others would have had experience either as members of the previous NCSC or as members of the care standards working groups.
2.2 The members then introduced themselves and outlined their backgrounds. Adam thanked everyone and commented that it was clear that this Committee had a wide range and wealth of experience.
2.3 David Whiteoak asked that the Scottish Independent Hospitals Association (SIHA) should be invited to join the NCSC as at present no providers of independent healthcare were on board (Gordon Masterton is representing the Independent Healthcare Panel). When the review of the draft standards starts other groups may require representation. It was agreed that Rab Mowatt should contact SIHA asking for a representative. The Clinical Standards Board for Scotland should also be invited to join the group
3. Terms of Reference (Paper 1)
3.1 Everyone had received a set of papers setting out the background to the NCSC, the development of the National Care Standards, the proposed workplan and the terms of reference as approved by Ministers. Adam invited Lorraine Briggs to give the Committee a short presentation setting out the background to the development of the standards so far, the underlying principles of the standards, the status of the terms of reference and the implications for the work of the NCSC. Lorraine emphasised the role of users and the NCSC's role in ensuring that users' views were taken on board throughout the standards. Adam thanked Lorraine and asked for any comments, questions or observations on the terms of reference.
3.2 Janie Allen queried whether the word 'independent' in the terms of reference was intended to include the voluntary as well as the private sector and Lorraine confirmed that this was the case.
3.3 Chris Stadames asked if user groups would be consulted on the standards. Linda advised that any relevant user groups that the Scottish Executive was aware of would receive copies of the draft standards at the consultation stage. In addition the draft standards would be made available to the general public on the Executive's website. The Secretariat would consider the inclusion of users in the first bullet.
3.4 Pat Dawson asked if the phrase "longer term" in the last part of the terms of reference could be amended as she felt that it was inappropriate. Adam agreed to take this away and consider further.
3.5 It was agreed that secretariat would consider bringing out the relationship with Ministers in the terms of reference, and consider further Pat's point above.
4. Workplan (Paper 2)
4.1 Adam asked Linda Gregson to outline the workplan. The Committee were told that the workplan reflected the urgency of having the 4 remaining standards published by May or June 2003. This was later but more realistic than April 2003, which had been intended as the original publication date. An early publication date was particularly important for the childcare agencies and specialist clinics standards, where some services are already registered with the Care Commission. The four working groups must have their draft standards ready to come to the NCSC by 19 October. The Committee's workplan takes account of the need to get Ministerial approval prior to consultation. An 8-week consultation period was then proposed starting around Christmas/early New Year with updates; and the summary consultation report and recommendations taken at a later meeting. The proposals for reviewing the standards would be introduced at the January meeting, taking advantage of the consultation period.
4.2 A revised workplan that included proposed dates and venues for all future meetings was handed out. It was recognised that not all members would be able to attend every meeting but where they could not attend it was hoped that they would send a deputy in their place. Adam thanked Linda and invited comments on the workplan.
4.3 There was a general discussion about the timing of the consideration of the process for reviewing the existing standards. It was agreed that the review of the standards was a very important issue but that on balance January and beyond would allow the Committee good time to agree a way forward.
4.4 Adam made it clear that the workplan was flexible. Important issues impacting on existing standards as a result of the consideration of the 4 sets within the Committee's current remit could be raised at any meeting.
4.5 Lorraine said that members should be thinking now about their ideas for a good system for reviewing the standards and incorporating any feedback received; and what the Committee's role might be in that process. However Ministers have the ultimate responsibility of deciding if and when standards need reviewed and republished.
4.6 Mary McCann made the point that dentistry was already subject to intense monitoring and that it was important that the profession was not over regulated. Lorraine clarified that the standards currently being drafted were for wholly private dental practices who were not currently regulated.
4.7 Janie queried the consultation period and timing of it. She felt that the Christmas and New Year period could delay the process. Linda said the standards should go out by Christmas and the consultation period would be 8 weeks. However it was agreed to move the March, April and May meetings from the middle to the end of each month. Rab to arrange and advise members of new dates.
