Jersey Care Commission Annual Report 2020

2020

Providing independent assurance, promoting best practice and improving health and social care outcomes for the people of Jersey.

CONTENTS

OUR YEAR AT A GLANCE  2 INTRODUCTION  4 FOREWORD  5 PERFORMANCE SUMMARY  7 FINANCIAL PERFORMANCE AND ACCOUNTS  9 ORGANISATIONAL STRUCTURE  12 PERFORMANCE ANALYSIS  13 REGULATION AND INSPECTION  14 PROFESSIONAL REGISTRATION  23 PUBLIC ENGAGEMENT  26 INFORMATION GOVERNANCE  28 LEADERSHIP AND DELIVERY  30 PLANNING  31 KEY PERFORMANCE INDICATORS (KPI S)  32 PRIORITIES IN 2021  36

APPENDIX A: THE JERSEY CARE COMMISSION

REGISTER OF BOARD MEMBERS INTERESTS 2020  38 APPENDIX B: THE BOARD OF COMMISSIONERS  39

APPENDIX C: PROFESSIONS WHICH ARE  

REGISTERED BY THE COMMISSION  40

OUR YEAR 2020

at a glance 2020

OUR ROLE ACHIEVEMENTS

The Commission was appointed to:

provide the people of  

Jersey with independent  

assurance about the  

quality, safety and  

effectiveness of their  

health and social care  

services

Recruited four new members of staff to the Team and appointed three new Commissioners who will  commence their terms of  

promote and support best  

practice in the delivery of  office in 2021. health and social care by  

setting high standards and  

challenging poor  

performance

engage with service users  

and their families and carers  

to improve their experience  Developed and implemented  of health and social care and  a process of quality  achieve better outcomes assurance monitoring  

following inspections, with  further quality assurance  visits to be undertaken in  2021.

facilitate the registration of a range of health and social care professionals in order that they may lawfully practise in Jersey  

Successfully revised the  

Code of Practice for  

Piercing and Tattooing,  

which has been published  

on the Commission's  

website.

undertake regulatory  Published 61  functions prescribed by the  inspection  Regulation of Care (Jersey)  reports.

Law 2014 and other laws

2020 2020

2020

Carried out inspections Implemented Standards  of seven children's across all regulated activities  care homes and

registered an additional and ensurinvolved the assessment of ed that inspections  service towards the end

performance against these  of 2020. Standards.

Granted applications for registration for 338 health  care staff (representing an  

increase of approximately  50% compared  

with 2019).

Prioritised the registration of health care professionals,

Ensured that each regulated  many of whom needed to

activity has a designated  become registered in response Regulation Officer to ensure  to the establishment of

consistency and a point of  Jersey's Nightingale ward contact and implemented an  and the Covid-19 vaccination

inspection scheduling tool to  programme.

better enable the prioritising of

inspection work.

Provided Continuity throughout the height of

the Covid-19 pandemic by temporarily operating a 7-day service, and continuing to operate a Duty System, providing guidance, reassurance and advice across the sector.

Continued to ensure the health and social care workforce in

Added the facility to our

Jersey is appropriately website to make

qualified, registered and fit complaints directly,

to practise. Developed the although other methods

renewals process in order that the including letters, telephone

Commission can more effectively calls and emails

establish fitness

also exist.

to practise.

INTRODUCTION

The Jersey Care Commission, (the Commission), was established on 1st January 2019 in accordance with the enactment of the Regulation of Care (Jersey) Law 2014 (the 2014 Law), and the Regulation of Care (Transfer of Functions) (Jersey) Regulations 2018.*

The Commission was appointed to:

provide the people of Jersey with independent  assurance about the quality, safety and effectiveness  of their health and social care services

promote and support best practice in the delivery of  health and social care by setting high standards and  challenging poor performance

engage with service users and their families and  carers to improve their experience of health and  social care and achieve better outcomes.

Facilitate the registration of a range of health and  social care professionals in order that they may  lawfully practise in Jersey

undertake regulatory functions prescribed by the  Regulation of Care (Jersey) Law 2014 and other  laws; the regulatory responsibilities having been  transferred from the Minister for Health and Social  Services to the Commission on 1st January 2019.

This is the Commission s second annual report  and describes our performance against the  strategic and operational objectives set out in our  2020 Business Plan. The outbreak of Covid-19  in Jersey disrupted our operations significantly.  Despite this, the Commission successfully  achieved many of its strategic and business  objectives as documented in this report.

This report, whilst setting out the achievements,  also describes the impact of the challenges  associated with Covid-19 and notes where further  progress is needed in 2021.  

* See also: Regulation of Care (Standards and Requirements) (Jersey) Regulations 2018 and the Regulation of Care (Regulated Activities) (Jersey) Regulations 2018.

FOREWORD

The year 2020 will always be remembered for the impact of Covid-19.

The pandemic has touched people s lives in so many ways, including work, travel, family contacts and in social and leisure activities. Sadly, it has had a very real impact for the many who have lost a friend or family member to Covid.

During the first lockdown, following the instruction

to stay at home, all scheduled inspections were postponed. Regulation officers recognised and responded appropriately to the very significant impact of the pandemic for managers and staff working

in regulated activities and for people using these services. The Team provided a much needed advisory role, providing information to the public and to those working in regulated activities on issues such as access to PPE, testing for Covid, staff absences, the requirements to self-isolate and visiting arrangements.

In June 2020, the programme of inspections was reinstated, albeit with necessary modifications.

Despite the complex challenges for the care sector arising from the pandemic, the inspection findings were overwhelmingly positive, with regulated activities being consistently able to demonstrate high standards of care. In a small number of regulated activities,

some areas for improvement were identified and

most have been resolved swiftly and informally.

The majority of services inspected during 2020 were able to demonstrate compliance with the Regulations and Standards, despite the added challenges of dealing with Covid.

Commissioners were unable to visit the island to

the same extent as previously. There were fewer opportunities to meet with service providers and with people who use services. We intend to remedy this

in 2021. The Commission has adapted successfully to remote working, using the internet to host Board meetings. Whilst this is less than optimal, I can report that all scheduled meetings took place, either in Jersey or as virtual meetings.

The Commission provided advice to the Government of Jersey on the drafting of the Emergency Covid-19 Regulations. This advice was applied appropriately,

not only in the drafting stages but in the subsequent review of these Regulations.

In January 2020 Charlie Parker, the former Chief Executive of the States of Jersey, along with Mark Rogers and Mark Owers, attended the Board

to discuss regulation and inspection in respect

of Children s Services. During the year, despite Covid, we completed scheduled inspections of all registered children s homes in Jersey.

Several care services operated directly by the Government of Jersey, had not completed applications for registration in 2019, having been established before the Regulation of Care (Jersey) Law 2014 was fully enacted. They had continued to operate outside the regulatory framework in 2020, potentially placing staff and care receivers at risk. This non-compliance was escalated to Ministerial level and by December, most of these services had submitted completed applications or had been granted registration.

In November 2020, I met with Deputy John Young, the Minister with responsibility for regulation of care, to provide an overview of the Commission s work and its response to the Covid pandemic.

The Minister expressed his support for the Commission s work during the pandemic.

The Commission is grateful to staff in Strategic Policy, Planning and Performance (SPPP), and in Treasury for their help and support in shaping the Commission s relationships with the Government of Jersey. In May 2020, after much deliberation, we concluded a new Framework Agreement describing the independence of the Commission and its relationship with the Government of Jersey.

The profile of the Commission changed in 2020. We bade farewell to Ann Abraham, one of the first cohort of Commissioners. Ann brought a breadth of experience, both as Parliamentary and Health Services Ombudsman and as Chair of Dorset Healthcare University NHS Foundation Trust. Ann provided expert advice on the development of

the Framework Agreement, the Commission s Constitution and Governance Framework and on key policies and procedures.

I am pleased that Alison Allam, Lisa Jacobs and Si n Walker McAllister, appointed in 2017, remain with the Commission. In November we recruited three new Commissioners, Jackie Hall , Noreen Kent and Angela Parry, all with recent relevant experience of oversight of health and social care systems.

In 2020 we said farewell to two members of

staff, Sally Hazley and Geoff Gurney. Sally had transferred to the Commission from the former Professional and Care Regulation Team. Geoff Gurney, Regulation Officer, took a lead role in the regulation and inspection of children s services.

