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R.106/2022
CONTENTS
2021 HIGHLIGHTS & ACHIEVEMENTS (AT A GLANCE) 2 INTRODUCTION 4 FOREWORD 5
PERFORMANCE SUMMARY 8
Performance Report 9 Regulation and Inspection 10 Professional Registration 16 Public Engagement 18 Information Governance and Responsiveness 20 Governance Framework 21 Planning 22
Providing independent
assurance, promoting best KEPPYriority 1: Regulation and Inspectionriority 2: PPERFORrofessional RegistrMANCE INDICationATORS (KPI S) 22326283 practice and improving health PPPriority 3: Priority 4: Information Governance and Responsivenessriority 5: Governance Frublic Engagementamework 2931 and social care outcomes for Priority 6: Planning 33 the people of Jersey. [a]A CDCAOY UINN TTAHBEI LLI ITFYER EFPIOORNTA MCLAUGHLIN 3345
REGISTER OF INTERESTS 37 STATEMENT OF RESPONSIBILITIES OF THE CHAIR 38 STATEMENT OF RESPONSIBILITIES OF THE CHIEF INSPECTOR 39 THE WORK OF THE BOARD IN 2021 41 STAFF REPORT 42 SUSTAINABILITY REPORT 42 FINANCE REPORT 44
APPENDIX 1: INSPECTIONS QUALITY ASSURANCE
SUMMARY OF RESPONSES 48 APPENDIX 2: HEALTH CARE REGISTRATION: 54
Highlights & Achievements 2021 2021 at a glance
2021 OUR ROLE ACHIEVEMENTS
The Commission was appointed to:
provide the people of
Jersey with independent
assurance about the Appointed
quality, safety and
effectiveness of their one new Registered health and social care Completed Commissioner 127
services
105 medical inspections of practitioners
promote and support best regulated activities (doctors) practice in the delivery of
health and social care by
setting high standards and
challenging poor
performance
Appointed
engage with service users 2 regulation officers Successfully prthe renewals of the ocessed and their families and carto improve their experience ers Registered and 1 Administrative registration of
of health and social care and 338 Assistant 2219 health/care achieve better outcomes professionals
health/care professionals
facilitate the registration of a range of health and social care professionals in order that they may lawfully practise in Jersey
Registered
53 Successfully
dental health completed the recruited a new Successfully undertake regulatory professionals move to new Chief Inspector
functions prRegulation of Carescribed by the e (Jersey) Publishedinspection 73 office premises
Law 2014 and other laws reports
INTRODUCTION FOREWORD
The Jersey Care Commission, (the Commission), was established on 1st I wish to express my sincere I would commend all those employed in the front line of delivery of health and social care in Jersey
January 2019, with the enactment of the Regulation of Care (Jersey) Law thanks and appreciation to the for their continuing dedication and commitment to 2014 (the 2014 Law), and the Regulation of Care (Transfer of Functions) Team and to Commissioners for supporting the most vulnerable in society, sometimes
at considerable personal cost. Families too have (Jersey) Regulations 2018. their excellent contribution to the made great personal sacrifices in abiding by the
visiting restrictions imposed on care Homes during work of the organisation over the the height of the pandemic.
The Commission was appointed to: past year, particularly in light of The Board held six scheduled meetings during 2021.
provide the people of Jersey with independent facilitate the registration of a range of health continuing challenges associated Some werdistancing re held restrictions. During the second half of emotely, due to travel and social assureffectiveness of their health and social carance about the quality, safety and e and social carthey may lawfully pre professionals in oractise in Jerseyder that with Covid-19. the year Commissioners met in person, in Jersey.
services The minutes of our meetings are accessible on the undertake regulatory functions prescribed Commission's website.
promote and support best practice in the delivery by the Regulation of Care (Jersey) Law 2014
of health and social care by setting high standards and other laws; the regulatory responsibilities In 2021 we bade farewell to our first Chief Inspector and challenging poor performance having been transferred from the Minister who led the Team during the Commission's formative
for Health and Social Services to the years and had established a firm foundation. The
engage with service users and their families and Commission on 1st January 2019 search for a replacement concluded with the carers to improve their experience of health and appointment of Becky Sherrington. Becky is a
social care and achieve better outcomes qualified nurse and an experienced healthcare leader. Before joining the Commission in December 2021,
Becky was responsible for the Covid vaccination
This is the Commission s third annual programme in Jersey.
