Jersey Care Commission: Annual Report 2019

Annual Report

INTRODUCTION 2

FOREWORD 3

PERFORMANCE SUMMARY  4

FINANCIAL PERFORMANCE AND ACCOUNTS  6

ORGANISATIONAL STRUCTURE  8

PERFORMANCE ANALYSIS  9

REGISTRATION AND INSPECTION  10

PUBLIC ENGAGEMENT  15

PROFESSIONAL REGISTRATION  18

COLLABORATIVE WORKING  21

LEADERSHIP AND DELIVERY  22 Providing independent assurance,

promoting best practice and improving  KEY PERFORMANCE INDICATORS (KPI S)  23 health and social care outcomes for

PRIORITIES IN 2020  26 the people of Jersey.

APPENDIX 1: PROFESSIONS WHICH ARE  28 REGISTERED BY THE COMMISSION

The Jersey Care Commission (the Commission), was  The establishment of the Jersey Care Commission is the culmination established on 1st January 2019 in accordance with the  of the extensive preparations to introduce independent regulation of enactment of the Regulation of Care (Jersey) Law 2014 (the  health and social care in Jersey.

2014 Law), and the Regulation of Care (Transfer of Functions)

(Jersey) Regulations 2018.* The Regulation of Care (Jersey) Law 2014,  I believe the Commission has acted

and the associated Regulations determine  fairly and impartially in its dealings

the remit and responsibilities of the  with individuals and services operating

The Commission existed in shadow form    to promote and support best practice in  Commission and confirm its independence  within the scope of the regulations and prior to the enactment of the 2014 Law.  the delivery of health and social care by  from the Government of Jersey and from  standards.

setting high standards and challenging  those who deliver health and social care in  I wish to acknowledge the support of the The end of 2019 represented the first  poor performance Jersey. Chief Minister, the Council of Ministers, full year of the Commission s existence and, as such, was the opportunity for the  I am honoured to have been appointed  and other elected representatives who Commission to commence its range of   to engage with serfamilies and carers to imprvice userove their s and their  to serve as the first Chairperson of the  have campaigned for the establishment of

functions and to consolidate its role. experience of health and social care and  Commission. The Commission consists  the Commission. Without their persistence

achieve better outcomes. of a team of five people appointed to  and determination, the necessary

The Commission was appointed to  serve for an initial term of three years.  preparatory work, including the policy and undertake the following three strategic  This first annual report demonstrate how  Commissioners were appointed on  legislative framework, could not have been priorities: - the Commission has begun to achieve  the basis of their knowledge, skills and  accomplished.

to provide the people of Jersey with  these objectives and indicates the range of  experiences of working in the public  I wish to acknowledge too the work of the

independent assurance about the quality,  work which will be undertaken in 2020 and  service, and through having experienced  former Professional and Care Regulation safety and effectiveness of their health and  beyond. what it is to be a carer for a family member.  Team, the forerunner of the Care

social care services The operational arm of the Commission  Commission, which undertook a range of

consists of a team of Regulation  duties and responsibilities, including the Officers and support staff headed by a  regulation of the health and social care Chief Inspector. The team consists of  workforce and inspections of independent people who have health and social care  care services.

qualifications and have had experience

As you read this report you will gain

of working in the delivery and regulation

an insight into the work of the Care

of health and social care in Jersey and

Commission in 2019. It has been a elsewhere.

productive first full year of activity. There is Creating a new public body has many  still much work to do, but we look forward challenges. It is important in the first year  to building on the strong foundation we

of operation to establish a reputation for  have already created.

collaborative working, whilst maintaining

independence of thought and action.

Glenn Houston

Chair of the Jersey Care Commission

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

The Commission s first year has focussed on the establishment  and consolidation of its role and function. The Commission has  successfully formalised its constitution and has established its  first Business Plan, setting out key objectives and performance  indicators for these initial stages of the Commission s operation.  

Alongside a range of formal strategic and  In seeking to raise its profile and to publicise  operational governance arrangements,  its work, the Commission has established  the Commission has written and approved  a website and has undertaken a series  standards relating to each of the areas  of workshops with service providers and  

of health and social care services which  managers. The Chief Inspector has met  

the Commission regulates. Services have  a wide range of stakeholders including  

been and will continue to be inspected and  service providers, partner agencies,  assessed against these standards. service users and carers as well as many  

others interested and concerned with the  The Commission is responsible for the  

work of the Commission.

registration of health and care professionals,  

medical professionals, piercing and  The Commission has published policies  tattooing premises and premises where  to support its aims and objectives and  certain classes of lasers are used. This  continues to develop its policy framework.  work was completed, and all renewals of  These include policies relating to  registration were processed in a timely  inspections, enforcement and in making  manner.  complaints or raising concerns about  

service providers.  

A range of services (regulated activities)  

became registered with the Commission  A significant aspect of the role of the  

during 2019 with further applications  Commission has been in responding to  received and in process. Inspections of  enquiries and in undertaking investigatory  regulated activities were also undertaken  work where this is required. This includes  throughout the year. the need to listen to the public, service  

users, families and carers so that their  

In 2019 the Commission successfully  

concerns are responded to effectively,  recruited a Chief Inspector and a Head of  

whilst supporting service providers in being  Governance, Policy and Standards. It has  

able to successfully meet the required  

also recruited two additional Regulation  

standards relating to provision of care.  Officers, who will commence their roles in  

early 2020. This will continue to be a challenge moving  

forward, but the Commission is well-placed  Following the first Ofsted-led inspection of  

to respond to these needs and priorities. children s social work services in 2018, a  

follow-up inspection was commissioned and  

successfully completed in 2019.  