We welcomed three new staff members: Lesley Callander and Alli Tandy as Regulation Officers, and Francesca Bihet as an Administrator.

In preparing this, our second Annual Report,

the Commission has referred to the findings of

the Comptroller and Auditor General in Annual Reporting, A Good Practice Guide - August 2020 .* The report describes our achievements, the impact of the challenges associated with Covid-19 and areas where further progress is needed in 2021.

Glenn Houston

Chair of the Jersey Care Commission

* Office of the Comptroller and Auditor General. Annual Reporting, A Good Practice Guide August 2020. Jersey Audit Office. Available at: https://www.jerseyauditoffice.je/wp-content/uploads/2020/08/CAG-Good-Practice-Guide-to-Annual-Reporting.pdf

PERFORMANCE SUMMARY

The Commission s second year of operation has focussed on the consolidation of its role and function, the publishing of inspection reports, efforts to source feedback relating to the quality and benefit of the inspection process and the development of the team. All of this has been set against the backdrop of the Covid-19 pandemic which had the effect of significantly interrupting and slowing progress in respect of each of these activities.

Inspections

Despite the unprecedented challenges, the Commission has continued to undertake inspections of regulated activities, albeit with an adapted methodology. The reports of every completed inspection have been uploaded onto the Commission s website.

Where areas for improvement have been identified by the Commission, these have been addressed by service providers, using a staged and collaborative approach, with the aim of driving improvement.

Governance

The Commission has produced and finalised a suite of policies to inform its governance framework. These include policies relating to inspection, escalation and enforcement, and complaints.

Travel restrictions required the Commission to hold Board meetings remotely for much of 2020. Despite this, the Board has continued to operate successfully, providing strategic oversight of the Commission s activities, setting strategic objectives and in holding services to account where there has been a need to take action to effect change.

Registration

The Commission is responsible for the registration of health and care professionals, medical professionals, piercing and tattooing premises and premises where certain classes of lasers are used. The Regulation of Care (Transfer of Functions) Jersey Regulations 2018 placed a duty on the Commission to ensure that a range of legislation relating to the registration of these individuals and premises is implemented.

Legislation

A significant piece of work relates to the degree

to which the Commission cooperated with the Government of Jersey in the development and the implementation of the amended Regulations relating to the Regulation of Care (Jersey) Law (the Regulation of Care Standards and Requirements) (Jersey) Regulations 2020).

The emergency legislation introduced at the height

of the pandemic was, for the most part, not relied

upon. However, in April 2020, three care homes had to implement the temporary measures set out in the amended Regulations, having declared that, due to Covid-19, they were unable to carry on their service

in accordance with their Statements of Purpose, due to staffing challenges. This resulted in a condition of their registration being suspended until 30 September 2020. Commission staff ensured that these measures remained under close scrutiny and liaised regularly with the care home managers.

In accordance with the Regulation of Care (Standards and Requirements) (Jersey) Regulations 2020, the Commission reported to the Minister two situations in which there were concerns relating to serious risks to care receivers on account of staffing shortages and proposed recommendations. Ultimately, staffing levels were restored to normal levels and a crisis averted.

The Commission provided advice to the Government of Jersey in relation to both the Regulation of Care (Amendment of Law) (Covid-19 Temporary Amendment No. 2) (Jersey) Regulations 2020 and the Medical Practitioners (Registration) (General Provisions) (Covid-19 Temporary Amendments) (Jersey) Order 2020.

The Covid-19 (Capacity and Self-Determination) (Jersey) Regulations 2020 came into force on 14 May 2020.

The Commission identified several areas of concern relating to the rights of care receivers and the role of care home managers, were these Regulations to become enacted. Consequently, the Commission prepared

a paper outlining its position, which was submitted to the Minister for Health and Community Services, the Chair of the Health and Social Security Panel and to the Children s Commissioner for Jersey. This document was published on the Commission s website.

In compliance with Regulation 32A of the Regulation of Care (Standards and Requirements) (Covid-19 Temporary Amendments) (Jersey) Regulations 2020, the Chief Inspector notified the Chief Minister of the Commission s intention to postpone its inspection schedule and provided an assurance that any inspections which had to be postponed would be

undertaken within two years of the due date. Although inspection activity was suspended for a 12-week period, the recommencement of inspections in June 2020 led to most scheduled inspections having been completed prior to the end of the calendar year.

Consultation

The Commission contributed to consultation requests which have included, Brexit Preparations and Business Readiness in Jersey; the Care Needs at Home project; the potential introduction of an Inquiries Law for Jersey, the existing redress and accountability systems in

Jersey and the Jersey Care Model. The Commission will continue to be responsive to all relevant requests and

is committed to working collaboratively with external agencies where there is mutual interest. There is increasing evidence that the Commission s perspective is being routinely sought and valued by both law drafters and policy makers.

I contacted the Jersey Care Commission. From my very first e-mail, I received a prompt response, reassurance and indeed a follow up phone call om a Regulation Officer, which gave me confidence that I was indeed, in the right hands for my situation to be viewed holistically.

I have no hesitation in recommending the services of the Jersey Care Commission to the people of Jersey.

A care receiver s relative

FINANCIAL PERFORMANCE AND ACCOUNTS

This section includes information on income and expenditure, details of remuneration (including any non-cash remuneration) and interests of Board members.

Under the provisions of the Regulation of Care (Jersey) Law 2014 the Commission is required to: -

1. keep proper accounts and proper records in relation to the accounts; and
2. prepare accounts in respect of each financial year and a report on its operations during the year.

Income forecasts and the expenditure budget are agreed at the beginning of each financial year with the Accountable Officer. The Commission determines areas of expenditure in accordance with its annual priorities and commitments as described in its Annual Business Plan.

The Commission cannot commit to any new expenditure unless it can be met from within available funds, or from an additional recurring or non-recurring allocation approved by the Government of Jersey.

The Government of Jersey provides a financial management service to the Commission, including in relation to its core budget and fee income (Commission funds).

Income Sources

Income is received from two sources. Fees are derived from healthcare professionals, regulated activities, individuals, and premises. The Commission also receives a direct allocation which is provided from the Government of Jersey and specified within the core budget.

The Regulation of Care (Jersey) Law 2014 was agreed by the States Assembly on the understanding that

the former Inspection Team s budget would be grant funded to the Care Commission and that this would represent approximately 45% of the total cost of administering the Law. These monies, the core budget, were transferred to a dedicated Care Commission

business unit for financial accounting purposes.

In addition, the Commission received income from fees prescribed by the Chief Minister at the point at which the 2014 Law came into force.

These fees include: -

Making an initial application for registration as a provider or a manager (Article 4)

An annual fee for continued registration (Article 9)

Applying for a variation on conditions of registration (Article 17)

Replacement of registration certificates (Article 8)

Provision of printed copies of Commission reports (Article 38)

The division responsible for the provision and oversight of adequate financial and other resources required to support the function of the Commission

is the Department for Strategic Policy, Planning and Performance (SPPP), within the Government of Jersey.

The Accountable Officer for the appropriate use of public funds, including the funding for the Commission, is appointed in accordance with the Public Finances (Jersey) Law 2019, and is the Director General for SPPP. It is the responsibility of the Accountable Officer to ensure the Commission represents value for money.

Where the Accountable Officer has concerns relating to fee income, the Accountable Officer will inform the Chair and Chief Inspector and may report

those concerns to the Treasury and Exchequer; the Comptroller and Auditor General. No such concerns arose or were reported in 2020.

The Accountable Officer delegates the management

of funds to the Chief Inspector in accordance with

the Department s Scheme of Delegation and the Government of Jersey s Financial Directions. The Board of the Commission supports the Chief Inspector with scrutiny and oversight of financial performance.

The SPPP Department provides a HR framework for supporting staff appointed by the Commission and works with the Treasury Department to ensure the provision of a core budget to the Commission, post staff to the Commission and to provide financial management and other agreed services to the Commission.

The staff working for the Commission are employed by the States of Jersey Employment Board (SEB). The terms and conditions of employment of Commission staff are the standard SEB terms and conditions, and staff are remunerated accordingly. The Commission appoints and manages its staff in accordance with the relevant SEB policies and procedures.

The main components of expenditure consist of pay, including staff salaries and pension contributions, and non-pay, including goods and services.

