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19th June 2017

Draft regulations for care provision in Wales out for consultation

I have been involved for about two or three years working with Welsh Government on aspects of the Regulation and Inspection Act. The latest work has centred around the regulations that ‘put the meat on the bone’ of the Act. These are probably more significant than the Act itself. This is where responsibilities of managers, responsible individuals and providers themselves will be set in stone until the next review probably in 10 or 20 years. It is important then that existing providers and providers who may be considering investing in Wales have the opportunity to express their support or concerns at the proposals.

As far as existing providers are concerned, the one aspect that will be of particular interest is that if you are registered now then that registration will move over to the new regime. As far as I am able to ascertain if you are wanting to dispose of your existing provision then it can be transferred without having to comply with new standards. At one time only if you were selling a limited company could you be assured of being registered again with CSSIW without having to comply with national minimum standards.

The draft regulation can be found here.

The consultations can be found here.

What else is in the draft regulations?

New provision of care homes will have to comply with higher physical standards. En-suites will have to have a shower now, this will also have to apply to extensions to existing homes.

The change in responsibilities of the chain of command will be significant and onerous. No longer it will be possible to have a Responsible Individual (RI) looking after a hundred homes or ones that are so far apart that they cannot be monitored regularly. This will apply to a number of corporates who will have to re-organise their structures.

The Minister for Public Health and Social Services, Rebecca Evans

Rebecca recently wrote to me,

‘I am very grateful to everyone who gave their time to engage with us and to inform the development of these. I know you were involved in some of those discussions, as were a range of others from across the sector including commissioners. This type of engagement is absolutely critical if we are to develop requirements which are right for the sector and, of course, people using regulated services. Thank you for your time and involvement in this piece of work.

As you will see the approach which we have taken in developing the draft regulations is that requirements placed upon providers should be proportionate and focussed on outcomes for people. The intention is that there should be sufficient flexibility for providers to enable them to care for and support people in a way which puts the individual and their outcomes at the centre of their care.

I am very aware of the differing views and perspectives about the value of facilities, like ensuite bathrooms and other premise-related requirements which you mentioned. The public consultation will be the opportunity to test out views on this. I am not able to pre-empt the outcome of course, but I can say that in developing our approach we have been acutely aware of the potential impact on the stability of the market and viability of existing providers resulting from the requirements the regulations put in place.’

As Rebecca explains our input is wanted. We need to explain that Welsh Government need to assess whether they need adequate provision for the people of Wales or unaffordable higher standards. There is presently inadequate nursing home provision and in my view unless there is a major change in funding, there will be only a limited increase in provision in the wealthiest parts of Wales. There needs to be commissioning guidance that is enforceable on commissioners. At the moment there is good guidance but no teeth to make it work unfortunately.

Mike Kemp

Welsh Regulation Specialist

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