The Commission is grateful for the  

assistance of Ofsted, the Chief Minister  

and the Minister for Health and Social  

Services in facilitating this. The report of this  

inspection is available on the Commission s  

website.

1 / 2 Making a Difference; Driving Improvement: A Follow-Up Report  

https://carecommission.je/wp-content/uploads/2019/12/Ofsted-progress-report-FINAL-Copy.pdf  

The Commission s first year has focussed on the establishment and consolidation of its role and function. The Commission has successfully formalised its constitution and has established its first Business Plan, setting out key objectives and performance indicators for these initial stages of the Commission s operation.

This section includes information on income  Care Commission business unit for financial and expenditure, and details of remuneration  accounting purposes.

(including any non-cash remuneration) and  In addition, the Commission received income interests of Board members. from fees prescribed by the Chief Minister at

Under the provisions of the Regulation of Care  the point at which the 2014 Law came into force. (Jersey) Law 2014 the Commission is required  These fees include: -

to: -

Making an initial application for registration as

1. keep proper accounts and proper records  a provider or a manager (Article 4)

in relation to the accounts; and

An annual fee for continued registration

2. prepare accounts in respect of each  (Article 9)

financial year and a report on its

operations during the year.  Applying for a variation on conditions of

registration (Article 17)

Income forecasts and the expenditure budget

are agreed at the beginning of each financial   Replacement of registration certificates

year with the Commission. The Commission  (Article 8)

determines areas of expenditure in accordance   Provision of printed copies of Commission with its annual priorities. report (Article 38)

The Commission cannot commit to any new  The sponsor division is the Department for expenditure unless it can be met from within  Strategic Policy, Planning and Performance the Commission s available funds or from an  (SPPP), within the Government of Jersey. additional recurring or non-recurring allocation  The Department (SPPP) has responsibility for approved by the Accounting Officer.  the provision of adequate financial and other In 2019 the Commission received the necessary  resources required to support the function of approval and a non-recurring allocation of  the Commission.

funds to engage Ofsted to undertake a follow  The Accountable Officer for the appropriate up inspection of children s social work services. use of public funds, including the funding for The Government of Jersey provides a financial  the Commission, is appointed in accordance management service to the Commission,  with the Public Finances (Jersey) Law 2019, including in relation to its core budget and fee  and is the Director General for Strategic

Policy, Planning and Performance. It is the income (Commission funds).

responsibility of the Accounting Officer to Income Sources ensure the Commission represents value Income is received from sources including fees  for money.

from medical and healthcare professionals,  Where the Accounting Officer has concerns from regulated activities and from piercing and  relating to fee income, the Accounting Officer tattooing practitioners and premises. A direct  will inform the Chair and Chief Inspector and allocation is provided from the Government of  may report those concerns to the Treasury Jersey specified within the core budget. and Exchequer; the Comptroller and Auditor The Regulation of Care (Jersey) Law 2014  General. No such concerns arose or were

was agreed by the States Assembly on the  reported in 2019.

understanding that the former Inspection  The Accountable Officer delegates the

Team s budget would be grant-funded to the  management of funds to the Chief Inspector Care Commission and that this would represent  in accordance with the Department s Scheme approximately 45% of the total cost of  of Delegation and the Government of Jersey s administering the Law. These monies, the core  Public Finances Manual in accordance with the budget, were transferred to a dedicated  Public Finances (Jersey) Law 2019.

The Department works with the Treasury  The staff working for the Commission are Department to ensure the provision of a core  employed by the States of Jersey Employment budget to the Commission, post staff to the  Board (SEB). The terms and conditions of Commission and provide a HR framework for  employment of Commission staff are the supporting staff appointed by the Commission  standard SEB terms and conditions, and staff and providing financial management and other  are remunerated accordingly. The Commission agreed services to the Commission. appoints and manages its staff in accordance Recurring expenditure consists of both  with the relevant SEB policies and procedures.

pay, including staff salaries and pension  The Commission is required to complete an contributions, and non-pay, including goods  Annual Financial Assurance Statement.

and services.  The Commission s accounts for 2019 have been Essential support services including provision of  audited as part of the whole of Government

office accommodation, information technology,  accounts and the Government of Jersey Annual payroll and legal services are provided directly  Report and Accounts for 2019 was published on to the Commission by the Government of  02 April 2020.

Jersey at no direct cost. This represents part of

the Government of Jersey s contribution to the

overall operation of the Commission.

