All change in health and social services
Care services in Scotland, and their regulation, are undergoing major changes in how they operate. I have written about new Health and Social Care standards, currently undergoing final consultation to be implemented in 2017/8. Inspections by the Care Inspectorate are changing also, being more proportionate and focussing on the experience and outcomes for people who use the service. New reporting methods are also coming into force, reflecting these changes. Health and social care support services are now integrated under a system of local Integration Boards.
The Scottish Social Services Council (SSSC) has also introduced changes broadly in line with the above. The SSSC oversees the registration of social care and social work staff, to promote the values and principles of how care is provided. Codes of practice for social care workers and social care employers have been in place since 2003, and managers, employers and direct care providers are expected to comply with these codes.
New codes of practice
After consultation, the SSSC has introduced a revised version of these codes (one for employers, the other for social service workers (including support and social work staff). Along with this, there is new guidance and support on offer concerning how supervision fits with providing good quality care, and the duty of candour is introduced and laid out for guidance. Overall, the SSSC states that it is moving to a fitness to practice model for the regulation of social service staff. As with recent government guidance on the recruitment of social service staff, the model is positively tuned to a values-based approach looking at the worker’s character, conduct and competence.
Fitness to practice is legally defined, and can be impaired by: misconduct; deficient professional practice; health; a decision about them by another regulatory body; a conviction in the United Kingdom, the Channel Islands or the Isle of Man for a criminal offence or a conviction elsewhere for an offence which, if committed in Scotland, would constitute a crime.
What changes are made?
Employers should have a greater focus on values and attitudes and the potential to acquire knowledge and skills rather than an expectation that workers already have knowledge and skills. Co-production is emphasised, as is listening and where necessary acting to report or implement comments received on practice. This covers whistleblowing by staff, feedback from service users, and the duty of the organisation to promote candour. The code for social service workers largely follows that for employers, with some relevant changes.
The codes came into force on 1 November 2016.
How will the changes improve things?
There is a strengthened duty to obtain, listen to and take account of the views of service users. This is welcome and follows the changes in inspection, and in the new national standards which will be introduced.
The availability of guidance on candour is welcome, which should encourage staff to report and be open about when things go wrong.
There is also additional support for supervision and good communication between all concerned in supporting people who use services.
Are the changes needed?
Recent news articles confirm that it is regrettably frequent that the wrong person is in the wrong post to care for vulnerable people: the ongoing revelations in football coaching, and the Panorama investigation of poor practice in care homes in the south of England; are two examples which should give us pause for thought.
It is to be hoped that current changes, including these new codes of practice and new care standards, will minimise the possibility of people being harmed by those in a position of power.