Essential support services including provision of office accommodation, information technology, human resources, payroll and legal services are provided directly to the Commission by the Government of Jersey at no direct cost. This represents part of the Government of Jersey s contribution to the overall operation of the Commission.

The Commission is required to complete an Annual Financial Assurance Statement.

The Commission s accounts for 2020 are audited as part of the whole of Government accounts and published in the Government of Jersey Annual Report and Accounts for 2020.

TABLE 1

Income and Expenditure

Jersey Care Commission - Statement of

Comprehensive Net Expenditure for the

year ended 31 December 2020 2020 Budget  2020 Actual Budget 2019 Actual  

£ £ £

INCOME

Fee Income - regulated activities  (330,000) (303,937) (206,230) Fee Income - other (39,000) (34,495) (31,060)

(369,000) (338,432) (237,290)

EXPENDITURE

Staff Expenditure 598,759 574,894 472,541 Supplies & Services 108,000 74,308 112,062 Administrative Expenditure 5,000 3,796 7,200 Premises & Maintenance 1,000 2,796 1,139

712,759 655,794 592,942

Net Expenditure -

343,759 317,362 355,652 Funding recived from Goverment of Jersey

NOTES TO TABLE 1.

1.0 The Commission s total fees budget was £369,000

2.0 The Commission s full year actual net expenditure was £317,362

3.0 Overall net expenditure variance was a budget underspend of £26,397

4.0 The accounts of the Commission must be audited by auditors appointed in respect of each financial year by the Minister for Treasury and Resources and qualified for appointment as auditors by virtue of Article 113 of the Companies (Jersey) Law 1991. The Care Commission accounts will be audited as part of the overall Government of Jersey audit.

TABLE 2

Remuneration of Chair and Non Executive Board Members:

Benefits in  

Restated salary Date  Salary (bands of  Kind (travel,  

Name 2020 Total  

Appointed £5,000) £000 accommodation

(Salary + Benefits) and subsistence)

Glenn Houston

01 May 2017 >£15,000 <£20,000 <£5,000 >£15,000 <£20,000 Chair

Ann Abraham  

10 May 2017 <£5,000 <£5,000 <£5,000 Commissioner

Alison Allam  

10 May 2017 <£5,000 <£5,000 <£5,000 Commissioner

Lisa Jacobs  

01 July 2017 <£5,000 <£5,000 <£5,000 Commissioner

Si n Walker -McAllister

10 May 2017 <£5,000 <£5,000 <£5,000 Commissioner

NOTES TO TABLE 2.

1.0  Fees are stated in bands of £5,000 for the period from 01 January - 31 December 2020

2.0 Four of the five Commissioners live outside Jersey and incur additional costs in respect of travel, accommodation, and subsistence.

3.0 Commissioners were appointed for an initial term of 3 years.

4.0 Expenses are rounded to the nearest £100

5.0 Travel restrictions necessitated that Board meetings in May, July, September, and November 2020 were held virtually (or with limited travel to Jersey). This had the effect of travel and accommodation expenses being less than might otherwise have been the case.

ORGANISATIONAL  STRUCTURE

The Commission has both a strategic and an operational structure. Its work is overseen by a Board of Commissioners who have a range of professional and carer/service user experience.

In 2020, each of the existing Commissioners initial three year terms came to an end. Four Commissioners, including the Chair, were appointed by the Chief Minister to serve for a second three year term. Towards the end of 2020, three additional Commissioners were recruited, and their appointments were ratified by the Minister for the Environment (Please refer to Appendix B).

Left to right: Alison Allam, Ann Abraham, Glenn Houston (Chair), Si n Walker -McAllister, Lisa Jacobs

The operational aspects of the Commission s function are undertaken by a team, which in 2020 consisted of: (Left to Right) Stephanie Kuryszezak, Lesley Callander, Linzi Mudge,

Bradley Chambers, Alli Tandy, Mandy Bates, Geoff Gurney, Audrey Murphy.

Audrey Murphy   Dave Luscombe  Lesley Callander  An additional Regulation Officer Chief Inspector Regulation Officer Regulation Officer  was employed in late 2020 and will Bradley Chambers Linzi Mudge  Alli Tandy  commence employment in 2021.

Head of Governance,  Regulation Officer Regulation Officer  Mandy Bates Policy and Standards Geoff Gurney   Executive Officer

Regulation Officer Sally Hazley  

Administrator

PERFORMANCE ANALYSIS

The Commission s strategic focus is to develop a comprehensive and effective regulatory infrastructure that protects and promotes the rights of people who use the services it regulates.

The Commission had six key priorities throughout the course of 2020. These were to:

1. Ensure that the services we regulate are safe, well led and of high quality, by developing and delivering an effective system of regulation and inspection of health and social care services in Jersey.
2. Maintain a register of relevant health and social care professionals working in Jersey
3. Raise the profile of the Commission by involving people who use and provide care services by consulting and engaging with service users, carers, providers and other stakeholders in all aspects of our work and by developing and implementing the Commission s communication strategy.
4. Raise the profile of the Commission by involving people who use and provide care services by consulting

and engaging with service users, carers, providers and other stakeholders in all aspects of our work and by developing and implementing the Commission s communication strategy.

5. Improve the Commission s capacity to gather, interpret and respond to information and intelligence regarding regulated activity and registered professionals (including concerns, complaints and compliments), and using this data to inform regulatory activity.
6. Develop both a three-year financial plan setting out how the Commission will utilise income received from fees/ other sources and a three-year strategic plan setting out how the Commission will deliver its core functions and will extend regulatory reach to those aspects of health and social care which fall within scope.

Regulation and Inspection  Public Engagement  Leadership and Delivery

Professional Registration  Information Governance  Planning

The next section of the report will provide a detailed analysis of performance in respect of each of these priorities.

REGULATION  

& INSPECTION

Establish a strong team of skilled  and experienced regulation  officers and support staff who  will deliver an effective regulatory  regime for Jersey which supports  best practice and drives  continuous improvement. As part  of this ambition, the Commission  will develop individual areas of  interest and expertise within the  team, allocating specific project  work to staff members who are  best placed to lead in these  

areas.

How successful has this been so far? What more needs to happen?

Despite a particularly challenging year, the team has  The Commission has been advised of the

largely stayed intact. At the height of the pandemic,  Government s intention to extend regulation to include one staff member was temporarily seconded to  additional aspects of children s services, for example support a Government of Jersey service. Another staff  social work, child protection, adoption, fostering member had a fixed term contract which came to its  and CAMHS, which will require team expansion over natural end.  the course of the coming years. The Commission is The Commission successfully recruited two new staff  seeking to recruit an additional Regulation Officer early members in the first quarter of 2020. A further staff  in 2021 with a background in children s services, to member was recruited in the final quarter of 2020 and  undertake regulatory activity in this area of planned commenced work in January 2021.  development.

The Commission s administrative function has been  A budget build has been drafted and a plan is in place boosted by the appointment of a full-time administrator  to recruit a Programme Manager, additional Regulation following the retirement of a long-serving staff member  Officers and additional administrative support to ensure in 2020. the Commission is appropriately resourced to meet the

demands of this expansion of its regulatory scope. Despite the varied difficulties associated with the

pandemic, the Commission has undertaken its role  The development of individual areas of interest and effectively and has retained its focus on continual  expertise and the allocation of programme work has of improvement across the health and care sector  necessity, been curtailed due to other demands and and the identification and upholding of best practice.  constraints. It is intended that this be revisited in 2021.

Undertake a training/ learning needs analysis to identify any gaps in skills within the team and devise a plan in respect of how these might reasonably

be addressed; develop a staff training programme including the identification of mandatory and other training requirements.

How successful has this been so far?

An ambition outlined in the 2019 Annual Report was that the Commission should develop its induction programme for new members of staff and to ensure that existing staff have access to appraisal and workforce training opportunities. The period of lock-down in Spring 2020 curtailed inspection and other site visits. Consequently, the team members made use of the available time to take part in online training and to attend to aspects of their Continued Professional Development (CPD). Examples have included training relating to capacity assessments and best interest decision-making, tenancies relating to home care services and best practice relating to dementia in care homes.

What more needs to happen?