Income and Expenditure Jersey Care Commission Budget Outturn 31 December 2019

Year to date  Full Year  Full Year Forecast Year to Dec  Year to Dec  Full Year

IFRS Consolidation Budget Variance  Budget Variance  

Actual 2019 Budget 2019 Forecast 2019

(Adv)/Fav 2019 (Adv)/Fav

Fee income - regulated

(206,230) (167,715) 38,515 (167,715) (167,715) 0 activities

Fee income - other (31,060) (34,755) (3,695) (34,515) (34,755) (240) Total Income (237,290) (202,470) 34,820 (202,230) (202,470) (240)

Staff Costs 472,541 495,252 22,711 476,026 495,252 19,226 Supplies and Services 112,062 111,528 (534) 107,243 111,528 4,285

Administrative Expenses 7,200 3,500 (3,700) 3,500 3,500 0 Premises and Maintenance 1,139 12,250 11,111 13,450 12,250 (1,200) Total Expenditure 592,942 622,530 29,588 600,219 622,530 22,311

Total Net Expenditure 355,653 420,060 64,407 397,989 420,060 22,071 355,653 420,060 64,407 397,989 420,060 22,071

The Care Commission s final outturn was an  NOTES TO TABLE 1.

underspend of £64,407. 1.0  The Commission s total net budget was reported as £420,060

2.0 The Commission s full year forecast expenditure was reported as £397,989

This was mainly attributable to an overachievement  3.0 The Commission s full year actual net expenditure was reported as £355,653 of income (£34,820) and an underspend in staff  4.0 The budget variance was reported as an underspend of £64,407

5.0 The Care Commission accounts were audited as part of the overall

costs (£22,711) Government of Jersey audit

Remuneration of Chair and Non-Executive Board Members:

Expenses (travel,  Restated Fees Date  Fees (bands of

Name accommodation  2019 Total (Fees +

Appointed £5,000) £000

and subsistence) Expenses)

Glenn Houston / Chair 01 May 2017 15-20 3200 15-20 Ann Abraham / Commissioner 10 May 2017 0-5 2600 5-10 Alison Allam / Commissioner 10 May 2017 0-5 1700 0-5 Lisa Jacobs / Commissioner 01 July 2017 0-5 0 0-5 Si n Walker -McAllister / Commissioner 10 May 2017 0-5 3000 5-10

NOTES TO TABLE 2. 2.0 Four of the five Commissioners live off Island and incur additional costs in 1.0  Fees are stated in bands of £5,000 for the period from  respect of travel, accommodation and subsistence.

 01 January - 31 December 2019 3.0 All five Commissioners were appointed for an initial term of 3 years.

4.0 Expenses are rounded to the nearest £100 Jersey audit

The Commission has both a strategic and an operational structure.  The Commission s strategic focus is to develop a comprehensive Its work is overseen by a Board of Commissioners who have a  and effective regulatory infrastructure that protects and promotes range of professional and carer/service user experience. the rights of people who use the services it regulates.

1. Ensuring that the services we  To enable the Commission to deliver its regulate are safe, well led and of high  strategic priorities, it had objectives linked quality, by developing and delivering  to the following key business priorities for an effective system of regulation and  2019-2020:

inspection of health and social care   Regulation and Inspection

services in Jersey.

2. Involving people who use and provide   Public Engagement

care services by consulting and   Professional Registration

engaging with service users, carers,   Collaborative Working

providers and other stakeholders in

all aspects of our work.  Leadership and Delivery

3. Keeping the people of Jersey  The next section of the report will constitute informed about the work of the  an analysis of performance in respect of Commission and the outcome of our  each of these priorities.

inspections.

Left to right: Alison Allam, Ann Abraham, Glenn Houston (Chair), Si n Walker -McAllister, Lisa Jacobs 4.  Encouraging the services which we

regulate to be self-motivated with a

focus on quality improvement.

The operational  Audrey Murphy   Linzi Mudge  Allison Tandy  aspects of the  Chief Inspector Regulation Officer Regulation Officer  

Commission s  Bradley Chambers  Geoff Gurney   (commencing 2020) function are  Head of Governance,  Regulation Officer Mandy Bates  

undertaken  Policy and Standards Administrative Officer by a team  Dave Luscombe  Lesley CallanderRegulation Officer   Sally Hazley  

consisting of: Regulation Officer (commencing 2020) Administrative Officer

Build a strong team of skilled and experienced regulation officers  Carry out a planned annual programme of announced and and support staff who will deliver an effective regulatory regime  unannounced inspections of all registered services for adults for Jersey which supports best practice and drives continuous  and children in Jersey.

improvement.

How successful has

How successful has this been so far? Despite the turnover and the lead in  this been so far?

time to complete key appointments,  It is a legal requirement that

The composition of the Commission  the Commission has undertaken its role  every service registered under changed throughout the course of 2019.  effectively, albeit with a need to manage  the Law receives a minimum of Following the retirement of the former Head  the particular challenges associated with  one annual inspection in every of Professional and Care Regulation who had  recruitment and retention. 12-month period since it became managed the team thrprior to the enactment of the Lawoughout the period , the new  registered.

What more needs to happen?

Chief Inspector took up her appointment in

The number of regulated September 2019.  The Commission needs to ensure that all

activities as of the end of 2019 new staff members receive appropriate

The role of Head of Governance Policy and  are represented in Figure 1.

induction and that existing staff have

Standards came into being in early 2019 and

access to appraisal and workforce training

the new post holder commenced in June.  The number of inspections which

opportunities. New staff need to feel

were completed as of the end of Two Regulation Officers left their roles in  welcomed into the team and fully involved

2019 are represented in Figure 2. 2019 and have been replaced by two new  in the operation of the team. This is a priority

Regulation Officers appointed towards the  in the first quarter of 2020.

end of 2019.  What more needs to

All staff members will require an annual  happen?