report and describes our performance
against the strategic and operational We said farewell to Lisa Jacobs, our Island based objectives set out in our 2021 Business Commissioner, and welcomed Lesley Bratch,
Plan. appointed for a three-year term. Lisa had made a significant contribution since 2018, and we have
The impact of Covid-19 in Jersey found an able replacement in Lesley. We appointed continued to be felt in respect of the two new Regulation Officers and an Administrative Commission s operations throughout Assistant.
2021. This report, whilst setting out our
achievements, describes the impact In April, the Commission published an Overview
of the challenges associated with Report of inspections of the seven registered care Covid-19 and identifies areas where homes for children and young people in Jersey. further progress is needed in 2022. Much of the fieldwork was undertaken in 2020.
The report highlighted concerns about children
going missing from care, the quality of the monthly monitoring reports, recruitment records and staff accommodation.
In July, the Commission published a review of arrangements for the regulation and inspection of Independent Home Care Workers (IHCWs). Of the 35 registered IHCWs, 12 voluntarily cancelled their registrations and the remaining 23 successfully applied to have their registrations renewed. In August, we published Procedures for Registration, a step-by-step guide for healthcare practitioners required, under the Healthcare Registration (Jersey) Law 1995, to register with the Commission.
We invited senior officials to Board meetings. In January the Director General for Strategic Policy, Planning and Performance (SPPP) outlined the key challenges facing the Government in respect of Covid-19 and the Government's plans for the extension of regulatory oversight of Children's Services. In July, a Policy Principal introduced the proposed new Regulations for services for children and young people, coming into effect in 2022.
The Children's Commissioner, attended the Board in September and outlined the findings of the publication 'Life on the Rock', stories of 21 young people living in Jersey. The Children's Commissioner highlighted the need to provide suitable accommodation for children and young people who are Looked After by the State, and the provision of effective support for those leaving care.
All regulated activities received at least one planned inspection. Inspection reports identify best practice and areas for improvement and are accessible on our website. The Commission placed discretionary conditions on some care home and home care providers, where appropriate.
In the first half of the year the Commission responded to requests made under the Regulation of Care (Standards and Requirements) (Covid-19 Temporary Amendments) (Jersey) Regulations 2020, to temporarily suspend conditions for some providers experiencing staffing shortages.
Throughout the year we met with Ministers, the Chief Executive and with other senior representatives of the States of Jersey. We strengthened our Governance arrangements in accordance with the recommendations of an Advisory Audit, undertaken by BDO on behalf of Internal Audit.
The search for suitable office accommodation concluded with a move, in December, to the new offices in Church Street, which provide the Team with much needed additional space in an environment conforming to the access requirements of the Discrimination (Disability) (Jersey) Regulations 2018.
Looking forward, we are preparing to extend registration and inspection to social work services for children and young people, to include fostering, adoption, child and adolescent mental health services and some other associated activities.
I hope you find this report both interesting and informative.
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 pandemic continued to present obstacles, but the Commission successfully completed the overwhelming majority of its scheduled inspections, albeit with more announced inspections than it would have preferred. Feedback from Providers and Managers from across the sector has been positive, with most respondents commenting that the inspection process is of benefit and has an impact in improving the quality-of-service provision.
The Commission s Board met six times in 2021 and An independent advisory audit of the Commission s maintained strategic oversight of the work of the governance arrangements was concluded in 2021
Commission. The Board put arrangements in place and led to a series of actions which have significantly to ensure that the Commission continued to function improved the Commission s ability to gather and effectively between August and December 2021, respond to information relating to the regulated sector.
during the Chief Inspector vacancy.