Further analysis is required to update the learning needs assessment across the team and to devise a plan as to how these needs will be met, with a renewed focus on ensuring that mandatory training is taken forward in 2021.

Implement a system of  How successful has this been so far?

regular staff supervision  Aw isthu psetarffvi.s iDoens ppoitleicyth hea dsi ffibeceunlt idese vwehloicphe ad r fooslleo wini nthgeceoanrsliuelrt asttiaognes utilising a designated  of the pandemic, group supervision continued to be provided

template and associated  wreeceokmlymaenndc, eads tinh ethseit uthairtido nq usatartbeilri soefd 2,0o2n0e. t Tohoisn we assu pweerlvciosimone d supervision policy;  bcoy nthtaec tte ias mcr uacnida li ti nwsauspapcokrntionwgl estdagffeidn tbheaintdgi raebcletmtoa sneaegke aridalvice, undertake annual  guidance, and support.

appraisals and mid-year  What more needs to happen?

performance reviews. Work will continue to develop a system of annual appraisals and

mid-year performance reviews in 2021.

Apply the approved  How successful has this been so far? standards for all  TahcetivSittiaens daanrdd sth hea ivnes pbeecetnio inmspinlevmolevnet te hd e a ac sr soes ss s amll erengt oulfa ttheed

regulated activities as a  performance of regulated activities against these Standards. framework to measure  What more needs to happen?

the quality, safety and  Feedback from across the sector indicates that the existing

Standards are appropriate and fit for purpose. effectiveness of these  New Standards are to be developed in respect of supported

services. accommodation for young people and for various aspects of

children s services. A plan is in place for this to be completed

in 2021.

Encourage the providing  How successful has this been so far? of feedback across  TShtaenrdeagrudlas,t eedit hseerctfoorr misaellnyc ooru inrafog re md  atolly s . u Ab dm di it t  if oe ne ad llb y,a qck u  ao ln ity  

the sector in relation  monitoring of the inspection process has commenced and

to the standards and  iGs opvreorvninagn ctoe ,b Peo sliuccycaensds fSutl aannddawrdesll -hraescepirvoevdid. eTdh uepHdeaat des o i fn collate this information:  rweisll pceocnt t  io nf u t eh i tsh wroourgkh aot ueta 2c0h2 B1oaanrdd tmhee efitnindgin. gQsu wa il li lt yb  em ocnoiltlao tr eindg ensuring that the Board  into a summary report and presented to the Board.

is appraised of the  What more needs to happen?

findings associated with  Further developmental and collaborative work needs to take

place with stakeholders to ensure that the Standards are this evaluation. appropriate, that people who use services are aware of and

understand them and that they are meeting the needs of each

sector. Depending upon the outcome of this collaborative

approach, the Standards will be reviewed and may be updated

accordingly.

The carers were welcoming...  I could see on my first visit there was a lovely interaction between the carers and care receivers.

Feedback from a family member

Work with Government of Jersey policy leads in the development of Regulations and Standards relating to children s social work and Child & Adolescent Mental Health Services (CAMHS); ensure that appropriate

action is taken to facilitate the development of capacity within the Commission to absorb

any additional developmental work relating to these.

How successful has this been so far?

The Chief Inspector met with the Government of Jersey Policy Leads on several occasions throughout 2020 and has contributed to joint planning in this respect. A paper and accompanying presentation from senior policy staff was presented to the Board meeting in September 2020.

What more needs to happen?

Recruitment has commenced relating to the appointment of a Regulation Officer with specific children s service experience. It is anticipated that this post will be filled in the second quarter of 2021.

It may be necessary to source external consultancy input in respect of the drafting of Standards relating to statutory children s services and this is intended in 2021.

How successful has this been so far?

Develop a caseload  Each Regulation Officer carries a caseload of regulated allocation system to  services for which they are responsible.

ensure that all regulated  What more needs to happen?

services have a designated  Naloloacdatdioitniosnwali lwlcoornktiisn unee etod ebde imnothnisit oreregda rtdo oetnhseurrtehtahna tt hthaet t he Regulation Officer. system remains effective.

Develop and implement an inspection scheduling tool to better enable the prioritising of inspection work.

Ensure that service providers can be readily

held to account where there are concerns relating to adherence to Regulations and Standards by fully implementing the Escalation, Enforcement and Review policy following consultation with the sector.

How successful has this been so far?

This activity was in progress until the pandemic caused it to be delayed. Inspections have needed to be re-prioritised, with some planned inspections having to be postponed until 2021. However, the tool itself is in operation and will be further refined in 2021.

What more needs to happen?

It is intended that a full programme of annual inspections will take place in 2021. However, the Commission will remain apprised of developments affecting the sector relating to the pandemic, and will adapt by modifying its inspection methodology accordingly.

How successful has this been so far?

The Escalation, Enforcement and Review policy was approved by the Commission s Board and is publicly available on the Commission s website. The policy continues to guide the Commission s practice and decision-making.

What more needs to happen?

The policy will remain under continuing review and will be adapted and updated periodically as required.

The staff are absolutely tremendous, they are amazing, and the care is

all about the people in the home. There s a happy atmosphere, there s something special about it when you walk through the door

Feedback from a family member

Work collaboratively with the sector; encouraging improvement by actively providing advice and support as required.

Introduce Improvement Plans in a designated format. These will include timescales associated with improvement and an outline of the form that improvement should take.

Finalise the Inspection Policy following consultation with the sector.

How successful has this been so far?

Each regulated activity is assigned a designated (named) Regulation Officer and the Commission operates a duty system during office hours which ensures that advice and support can be provided if the designated officer is unavailable. Advice

and support are also provided by Regulation Officers to staff in regulated activities during the inspection process. Feedback, as sourced in the quality assurance visits, has been positive in the most part.

There is evidence that managers and providers of regulated activities have welcomed the support the Commission provided during the height of the pandemic, in April-June 2020, when inspections were temporarily halted. During this period, Regulation Officers proactively maintained contact with the sector and responded to concerns as they arose.

The Commission communicates with the sector through a process of regular email correspondence, telephone contact and newsletters. Feedback is always welcomed and acted upon and stakeholders are consulted about Commission policies

and any changes to practice. The Commission s website is regularly updated to include guidance and policy provided by the Government of Jersey and other relevant bodies.

What more needs to happen?

Collaborative working in developing and implementing a communications strategy is ongoing.

How successful has this been so far?

Areas for improvement are addressed directly in discussion between Regulation Officers and managers/ providers, and

this informal approach often avoids the need to produce Improvement Plans, forming part of the collaborative approach to achieving best practice. Where such matters cannot be resolved informally, Improvement Plans are produced in a consistent format, with appropriate timescales included.

What more needs to happen?

The process associated with making improvements will continue to be reviewed periodically.

How successful has this been so far?

The policy was reviewed in quarter two of 2020, due to the changes in the inspection methodology which were necessary because of the challenges associated in undertaking inspections during a pandemic and on account of related temporary amendments to legislation.

What more needs to happen?

The policy will remain under continuing review.

It s great, I really like it. I like the atmosphere and there s lots going on I can go out whenever I want

Feedback from a care receiver

How successful has this been so far?

Implement the Inspection Report template and evaluate its effectiveness.

Develop a robust system in supporting prospective service providers to complete the registration process, ensuring that the role and remit of the Commission is easily understood.

The inspection report template has been implemented. Its effectiveness will be evaluated in 2021 and a plan formulated to enable this. Following feedback from the sector, the template will be revised to better focus on outcomes, as opposed to process.

What more needs to happen? The template will be evaluated in 2021.

How successful has this been so far?

All the activities which were anticipated to have become registered have done so, excepting some services carried on by the Government of Jersey. In respect of each of these, the Chief Inspector met with a range of senior staff members in Government of Jersey to ensure these services submit the necessary applications to become registered and achieve compliance with the law.

What more needs to happen?

The Commission requires that any remaining Government of Jersey services which meet the definition of a regulated activity and continue to operate complete the mandatory application process and become registered.

The Commission always provides guidance and support throughout the registration process and will continue to work with any new services which are seeking to become registered so that they are able to operate lawfully.

Carry out a planned annual programme of announced and unannounced inspections of all registered services for adults and children in Jersey.

Children's Residential Homes (8)

Home

Care

Services

(33) Adult Care Home (65)

Day Care (5)

Figure 1: Number of services which are subject to the provision of the Regulation of Care (Jersey) Law 2014 as of 31 December 2020.