There are two administrative staff members  appraisal in 2020 and will receive support

who provide the necessary office support  to ensure that their needs in respect of  The programme of inspections functions, facilitating the effective operation  Continued Professional Development  needs to continue in 2020

of the service.  (CPD), are met. to ensure that the statutory

requirement is met and continues to be met.

Type of Regulated Activity

7 Children's Residential Homes

1 Day  Care  

Home  47 Care

25 Care Homes

Figure 1: Number of services which are subject to the provision of the Regulation of Care (Jersey) Law 2014 as of 31 December 2019

Inspections completed

6 Children's Residential Homes

1 Day  

Implement the approved standards for all regulated activities as  Care  a framework to measure the quality, safety and effectiveness of  Home  

these services 8 Care

How successful has this been so far?  What more needs to happen? 43 Care The Commission has developed four sets  The standards need to be reviewed following  Homes of standards for each of the following areas  feedback received from service providers,

of regulated activity: care homes; children s  to ensure that they are focussed on meeting  Figure 2: Number of registered services which received at least one residential care services; home care services  the needs of service users. One such  inspection as of 31 December 2019

and day care services. These standards are  example has been involving service users

published on the Commission s website -  in the development of standards relating to

www.carecommission.je. children s supported accommodation.

Regulated services are inspected against  As other services become regulated, these standards. Following an inspection,  new standards will be developed and services are issued with a report which  published for activities new to regulation. summarises these findings. In the event

that they do not demonstrate that they are

meeting the standards, a service may be

issued with an improvement notice.

Complete a programme of pre-registration inspections of all services new to regulation including residential care homes, domiciliary care providers and adult day care service providers.

How successful has  What more needs to happen?

this been so far? The Commission must continue to work The Commission has worked with each  with any developing services which are yet

of the services required to register in  to register to enable them to confidently 2019 and has developed a collaborative  and successfully complete the registration approach in supporting them to become  process.

registered. Pre-registration visits took

place throughout 2019 and will continue

to occur as new services are developed

across the island.

Introduce a programme of regular inspections for all children s

residential care services in Jersey.  Commission a follow up inspection of children s social work

How successful has this been so far? relating to children s residential services.  services in Jersey.

This has been of significant benefit to the

Children s residential care services include

Commission and has provided an excellent  How successful has  What more needs to happen?

care homes, secure accommodation and

foundation upon which the Commission is  this been so far?

residential respite settings in which children

able to build.  The findings of these inspections continue and young people live or stay and receive  The Commission appointed Ofsted to  to be considered by the Government of personal support, personal care or nursing  What more needs to happen? return to Jersey in 2019 and undertook a  Jersey and embedded into practice.

care. There are currently seven children s  The Commission must continue to build  follow up inspection of children s social  The Commission will consider undertaking residential care services registered in Jersey  and maintain relationships with each of  work services in September.  targeted work in specific areas where a

for children and young people aged between  the newly-registered children s residential  The follow up report (Making a Difference;  need for improvement has been identified. 0 and 18 years. These comprise four small

care services to ensure that the children

children s homes; two short breaks centres  Driving Improvement - An Inspection of The  It is intended that the inspections of

and young people living in these facilities

for children with a disability; and one secure  Government of Jersey Children s Social  children s social work services will become

are directly engaged and can inform the

children s home. Work Service) was published in December  a statutory duty of the Commission.

outcome of the inspection process. and is available on the Commission s  As such, regulations and standards

In addition, the Commission has also  There are currently 5 hostels for young  website.* covering specific aspects of services for registered two supported accommodation  children and young people (to include early

units for young people and young adults  people and young adults, aged between  It is intended that further work will continue  help; fostering; leaving care and support aged 18 to 21 who require additional support  18 to 25, operating in Jersey. On account of  and that the Commission will, over time,  after leaving care), will be developed in

as they move towards independence.  the rin these facilities, they do not currelatively low level of support prently ovided  build capacity within the team to undertake  consultation with stakeholders.

It has also registered a homeless hostel for  inspections of children s services, drawing

meet the definition of a regulated activity.

children, young people and young adults  support from Ofsted and other external

However, this will remain under review and

aged between 16 and 25. sources as required.

the Commission may support these services

Each of these services have been subject  to seek to register in the event that the level

of registration and a first inspection and will  of support provided increases.

receive a minimum of one inspection per

The Commission will work with the Children s

annum.

Commissioner in developing and facilitating

One regulation officer has recent relevant  a rights-based approach to the inspection of

experience of working with children and  services for children and young people.

young people and specific knowledge

* Making a Difference; Driving Improvement: A Follow-Up Report https://carecommission.je/wp-content/ uploads/2019/12/Ofsted-progress-report-FINAL-Copy.pdf

Hold service providers to account by taking corrective action  Provide a voice for service users, by ensuring that service providers when they fail to comply with regulations or conform to the  operate robust systems for investigating complaints relating to relevant standards in delivery of health and social care.  possible regulatory breaches and, where necessary, undertaking

inspections to investigate concerns.

