Respond directly on the coursework template provided, analysing current legislation and statutory guidance that applies to all aspects of your service provision.
You can consider the following:
• The Health and Social Care Act 2008 (Regulated Activities) Regulations 2015 – invokes statutory duty of candour, and requires registered persons to be open and honest with the people who use their service when something goes wrong with their care or treatment.
• Care Quality Commission (Registration) Regulations 2009 – establishes the Care Quality Commission and provides for the registration of persons carrying out a regulated activity.
• The Equality Act 2010 – legally protects people from discrimination in the workplace and in wider society.
• The Human Rights Act 1998 – sets out the fundamental rights and freedoms that everyone in the UK is entitled to.
• The Care Act 2014 – informs the way the adult social care system works in England, including how care is delivered. It includes specific information on the way in which safeguarding measures must be implemented.
• Safeguarding Vulnerable Groups Act 2006 – requires all staff, or anyone who wishes to work or volunteer to help vulnerable groups, to be checked prior to starting work through the Disclosure and Barring Service (DBS).
• The Health and Safety at Work Act 1994 -outlines the duties of employers and workers when it comes to health and safety. Employers are expected to identify and reduce risks. Workers are expected to follow the guidance of the employer.
• GDPR Regulations 2018 (Data Protection Act 2018). You are required here to ensure confidentiality and protect the privacy of your clients and workers. The act gives clients the right to access information written about them. It also gives them the right to request a correction of any information which is not current. Clients have the right to know how their information will be used and stored.
• Mental Capacity Act 2005. This act has five principles. You should always assume clients have capacity to make informed decisions until proved otherwise.
You will need to participate in a recorded discussion evaluating your own role, accountability, and responsibility in applying legislation and statutory guidance within your service provision.
Remembers managers of adult care services have a wide range of responsibilities: duty of care, safeguarding, recruitment and retention, funding, budgeting, meeting quality indicators, to name but a few. For all of these activities, and others, managers also assume accountability.
Where and how can accountability in relation to an organisation’s governance structure vary? For example, the manager may only be accountable directly to one person, or in contrast, they might be accountable to a large committee, several layers of management away.
You will need to participate in a recorded discussion describing the key roles, remits and responsibilities in registered services of the registered manager, the nominated individual and the ‘fit and proper person’.
a) Registered Manager: Registered Managers must be registered by the Care Quality Commission (CQC) and Managers have to be able to demonstrate to CQC their experience and expertise to carry out the role. The Registered Manager must also have the right qualifications and knowledge required for the role. Registered Managers are responsible for all operational, day to day activities. These could range from recruitment to attending care planning meetings. A Registered Manager has the legal responsibility for the service and therefore can be held accountable.
b) Nominated Individual: The regulations require identified regulated service providers to nominate an individual to act as the main point of contact with the Care Quality Commission (CQC). This role has responsibility for supervising the management of the regulated activity, so that person should have the necessary expertise to be able to do so. The person should be an employed director, manager or secretary of the organisation. It is up to the provider who to nominate, but the person must meet these
criteria.
c) ‘fit and proper person’: All providers registered with the Care Quality Commission (CQC) must assure themselves that all directors, or those in equivalent roles, who are responsible and accountable for delivering care are fit to carry out their responsibility for the quality and safety of care.
Respond directly on the coursework template provided, analysing internal governance procedures used within own organisation.
Consider governance mechanisms such as policies, procedures and agreed ways of working. Their application can involve changes to practice, joint working, resourcing, staffing, monitoring, implementing quality indicators or accessing funding.
The impact on managing and leading adult care services can be minor or major. For example, the recruitment of specialist practitioners requires resourcing and commitment from managers and leaders. Therefore, the organisational identity, focus or priorities may have to change; changes may need to be made to key drivers and objectives, the environment and staffing.
Managers may need to upskill and gain an understanding of what exactly is required to drive the service forward to meet the requirements of the organisation.
You will need to participate in a recorded discussion explaining your own role in applying, leading and evaluating own service’s governance procedures and agreed ways of working.
You can consider referring to a wide range of responsibilities: duty of care, safeguarding, recruitment and retention, funding, budgeting, and meeting quality indicators, to name but a few. For all of these activities, and others, managers also assume accountability.
Where and how can accountability in relation to an organisation’s governance structure vary? For example, the manager may only be accountable directly to one person, or in contrast, they might be accountable to a large committee, several layers of management away
Agreed ways of working direct practice in an adult care setting; they guide and inform what practitioners do. In turn governance and accountability involves taking responsibility for decisions relating to practice and vice versa.
All areas are directly linked and have to respond to each other in terms of practice and reporting. For example, managers are responsible for overseeing practice which in turn is linked to accountability for health and safety in the settings they manage, which also informs governance.