The Commission incurred additional one off and There have been several occasions when the recurring expenditure during 2021, such as contracting
Commission s Escalation, Enforcement and Review external consultants to lead and co-ordinate the search
Policy was utilised to hold providers of regulated for a new Chief Inspector, administrative support for Performance Report
activities to account, and approved Representation projects, and office relocation and rental costs. These The Commission s strategic focus is to develop a 5 ensure financial stability for the Commission to Procedures have been used on one occasion in 2021. additional costs were discussed and agreed with the comprehensive and effective regulatory infrastructure that deliver its core functions and the extension of
Government sponsoring department, Strategic Policy, protects and promotes the rights of people who use the those functions to all other health and social care TJheers reeyghisatse rb oefe hn e kaeltpht aunpd t oc adraet ep,r owfieths saiopnpaliclsaitnions for Planning and Performance, consequently additional services it regulates. services
funding was made available to cover these costs. The Commission had six key priorities throughout the
registration and renewal being processed promptly.
The register of medical practitioners allowed to practise The Commission s existing Standards remain course of 2021. These were to:
in Jersey needed to be revised and updated and action appropriate, but feedback from both the sector and 1 deliver an effective system of regulation and 6 engage effectively with representatives of
has been taken to address this. This work will continue the Commission s staff reflect a need for a review. In inspection of health and social care services in the Government of Jersey to develop robust
into 2022. addition, the Commission needs to develop Standards Jersey Regulations and Standards for services new to
In respect of the Commission s profile, it is apparent relating to statutory children s services, in order to regulation.
regulate this new area of work in 2022. 2 maintain an accurate register of relevant health and
that providers and managers of regulated activities social care professionals working in Jersey To enable the Commission to deliver its strategic
are aware of the Commission and its functions. The priorities, it established six key business objectives for number of duty calls, and notifications is testament 3 raise the profile of the Commission by consulting 2021 2022 under the following headings:
to this. However, there is a need to raise the and engaging with people who use and provide
Commission s profile more widely, to ensure that care services and other stakeholders in all aspects of Regulation and Inspection
receivers, their families and members of the public our work Professional Registration
have a clearer understanding of the role and functions 4 improve the Commission s capacity to gather, Public Engagement
of the Commission. This is an area of development and interpret and respond to information and Information Management and Responsiveness work will be undertaken in 2022 to address this. intelligence regarding regulated activities and Governance Framework
registered persons Planning
The next section of the report will provide a detailed analysis of performance in respect of each of these priorities.
Carry out a planned annual programme of announced and unannounced inspections of all regulated services and activities for adults and children in Jersey and publish the associated inspection findings on our website.
How successful has this been so far? The Commission undertook four pre-registration The intended annual programme of inspections has inspections to services which had applied to
been carried out successfully. become registered in 2021. This process enabled
the service providers to fully understand the
A total of 105 inspections were undertaken in 2021, requirements of the Regulation of Care (Jersey) Law Seven continued into early 2022. The Commission 2014 and the associated Regulations. It enabled
is required by law to undertake one annual them to ensure that appropriate preparation was inspection of each regulated activity and more made for registration and that the services would than one inspection at its discretion. In 2021, two meet the Commission s Standards.
services were inspected more than once. Four pre-
inspection visits were undertaken in services which What more needs to happen?
Maintain an effective system of regulatory oversight throughout the Covid-19 were newly registered in 2021. Of these services, The Commission will continue to undertake a full
one closed in 2021, two were inspected and one schedule of inspections of all regulated activities pandemic, continuing to adapt the inspection regime as necessary to will be inspected in 2022. All services that were due in 2022. It will continue to make appropriate
an annual inspection in 2021 have received at least preparations for the regulation of statutory safeguard people and prevent the spread of infection. The Commission will one. children s services and intends to commence
also develop a plan of recovery from the Covid-19 pandemic. The Inspection Reports pertaining to each of these inspection of some of these services in Quarter 4,
services, were published and are available on the 2022.
Commission s website.
How successful has this been so far? stakeholders, including the Jersey Care Federation.