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

The Commission has undertaken 10  The Commission must ensure that the  How successful has  What more needs to happen? investigations relating to complaints/ Escalation Enforcement and Review  this been so far?

concerns about standards of care in  policy is ratified and published following  The Commission has produced a regulated activities in the course of 2019. consultation.  All service providers are required within  Communication Strategy which includes

the standards to have and to operate a  the following priorities:

The Commission has the authority to issue  The Commission will continue to adopt a  complaint process and complaints must be

improvement notices where it identifies  right touch approach whereby responses  directed to the responsible individual at the   Develop an understanding among people breaches of regulations or standards. No  are evidence-based and proportionate  regulated activity in the first instance. who use services, their families and improvement notices have been issued in  to the level of concern.  carers and members of the public of 2019. However, where concerns relating to  When a complaint is brought to the  the role of Commission.

any potential breaches have been identified,  The Commission has identified a need to  attention of the Commission it is responded

the Commission has acted by issuing advice,  improve its recording systems in relation  to appropriately. Complainants are   Encourcarers and otherage service users to contact the s, relatives,

both formally and informally, to services  to information received relating to  provided with information relating to

about how they might ensure that deficits  standards of care. how the complaint has been addressed,  Commission when they have a concern might be resolved. either by the service provider or by the  renhancing an island-wide underegarding a service provider by standing

The Commission has developed a draft  Commission.  of and confidence in the Commission. Escalation, Enforcement and Review policy.  Inspections have included the voice of

The purpose of the policy is to ensure that  the service user; Regulation Officers   Ensura process of stakeholder consultation e that new policies are subject to there will be a transparent process through  have sought the views, opinions and  before being approved.

which the Commission can hold services to  perspectives of people who receive

account where there are identified breaches  services and have recorded these within  In addition, a draft Complaints Policy

in either regulations or standards. inspection reports.  (which sets out the Commission s expectation that providers of regulated

Each of the Commissioners has lived  activities have robust complaints experience of caring for others. One  arrangements in place in responding to

Commissioner is actively caring for a family  complaints about the quality of care) member with special needs. This has  is due to be finalised early in 2020. proven to be invaluable in ensuring that

the Board reflects a variety of perspectives  In combination, these priorities are

which can better inform practice. intended to become embedded into the

work of the Commission to ensure that the public understand the role, function and purpose of the Commission.

Provide the public with access to relevant information such as  The Commission is able to accurately

quantify the number of phone calls it registration guidance, application forms, legislation, regulation  receives but does not currently log the

and standards and inspection reports.  number of emails it receives. It will devise

a means of capturing this information

alongside the evaluation of the usefulness How successful has this been so far? What more needs to happen? of the website and other media.

The Commission s website includes all of  The website is in the process of being  Further workshops and engagement

the necessary guidance and forms relating  further developed to provide more  events will allow the Commission to source to the registration process. The website  extensive and detailed information.  the views of a range of stakeholders,

also includes information about the relevant  It is acknowledged that the website  particularly in the development of further legislation, regulations and standards.  needs to be more accessible and easier  sets of standards and policies.

The Commission has been mindful of the  to navigate. Additional improvements

need to respond positively to feedback from  will be necessary. It is also acknowledged

stakeholders with regards to the quality and  that other mechanisms for engendering

accessibility of its website. Consequently,  public engagement e.g. use of other social

numerous changes, alterations and  media resources, would be of benefit.

improvements have been made to the

Inspection reports will be included on the

website throughout the year in response to

website in 2020.

the feedback received.

To ensure that regulated services feel adequately supported by the Commission, each service is allocated to a Regulation Officer. This promotes consistency and continuity. The office duty system will continue, during working hours, so that requests for advice and support will be responded to as quickly and efficiently as possible.

Over the course of 2019, the website had 3,335 users and 6,780 hits.

Raise the profile of the Jersey Care Commission with the  organisations we regulate, as well as with service users  and carers.  

How successful has this been so far? The Commission has facilitated four  

workshops in 2019 on the subjects of  Since its inception in 2019, the Commission  

Statements of Purpose; Quality Assurance  has engaged with many services through  

and monthly reporting and the inspections  its process of pre-registration visits and  

process. These workshops were well  annual inspections. It operates a duty  

attended by providers and managers of  system whereby a representative of a  

regulated services and have been both  regulated activity may contact someone in  

positive and productive in seeking their  the Commission for guidance, advice and  

views on the implementation of the  support; to request information or to raise  

regulations and standards.

concerns/make complaints. This system is  

well-utilised, and the Commission receives  What more needs to happen?

many contacts from people requesting  

The Communication Strategy outlines the  advice daily.  

types of activity which the Commission  In the course of 2019, the Commission  must undertake to raise its profile and  received a total of 5868 phone calls. to enhance its reputation with regulated  

services as well as with service users  

and carers.

DENTAL MEDICAL Ensure the health and social care workforce in Jersey is  PRACTITIONER

appropriately qualified, registered and fit to practise.

How successful has this been so far? The Commission maintains a register of all

bodies corporate carrying on businesses

Tunder this law arHealth and social carhe list of professions which are listed in Appendix 1e professionals e register. able  3 139

as optometrists or as dispensing opticians.

The following tables detail the number of

health and care professionals who were

are required to have and to maintain  New  New

registered by the Commission in 2019:

qualifications which are directly  Registrations  Registrations commensurate to their role. Most are also  in 2019 in 2019

required to be registered with a relevant UK  

registering body. These requirements vary  HEALTH CARE

depending upon the role. For example, in

order to practise in Jersey, a social worker  REGISTRATION: Dental Nurse 2

must have a professional social work

qualification and must also be registered  Dental Hygienist 1 Medical practitioners are

with Social Work England.  not required to undergo a

In addition, 38 dental professionals  renewals process.

