Registrations

Time limited conditions expiration (Added 25 September 2020)

We are aware that many of you will have time limited conditions that were applied to your existing registration, to allow you to provide care services in response to the Covid-19 pandemic. Many of these time limited conditions will be due to expire soon. We would like to remind you that if you wish to extend or amend the previous agreement (as detailed in the time limited condition), you are required to submit a variation for assessment.

This can be done through eForms.

If you no longer require the time limited condition, and wish for this to be removed from your registration certificate, please submit a variation for its removal.

Deferment of continuation of Registration Fees (added 8 April 2020)

The Care Inspectorate and Scottish Government recognise the financial and other pressures that providers of care services are currently under.  To support service providers and assist with alleviating cash flow problems service providers are encountering at this difficult time the Care Inspectorate will delay the collection of continuation of registration fees due by care services until July 2020. We will review this position again in June 2020 before any fee collections are made.

This will mean care service providers need not pay any balance of the fees due for the 2019/20 financial year until July 2020.

Service providers normally due to receive fee invoices in April 2020 will not receive an invoice for the 2020/21 financial year until July 2020 (position subject to review in June 2020).

We are happy to make arrangements with service providers that would prefer not to defer the balance of 2019/20 fees.  We are issuing more detailed guidance directly to care service providers.   

• Deferment of continuation of Registration Fees guidance 

Staffing in services during coronavirus outbreak (updated 20 March 2020)

Child to adult ratios feature in our registration and inspection of early learning and childcare (ELC). However, for other service types, including care homes, the Care Inspectorate stopped issuing staffing schedules at the point of registering a service in 2018. Instead, we expect the staffing numbers, and skills and experience of staff to reflect the needs of people who use services. 

At this extremely challenging time, we will support all services in their need to apply flexibility and judgement around staffing to ensure the safety and wellbeing of people using the service. We recognise that services will need to be creative and make use of a wider range of resources. This could potentially include staff from other public services and volunteers. We recognise that this will mean services may not be able to undertake all normal recruitment checks as quickly and easily as they did before. 

However, during this period it is important that providers put in place structures to support and oversee staff in their role, including any volunteers and unregistered staff. The Scottish Social Services Council (SSSC) is responsible for registering the social care workforce. People can work in registrable roles for a period of 12 months without being registered, which enables services to adopt a flexible approach.

This highlights the six-month period after starting work to obtain registration. This applies to:

• new staff you might recruit
• workers covering other roles due to staff shortages
• students who seek work to help with shortages.

Policy position on the use of restrictive practices

Introduction

Everyone in health and social care has a role to play in upholding people’s rights. This includes the right to person centred and trauma informed care and support. Restrictive practice which includes restraint, seclusion, segregation and other less direct practices may form part of a person’s plan of care or support. This includes all people from infants and children, through to young people, adults, and older people. This policy states our position on the use of restrictive practice in all services, to ensure this being the ‘last resort’ and where the risks and benefits to the person have been considered within a legal, ethical and practical framework. This statement should be read in conjunction with the guidance for specific services.

Definition

Restrictive practice is defined as making someone do something they do not want to do or stopping them from doing something they do want to do, by restricting or restraining them, or depriving them of their liberty.¹

Restrictive practices relate to different types of restraint. This can be physical, mechanical, chemical, cultural, environmental or psychological restraint, surveillance or blanket rules.

Policy position statement

The Care Inspectorate is committed to upholding and promoting human rights and the rights of the child. These rights may only be restricted as a last resort, including in the use of restraint. The use of restrictive practices, including physical restraint, must be considered within a context of the conflict in the promotion of rights, independence and choice for children and adults, versus promoting and maintaining our duty of care.² In law³, the use of force in any form is required to be justifiable, reasonable and proportionate. Practitioners may be required to take protective action to keep children and adults safe from harm that may affect rights, including choice, dignity and freedom. However, this must be delivered within a context of positive risk taking and compassionate care.

Legislation and standards

Whilst there is no specific piece of legislation that focusses on restraint, the Care Inspectorate is guided by the following legislation and standards.

The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011, which specifies:

• under welfare of users that “A provider must ensure that no service user is subject to restraint, unless it is the only practicable means of securing the welfare and safety of that or any other service user and there are exceptional circumstances” (4(1)(c)).
• under fitness of premises that “Accommodation must not be provided and used for the purpose of restricting the liberty of children in any residential premises where care services are provided unless such provision and use have been approved by the Scottish Ministers” (10 (3)).

The Health and Social Care Standards, which set out that:

• “If my independence, control and choice are restricted, this complies with relevant legislation and any restrictions are justified, kept to a minimum and carried out sensitively” (1.3).
• “My care and support meets my needs and is right for me” (1.19).
• “Any treatment or intervention that I experience is safe and effective” (1.24).
• “I experience warmth, kindness and compassion in how I am supported and cared for, including physical comfort when appropriate for me and the person supporting and caring for me” (3.9).
• “I am protected from harm, neglect, abuse, bullying and exploitation by people who have a clear understanding of their responsibilities” (3.20).
• “I experience care and support free from isolation because the location and type of premises enable me to be an active member of the local community if this is appropriate” (5.9).
• “If I experience 24 hour care, I am connected, including access to a telephone, radio, TV and the internet” (5.10).
• “I can independently access the parts of the premises I use and the environment has been designed to promote this” (5.11).
• “If I live in a care home, I can control the lighting, ventilation, heating and security of my bedroom” (5.12).

