Developments in Wales 16-23rd Jan 2018

January 31, 2018

No More Managers Registered with CIW

The last week has seen a number of key developments affecting the care sector in Wales. Firstly, the Care Inspectorate Wales announced that it would no longer be accepting applications from Registered Managers. This only applies to the following types of services:

  • Care homes
  • Children’s homes
  • Domiciliary care agencies
  • Secure accommodation and
  • Residential family centres.

This is in preparation for the changes to the registration of managers which come with the Registration and Inspection of Social Care Act (Wales) 2016. From 1st April 2018, Managers of services will be required to be registered with Social Care Wales (formerly Care Council for Wales) rather than with CSSIW and SCW. Care Inspectorate Wales reminded care providers that they must still appoint a manager and the manager should be appropriately qualified and registered with Social Care Wales.

Care Homes Failing Residents

On 23rd January 2018, the Older People’s Commissioner for Wales, Sarah Rochira, said that care home residents are being failed due to a lack of Welsh Government action. These comments were underpinned by concerns that the Welsh Government had not fulfilled promises made in 2014 to improve residents’ quality of life. Criticisms included the overuse of antipsychotic medication and a failure to prevent falls; these are among  15 concerns she has raised. Ms Rochira’s new report, ‘A Place to Call Home: Impact & Analysis’, is also critical of health boards and local authorities.

Her recommendations include:

  • Providing specialist continence support for all care homes
  • Giving access to specialist services after a resident has a period of ill health
  • Ensuring staff understand and are able to minimise risks linked with falls
  • Basic dementia training for all staff
  • Encouraging the use of befriending schemes
  • Publishing guidelines annually about the use of antipsychotics in homes
  • Developing a system of health and social care inspection
  • Producing an annual report on the quality of clinical care

Care providers in Wales can learn much from this report and should consider how well they currently provide a service to meet the needs of all people and especially in those areas highlighted by the report and in the recommendations above.

Re-registration – My Journey

On a personal level, I have been thinking about how the re-registration process due to commence in February 2018 will affect the services I operate. As I operate two care homes at present, if I am to register these under one registration then this makes me a “complex” application. The CIW guidance implies that the re-registration process will be more rigorous and will probably require a visit from an inspector. Whilst I always welcome a visit from the inspectorate it does not seem to me to be a good use of public resources especially for services which have not long been inspected. I  may submit two separate registration applications, one for each service but that will require two separate legal entities, again more applications and paperwork. I have also been looking at the format of the Statement of Purpose and I can see that to complete this will be quite a lot of work to do it well. I am diarising some time to work on this for my services and I am suggesting to other care providers in Wales that they do likewise. In my consultancy role, I am speaking to a number of home care providers who would like some support with the re-registration process and especially the Statement of Purpose. So, it seems like I will be experiencing this process for both care homes and home care. Another key task for me this week has been to change the format of my provider visits (Reg 27 for care homes) to reflect the new CIW inspection framework. I recently undertook a provider visit to one of my services and I tried to focus on the key elements; quality of life, quality of staffing, quality of care, environment. Unfortunately, unlike the CQC key lines of enquiry, the inspection framework in Wales is less precise and it has taken me some time to work out which aspect of my service provision fits into which quality statement. I have also tried to focus my provider visit on the information that the new Statement of Purpose asks for so that I can make best use of my time.

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