Some registered professionals are required  renewed their registration with the

238

to complete an annual renewal application  Commission in 2019.

in order that they may continue to practise

in Jersey. The Commission has successfully

ensured that this has taken place. RegistrNew ations

In addition, the Commission has statutory  in 2019 What more needs to happen?

functions designated under the following  PIERCING &  The Commission will develop, with external laws: TATTOOING  support, the online renewal process and an

Piercing and Tattooing (Jersey) Law 2002  PRACTITIONERS online registration process. This will have the (including the practices of acupuncture  effect of making the registration and renewal and electrolysis) process more streamlined and user friendly.

Whilst this is in progress, the Commission will continue to maintain its existing process which

Designated Yellow Fever Centres -  

International Health Regulations 2005

24

is a combination of both paper-based and online registration.

Nursing Homes (Jersey) Law 1994 (in  

respect of the use of certain classes of  lasers)

The Commission will continue to work with members of the health and social care workforce to ensure that any difficulties associated with individual registrations are promptly and successfully remedied. It will continue to support all registered professionals in maintaining their registered status and

New Registrations in 2019

Opticians (Registration) (Jersey) Law 1962

In 2019, the Commission renewed the  registration of 60 piercing and tattooing  premises. There were seven newly  registered piercing and tattooing premises  in 2019.  

Premises 7 Practitioners 17

will continue to ensure that applications for renewal are processed quickly.

While the Commission is not required to  

The Commission will support professionals undertake an annual inspection of these

who are new to the process of registering in premises 61 inspections were undertaken in  In addition, 1903 health

2019.  professionals renewed their  In addition, 65 premises and

Jersey to ensure that they understand their registration with the Commission  85 practitioners renewed their  own responsibilities as well as the role and

All premises registered to operate certain  in 2019. registration with the Commission  responsibilities of the Commission.

classes of lasers received an inspection.  in 2019.

All Designated Yellow Fever Centres received an inspection.

Maintain effective regulatory links with other organisations which  Maintain and develop appropriate links with organisations that have shared responsibilities for the oversight of professional  have a shared interest in the areas regulated by the Jersey Care regulation in Jersey, e.g. General Medical Council (GMC),  Commission e.g. Safeguarding Partnership Board, Office of the Nursing and Midwifery Council (NMC), Social Work England  Children s Commissioner, Chief Nurse, Medical Practitioners local and Health and Care Professions Council (HCPC)  Responsible Officer.

How successful has this been so far?

The Commission has raised the awareness of its existence and role with organisations which are external to Jersey. This has taken the form of communications relating to the registration of individual professionals who are registered with UK bodies and who are seeking to register to work in Jersey.

What more needs to happen? How successful has

The Commission will ensure that all the  this been so far?

regulatory bodies are made aware of its  The Commission has developed links role and function and are invited to engage  with each of these organisations. There is in the formulation of formal Memoranda  already a Memorandum of Understanding of Understanding and/or Data Sharing  with the Government of Jersey. Therefore, Agreements. all organisations within the Government

of Jersey are able to share information with the Commission as appropriate, in the interests of safeguarding adults and protecting children.

What more needs to happen?

The Commission needs to ratify memoranda of understanding with the Safeguarding Partnership Board and the Office of the Children s Commissioner.

It needs to sustain and develop its relationship with each of the organisations which have a shared interest in the matter of regulated services. and purpose of the Commission.

The Commission has a responsibility to share such information with these bodies as required and in line with associated data protection law and policy.

Appoint a new Chief Inspector to assume the responsibilities of the Head of Professional and Care Regulation, in June 2019

How successful has this been so far? Appoint a Head of Governance, The Chief Inspector was appointed to this  Policy and Standards to support role and took up her responsibilities in  the role and functions of the September 2019. Care Commission

The Head of Governance, Policy and Standards was appointed to this role and took up his responsibilities in June 2019.

Maintain and develop a system of corporate governance which ensures effective oversight and accountability for the work of the Care Commission

How successful has this been so far?

The work of the Commission is overseen  Glenn Houston 6 out of 6 by a Board of Commissioners. The role and

responsibilities of the Commission are set  Ann Abraham 5 out of 6 out in Schedule 2 of the Regulation of Care  Alison Allam 5 out of 6

(Jersey) Law 2014. The Board usually meets

six times a year. These meetings are open to  Si n Walker -McAllister 5 out of 6 the public.  Lisa Jacobs 6 out of 6

The Board receives reports from officers

employed within the Commission and also  Where Board members were unable to receives updates of progress of work. It  attend, apologies were received on each maintains and updates a risk register of both  occasion.

strategic and operational risks. The Board

also ratifies policies and other corporate  In addition to the Board meetings, the documentation.  Commission facilitated two workshops

in 2019 which were attended by both

The Commission is accountable to the  Commission staff members and Government of Jersey as an arms- Commissioners.

length organisation. This concords with

a Memorandum of Understanding which  What more needs to happen?

was signed by the Chair of the Board of  The Board members current terms of office Commissioners and by the Chief Minister in  are due to be reviewed in 2020.

