Involving people in regulation and inspection of care leads to safer and better services
says Imelda Richardson, Chief Inspector of Care and Social Services Inspectorate Wales (CSSIW).
Launching the annual report for 2012-13 during first meeting of CSSIW’s new National Advisory Board, she said that working in partnership with the public is crucial to improving care.
The Chief Inspector said:
The findings from the reviews of Mid Staffordshire NHS Trust and Winterbourne View have reinforced the importance of regulation and inspection in ensuring that our most vulnerable people are safe and receive high quality services.
Seeing services ‘first-hand’ remains at the core of our work and during the year we delivered our inspection programme by visiting 3990 settings to inspect the services being provided. This included at least one unannounced inspection of every care home for older people in Wales.
We have got tougher about tackling poor services. We cannot be in every home, nursery or service every day so people who use services, families, carers – are our eyes and ears on the ground and our allies in driving out poor care.
We can’t investigate complaints about the care individuals are receiving, but we can advise them where to go. When we investigate concerns we look at how it is meeting the needs of all the people using the service, to assess whether there are wider problems.
CSSIW have prioritised the importance of responding to concerns about services as they can act as an effective early warning system for emerging problems. As a result there has been an increase in people reporting concerns, some which have resulted in inspections, especially if the information suggested that people using a service were at risk of harm.
The most common causes for concern were neglect of service users, protection and physical abuse of service users, concerns about the behaviour and attitude of management, concerns about the competency and training of staff.
In 2013 CSSIW published its Participation Plan outlining how it would involve people in its work and the annual report documents progress in implementing the plan.
CSSIW has established a National Advisory Board bringing together people who have experienced services, people providing services, people who commission services and a range of voluntary and advocacy organisations in advising and directing its work.
CSSIW also worked with two voluntary organisations to pilot an ‘independent visitor’ scheme in homes for older people and people who use learning disabilities in west Wales. People were recruited and supported by Age Cymru and the All Wales Forum to go into homes to talk and listen to people using services, carers, staff and managers, independently of CSSIW inspectors. A similar pilot in children’s homes will take place in 2014, after which CSSIW will look to develop a sustainable scheme to roll-out nationally.
During the year CSSIW:
- Registered 470 new services, including 221 child minders;
- Undertook 3990 inspections and wrote a report on each service - all reports are publically available;
- Took enforcement action against 43 services it classed as a service of concern;
- 12 local authority local authority reports were published as well as an annual performance report for each of Wales’ 22 local authorities;
- Undertook three national reviews including a review of looked after children and the role of the Director of Social Services;
- Undertook two joint reviews with other regulators and inspectorates, including a joint review with Estyn into safeguarding arrangements for children in Pembrokeshire.
Other finding from the Annual Report for 2012-13, which also includes a commentary on the performance of local authority social service departments were:
- Planning budget pressures were evident across all local authorities; while many were restructuring to achieve more efficient service delivery, the capacity to deliver change at pace was variable and presented a significant challenge to some authorities;
- A greater focus on early intervention and preventative services for adults and children’s services was apparent;
- Partnership working was taking place at an operational level rather than strategic level and, as a result was not likely to produce the step changes needed for sustainability;
- There has been an upward trend in the number of looked after children in recent years and this continued in some authorities which already had a high number of children in care;
- There were a high number of changes in directors of social services.