4.8 There was a discussion about the Committee's role in identifying and advising Ministers on care services not currently covered by either the standards or the Regulation of Care (Scotland) Act 2001 and whether this should be explicit in the terms of reference. e.g. physiotherapy. A change in legislation would be required to cover any additional services. Adam said that it was not the role of the group to extend the scope of regulation. The immediate task to be taken forward by the NCSC was the consideration and publication of the standards covered by the 4 current standards working groups. The present NCSC membership reflected this. As constituted the Committee does not at present have the representation to look at or cover any extension of services. Where discussion strayed into these areas from time to time this would be recorded in the minutes and passed to the relevant person in the Executive to take forward.
4.9 In any event the scope of regulation could not be extended until the Care Commission was working effectively on the services it presently has to regulate and inspect. If after consultation it was felt that the scope of regulation required extension then the Committee's terms of reference and membership would also need to be extended to take account of this.
4.10 Linda assured members that any items that came up during meetings would be taken away and considered. However the Care Standards and Sponsorship Branch, which services the Committee, does not have policy responsibility for the range of services regulated by the Commission. Policy issues would be passed to the relevant policy Division for consideration. Val Cox said that this addressed some of her concerns and Adam agreed that any comments would be passed on to the relevant areas for consideration.
4.11 Adam thanked everyone for their comments and suggestions. These would be taken away, considered and a second revised workplan circulated prior to the next meeting.
5 Childcare Agencies Standards - Draft 4
5.1 Adam advised that the proposal is that the Care Commission will regulate childcare agencies from April 2003. Unlike the independent healthcare working groups, who have the Independent Healthcare Panel to refer to, the childcare agencies working group have no intermediate referral group. They were looking to the NCSC for advice, guidance and comments on the 4th draft of their standards prior to producing the final draft at their next meeting on 15 October.
5.2 Janie introduced the standards, explaining the working group membership and outlining some of the difficulties that it had faced in defining a childcare agency. In considering both the format and content the group had looked at other standards already published and codes of practice from existing childcare agencies. Annex A and B still had to be finalised.
5.3 Adam thanked Janie and asked for any comments. It was agreed that rather than discuss detailed drafting comments at the meeting these would be sent to Rab who would collate them and pass them to the working group.
5.4 The attempt to regulate and standardise nanny agencies was welcomed by Margaret Davidson. The Committee was told that the Care Commission had set up a group to look at inspection methologies for childcare agencies which would be used to inspect services against the standards.
5.5 The Committee then agreed to raise any substantive issues and comments on the standards in turn. Janie would then take these back to the working group for consideration and inclusion in the next draft.
5.6 Introduction
Sally felt that the examples of agencies should be expanded to show the breadth of services covered.
Margaret Davidson queried how much recruitment agencies were covered in respect of any childcarers that they provided. She was advised that the legislation covered supply of or introducing childcarers. Can respite care be included in the introduction? The working group would look again at the first couple of sentences in the introduction.
Andy Smith asked what the scale of the issue was - just how many childcare agencies were involved in this? It was thought unlikely that the size of the sector would be known until regulation was commenced and agencies begin to register.
Andy also queried whether the standards only apply to childcare agencies that have an office in Scotland. If an agency only has offices in say England but supplies childcarers to parents or organisations in Scotland do they come under the standards? Linda to investigate.
5.7 The National Care Standards: the sentence in the second last paragraph which states "They describe what the parent and child can expect from the childcare agency". It was felt that this would be difficult for a child to understand and perhaps a more "child friendly" sentence could be used as it is hoped that the Care Commission inspectors will speak to some children as part of the childcare agencies inspection process. However Val felt that it was the parent's responsibility to explain what the childcarer is there to provide for the child.
5.8 Standard 1
Carole raised bullet point 6 - code of practice. Could childcare agencies be asked to use the SSSC's code of practice? Working group to consider this.
