Regulating Care and the Social Services Workforce (Consultation)

1. PURPOSE AND BACKGROUND

Introduction

1. The purpose of this document is to seek views about how new and improved arrangements for the regulation of care and the social services workforce should be taken forward. The White Paper Aiming for Excellence: Modernising Social Work Services in Scotland (March 1999), drawing on previous consultation, set out proposals relating to two new bodies:

• a Scottish Commission for the Regulation of Care to regulate care services; and
• a Scottish Social Services Council to regulate the social services workforce.

The setting up of these two new bodies will require an Act of the Scottish Parliament.

2. This paper is a key part of the consultation process prior to developing this legislation. It concentrates on those aspects requiring primary legislation. Much of the detail of the operation of the Commission and the Council will be dealt with by shadow bodies which will be established once the Parliamentary process of the legislation has commenced. This will include details such as office location.

3. We have already started to consult and work on these proposals. A consultation paper on workforce regulation was issued in November 1998. A seminar attended by over 60 different interest groups was held on 24 September 1999, involving the public, private and voluntary sectors. We have also met a number of groups to discuss particular points of concern. These discussions and the conclusions from the seminar have helped frame the issues set out in this paper. We have also set up a Reference Group of experts. This group has contributed to the development of this paper and will continue to assist us in the development of our proposals. Details of this work are given in Annex A.

4. We have asked for specific views on certain aspects, particularly relating to the Commission where there has been no previous consultation paper. We are sure, however, that there will be many views on the contents of this paper as the proposals are far-reaching, so please let us have your comments on any aspect of the paper. Details of where to send your comments are given at the end of the paper.

Care regulation

5. Currently the care registration and inspection system includes the following:

• private and voluntary sector residential care homes are registered and inspected by local authorities;
• nursing homes are registered and inspected by health boards;
• residential care homes and day care provided by local authorities are subject to inspection;
• day care and child minding for children under 8 is registered and inspected by local authorities;
• secure accommodation for children and some adoption services for children are approved by the Social Work Services Inspectorate; and

• some grant-aided and independent schools are registered and inspected. Others may register voluntarily.

Care provided for people in their own homes is currently unregulated.

6. The current system of care regulation has been criticised on 3 main counts:

• lack of independence — local authorities are currently responsible for purchasing, providing and regulating residential care, while health boards may purchase nursing home care as well as regulating it;
• lack of consistency — standards inevitably vary across Scotland, creating uncertainty for people using services and providers; and
• lack of integration — in particular separate regulatory regimes for residential and nursing homes makes it difficult for both residential and nursing care services to be provided from one establishment and can result in disruptive moves as the needs of people using the service change.

Workforce regulation

7. More than 100,000 people work in social services in Scotland. About half of these are employed by local authorities and the remainder work in private and voluntary agencies. Currently there is no statutory regulation of the social services workforce, other than statutory requirements that holders of Chief Social Work Officer and Mental Health Officer posts have particular qualifications. Appointments to social worker posts have generally been restricted by employers to holders of recognised qualifications.

8. At present the Central Council for Education and Training in Social Work (CCETSW) has responsibility for promoting, developing and regulating education and training at all levels and awarding qualifications in social work. CCETSW formerly awarded vocational qualifications in social care, in partnership with the Scottish Qualifications Authority (SQA). CCETSW has, however, now withdrawn from this arrangement and is no longer an awarding body for vocational awards.

9. This large and varied workforce undertakes a wide range of tasks of a complex, sensitive and sometimes personal nature. People using services must be confident in those who provide the services. The Scottish Executive is committed to ensuring that confidence is well placed and that the commitment and value of the current workforce is built on. The proposals set out in this paper will strengthen and support the professionalism of the workforce and protect and benefit the people who use social services.

10. Equally, those engaged in this type of work should be confident that where their practice is called into question this will be objectively tested against one set of standards and any consequent measures will be fair and consistently applied throughout Scotland.

A new approach to regulation

11. As the White Paper indicated, to address the above concerns and to improve services for people who use social services we propose to create two new public bodies. These bodies will be independent of service providers and in their day-to-day operations, but will be accountable to the Scottish Executive (which includes the Scottish Ministers) and in turn to the Scottish Parliament:

• the Scottish Commission for the Regulation of Care — will assume the registration, inspection, enforcement and complaints investigation functions of local authorities and health boards in relation to currently regulated day care, residential care and nursing care facilities, and will regulate other forms of care not currently regulated, including facilities provided by local authorities;

• the Scottish Social Services Council — will register staff in certain key groups as a pre-condition before they can be employed or can continue in employment. It will also assume the functions of CCETSW and the Training Organisation for the Personal Social Services (TOPSS) in relation to the development, promotion and regulation of social services education and training, and will publish codes of conduct and practice.

12. Subject to completion of the Parliamentary process it is intended to establish the Council and Commission from 1 April 2001. It is envisaged that the Council will be fully established from that date. The Commission will, however, commence its operations on a phased basis with the first tranche of care regulation being taken on as soon as feasible after April 2001, most likely September 2001. At present we envisage that care homes and day care for adults will be taken on first, followed as soon as practicable by day care for children and then home care. We expect that adoption and fostering services and specialist accommodation for offenders will complete the process.

13. The legislation will avoid tight prescription of the functions of the Commission and the Council and will be as enabling and flexible as possible. The Scottish Ministers will have powers to prescribe details by regulation, subject to Parliamentary approval. Should the Commission and the Council not exercise their functions properly, there will be default powers for the Scottish Executive to utilise. Future Scottish Executive guidance will also assist the development and implementation of this new regulatory regime.

14. In proposing these two new bodies we are seeking to meet a number of objectives:

• strengthen the protection of children and vulnerable adults;
• ensure an emphasis on people using services and their carers;
• ensure we have a competent and confident workforce capable of delivering high quality services which meet people’s needs;
• create an independent form of regulation which has public confidence;
• bring different regulatory regimes together into one integrated system of regulation, in particular having one system for regulating care homes, thus ending the present distinction between nursing homes and residential care homes;
• assist the move away from institutional care towards a flexible system of community care that meets the desired needs of people; and
• be responsive to local concerns and needs.

Index of unsuitable adults

15. In addition to the two new bodies described above, Aiming for Excellence also proposed the setting up of a statutory Index, managed within the Scottish Executive, which will hold information about those considered unsuitable to work with children and young people. It is intended that this Index will also be capable, in time, of being applied to people working with vulnerable adults. The setting up of this Index will be subject to separate pre-legislative consultation early in 2000.