The Commission developed a Covid-19 recovery This group discussed and formulated strategic An overview report of the Commission s regulation
plan which was reviewed periodically according responses to ongoing Covid-19-related matters. and inspection of the Government of Jersey s
to changes in the rates of infection in Jersey. This care homes for children and young people was involved a combination of measures to ensure that OConm3 mociscsaiosino nthsaitnd2u0e2t1o,pCroovviidd-e1r9s, nthoetiyfi ewdetrheeunable issued to the Director General of Children, Young
staff could work safely to undertake all scheduled to meet certain conditions on their registration. People, Education and Skills in March. The report inspections due in 2021. In undertaking inspections, Staffing shortages have been challenging and these sets out several key findings from the inspections Regulation Officers liaised with care home providers have arisen mainly due to outbreaks in care homes, completed in 2020, including concerns about
to ensure that inspections were undertaken staff testing positive for Covid-19 and/ or being missing from care episodes, staffing arrangements,
safely and with appropriate modification of the identified as direct contacts. Staffing shortages staff recruitment records and the role of the inspection methodology. All planned inspections led to a need for some care providers to source Independent Person.
were announced in the first half of 2021, although additional staff at short notice to ensure continuity The Commission continues to monitor information unannounced inspections became more frequent as of care. As a result of temporary amendments to submitted by Children s Services in relation to restrictions were eased. Regulations, the Commission was able to respond children s homes. This includes the reports of the
promptly and effectively, by providing a report to both visits undertaken monthly by the Independent Dapuprirnogp ir niastpee PcPtiEon,hs,a Rd edguuel aretiog na r Od ffifo cr e s ros c wia ol r e the Minister for the Environment and the Minister for Person, notifications of incidents, manager
distancing requirements and reduced the amount Health and Social Services, with recommendations absences, applications to vary conditions and
included. In each of these circumstances, a updates to Statements of Purpose.
oThf ed iCreocmtcmoinstsaiocntt hhaesy bheaednwmithincdafurel oref ctheeiv neerse.d to satisfactory conclusion was achieved quickly, and
balance such requirements against the requirement normal working practices were resumed. Aupptoosst-ixrecghisiltdrraetino nan indsypoeucntigo np eoof pal ecaargee hdo1m3ey rfso r to assure the public of Jersey that inspections have What more needs to happen? 18yrs, was undertaken in February. This facility
remained sufficiently thorough and robust. was the first and only care home for children and
The Commission will continue to be alert to
The Commission maintained its office duty system, young people provided by the independent sector.
government advice and direction and will make
The purpose of the home was to provide short
tforormemaacirno sasbtleh eto c raercee sive ec t ionfr, o arms wateioll n a sa nb de i inngte allbigl ee n ce term (four week) placements for children and
whatever adjustments are necessary to maintain a
satisfactory level of inspection. Our focus will remain
to respond promptly and effectively to queries and young people experiencing emotional difficulties,
on ensuring that the schedule of annual inspections
requests for advice, guidance, and support. or addiction and substance misuse. The home
is completed.
remained registered throughout 2021 but was
The Commission provided input into the weekly deregistered towards the end of the year.
Community Care Hub meetings, chaired by Health
and Community Services and attended by a range of
Apply the Regulations and Standards for all regulated activities as a framework to measure the quality, safety and effectiveness of these services.
How successful has this been so far? Ongoing escalation process from 2020 Regulations and Standards continue to be applied which culminated in the registration of a
in respect of all regulated activities. Where there home care service being cancelled.
is clear evidence that a regulated activity is not Decision to cancel the registration of an meeting the requirements of either the Regulations individual home care worker.
or Standards, an area for improvement is
identified in inspection reports. This correlates to Decision to issue an Improvement Notice in a requirement that the provider of the regulated respect of staffing concerns affecting one activity provides details of how any requested children s residential home.
improvement will be achieved. There were also several examples of escalation
processes being applied, with matters being
Timhep rCoovemmmeinsst iaonnd s metosnaiptoprrsotphreiamteetaimsuersecsawlehsi cfohr successfully concluded prior to formal
are taken to achieve the required outcome. This enforcement becoming necessary.
includes a follow up visit to a service provider, as What more needs to happen?
necessary. The Commission has further powers The Commission welcomes feedback in respect
to ensure that any necessary improvement of its existing Standards and will continue to
takes place and will take appropriate steps, in develop them throughout 2022. The Commission accordance with its Escalation, Enforcement and will develop new Standards in respect of ten Review Policy to ensure full compliance with the areas of statutory children s services which are Regulations and Standards. new to regulation. The Commission needs to
There have been three occasions in 2021 when develop Standards for the regulation of Supported enforcement processes were applied: Accommodation for young people.