December 2018.

The Board will continue to meet throughout In 2019, six meetings of the Board of  2020 and will continue to hold the

Commissioners took place. The attendance  Commission to account for its operational of Board members is shown in the following  activity.

table:

The existing KPI s are predominantly quantitative. Whilst this was appropriate

in the earliest stages of the Commission s existence, it is now necessary that the Commission develops other KPI s in order to have a varied range of outcome measures and to assess its progress more holistically.

1. The number of inspections carried out and inspection reports published in each of the following services

Care Homes for adults

Children s Homes

Domiciliary Care Providers (Home Care) Adult Day Care Centres

The Commission s follow up inspection report involving Ofsted, published in December 2019, Making a Difference; driving Improvement , is available on the Commission s website.

No other inspection reports have been published on the basis that 2019 was the first year of enactment of the new law.

As such it was reasonable that service providers were provided with a 12-month period in which to become familiar with the law and of the regulations and standards associated with their obligations under the law.

Service providers were provided with advance notice that 2020 would constitute the first year in which inspection reports would be published openly. Consequently, it is the Commission s intention that

these reports will be published on the Commission s website throughout 2020 as they become available.

Service providers will be provided with the opportunity to read the reports and to undertake a factual accuracy check prior to them being published. The Commission operates a no surprises policy in this

Therefore, the Commission will develop a set of outcome-based performance measures throughout the course of 2020.

The following indicators, linked to our strategic and business objectives described above, were used in 2019:

regard whereby providers should be made fully aware of the content of a report about their service prior to it becoming publicly accessible.

2. The number and outcome of enforcement actions

To date there have been no enforcement actions undertaken. This is positive in that the Commission will endeavour not to pursue formal enforcement actions

in respect of service providers where recourse to advice and guidance is appropriate and appropriate and is sufficient to bring about the desired change.

The Commission seeks to adopt a collaborative approach in working with service providers to encourage improvement rather than to pursue a process of escalation and enforcement.

However, it is acknowledged that

there may be occasions where such

action is warranted. The Law has provision to enable the Commission to intervene through a stepped approach

to enforcement. Consequently, the Commission has developed an Escalation, Enforcement and Review policy. This is currently a working draft pending a period of consultation with relevant stakeholders. Once this is completed, the policy will be ratified and made available publicly on the Commission s website.

The Chair of the Board, in combination with the Chief Inspector and Head of Governance, Policy and Standards will continue to

meet quarterly with representatives of the Government of Jersey in order to provide assurances that its contractual obligations

are being met.

3. The number of health and social  7. The number and outcome of  

care professionals added to  reports about health and social  and removed from the Jersey  care services requested by the  register. Chief Minister or Health Minister  In the course of 2019, 284 health and  and provided by the regulator in  social care professionals were added  response to emerging issues.

to the register and 168 were removed.  A Ministerial Direction was issued to  

A total of 1894 renewals were received  the Commission in 2019 to facilitate  

by 31 December 2019.  the independent follow up inspection  

of children s social work services with  

4. The number of health or social  Ofsted.

care professionals referred to

a UK regulator for fitness to  8. The number and outcome of

practice issues. reports about health and social  9. The number and outcome  10. The number of Memoranda of

To date, one such professional has been  care services initiated by the  of public and stakeholder  Understanding (MOU s) agreed referred to their UK regulator on account  Commission in response to  engagements and consultations  with relevant regulatory bodies. of fitness to practice issues. emerging issues aimed at raising the profile of the  To date the Commission has an MOU

5. The number of inspections  As referred to in 5 (above), ten instances  Care Commission in Jersey. with the Government of Jersey. It

of regulatory activity arising from  In the course of 2019, there were five  has MOU s in draft form with each carried out in response to a  information received about standards  of the Safeguarding Partnership

concern or complaint about  of care are recorded. Some of this  separate stakeholder consultation events  Board and the Office of the Children s service level provision in a  activity pre-dates the point at which  which focussed upon the following areas  Commissioner. The development of particular setting. services became registered (and  of activity: MOU s with regulatory bodies external

Ten inspections were undertaken in  therefore regulated).   Statements of purpose to Jersey is a priority for 2020.

response to a concern or complaint  The regulatory activity did not   Quality Assurance and monthly

received relating to service level  necessarily result in the compiling  reporting 11. The outcome from surveying provision in 2019. of inspection reports.   Standards for children s supported  service providers and other

The Commission will systematically  accommodation services stakeholders to gauge their

6. The number and outcome of  receive and record information   Inspection process and reports  views about the impact of consultations completed in  pertaining to emerging issues and  (2 sessions) inspection on driving service respect of draft standards. will determine how best to analyse  The feedback from each of these  improvement  

Care Standards relating to Care Homes,  and respond to these contacts. sessions was overwhelmingly positive.  This is an ongoing area of work in Home Care, Children and Young  As a result of the inspection sessions in  that service providers and others will People s Residential Care, Day Care  November, the Commission has a pool of

have been completed and published  stakeholders who have offered to provide  be able to continue to provide their

on the Commission s website.  support in contributing to consultation  perspectives in relation to inspections.

work relating to draft policies. This will

Consultation events with representatives  take place in 2020.

of regulated activities took place at the

end of 2018 and the feedback from  Engagement and consultation has been

stakeholders was used to inform the  broader than formal and organised

final versions of the standards.  events. Much of this work necessarily

happens on a smaller and less formal

Currently, the Supported  basis. For example, the standards

Accommodation standards for young  relating to children s supported

people leaving care are in draft form and  living services have been shared and

consultation has taken place in respect  discussed with each of the proposed

of these. registered managers and were presented

to and discussed with young people

using the service.