Home Care Services (23)

Adult Care Home (45)

Children's Residential Homes (7)

How successful has this been so far?

It is a legal requirement that every service registered under the Law receives a minimum of one annual inspection in every 12-month period since it became registered.

In 2020, the Commission completed 45 inspections of adult care homes, seven inspections of children s residential homes and 23 inspections of home care services.

It has not been possible to inspect all regulated services/activities, on account of the necessary restrictions associated with the Covid-19 pandemic. However, a robust plan is in place to ensure that all outstanding inspections are completed in 2021.

Each service needs to be inspected against specific Standards, depending upon the activity s Statement of Purpose. It is intended to develop a framework to better enable the Commission to tailor its inspection activity to the needs of individual services.

The number of regulated activities as of the end of 2020 are represented in Figure 1.

Alongside inspections of regulated activities, the Commission undertakes routine inspections of Piercing and Tattooing premises. This was not possible in 2020 due to the restrictions associated with Covid-19. Specifically, infection control requirements limited the possibility of Regulation Officers undertaking physical inspections of premises.

This was coupled with the inability of Piercing and Tattooing practitioners to practise throughout

parts of the year. However, the Commission was proactive in revising the Code of Practice for Piercing and Tattooing, which has been published on the Commission s website.

What more needs to happen?

The programme of inspections needs to continue in 2021 to ensure that the statutory requirement is met and continues to be met.

Figure 2: Number of registered services which received at least one inspection as of 31 December 2020

N.B. Seven children s residential homes were inspected in 2020. A further home became registered at the end of 2020 and will be inspected in 2021.

Hold service providers to  How successful has this been so far? account by taking corrective  Tahvaei lEasbclea loanti othneaCndo mEnmfoisrscieomn esnwt ePbosliictey. i s Ccoormrepclteivtee aacntdioins was

action when they fail to  necessary in 2020 in respect of one regulated activity. comply with Regulations  TThheeCCoommmmiissssiioonnirse sfuelrlyv easb  lt eh eto r i tgahkt e t osu fochrmaacltiisoens ausc rhe quired.

or to conform to relevant  eCsocmalmatiisosnio ann md eeentfso rwciethm menat n aacgt eivristyaansdrpeqrouvirideedr.s Tahse part of its Standards in the delivery  regulatory function and holds providers to account through a

of health and social care. pFororctheess m oof stet lpeaprht,o int eis  cpoomssmibulen i fcoart cioonn, cleetrtnesrs t,o a bned rmeseoelvti en dg s.

effectively through a collaborative and stepped approach which involves providers and the Commission working together to resolve issues as they arise and to proactively drive forward improvements in the delivery of services.

What more needs to happen?

The Commission will maintain its commitment to working with providers to improve the quality of care across the sector.

To work with the Government  How successful has this been so far?

of Jersey to develop a  TChoemsmevisesnio cnh iilnd 2re0n2's0 rheasvideebnetieanl sinesrvpieccetse rdeganisdte trheedi nwsitphe tchteio n programme of inspection  reports are accessible on the Commission's website.

and monitoring visits for  What more needs to happen?

children s services. Create  Further regulatory powers and responsibilities will be given

to the Commission as new legislation is expected to come the capacity within the team  into force in 2021. This will increase the Commission s remit

to effectively absorb this  ttohereirgfaismteirli easn din  cinluspdeinc gt  aso racin agl e w  oo rf  ks ,e cr hvi ic lde ps  rf oo tr e c ch tii old nr ,e an d a on pd ti  on, area of work and source  fostering and CAMHS. Consequently, the Commission is in

the process of increasing its capacity to absorb this work by independent external  recruiting an additional staff member with experience of this

support as necessary (in line  area and in sourcing external expertise to support its work. with the expectations of the

Independent Jersey Care

Inquiry).

PROFESSIONAL REGISTRATION

Maintain an online register of

all registered health and social care professionals which is kept

up to date and which is available to the public. Ensure that the Commission can introduce professionals to the register and renew registrations annually. Review and expand the capacity of the Commission in order that it can service the register in partnership with colleagues in IT.

How successful has this been so far?

The register is appropriately maintained, kept up to date and is publicly available. The Commission can introduce new professionals to the register and can renew registrations annually. The Commission also maintains

a register of bodies corporate which are carrying on business as either optometrists or dispensing opticians.

There are significant challenges associated with

the register relating to the registration of medical professionals. This part of the register is not up to date and needs significant cleansing , to ensure that medical professionals who are no longer working in Jersey or in clinical practice are removed.

What more needs to happen?

The register relies upon input from the Government

of Jersey and from a private IT provider to enable it to operate effectively. This poses difficulties regarding the ability of the Commission to manage the annual renewal process independently.

Overall, the registration and renewal processes are cumbersome and time-consuming. As such, it would benefit from considerable reform and additional administrative resources.

The Commission has formulated a budget build for 2021 which includes the provision of additional capacity to construct an electronic portal to enable registrants to complete the registration and renewal process online.

It also includes provision to increase the Commission s administrative capacity to ensure that the medical professionals register is updated.

Ensure the health and social care workforce in Jersey is appropriately qualified, registered and fit to practise. Develop the renewals process in order that the Commission can more effectively establish fitness to practise.

How successful has this been so far?

The Commission has adapted its registration and renewal process in order that fitness to practise can be better ascertained.

In 2020, applications for registration were granted for

338 health care staff which represents an increase of approximately 50% compared with 2019. It is noteworthy that there was an increase in registration activity in March and April 2020. Most applications were from nurses; and the Commission registered twice as many nurses in 2020 as in 2019.

There was a 40% decrease in applications from medical professionals compared with the previous year. This concords with the travel restrictions imposed by the Covid-19 pandemic and the reduction in some areas of activity at the General Hospital during the earlier stages of the pandemic.

The Commission continues to prioritise the registration

of health care professionals, many of whom have sought registration in response to the establishment of Jersey s Nightingale ward and the Covid-19 vaccination programme which has been underway since early December 2020.

The annual renewal of health care and dental professions concluded on 31 December 2020. The Commission has successfully managed these renewal applications.

In addition, the Commission maintains a register of individual home care workers.

What more needs to happen?

A further increase in dental professional registration applications is projected in 2021 when the Commission will implement Article 26 of the Dentistry (Jersey) Law 2005 which comes into force on 26 February 2021. This will mean that all dental nurses will be required to register with the Commission. The Commission must ensure that it is properly equipped to meet the demands associated with this increase in workload.

Recruitment and project planning will be necessary to ensure the Commission can successfully implement the Professional Registration (Jersey) Law, (which is likely to come into force in early 2023).

Continue to review the IT  How successful has this been so far? support which is necessary  Tchhea lrleenggisitnrga,tibonutatnhde rCeonmewmailssspiorno cheasss seesc ruermeda itnhe

to ensure that the registration  necessary IT support to facilitate the change process, and renewals process is more  making it more streamlined and efficient.

streamlined and efficient. What more needs to happen?

Additional capacity will be required to make this change and the Commission has prepared a budget build which includes the costs associated with this.

Work with the Government  How successful has this been so far? of Jersey policy lead in  Tohf eJeCrsheieyf PInoslipceyc Lteoar dcso natnindupelsa ntos mareee int wdiethveGloopvmerennmt eton t

considering the implications  enable the Commission to respond to the requirements

of the new Professional  aosf sJoecrsiaetye pdo wliicthy tshtaisffaarettae nodf eledgtishlea tSioenp.t eSmenbieorr  mGoe ve eti rn ng m o ef n  t Registration Law.  tthheesCeo dmemveislospiomne Bn otsa. r  d to provide an update relating to

What more needs to happen?

The Commission will continue to work with the Government of Jersey to ensure the Commission becomes appropriately equipped and resourced to meet the demands associated with expansion in regulatory scope.

Establish effective

regulatory links with other organisations which have shared responsibilities for

the oversight of professional regulation in Jersey, e.g. General Medical Council (GMC), Nursing and Midwifery Council (NMC) and Health

and Care Professions Council (HCPC), General Dental Council (GDC) and Social Work England.

How successful has this been so far?

This has happened, but to a limited degree. The Commission has written to all the relevant organisations and a small number have responded. The Commission will continue to liaise with relevant organisations as specific needs require.