Review the effectiveness of the existing Standards, incorporating the views of people who use and provide services.
Work 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.
How successful has this been so far? Commission is in the process of developing new A period of consultation in relation to the draft Standards which accord to these new Regulations.
Regulations associated with the regulation of What more needs to happen?
statutory children s services, was completed in
The Commission is in the process of working with 2021. The Commission provided a response to the
an external consultant to consider how they might consultation and sourced independent legal advice
be able to support the Commission in preparing for to assist in the scoping of the work associated
the regulating of statutory children s services. with the new areas of regulatory activity. The
Source suitable alternative office accommodation to meet the existing and future needs and requirements of the Commission in facilities suitably adapted to provide access to people who use and provide services.
How successful has this been so far? The Commission worked with Jersey Heritage to The Commission moved to the new premises ensure that documentation which needed to be in November 2021. The new premises are retained was transferred to the Jersey Archive. centrally located, fully accessible and meet the This was completed successfully.
requirements of the Discrimination (Disability) What more needs to happen?
Jersey Regulations 2018 and will enable the
This project has been completed successfully. growth of the Care Commission team.
How successful has this been so far?
The Team developed a targeted approach to inspections in 2021, which means that specific standards can be focussed on, in line with the type and categories of care provided. The Commission determines at the outset of each year which of the Standards it will afford priority, during that year s inspection programme.
Whilst it has been difficult to gather the views of people who use and provide services, due to
the restrictions associated with Covid 19, the Commission has sourced feedback from providers and managers of regulated activities. A common theme is that the Standards would benefit from a review in 2022.
Recruitment of a Regulation Officer with specific Hold service providers to account by taking corrective action when they fail to children s service experience was completed comply with Regulations, or to conform to relevant Standards, in the delivery
in 2021. This has enabled work to commence
in developing new sets of Standards relevant to of health and social care.
statutory children s services.
How successful has this been so far? Representation Procedures were approved by the What more needs to happen? Board in 2021. These needed to be applied for the Further developmental and collaborative work Twhaes Easpcparloavteiodn,b Ey nthfoer cCeommemnitsasniodnRseBvioeawr dp oalnicdy first time in the final quarter of 2021.
needs to take place with stakeholders to ensure is publicly available on the website. The policy What more needs to happen?
that the Standards remain appropriate, that people continues to guide the Commission s practice
who use services are aware of and understand and decision-making. In the main, there has been The policy will remain under continuing review them, and that they are meeting the needs of limited need for the Commission to take formal and will be adapted and updated periodically as people who receive care. Depending upon the enforcement action and it has usually succeeded required. The Representation Procedures need outcome of this collaborative approach, the in resolving matters of concern by escalation. to be fully concordant with both the Policy and Standards will be reviewed and may be updated In 2021, there have been two examples of principles of natural justice. Advice from Law accordingly. enforcement action resulting in the cancellation of Officers Department is being sourced, to ensure
that the Procedures are fully compliant. registrations. There has been one further example
of enforcement action which resulted in the issuing
of an Improvement Notice.
Professional Ensure the health and social care workforce in Jersey is appropriately qualified, Registration rCeogmistmerisesdio ann cda fint tmo oprrea cetfifseec.t Diveelvye elospta tbhleis rhe fintenwesasls t op rporcaecstiss ein. order that the
How successful has this been so far?
The Commission maintains the register and continues to process registrations of health and social care professionals in Jersey.
While there is no requirement to inspect registered
individual home care workers, a project has been Develop the use of the new IT portal to continue to maintain an accurate established to engage each worker in a process of
public register of all registered health and social care professionals, removing providing the Commission with assurances as to their
training and on-going fitness to practise. Following this lapsed registrations and ensuring that new registrants can register and renew review, the Commission has made amendments to the
registration process, but the annual renewal process registrations electronically. has not been changed.
