30th April 2018

Code of Practice for Inspection of Services in Wales

 

 

The Care Inspectorate Wales (CIW) have published an updated version of the Code of Practice for Inspection – April 2018.   This document was available as a consultation version since November 2017.  The Code of Practice can be accessed here.

The aim of the Code of Practice (CoP) is to inform everybody who care and support services are inspected in Wales. It provides information on:

How inspection is based upon human rights legislation; i.e
  • Choice and control
  • Safety
  • Respect
  • Having a voice
  • Help to develop full potential
The inspection principles, these are explained in section 4.2 of the CoP under these headings:-
  • Being people focused
  • Supporting involvement
  • Being transparent
  • Being fair and impartial
  • Being robust
  • Being proportionate
  • Being consistent
The inspection process, sections 4.3-4.10 cover this and include:-
  • Inspection planning
  • Inspection visits
  • Feedback
  • Reporting
Focus of inspection, there are 4 assessment themes, these have been in use for a couple of years and are:-
  • Well-being
  • Care and support
  • Environment (this section does not apply to services which do not provide accommodation)
  • Leadership and management
Types of inspection, section 5 describes these as:-
  • Full inspection – an in depth consideration of all 4 themes, the first full inspection will take place approximately 6 months after the provider is registered or begins to provide a service at that location.
  • Focussed inspection – usually carried out in response to a concern or to follow up on regulatory breaches (usually within 6 months of the previous inspection)
  • Provider inspection – looking specifically at corporate governance and management arrangements
  • Thematic inspections – a focus on specific areas of care practice across the sector

Length of inspections – Section 5 provides information that this is dependent on the type of service and level of compliance.

Scheduling of inspections – Section 6 describes the CIW evidence based approach to the frequency of inspection and intervals between inspections (See Table 1 of the CoP). Note that the maximum interval for care homes and domiciliary care is 18 months.

Conduct during inspection (section 7) – this sets out:-
  • Expectations on inspectors
  • How service providers and staff can support the inspection process

Feedback – Section 8 describes the feedback process, the feedback will be provided to the Responsible Individual, this is an opportunity for the service to challenge any inaccurate information.

Inspection report - Section 8 also describes the process including timescales:-
  • CIW aim to draft, finalise and publish inspection reports within 50 working days following the completion of inspections
  • CIW aim to have each inspection report is expected to be written and issued to the relevant person as a draft version within 25 working days of the last inspection activity.
  • A period of 10 working days is allowed for the service provider to consider and respond to the draft report.
  • CIW response and a copy of the amended report, where appropriate, will be provided to the service provider within 5 working days, following receipt of the challenge
  • CIW will consider and respond to any second challenge raised by the service provider within a further 5 working days.

Ratings – The CoP says “At present we do not issue ratings for services regulated under the 2016 Act; however our inspection frameworks have been developed with ratings in mind. Our inspectors will continue to use these inspection frameworks to make judgements about their findings and capture these in the narrative of their report under each theme, using qualitative language” This implies that ratings for services in Wales are planned for the future.

Complaints – Section 8 also provides information on how to raise a complaint about an inspection, the conduct of an inspector or any CIW staff member. The CoP makes it clear that the complaints policy is separate to responding to the inspection report and a complaint made against an inspector will not normally delay the publication of an inspection report.

Improving the quality of services – section 9 describes the actions that CIW can and will take to improve the quality of services, these include:-
  • Recommendations
  • Informing the provider that they are non-compliant but not issuing a non-compliance notice
  • Issue of a non-compliance notice
  • Taking urgent action to place restrictions or cancel the providers registration
Enforcement – section 9.3 details the range of actions CIW can take under their enforcement process, these include:-
  • Issuing a non-compliance notice;
  • Requiring the provider to meet with us to discuss what actions have
  • Been taken to address poor care;
  • Imposing, varying or removing conditions on the provider’s registration;
  • Cancelling the provider’s registration;
  • Issuing an improvement notice;
  • Issuing a penalty notice;
  • Prosecuting the provider.

The CoP is very informative and makes the CIW inspection process easy to understand for Service Providers, Responsible Individuals, Registered Managers, staff and the people who use the service.

Service Providers should use the CoP to inform their processes for planning, preparing and responding to a CIW inspection. Responsible Individuals must obtain, read and understand the whole of the CoP and have a copy to hand during the inspection and during the feedback session.

The section on feedback and challenging inaccurate information is vital to ensure that inspection reports reflect the service provided. It is also important to be pragmatic if the CIW inspection identifies areas of improvement, many providers challenge everything without a robust basis on which to do so and this is in many cases a waste of energy, time and precious resources. Often these could be better used to make the improvements identified.

Responsible Individuals must be aware of their responsibilities under the Statutory Guidance: For service providers and responsible individuals on meeting service standard regulations: Parts 3 to 20 of The Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017. This is especially true of the regulations contained in Chapter 2: requirements on Responsible Individuals. A Responsible Individual who is not ware of their responsibilities will not be regarded as running a service which has effective leadership and management.

 

*All information is correct at the time of publishing

Tim Dallinger

For the last 30 years, Tim has been actively involved in the health & social care sector and in particular in owning and managing an organisation which provides residential care for adults with a learning disability and/or mental health needs in small group settings within the local community. Read more

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