What more needs to happen?

The Commission will continue to work with external organisations associated with the registration of the health and social care profession. Where appropriate, the Commission will seek to develop formal arrangements to enable the sharing of information in line with relevant legislation and policy.

PUBLIC ENGAGEMENT

Provide a voice for service users, by ensuring that service providers operate robust systems for investigating complaints relating to possible regulatory breaches and,  where necessary, undertaking  inspections to investigate concerns.

How successful has this been so far?  

All regulated activities are required to maintain  and to operate effective complaints processes.  Each inspection involves a review of complaints  policies and procedures, with an improvement  plan being devised where deficits are identified.  

The Commission has introduced and has fully  implemented its own complaints policies, in  relation to both complaints about the Commission  and about regulated activities. A complaints  leaflet has also been published. These documents  are available electronically on the Commission s  website. The complaints leaflet is distributed  across the sector by Regulation Officers when  undertaking inspections.

What more needs to happen?

The complaints policy relating to the Commission  and the policy relating to regulated activities, along  with the complaints leaflet, will be reviewed in the  first quarter of 2021.  

Raise the profile of the Jersey  How successful has this been so far? Care Commission with the  Thhaes bCeoemnm imispslieomn he an ste ad C too  manm e ux nteicn at.t i ons Strategy which

organisations we regulate,  However, despite the difficulties presented by the

as well as with service users  pandemic, the Commission has proactively responded and carers through a planned  tsop ethceifincepeadgseoof nthietssweecbtosri tbeyadnedvkiseinegp ian gCtohvisidr-e1g9u-larly

programme of engagement  uppodlicayt,e adn wdi tghuriedlaenvcaen.t information including legislation, activity.

The number of visits ( hits ) to the website has increased significantly throughout 2020 by over 70% since 2019 (38,806 compared with 22,807). There was a marked increase in visits between July-November, compared with the previous year. In addition, inspection reports have been accessed 6,554 times and the Covid-19 page has been accessed 2,769 times.

Regulation Officers have consulted with a range of stakeholders including service providers, managers, and care receivers family members, particularly during the period of lockdown and of restricted visiting of care homes.

The Commission provided the local media with several press releases throughout 2020 which resulted in media coverage of the publication of inspection reports and concerns within the care sector relating to the impact of Covid-19. Journalists and reporters sought the views of the Commission in respect of matters relating to the pandemic and how they affected the care sector. These included changes to Regulations; the restrictions on visiting; difficulties relating to staffing levels; access to PPE and access to Covid-19 testing.

A range of communication media were utilised by

the Commission throughout 2020. The Commission provided regular updates via email to the care sector and produced newsletters which were distributed to care home and home care service managers and providers. The Commission also provided updates to the wider community through its Twitter feed.

What more needs to happen?

The Commission will review its Communications Strategy

in the first quarter of 2021 with a view to implementing

it more fully. In reviewing the effectiveness of its communications, the Commission is considering the use of additional formats including the possibility of launching a Facebook page in 2021.

INFORMATION  GOVERNANCE

How successful has this been so far?

Ensure that the  The Commission receives information through a range of Commission has an  mtherocuhgahn iaspmpsr.o pDraiatatei srehteelndt isoencaunredl yd aisnpdo sisa mlsacnhaegdeudle esff. ectively

effective system to

What more needs to happen?

enable it to manage the  An external advisory audit has been commissioned in the first complexity of information  quarter of 2021. This will assist the Commission in maintaining

and operating a comprehensive and appropriate suite of which it receives. policies relating to the governance of data.

How successful has this been so far?

Develop a complaints  Complaints policies have been devised, regarding both procedure to ensure  rpeugbulilcaltye ad v aacilt aivbitleie as n adn dw  it lhl be e C roemviem wis es dio inn   2it 0se 21lf ..   These are

that people can make  The Commission encourages care receivers, their families complaints about both  and carers, care providers, as well as members of the

service provision and  pduisbslaicti stofa mctaiokne arebporuetsaennytaretiognu lwatheedr ea cthtievirtey .i s a concern or about the Commission  The Commission has modified its website to include the facility

itself. toothmear kmeecthoomdpsl aininctlsu ddiinregcltelytt tehrrso, uteglhe pthheo nwee  bcasil tlse aanltdh oe umgahi ls

also exist.

What more needs to happen?

The Commission s complaints process includes the ability for complaints to be made about the Commission itself. Where possible and appropriate, such complaints will continue to be managed informally or internally. However, it is acknowledged that the Commission will need to source an independent complaints reviewer in 2021.

Implement an internal records retention and disposal schedule to ensure that data is processed in accordance with all relevant statutory and policy requirements.

Undertake an audit of in- house activity, policy and training relating to building security, health and safety, moving and handling, first aid and fire safety.

How successful has this been so far?

A retention and disposal schedule has been devised but has not been fully implemented. The Commission maintains a large amount of documentation in paper form. Additional capacity will be required to enable the Commission to effectively process this information.

What more needs to happen?

The Commission will require additional administrative capacity to meet the needs associated with cleansing the archive of paper documentation. These resources will be sourced early in 2021 on a temporary basis.

How successful has this been so far?

Fire Safety training has been undertaken and a Fire Marshal

is in place. Additional First Aid and Health and Safety training may also be required. The overall security and suitability of the current office accommodation remains problematic because of its inaccessibility and alternative premises are being sought.

What more needs to happen?

The Commission is in the process of sourcing alternative office accommodation, having explored a wide range of potential alternative locations throughout St Helier. Work with the Government of Jersey in determining an appropriate and cost-effective long-term solution is ongoing.

LEADERSHIP  AND DELIVERY

Maintain and develop a system of corporate governance which ensures effective oversight and accountability for the work of the Commission. This will include the development of a suite of policies; maintaining of risk registers; reviewing of the Business Plan and the provision of performance reporting.

How successful has this been so far?

The work of the Commission is overseen by a Board

of Commissioners. The role and responsibilities of the Commission are set out in Schedule 2 of the Regulation of Care (Jersey) Law 2014. The Board usually meets six times a year. These meetings are open to the public.

The Board receives reports from officers employed within the Commission, provides governance and financial oversight, and maintains an integrated risk register of both strategic and operational risks.

The Commission is accountable to the Government of Jersey as an arms-length organisation. The relationship with the Government of Jersey is described in a Framework Agreement, dated May 2020 which replaced the pre-existing Memorandum of Understanding.

Ministerial responsibility for arms-length bodies including the Jersey Care Commission, transferred from the Chief Minister to the Minister for the Environment in 2020. The Chair of the Commission and others met with the Minister for the Environment during 2020.

In 2020, six meetings of the Board of Commissioners were scheduled to take place in Jersey. As the events of 2020 unfolded, travel restrictions made this impossible and it was therefore necessary to facilitate most of the meetings virtually. The attendance of Board members was as follows:

Glenn Houston 6 out of 6

Ann Abraham 5 out of 5 (see note below) Alison Allam 6 out of 6

Si n Walker 6 out of 6

Lisa Jacobs 6 out of 6

Note: Ann Abraham s term of office ended in 2020.

Each Board member has completed and regularly updates a declaration of interests which is reviewed and confirmed at every Board meeting. The Register of Interests is a public facing document, accessible on the Commission s website and included as Appendix A to this report.

Commissioners terms of office were reviewed in 2020 as their initial three-year terms came to an end. Four Commissioners agreed to continue for a further three- year term. In addition, three new Commissioners were appointed in 2020 and will commence their terms of

office in 2021.

What more needs to happen?

The Commission s governance arrangements are in the process of being audited to better determine their suitability and comprehensiveness. The outcome of this audit will be available in the second quarter of 2021.

PLANNING

Formulate a three-year  financial plan.

How successful has this been so far?  

A budget build for 2021 was prepared at the close of 2020  and the Commission is closer to achieving the formulating  of a comprehensive three-year plan than at any time over  

the past two years. However, the Commission needs to  undertake further and more detailed work with Treasury to  understand the financial context in which it is working and to  devise an agreed formula for funding expansion related to  proposed legislative changes and in managing its existing  resources effectively over a three-year horizon.

What more needs to happen?

The Commission will continue to work with the Government  of Jersey to address the requirement of a comprehensive  three-year financial plan.  