The Commission is engaged in a systematic
How successful has this been so far? What more needs to happen? cleansing of the medical practitioners register. This The Commission continues to process The register relies upon input from the Government is to ensure that the register can be relied upon to
registration and renewal applications and uses of Jersey and from a private IT provider to enable provide accurate and current information pertaining the existing system to do this. As the process it to operate effectively. This poses difficulties to medical practitioners who are registered to practise remains partially manual, this continues to regarding the ability of the Commission to manage in Jersey. Whilst this project is underway, the register constitute a significant demand on administrative the annual renewal process independently. has been temporarily removed from the Commission resources, particularly in the period between Website.
The Commission has formulated a budget build
October to December each year. A significant
for 2022 which includes the provision of additional On 26 February 2021, it became a requirement that all investment in developing an IT based solution
capacity to scope the requirements to construct an dental nurses working in Jersey must register with the will be needed to facilitate the introduction of
electronic portal to enable registrants to complete Commission. The Commission needed to satisfy itself a future Professional Registration Law.
the registration and renewal process online. It also that all dental nurses were fully aware of the need to includes provision to increase the Commission s become registered and wrote to every dental practice administrative capacity to ensure that the medical accordingly. This resulted in a further increase in professionals register is refreshed and continuously applications. All dental nurses will be required to renew updated. their registrations on an annual basis.
The Commission s oversight of the ten Designated
Yellow Fever Centres was modified in 2020 on account
of the Covid-19 situation, this arrangement continued
into 2021. A report was issued to the Minister for Work with the Government of Jersey Policy Lead to prepare for the Health and Social Services setting out the number
of registered designated Yellow Fever Vaccination implementation of the new Registration of Professionals Law. centres, the number of vaccines administered, and
the outcome of any inspections undertaken.
How successful has this been so far? What more needs to happen? What more needs to happen?
The Commission welcomes the introduction The Commission will need to scope the impact of The health care professionals renewals process
of a new law. This will ensure that health and this legislation to be properly equipped to meet the will remain unchanged until a new IT-build has been care professionals across Jersey are fully, demands associated with any increase in workload. completed. The project to cleanse the medical
and appropriately registered, and that robust A project plan and associated recruitment will practitioners register will continue in 2022, with a view assurances can be provided to citizens in respect be necessary to ensure the Commission can to it being completed by the end of Quarter 1. The
of the quality of health and care provision. The successfully implement the Professional Registration revised and updated register will then be uploaded to Commission acknowledges that the enactment of (Jersey) Law. the internet.
this new legislation will require significant planning
and preparation. Currently there is no confirmed The Commission will make sure that individual home timescale associated with this planned development. care workers are aware of the requirement to become
and to remain registered with the Commission.
Public Engagement
Ensure that, throughout all the work of the Commission, the voices of people who use and provide services, their families and carers, and representatives and those who deliver care services are heard.
How successful has this been so far? What more needs to happen?
The Commission ensures that each inspection Feedback has been positive, and it is apparent that
includes consultation with both care receivers the inspection process is working well. However,
and their relatives. The feedback is anonymised although it is apparent that the Commission has
and included in inspection reports. In addition, a relatively high profile with the services which it
managers and staff are consulted during regulates, this is not as evident in respect of people
inspections, as are allied healthcare professionals. who use services, their families, and members of
This feedback is captured within the public. Consequently, raising the Commission s Continue to raise the profile of the Commission with the organisations we inspection reports. public profile will be a priority for 2022. regulate and with those who use services, and their carers/representatives,
through a planned programme of engagements.
How successful has this been so far?
The Commission has taken opportunities to engage Provide the public with access to relevant information about the Commission s with the media on matters of relevance, for example
the publication of the Overview Report of inspections activities on the Commission s website and, where they cannot use a of children s residential care services. Media
reporting has provided a public platform to raise website, to provide access to other appropriate methods of contacting the the profile of the Commission. The Commission s
Commission. previous Annual Report received positive media
coverage.
