Gwenda Thomas, Deputy Minister for Social Services
In February 2011, the Welsh Government launched Sustainable Social Services for Wales: A Framework for Action, which detailed our ambitious programme to transform the provision of care and support for the citizens of Wales. We have already made significant progress in delivering that vision and the time is now right for us to look at the regulation of the social care sector as part of that change.
A great deal has been achieved in raising standards in the sector over the last decade by regulators in Wales, the Care and Social Services Inspectorate Wales (CSSIW) and Care Council for Wales (CCW), and also by the sector itself. However, the Social Services and Well-being (Wales) Bill, when enacted, will transform the nature of care and support in Wales. We therefore need a new legislative foundation for regulation that reflects this transformed landscape.
In addition over recent years significant concerns have been highlighted in the UK over care provision and the safety of those receiving it by cases such as Southern Cross, Winterbourne View and Mid Staffordshire. It is important that we learn from these, as well as from our experiences here in Wales.
Finally, the development of legislation over recent years has seen growing differences between the models of regulation in Wales and England, which has led to loopholes that need to be addressed in relation to the cross border regulation of social care.
We will therefore publish a White Paper on the future of regulation and inspection of care and support in September this year, followed by a Bill within the lifetime of this Government. This statement lays out the foundations of our policy ahead of that White Paper.
Our policy aims are to continue to provide public assurance and to place outcomes for the citizen at the heart of our regulatory framework.
Our objectives are to:
- Provide citizens with assurance about the delivery of social services and social care in Wales;
- Make a positive difference to the well-being outcomes for people in receipt of social services and social care;
- Strengthen the voice of the citizen in the work of social services and social care and its regulation;
- Develop a legislative framework that will stand the test of time and deliver a regulatory basis for a generation; and
- Reduce the overall burden of regulation proportionate to risk of need and to ensure well being and safety.
In addition we seek to develop:
- a robust and strong regulatory framework that is proportionate to risk
- a transparent, efficient and coherent approach to workforce and service regulation
- approaches that are consistent with wider Welsh Government policy
- approaches that do not require additional funding to deliver.
To deliver these aims and objectives we have set out a number of areas of change:
A focus on well-being
In the Social Services and Well-being (Wales) Bill we have set out a new landscape for care and support in Wales. At the heart of this new approach is the concept of an outcomes based approach to service delivery.
In April 2013, we published our Well-Being Statement, which is the first stage of this work. It describes the important well-being outcomes that users and carers can expect and how we will measure whether these outcomes are being achieved.
We must now shift how we regulate care and support to match this changing landscape. Regulation of care and support must be built around the impact that services have on people, not on a set of minimum standards. Standards will continue to have a role in our sector, but we will place those standards in the context of well-being and outcomes for people.
We want to ensure that providers, commissioners and professionals can demonstrate how they have put outcomes for people at the heart of their work, and if necessary we will legislate to support the regulators to ensure that this is done.
A stronger voice and greater control for citizens
Regulation can play its part in strengthening the citizen’s voice by ensuring meaningful information is available to all.
We have learnt lessons from important events outside Wales. Reports following Winterbourne View and Mid Staffordshire have demonstrated that complaints from users, carers and family members must be listened to and taken seriously. We intend to strengthen the requirements for openness and transparency by service providers, including the publication of annual reports that anonymously details progress against outcomes for users and carers, staff development and records of complaints and actions taken – from staff and citizens. These would be part of the requirement for remaining on any register maintained by CSSIW and would be available to the citizen. We will use registers to provide citizens with a straightforward way to access this information. We want this to be dynamic and meaningful and to provide transparent, up to date and accessible information about social care provision.
We also believe it is important that regulation itself is led by the citizen. The groundbreaking Welsh model of a lay-led Care Council has worked well and we will continue to support this model of governance. We are also minded to extend this model of governance, and to legislate to require CSSIW to ensure citizens are involved in shaping, assessing and even assist in carrying out regulatory activity.
Firm and broad regulation of service delivery
Regulation of services through CSSIW has delivered significant benefits for citizens over the past decade and a half.
However we have seen, in Southern Cross and elsewhere, the risks posed by unexpected failures in the viability of care providers. As I mentioned in my recent Written Statement on provider failure, as an immediate action I am seeking to make amendments to the Social Services and Well-being (Wales) Bill to place a duty upon local authorities in Wales to cater for the immediate care needs of those within its area affected by provider failure. This will mirror similar provisions within the UK Government’s Care Bill in relation to England. The White Paper will introduce further measures to tackle the causes of provider failure. It will move towards a register of organisations, with responsible named individuals, who must demonstrate appropriate fitness, financial robustness and governance in order to be able to operate as employers of suitably trained and/or qualified social care workers or social workers to provide services within our sector. We will expect these organisations to regularly confirm, through reports and evidence, their continued fitness to operate – where this is not done they will not be permitted to operate in the sector.