Develop operational links with local stakeholders that have a shared interest in the areas regulated

by the Commission e.g. Safeguarding Partnership Board, Office of the Children s Commissioner, Chief Nurse, Medical Practitioners local Responsible Officer.

How successful has this been so far?

Links have been made with local stakeholders including Ministers, other elected representatives and with senior officials in the Government of Jersey. Links have also been established with people who use services, their carers and family members, representatives of the voluntary and community sector and with managers and staff working in regulated activities.

What more needs to happen?

The Commission will renew its efforts to raise its profile and to develop appropriate links with local people and their elected representatives.

KEY PERFORMANCE INDICATORS (KPI S)

The following indicators, linked to our strategic and business

45 1.  The number of inspections carried out and inspection objectives described above, were used in 2020:

reports published in each of the following services: inspections  Car41 repore Homes for adults:ts published. 45 inspections undertaken.

of Adult Care

Homes  Childrundertaken. 7 ren s Residential Homes:eports published. 7 inspections

Home Care Services: 23 inspections

undertaken. 15 reports published.

7*  Adult Day Car0 reports published.e Centres: 0 inspections undertaken.

It is important to note that although care homes and

home care services continued to function throughout inspections of Children's  the pandemic, day centres were temporarily closed or Residential Homes  operCommission not to inspect day centrated differently. This contributed to a decision by the es in 2020.

* This is every Children's  2.  The number and outcome of enforcement actions.   Residential Home in Jersey

There was one enforcement action in 2020 in respect of a domiciliary care provider. This matter is ongoing.

23 3.  Tnumberunannounced; the length of time each inspection took both issue and publish (on the Commission s website) he number of inspections unders/percentage which were announced and taken including the to bring to completion; the length of time taken to

inspections  inspection reports.

of Home Care  A total of 75 inspections were undertaken in 2020. Each Services of these inspections will result in a published report

being produced although some of the reports will not be published until 2021. By the end of 2020, 61 inspection

61 Of the 75 inspections, 73 were announced inspections. reports were published on the Commission s website. A

further two were published in January 2021.

Two were unannounced. In general, the Commission will

undertake a combination of announced, unannounced

and partially announced (limited notice not exceeding inspection reports  24 hours) inspections. However, the impact of Covid-19

published on our website meant that it was not possible to undertake unannounced

inspections as routine, due to the need to adhere to

infection control protocols.

The length of inspection visits varied significantly and ranged from 150 to 795 minutes. This

was due to a need to spend a longer period

with services which were new to the inspection process, particularly home care services, where there was a need to visit both the service s offices as well as individual care receivers homes. Some inspection visits were significantly shorter than might ordinarily have been the case due to a need to have limited footfall in care homes and to only be able to access specific parts of a building. The average length of inspections was 269 minutes.

In respect of the length of time taken to both issue and publish inspection reports, once a report is finalised by the Commission, the provider and manager have a period of 28 days in which to confirm factual accuracy or to raise any concerns relating to the content of the report.

The length of time taken from the date of an inspection visit and the date at which a report is uploaded to the Commission s website has varied significantly during 2020, between 208 days and 48 days. The average amount of time taken was 87 days.

The length of time taken between issuing a report to the provider and manager of a regulated activity and uploading the report to the Commission s website also varied between 155 days and 8 days. The average amount of time taken was 51 days.

It is important to note that any urgent action in respect of safeguarding or health and safety concerns are addressed before a report is issued.

4. The number of registrations of service providers and the length of time required to finalise the process of registration.

There were 13 new managers of regulated activities registered in 2020. Of these, 10 were care home managers and three were home care managers.

In respect of regulated activities, 10 care homes became registered in 2020, 10 home care services became registered (one of which also closed in 2020) and four day care centres became registered.

Two services closed in 2020. Of these, one was a care home and one was a home care service.

8 new service providers

registered

338*health care

registrations

* Representing a 42% increase compared with 2019

111more nurses in 2020

compared with 2019

65 piercing &tattooing

+ premisesregistered

85 piercing & tattooing

practitioners

In respect of the length of time required

to finalise the process of registration, the

most common cause of delay relates to the sourcing of references and DBS (criminal record) checks. The Commission is proactive in supporting applicants to ensure that all necessary documentation is sourced promptly. Once the necessary supporting documents are received, in combination with the designated registration documents, the Commission is usually able to finalise registrations within a 48-hour period.

70%  marked increase in visits increase between July-November

38,806 compa in website hits when compared to 2019red with22,807 R6ep,o5rts5pa4ge hits C2ov,id7 196 p9age hits

5. The number of health and social care professionals added to and removed from the Jersey register.

Health Care Registration (new entries to the register):

Health Care Registrations by month:

A total of 227 health registrants were removed from the register in 2020. In the main, these removals were the result of the registrant not renewing their registration in 2019.

In respect of dental registrations, seven registrants were removed from the register in 2020, in the main because they did not wish to renew their registration.

A total of nine medical practitioners were removed, by their own request, from the register in 2020. This is in line with expectations as medical practitioners either retire from practise or leave Jersey.

6. The number of piercing and tattooing premises and practitioners; laser premises registered.

A total of 65 piercing and tattooing premises and 85 piercing and tattooing practitioners were registered in 2020. Of these, there were 11 new premises and 14 new practitioners registered in 2020.

There were six laser premises registered.

7. The number of Designated Yellow Fever centres inspected, and the number of vaccines provided.

There were 10 Yellow Fever Centres registered in 2020. The Commission has been advised of 62 vaccines having been given in 2020. This represents a significant reduction compared with 2019 when 323 vaccines were given. However, this accords with the impact of the Covid-19 pandemic and the reduction in international travel.

8. The number of health or social care professionals referred to a UK regulator for fitness to practice issues.

The Commission did not refer any professionals to a UK regulator in 2020.

9. The number of regulatory responses in relation to concerns or complaints about service provision.

The Commission received 16 complaints relating to regulated activities, in 2020. In line with its Complaints Policy, the Commission endeavours to ensure that complaints are managed and resolved by the service

to which the complaint relates in the first instance. Where this is either not possible or is unsuccessful,

the Commission reserves the right to undertake the investigation of complaints itself. In the course of 2020, no complaints required extensive input by the Commission (which might include a full investigation and several site visits). Three complaints required moderate input (which might include at least one

site visit or follow-up correspondence/ involvement

in meetings). Thirteen required minimal input (which might include correspondence by letter or telephone).

10. The number and outcome of consultations completed in respect of operational documentation.

There were two consultations undertaken in respect of both the Inspection Policy and the Escalation, Enforcement and Review Policy.

11. The number and outcome of reports about health and social care services requested by the Chief Minister or Health Minister (or initiated by the Commission itself) and provided in response to emerging issues.

There were no requests made in 2020.

However, there were some enquiries made by Ministers and members of the States Assembly relating to the impact of restrictions on visiting and the temporary suspension of physical inspections at the height of the pandemic.

The Commission responded to each of these enquiries.

12. Number and outcome of public and stakeholder engagements and consultations aimed at raising the profile of the Commission in Jersey.

The impact of Covid-19 has been such that physical stakeholder events have not taken

place throughout 2020. There was one rapid information session which took place virtually in November, with service providers and managers to discuss the impact of emergency legislative changes.

As new Standards will be introduced in 2021,

to meet the needs of services which are new to regulation, it is intended that there will be further direct engagement with stakeholders in 2021.

13. The number of Memoranda of Understanding (MOU s) agreed with relevant regulatory bodies.

14. The outcome from consultation service providers and other stakeholders in ascertaining their views about the impact of inspection on driving service improvement.

A programme of quality monitoring of the inspection process commenced in 2020. This was undertaken by the Head of Governance, Policy and Standards and involved a meeting (either in person, virtually or by telephone), with either the provider and/or the manager of a regulated activity which had been subject to a recent inspection.

The discussion included the manner of the inspection, whether any concerns or areas

for improvement were identified, whether the inspection process is of benefit to the service and what the impact of the inspection has been.

Although this process was in its early stages in 2020, it has been welcomed by providers and managers. Feedback has been overwhelmingly positive and has focussed on the approach taken by the Commission in working supportively and collaboratively with services wherever possible. The process has also identified some key areas of learning which will be consolidated in a report to the Board of Commissioners in 2021 to inform and improve the quality of the inspection process.