Margaret Davidson raised the bullet point on child protection policy and asked if this would be a standard policy for all childcare agencies. Val responded that each individual childcare agency would need to have their own child protection policy to reflect their particular responsibilities and the service provided. It would be the responsibility of the Care Commission to decide if a childcare agencies child protection policy was sufficient and met the service being provided. The same applied to all the other agencies policies.
For the policies listed a reference to the relevant contacts in the Glossary would be helpful, for example Health and Safety Executive for health and safety policies. However the standards are for the user, and childcare agencies should look to the Care Commission for guidance on the detail of any of their policies.
In the last bullet point the sentence "These would normally include" should have added to it "but not exclusively"
5.9 Standard 2. No comments on this standard.
5.10 Using the service - standards 3 to 6 introduction. Pek asked if the phrase "independent representative" in the last sentence could be changed to "independent interpreter".
5.11 Standard 3
Item 3.4 - Val felt that this should include a statement about "consistent care".
Item 3.8 - Pek asked if the use of "appropriate" could be removed from the last bullet point.
It was also agreed that this standard requires a statement on changing the childcarer if they are unsuitable.
5.12 Standard 4
Carole raised the employer's code of practice, which she felt should be included in this standard.
At bullet point 4 Pek felt that the phrase "taking account of any cultural differences" should be included. Sally asked that the phrase "you have" be removed. Val said that bullet points 3 & 4 would read better if merged.
At bullet point 5 it was agreed that the phrase "cultural sensitivities" or "diversities" should be included.
The last sentence should make clear that any evidence or confirmation should come from the Agency.
5.13 Standard 5
Item 5.2 - Carole outlined where the SSSC was with regard to registering staff and managers with the Council. Childcarers and early years workers covered by the early years standards will be covered in phase 2 of the registration process and registration should commence in 200? Work still needs to be done with the sector to see who is registered and who is not. Qualifications will be looked at after that. Working group to look at last sentence with a view to removing the reference to "registration" at present.
Item 5.5 - Pek advised that identity checks and checks on the right to work were sensitive issues. Sally said that identity checks were carried out under the enhanced disclosures from Disclosures Scotland. Working group asked to change this bullet point from "where appropriate" to "for all workers". Sally raised the bullet point on "checks with previous employers", as some of her volunteers may not have had a previous employer. Also her service does not take up medical references. Following discussion it was agreed to leave both bullet points in. Working group asked to look again at the bullet point on international criminal records checks.
Item 5.7 - Change "the continuing professional development" to "continuing learning development.
5.14 Standard 6
Carole raised item 6.4 on complaints and asked if the text of this could be further clarified. Linda also raised the process of the complaints procedure and advised that the dentists standards have reworded this item. Working group will consider this at their next meeting.
5.15 Annex A - Glossary. It was felt that a definition of "interpreting services" should be added into the Glossary. Also the staff definition should include a reference to volunteers.
5.16 Annex B - Useful Reference Material. Adam raised the reference to the Fire Precautions (Workplace) Regulations 1997. It was agreed that these applied to the childcare agency premises and not to the child's home and that this point should perhaps be clarified. Janie said that the Scottish Executive document "Regulation of Childcare - The Way Ahead" would be included under the policy papers section of this Annex.
6. AOCB
6.1 Linda outlined how the wording of all the previous drafts of standards had been reviewed by Violet Jardine, a PR consultant with a nursing background, to ensure a "you" focus. Violet worked closely with the previous NCSC to put the previous standards into a user-friendly format prior to the consultation process. Co-opting her onto the NCSC again would ensure a consistent approach to the language used throughout the standards. It was agreed that Violet should be approached and asked if she could attend the next meeting on 30 October.
7. Dates of Future Meetings
The Committee agreed to the dates, timings and locations of the future meetings as set out in the revised workplan with the following exceptions:
30 October meeting - this will now run from 10:30am to 1:00pm and a buffet lunch will be provided.
The meetings in March, April and May 2002 are to be moved to the end of each month. Rab to issue a further revised workplan showing the amended dates and timings for all future meetings.