Under the current legislation a range of traditional services, such as care homes, domiciliary care agencies and children’s homes are regulated; however, increasingly there are service models that fall outside our current regulatory framework. Our policy intent is to ensure that as far as possible all citizens in receipt of care and support can share the assurance provided by a robust regulatory framework. In the area of Direct Payments, for example, we will explore how we can improve the information available to these citizens to employ appropriate care providers through, if necessary, a legislative change. I will also explore how the regulatory regime should respond to any new legislative framework around advocacy services.
The possibility of charging for registration and some regulatory services will be explored through the White Paper and consultation, to assess whether this can further professionalise the relationship between the regulator and the sector.
Regulators in Wales have been developing a more robust framework for taking appropriate enforcement action when required and it is our intention to ensure that the Regulation and Inspection Bill supports them in this aim and ensures that robust enforcement is effective as part of a holistic approach to public assurance, safety and improvement.
A Strong and Professional Delivery Team
We have worked hard to improve the recognition and professionalisation of the social care workforce over the past 14 years. Consistent Welsh Government investment in regulation and training, and the successful work of the Care Council for Wales have supported significant advances.
As we look forward to the next decade we are minded to consider how the Care Council for Wales can evolve its development role towards a College of Social Care and Social Work in Wales in order to meet the workforce development challenges that lie ahead. We believe this could deliver the next step change in the professionalisation of our workforce without placing any new pressures on our limited resources. Its functions could include, for example, overseeing standards and development and learning schemes, acting as an information hub for best evidence-based practice, providing a focus for social services improvement schemes, supporting the development of research capacity and applied research, and assisting policy makers locally and nationally in developing best practice.
Our approach to workforce regulation will continue to be founded on the current qualification-based professional register. The register will allow the incorporation of individuals with varying routes into the profession from inside and outside Wales.
Whilst we are not persuaded at this point in time to require all social care sector workers to be registered in order to deliver services, we will legislate so that we can bring in new groups within the workforce as this may be necessary in response to the emergence of new service models and workforce roles in the future.
We will remove provision for voluntary registration for the purposes of regulation in social care because we believe that this does not contribute to public assurance and can cause confusion for the public and allow practitioners of a low standard to fall through the net.
Regulation and inspection of social services and social care is currently predominately the function of Welsh Ministers. These functions are delivered through the Welsh Government’s Care and Social Services Inspectorate for Wales (CSSIW) and the Care Council for Wales, a Welsh Government Sponsored Body.
The functions delivered through these arrangements are important and necessary.
The current legislative basis for the delivery and location of these functions is restrictive and does not provide us with flexibility to realign them if required. We will, through our White Paper, seek views on the appropriate delivery and accountability arrangements of regulatory functions in the future, including the role of Ministers, so that that can feed into our medium and longer term policy development. We will use the Bill to provide us with the necessary powers to ensure the appropriate arrangements for the delivery of functions in the long term.
We will use our resources to ensure efficiencies in the delivery of regulatory functions, enabling closer or joint working across agencies.
Close co-operation and joint working between regulatory bodies can deliver real benefits for the Government, providers and citizens. This has been a key lesson of recent reports into failures in social care. In Wales we have already seen significant improvements in the sharing of information and intelligence across CCW and CSSIW over recent times. We want that to continue but at an even greater pace. We see no reason why, with adequate safeguards, agencies cannot work to create a single approach to information and intelligence sharing.
Regulation of Adoption Services
In April 2014, we are launching the National Adoption Service for Wales. We will now be considering the implications for regulation and inspection of local authority adoption agencies under the new regional collaborative delivery model.
We will streamline the current process, to reduce the inspection burden on local authorities and the regulator, whilst maintaining public assurance. We propose to do this by exploring the possibility of inspecting each of the new regional collaboratives, rather than each of the 22 local authority adoption agencies. We do not propose any changes in respect of the regulation and inspection of the voluntary adoption agencies.
Legislative Streamlining and Consistency
The Care Standards Act 2000 (CSA 2000) provided a significant impetus for change and modernisation of regulation and inspection in Wales. However, the Act now needs to be replaced, not least because it has been largely superseded in England by other legislation. In respect of Wales the introduction of the Social Services and Well-Being (Wales) Bill also significantly alters the landscape for regulation and inspection.
The CSA 2000 also contains a number of aspects of social care regulation which by their very nature result in bringing cross border (Welsh/English border) issues to the fore. In particular, this includes Domiciliary Care Agencies in Wales that are a “satellite” of an English provider and are not registered by CSSIW but by the Care Quality Commission, who only regulate services in England, meaning that there are currently services operating in Wales that are unregulated by CSSIW.
To solve these ‘cross border issues’, we will introduce new legislation which will seek to re-define the regulatory system for social care, as one which applies solely in relation to Wales and those providing services in Wales in so far as is consistent with the legislative competence of the National Assembly and EU law in relation to the freedom of movement of services.