Issue 7: Nov 2013

WHO'S CARING FOR ...OUR GRANDPARENTS ...CHILDREN ...US?

By Professor Richard Kerley

A working background in the Health Service, membership of a Health Board and councillor with responsibilities for social work and community safety would seem to make the ideal CV for the person who chairs the Care Inspectorate - the body which inspects and regulates various forms of care provision throughout Scotland.

Paul Edie ticks all those boxes. He spoke recently to Scottish Policy Now.

The range of services regulated by the Care Inspectorate is extensive, both public and private services and facilities ranging from childcare through to care for the frail elderly and those with various forms of impairment and disability. The list of categories runs to 19 – quite a range of territory to cover and Paul stresses both how challenging and interesting it is for him and the staff team involved.

“Social care of various kinds is not as easy to regulate as some other very different services, but our teams of staff have clear criteria and they apply them in appropriate ways across the entire spread of services, whether public or private. We aim for consistency on our part so that providers have a very clear idea of where they are doing well, or whether and where they need to improve – and we’re doing that.”

We’re constantly developing and improving our methodologies for inspection, learning from each other and also learning from the sharing of ideas and experience with other regulatory agencies here and elsewhere in the UK.

“We’re constantly developing and improving our methodologies for inspection. Learning from each other and also learning from the sharing of ideas and experience with other regulatory agencies here and elsewhere in the UK.”

He is also ambitious for the Care Inspectorate:

“..we want to be the best at what we do. We’ll benchmark with other countries, learn from them and do what we do better.”

The degree of complexity involved in ensuring the quality and effectiveness of our range of social care services, particularly given the extent to which they overlap with health care provision is also reflected in the concurrent appointments that the Chair of the Care Inspectorate holds on the boards of the Scottish Social Services Council and Healthcare Improvement Scotland.

Paul makes the point that this is a very valuable set of joint memberships which enable him to get a really keen overview:

“I can get an overall picture of how the sector is changing, what staff developments there might be – such as the potential shortage of care workers that in some places is already on us - and the lessons that are flowing out of the improvement work we are seeing in health service facilities. “

He cites the extent to which the transfer out of hospital care into either social care settings or re-entry into the home is critically dependent on the availability of facilities and the staff to work in and run those facilities.

 “…we had seen great progress on ‘bed-blocking‘ and then in several parts of the country providers ran into problems with a shortage of trained staff and transfer places or options were simply not available. We need to understand that and find ways to address such problems – between us we can.”

High on the agenda for the Inspectorate: its board members and its professional leadership, is the manner in which the integration of care and health services is put into practice and how that is appropriately developed. 

“This is potentially one of the biggest changes we have seen in years and it can improve the lives of many people if we get it right so we need to share protocols and practice, be clear about who is doing what and also get our information sharing geared up to ensure privacy for the individual at the same time as the necessary knowledge is shared across professional teams.”

Edie also recognises the implications of a mixed economy of care, where care services of all types and for all ages and categories of service user are provided by councils, health organisations, charities and voluntary organisations on a very similar basis.

“It will continue to be a mixed economy and that’s one of the reasons why councils will stay in (this field). …though I think that this will lead to them up-skilling to deal with more complex needs and also at the same time keeping an awareness of how the field is developing and changing. It’s also clear that nobody goes into this just to make money and there are very good private providers.”

He’s also adamant that the inspection regime will be consistent across all types of providers whether public, private or voluntary.

“In the vast bulk of care services there is good practice but demands and expectations are constantly improving. What is currently very good practice will in 2 or 3 years be the norm for all good services. “

Paul is understandably unwilling to comment on some of the more controversial cases of care neglect reported in the media, which in some instances are still the subject of Care Inspectorate and even Police action.

“We’ll be constructive in inspecting and advising to ensure the raising of standards and the enhancing of practice but if necessary we'll act on poor practice – and we do.”

High on the agenda for the Inspectorate; its board members and professional leadership is the manner in which the integration of care and health services is put into practice and how that is appropriately developed.

He points out that CI staff are often the first point of reference to other organisations – such as the police - and work closely with the police officers who may become involved in some serious cases.

As to future issues, Paul sees potential major problems that could arise with the development of personal care.

“It can be an excellent choice for some people but there are complex aspects. We do not have regulation of personal assistants - incidentally, just as we don’t have regulation of au pairs - and problems can arise in such individual arrangements. Sometimes it can be the employer if those being supported employ people directly and there have been employment tribunal cases brought by personal assistants who have been concerned about their treatment.  Sometimes it can be the personal assistant, because in a one to one working relationship monitoring is not easy. The legal situation is complex and may need to be looked at by Parliament.”

Paul Edie is clearly enjoying the challenge of his several demanding roles and as care needs, expectations and regulation changes constantly that’s just as well.


By Professor Richard Kerley

Issue 7: Nov 2013

Issue 7: Nov 2013

HEALTH, WELL BEING AND AGEING: SCOTLAND 2020

Re-energising the move towards integrated care

Scotland's move to integrated care can learn from elsewhere by focussing on two key differentiators between successful partnerships and those paying lip service to integrated working: Shared outcomes and common language is one, the other is demonstrating mutual investments and mutual benefits.

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