Whilst this report covers our activities in 2019 it is appropriate to look to the future with confidence.

Regulation and Inspection  Encourage service users, relatives,

carers and others to contact the

The programme of inspections will

Commission when they have a concern continue in 2020 to ensure that the statutory

regarding a service provider by enhancing requirement is met and continues to be met.

an island-wide understanding of and

All regulated services will have a named  confidence in the Commission. Regulation Officer to better ensure business

As part of its communication strategy, continuity. Newer members of the team will

the Commission will develop its website in undertake inspection work with support

order that it encompasses a wider range from more experienced Regulation Officers

of information which is presented in a way as part of their induction process.

which is more accessible for members of Inspection reports will be published on the  the public.

Commission s website throughout 2020.

To Commission will continue to build and The Commission will continue to work with  maintain relationships with each of the

any developing services which are yet to  newly-registered children s residential register in order that they can confidently  care services. It will develop a strategy for and successfully complete the registration  ensuring that the views of the children and process. young people who receive care in these

facilities is consistently captured in order The existing standards will continue to be

to better inform the inspection process and applied with attention given to collating

in order to ensure that these service users and interpreting feedback from the sector

perspectives are more fully understood regarding their quality and utility.

As other services become regulated such  Professional Registration

as children s social work services and Child

and Adolescent Mental Health Services  The Commission will continue to work (CAMHS), the Commission will continue  towards developing the online renewal

to develop associated standards and to  process and registration processes.

publish them once they are finalised. It will continue in its role of providing

a service to professionals whereby

Public Engagement registrations are processed promptly

and where any difficulties arising from

The Commission will embed its

the registration processes are responded communication strategy into its culture

to efficiently.

and practice. Specifically, it will devise

a programme of communication  The Commission will continue to raise enhancement for 2020 based upon  awareness of its existence, role and function the following priorities:  with external regulatory bodies and will

formulate Memoranda of Understanding

Develop an understanding among people

or other such formal data sharing

who use services, their families and carers

arrangements where this is possible.

and members of the public of the role of

the Commission.

Collaborative Working Leadership and Delivery

The Commission will work with the  The Commission will work towards Government of Jersey in embedding into  strengthening its team of staff by inducting practice the recommendations of both  and supporting new staff members;

the Ofsted-led inspection and follow-up  ensuring that a programme of regular inspection. The Commission will determine  supervision is more fully embedded into how it can facilitate sustained improvement  the culture of the team and in undertaking and to make sure that any loss of  annual appraisals.

momentum is appropriately challenged.

Attention will be given to the matter of

The Commission will work collaboratively  Continued Professional Development (CPD) with the Government of Jersey to ensure  by devising a programme of training and that areas requiring improvement are  learning and by undertaking a detailed appropriately targeted and reviewed. analysis of individual learning needs.

The Commission will ensure that the  The Commission will consider its following policies are ratified, consulted  requirements going forward and whether on and published: it needs to expand its core skill set in

accordance with any planned extension of

Inspection Policy

its regulatory reach in 2020 and beyond.

Escalation. Enforcement and

Review Policy The Commission has identified a need to improve its recording systems in relation to

Complaints (about the Commission)

information received relating to standards Policy

of care. It will therefore undertake

Complaints (about regulated services)  a process of enhancing its internal

Policy  governance processes. This will include

In doing this, the Commission will facilitate  specific concentration on improving risk

a consultation process with relevant  management, information management, stakeholders. data protection and financial oversight of The Commission is conscious that it exists  income and expenditure.

within a context of change and improvement  The Board will continue to meet throughout in relation to service delivery. Consequently,  2020 and will continue to hold the

it will continue to be mindful of external  Commission to account for its operational drivers of change and will seek to engage  activity.

with bodies such as the Office of the

The Chair of the Board, in combination Children s Commissioner, the Safeguarding

with the Chief Inspector and Head of Partnership Board as well as with

Governance, Policy and Standards Government of Jersey agencies where there

will continue to meet quarterly with

is a benefit associated with coordination of

representatives of the Government of activities and of joint-working.

Jersey in order to provide assurances that its contractual obligations are being met.

The constitution of the Board will be kept under regular review and where necessary, recruitment of additional Commissioners initiated.

Professions which are registered by the Commission.

Legislation Registrable Professions

Ambulance paramedic

Art Therapist

Biomedical scientist

Chiropodist

Chiropractor

Clinical psychologist

Dietitian

Midwife

Midwife prescribing practitioner Nurse

Nurse prescribing practitioner Occupational therapist

Operating department practitioner Orthoptist

Health Care (Registration) (Jersey) Law 1995.  Osteopath

Physiotherapist

Health Care (Registration) (No.5)  Podiatrist

(Jersey) Regulations 2019: 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

Clinical dental technician Dental hygienist

Dental nurse

Dentistry (Jersey) Law 2015

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

30 | Jersey Care Commission | 2019 Annual Report