22 April 2015
Article by Amy Clifton, National Assembly for Wales Research Service
Words like regulation, registration and inspection may not immediately grab your attention… Nevertheless, the way in which we regulate and inspect social care services has a big impact on the lives of some of the most vulnerable people in our society.
Most of us will at least know someone who receives social care, either in their own home, in the community or in a care home. We all want to feel confident that the service they get is of the best possible standard and enables them to have the best possible quality of life.
The Regulation and Inspection of Social Care (Wales) Bill aims to drive up improvement and set quality standards for care services. The Welsh Government wants the Bill to ensure there are robust systems in place for monitoring and inspecting services to judge whether they are up to scratch, and to enable rapid action to be taken if they are falling short.
The Welsh Government has also produced a statement of policy intent for regulations to be made under this Bill.
Stage 1 of scrutiny of the Bill has begun, and the Health and Social Care Committee’s second oral evidence session is taking place on Thursday 23 April 2015 (watch on Senedd TV).
Issues raised in the session with the Minister included:
The social care services which are currently regulated (i.e. formally registered and monitored) are residential and accommodation services; adoption and fostering services; adult placement services and home care services
The Bill replicates this and does not extend the list of regulated services, but gives the power to add or exclude services through regulations.
Consultation responses to the Welsh Government’s White Paper identified advocacy and day care for adults (amongst others) as additional services which should be regulated. For example Carers Trust Wales stated:
The provision of ‘group’ day care services, e.g. dementia day centres, which can and do include intimate personal care, such as toileting and bathing, is widespread. These services are being provided by unregistered, unregulated providers and since these providers are coming into direct contact with and serving vulnerable people, the current lack of regulation presents a risk to those individuals and therefore, they should be regulated.
When questioned about this in Committee, the Minister stated that the Welsh Government is committed to bringing advocacy within the regulated service regime under the first tranche of regulations in 2016. He also said there are two others on the shortlist for consideration next – extra care, and then day care services, which he described as being ‘in third place’.
The social care staff currently required to register with the regulator are social workers; managers of regulated services (such as care homes); student social workers and residential child care workers. Again the Bill does not extend the current list but gives the Welsh Ministers the power to make regulations to do so. The Welsh Government does not intend to change the status quo on this at present. The Minister explained in Committee:
The Bill then provides a regulation-making power that will allow a future Minister to add other groups into that process. I don’t intend to do that at this point, because I want Social Care Wales to be able to concentrate on the things that it’s already being asked to do through the Bill, but, just as there are services, extra care, day services and advocacy, which we know are towards the top of the list, then I’m very well aware of the case that has been made, for example, for domiciliary care workers to be registered, for care-home workers in adult settings to be registered, for inspectors to be registered.
When pressed about residential care staff in adult care homes (who are not required to register), and the discrepancy with residential child care workers (who are required to register); the Minister stated that it would be on a short list of priority possibilities. However he said it wouldn’t personally be his top priority as social care workers in residential care settings carry out their duties ‘under the gaze of other people’. The Minister noted that his own top priority group would be domiciliary care workers, because they are completely unsupervised in people’s own homes. He went on to explain why he thinks the discrepancy in registration between adult and child residential care workers exists:
There is, I think, a different distinction to be drawn between children’s homes and adult social care homes, […] the sad history tells us that children’s homes tend to attract people to work there whose conduct in the discharge of their duties isn’t what we would like it to be. So, you know, there’s a vulnerable group of people, and it can attract people who trade on that vulnerability. There’s no real evidence that the adult care home sector attracts people who have abuse as part of their purpose in being there. It may attract people who are not good enough at the job and who are careless in the way that they go about things, but it isn’t abuse in the sense that we’ve come to recognise it in children’s homes.
The discussion and debate on the Bill will continue. The Committee’s consultation on the Bill is still currently open; the deadline for written evidence is 24 April 2015. Oral evidence sessions will continue over the next few months. You can find further information on the Bill webpage.