15. The number and volume of complaints received by the Commission.

The Commission received 16 complaints in 2020. Of these, 12 related to care homes, two related to home care services and one related to a piercing and tattooing practitioner. A further anonymous complaint was received but it was not possible

to ascertain which service the complaint related to. No complaints were received about the Commission in 2020.

The Commission is committing to formalise its working arrangements with regulatory bodies by developing MOU s. The Commission will continue to cooperate with regulatory bodies as required

and will share information on a case by case basis in line with data protection requirements.

PRIORITIES  IN 2021

Whilst this report covers our activities in 2020 it is appropriate to look to the future with confidence.

Regulation and Inspection

The Commission will develop a plan of recovery from the Covid19 pandemic and will continue to adapt the inspection regime as necessary to both safeguard people and to prevent the spread of infection.

The programme of inspections will continue in 2021 to ensure that the statutory requirement to undertake one annual inspection of each regulated activity, continues to be met.

Those services which were due an inspection in 2020 but did not receive one, on account of the temporary suspension of inspections, will have received their inspection early in 2021.

Inspection reports will be published on the Commission s website throughout 2021.

All regulated services will continue to have a named Regulation Officer to better ensure business continuity.

The team of Regulation Officers will expand in 2021 to enable the Commission to continue to deliver

an effective regulatory regime for Jersey which both supports best practice and drives continuous improvement.

The Commission will continue to work with any developing services which are yet to register in order that they can confidently and successfully complete the registration process.

The existing Standards will continue to be applied with attention given to collating and interpreting feedback from the sector regarding their quality and utility.

The Commission will continue to hold service providers to account by taking corrective action when there is a failure to comply with Regulations, or to conform to relevant Standards, in the delivery of health and social care.

The Commission will continue to work collaboratively with Government of Jersey policy leads in the

development of new Regulations and Standards relating to children s social work, fostering and adoption services and Child and Adolescent Mental Health Services; ensuring the Commission has enough capacity to absorb any additional developmental work relating to these activities. The Commission will continue to develop associated Standards for services new to regulation and will publish them once they are finalised.

The Commission will continue to make progress in sourcing alternative office accommodation. In doing so, the Commission will uphold its commitment to ensure that its accommodation is in premises which provides appropriate access to people who use and provide services.

Professional Registration

The Commission will continue in its role of providing a service to professionals whereby registrations are processed promptly and where any difficulties arising from the registration processes are responded to efficiently. The Commission will continue to work towards the development of an online renewal process and registration processes.

The Commission will continue to work with Government of Jersey policy leads in preparing for the implementation of the new Professional Registration Law.

In ensuring that the health and social care workforce in Jersey is appropriately qualified, registered and fit to practise, the Commission will further develop the renewals process in order that it can more effectively establish fitness to practise.

The Commission will continue to maintain regulatory links with other UK regulatory bodies which

have shared responsibilities for the oversight of professional regulation in Jersey and will formulate Memoranda of Understanding, or other such formal data sharing arrangements where this is possible.

Public Engagement

The Commission will continue to ensure that the  voices of people who use and provide services, their  carers, and representatives and those who deliver care  services are heard, throughout all the work which the  Commission undertakes.

The Commission s website will be regularly updated  

to ensure that the public are provided with access to  relevant information about the Commission s activities.  The Commission will remain mindful of the needs of  people who cannot access the internet and will ensure  that other appropriate methods of contacting the  Commission remain available.

The Commission will continue to raise its profile with  the organisations it regulates and with those who use  services, and their carers/representatives, through a  planned programme of engagements, which will reflect  arrangements associated with the Covid-19 pandemic  in Jersey.

Information Management and  Responsiveness

The Commission will actively explore ways in which to  strengthen its internal administrative systems to ensure  that they are sufficiently robust to manage and process  the complexity of information received from the public  and from regulated activities.  

It will implement an internal retention and disposal  schedule to ensure that data is processed in  

accordance with the General Data Protection  Regulations and the Data Protection Law and will source  additional capacity to do this.  

The Commission will continue to provide prompt and  detailed responses to consultations, correspondence  from Ministers and Government of Jersey departments,  as required.

Governance Framework

The Commission will ensure that its governance  framework and financial oversight remain robust.

In respect of the investigation of complaints, the  Commission will retain the services of an independent  body that can act for the Commission and on its behalf.

It will also appoint and retain the services of an  independent solicitor / advocate to act for the  Commission in specific matters.  

Planning

The Commission will formulate a three-year strategic  and financial plan.

It will develop operational links with local stakeholders that have a shared interest in the areas regulated by the Commission.

APPENDIX A:

The Jersey Care Commission Register of Board Members Interests 2020.

Board Member Paid employment/ Company  Other public   Unpaid office in

consultancy appointment charitable/other body

Glenn Houston None None Vice- Chair Disclosure and Barring  None None Non-executive  Service (DBS)

Chairperson

Member, Human Tissue Authority

Date of appointment:

01/05/2017 Member, Northern Health and

Social Care Trust (appointed for second term of four years commencing 01 January 2021)

Member, Board of the Public Prosecution Service, Northern Ireland

Dr Alison Allam  Director, Cootes (Fen Drayton)  None None None None Non-executive Board  Management Company Limited

member

Non-clinical honorary contract,

Date of appointment: Royal Marsden Hospital

10/05/2017

Lisa Jacobs Supply contract,  None None None Vice Chairperson, Non-executive Board  Mont a L'Abbe School

member Mont a L'Abbe School

Charity

Date of appointment: 07/07/2017

Si n Walker - Independent Chair, Adult  None None None None McAllister  Safeguarding Board, London

Non-executive Board  Borough of Lambeth

member

Independent Chair Devon

Date of appointment: Safeguarding Adults

10/05/2017 Partnership

Independent Chair, Bath

& North East Somerset Community Safety and Safeguarding Partnership, Bath and NE Somerset Council

Associate, UK Local Government Association (LGA)

Ann Abraham  Trustee of the Dorset Non-executive Board  Mental Health Forum member from 1/3/18

Date of appointment: None None None None Pro-Chancellor of 10/05/2017 the University of

Bournemouth appointed January 2019

The Commission s constitution requires that Board Members must ensure that no conflict of interest arises, or could reasonably be perceived to arise, between their public duties and private interests.

APPENDIX B:

The Board of Commissioners

Glenn Houston

Appointed 2017. Reappointed 2020.

Lisa Jacobs

Appointed 2017. Reappointed 2020.

Si n Walker -McAllister

Appointed 2017.  Reappointed 2020.

Dr Alison Allam

Appointed 2017.  Reappointed 2020.

Jackie Hall

Appointed 2020.  

Noreen Kent

Appointed 2020.

Angela Parry

Appointed 2020.

Details of each of the Commissioners is available at: www.carecommission.je/the-commissioners/

APPENDIX C:

Professions which are registered by the Commission

Legislation Registrable Professions

Health Care (Registration) (Jersey) Law 1995.  Ambulance paramedic

Health Care (Registration) (No.5) (Jersey) Regulations  Art Therapist

2019: Biomedical scientist

Chiropodist

Chiropractor

Clinical psychologist

Dietitian

Midwife

Midwife prescribing practitioner

Nurse

Nurse prescribing practitioner

Occupational therapist

Operating department practitioner

Orthoptist

Osteopath

Physiotherapist

Podiatrist

Psychotherapist

Radiographer

Registered nurse: first level

Registered nurse: second level

Social worker

Specialist community public health-nurse

Specialist community public health-nurse prescribing practitioner Speech and language therapist

Nurse independent prescriber

Optometrist independent prescriber

Paramedic independent prescriber

Pharmacist independent prescriber

Physiotherapist independent-prescriber

Podiatrist independent prescriber

Therapeutic radiographer independent -prescriber

Dentistry (Jersey) Law 2015 Clinical dental technician

Dental hygienist

Dental nurse

Dental technician

Dental therapist Orthodontic therapist

Medical Practitioners (Registration) (Jersey) Law 1960  Doctors

Providing independent assurance, promoting best practice and improving health and social

care outcomes for the people of Jersey.

Telephone + 44 (0)1534 445801 Email enquiries@carecommission.je

2nd Floor, 23 Hill Street, St Helier JE2 4UA

www.carecommission.je