1.  CQC 2023
2. Civil law
3. Common law

More information

Background

Phase 1 of our programme of joint inspections of adult support and protection services has now concluded, having taken place during 2020-23. The purpose of Phase 1 of the programme was to provide baseline information across the 26 adult protection partnerships not previously inspected in 2017/18. The intention was to follow this programme of inspections with a second phase of scrutiny and/or improvement activity, informed fully by Phase 1 findings.

We are now undertaking further scrutiny across Scotland, at the request of Scottish Ministers and in line with the Scottish Government-led improvement plan.

Phase 2 commenced on 1 August 2023 and will last two years. This phase of the programme will blend scrutiny activity with improvement support and include close collaboration with adult protection partnerships.

Scrutiny approach

Phase 2, first year

The programme provides assurance on the ongoing protection and risk management for adults at risk of harm. The first year of Phase 2 will include revisiting the six adult protection partnerships that were subject to adult support and protection inspections in 2017/18. We will use the inspection methodology we employed in Phase 1. These inspections will focus on key processes and leadership (see our quality indicator framework).

The first year of Phase 2 will also involve further development of the adult support and protection quality improvement framework by inspection partners, with input from stakeholders across the sector.

Phase 2, second year

Activity in the second year of Phase 2 will provide assurance of improvement and will include those partnerships that received inspection reports during Phase 1 where areas of weakness outweighed strengths. Some additional partnerships may also be revisited to provide assurance of improvement.

Additionally in this second year, indicators related to early identification of risk, early intervention and a trauma-informed approach will be applied on a voluntary basis with a select group of partnerships, which will augment their planned self-evaluation processes.

Scrutiny partners

The inspection programme will be led by Care Inspectorate in collaboration with His Majesties’ Inspectorate of Constabulary Scotland (HMICS) and Healthcare improvement Scotland (HIS).  Each scrutiny agency has identified dedicated staff with appropriate levels of experience and expertise in adult support and protection. This scrutiny and assurance will be undertaken in the context of health and social care integration.

Phase 2 inspection focus

The focus of our joint inspection will be on: 

• independent scrutiny and assurance of how partnerships ensure that adults at risk of harm are kept safe, protected, and supported  
• providing assurance to Scottish Ministers about how effectively partnerships have implemented the Adult Support and Protection (Scotland) Act 2007
• taking the opportunity to identify good practice and support improvement more broadly across Scotland
• providing a quality assurance framework for the adult support and protection community to use for multi-agency audit, self-evaluation and improvement activity.

Purpose of activity

The purpose of this programme of joint inspections is to seek assurance that adults at risk of harm in Scotland are supported and protected by existing national and local adult support and protection arrangements. The programme is one element of the Scottish Government-led improvement plan.

The partnership briefing document relating to phase two, first year inspections was prepared by the inspection team to give you an overview of the joint inspection programme and is available on our website. The documents below are referenced within the partnership briefing document.

• Definition of adult protection partnerships
• The public services reform (joint inspections) Scotland regulations 2011
  
• ASP Quality Indicator Framework
• Case File Sample Guidance
• Pre inspection return FAQs
  
• Position Statement template
• Supporting Evidence List
• Local authority notification letter

The joint inspection team has made a number of other documents available to support partnerships. Each partnership will receive the relevant documents at the appropriate time.

• ASP overview for staff
• Staff Briefing Focus Groups
• Guidance for remote access to files
• Key processes and timescales
• Pre inspection return March 2021 (.xlsx)
• Phase 1 main sample file reading guidance
  
• Phase 1 main sample file reading tool

Our inspections take account of the adult support and protection code of practice. For us to understand the degree to which partnerships were progressing with implementation we issued a single question survey. The survey was shared with Chief Social Work Officers, adult protection committee conveners and lead officers. The question was 'Please briefly describe your partnership’s approach to key processes, including the role of the Council Officer, around inquiries/investigations in light of the revised Code of Practice'. Please find our summary findings from that survey.

A communication and engagement strategy is available in relation to our Phase 2, first year quality improvement framework (QIF). The QIF is being designed in collaboration with the National Implementation Group and other stakeholders. Key elements of this will be used to inform our supported self-evaluation activity in Phase 2, second year.

We are at the very early stages of developing Phase 2, second year methodologies and will aim to include any relevant updates and material here when it is appropriate to do so.

Please email any enquiries to the joint inspection team at This email address is being protected from spambots. You need JavaScript enabled to view it.

Our quality assurance role

Our quality assurance role

The strategic inspection team supports learning and improvement in social work services and partnerships by providing an additional level of scrutiny to reviews which they carry out. The review processes which we quality assure are:

You can find more information in the links below:

• Deaths of Looked After Children 
  
• Deaths of young people receiving aftercare provision
  
• Deaths of young people in continuing care  
• Learning reviews (children and young people)  
• Initial Case Reviews (ICRS) & Significant Case Reviews (SCRS) – Adults  
• Serious Incident Reviews