Criteria 3.1
Respond directly on the coursework template provided specific legislation and regulations underpinning the inspection system in England.
Consider the CQC and local authorities. Reference to the Care Act 2014, Mental Capacity Act 2005, Accessible Information Standard, Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Make reference to complaints, duty of candour and safeguarding boards.
You will need to participate in a recorded discussion describing the range of legislation and statutory guidance that support and relate to the inspection process in England.
Managers should prepare thoroughly for, and be aware of, the specific requirements of the regulatory process for their service.
However, there may be additional regulatory activities which are carried out, for example the Health and Safety Executive (HSE) may carry out inspection, as does the Food Standards Agency. You can also consider the Environmental Agency and employment legislation. Reference can also be made regarding modern day slavery, minimum wages and other employee rights.
You will need to participate in a recorded discussion explaining the types of service provision which are subject to registration and inspection.
The Care Quality Commission (CQC) monitors, inspects and regulates services:
• provided by hospitals, GPs, dentists, ambulances and mental health services
• for adults in care homes and in people’s own homes, both personal and nursing care
• for people whose rights are restricted under the Mental Health Act
You will need to participate in a recorded discussion describing how services are inspected including the role of the regulator.
Refer to the key lines of enquiry (KLOE’s). Safe, Effective, Caring, Responsive and Well-Led. Make reference to participation of staff, individuals, their families and professionals.
You will need to participate in a recorded discussion explaining the purpose of the inspection system.
Consider discussing how this makes sure that individuals are safe and protected. This also enables regulators to ensure that legislation is being adhered to, prevent or reduce exploitation. Make links to abuse, equal pay, minimum wages, health and safety, data protection and modern day slavery. Inspections also gather the satisfaction levels of people receiving care.
Respond directly on the coursework template provided analysing the different types of inspection and key themes of the inspection process.
When referring to the CQC consider making links to comprehensive and focused inspections. Some links to quality statements will be good.
You will need to participate in a recorded discussion explaining how the ratings system is used?
When referring to the CQC consider the four ratings system (outstanding, good, requires improvement and inadequate).
You will need to participate in a recorded discussion describing when and how enforcement action can be used.
Refer to how the CQC can prosecute you if you put people at harm or do not meet the fundamental standards. You can be prosecuted for delivering regulated services when not permitted. You can be fined for not displaying your rating or submitting certain notifications such as the death of a service user, absence of a manager.
Respond directly on the coursework template provided analysing the ways in which information is collected about the service and used to inform inspection activities.
The CQC will collect evidence from a variety of sources including from whistle blowing, complaints, incidents, feedback from people using your service, local authorities, local Healthwatch and your staff. They also use information passed by your service as a routine on their portal. They can also ask you to directly provide certain information usually within a given timescale. You can also refer to local authorities, environmental agency, health and safety executive and the Information Commissioner here
Respond directly on the coursework template provided evaluating how the requirements of the regulations are met within own service.
Refer to the fundamental standards and how they are being met by your service (person-centered practice, dignity and respect, consent, safeguarding, complaints, staffing, duty of candor, fit and proper staff etc).
You will need to participate in a recorded discussion explaining who needs to be aware of, and involved in, the inspection process.
All inspections will require the input of individuals receiving care, families, members of staff, professionals such as GP’s and social workers and others who can give an opinion about your service.
You will need to participate in a recorded discussion explaining the range and types of evidence which can be used to demonstrate the service is meeting requirements.
Records of care, care plans, feedback forms, complaints, incident reports, audit checks, supervision records, MARS sheets, observation of staff.
You will need to participate in a recorded discussion describing ways to address the outcome and impact of an inspection in own service.
You start with accepting the outcome. There is no progress if you are in denial. Acknowledge areas or good practice and those that require improvement. It will also be key at this stage to also acknowledge your limitations such as lack of experience. You then come up with an action plan to address all areas of improvement. The plan should be based on SMART principles. There must be ways to review and monitor progress.
Respond directly on the coursework template provided analysing how outcomes of inspection can be used to drive service improvements.
You can start by embracing the regulations as a working tool. Regulators such as the CQC should be seen as partners (an opportunity to improve) instead of a threat. You are after all working towards the same thing, improving standards and providing effective caring services. If after receiving a bad report this should be taken as an opportunity to learn and improve. Do not spend unnecessary time in denial. Discuss the findings with your team and try to identify the cause and reason. What changed or could have happened? It is time to reflect and come up with solutions to all identified problems. It could be lack of training, growth of the organisation and lack of resources. A clear action plan based on SMRT objectives will need to be implemented.