Despite the difficulties presented by the pandemic, How successful has this been so far? are aware of the Commission and of its role and the Commission has proactively responded to the
function. The Commission will continue to review the needs of the sector by devising a Covid-19-specific All the Commission s inspection reports are publicly information on its website and across social media page on its website and keeping this regularly
awveabilsaibtele. aAnndin pfuobrmlisahteiodn o len a tflh ee t Cwoams pmriosds uiocnesd in to ensure that it remains current and relevant to the updated with relevant information, including 2021, alongside the pre-existing complaints leaflet. needs of the sector. It will also consider other ways in legislation, policy, and guidance.
which information is provided.
What more needs to happen? The Commission provided the local media with
several press releases throughout the year, which Iutnisd aeprtpaakreennttoth eants fuurreth tehra wt morekm nbeeerds s o tof t bh ee public 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.
Regulation Officers have consulted with a range of stakeholders including service providers, managers, and care receivers family members, and a range
of communication media were utilised by the Commission throughout 2021. The Commission provided periodic updates via email to the care sector.
What more needs to happen?
The Commission will review its Communications Strategy and devise a communications plan in the first quarter of 2022 with a view to implementing
it thereafter. In reviewing the effectiveness of its communications, the Commission is considering the use of a range of print and social media.
Information Governance Governance & Framework
Responsiveness
Provide assurance that the Commission s Governance Framework and financial oversight is robust.
Implement an internal retention and disposal schedule to ensure that data is
processed in accordance with the General Data Protection Regulations and How successful has this been so far? The Commission meets quarterly with the
the Data Protection Law. An Advisory Audit of the Commission s internal Accounting Officer (Director General SPPP) and
governance arrangements was undertaken with other representatives of SPPP and Treasury, as How successful has this been so far? What more needs to happen? by BDO Assurance. This audit made eleven necessary.
recommendations, some of which have been What more needs to happen?
A Retention and Disposal Schedule was devised by The Commission s complaints process includes resolved in full, whilst others require further input.
Jersey Heritage (the Jersey Archive) and has been the ability for complaints to be made about the The Commission s governance arrangements will applied in processing the Commission s sizeable Commission itself. There were no formal complaints Significant improvements continue to take place continue to be reviewed and improved, and a three paper archive. The Commission sourced external about the Commission in 2021. Where possible and in respect of the Commission s governance year financial plan will be developed in 2022. support to enable some of its documents to be appropriate, any new complaint will be managed arrangements. An example is the development of
scanned. This work was entirely completed prior to in a stepped approach, by attempting informal and the Commission s risk management framework and
the Commission s relocation to new office premises or formal resolution at stage 1; it is acknowledged integrated risk register.
in December 2021. however that the Commission may need to source
an independent complaints reviewer in 2022, as
part of stage 2.
Appoint and retain the services of an independent solicitor / advocate to act Continue to provide prompt and detailed responses to consultations, for the Commission in specific matters
correspondence from Ministers and Government of Jersey departments,
as required. How successful has this been so far? Department and seeks to limit its reliance as much The Commission continues to rely upon the as possible. However, the need for legal services
Government of Jersey s Law Officers Department will remain and the relationship will need to be How successful has this been so far? Tohf eInCfoormmmatiisosni oann dh aSsuabljseoc tr eAscpcoensdse Rde tqou aelslFtsr eweidthoinm aCsoimtsmpirsinscioipnaslosuorucrecde ionfdleepgeanl addevnict lee;g Ina l 2 a 0d 2v 1ic, eth e term. Alongside this, the Commission will continue
reviewed to ensure that it is sustainable in the longer Tmhien iCstoemriamlrisessipoonnhsaess caosn rteinq uu ee ds t teod p. rEoxvaidmep les designated timescales. on three occasions, where it was identified that to source independent legal advice, as needed. The
include the consultation on the draft Regulations What more needs to happen? a potential conflict of interest existed, were the extent of this requirement and the associated costs for Children s Services, engagement with the The Commission will continue to respond promptly Commission to rely solely upon the Government of are difficult to estimate. The Commission s 2022 Department of Health on the Ethical Care Charter and efficiently to all such requests, as they are Jersey s Law Officers Department. Budget Build includes an estimated provision for and Assisted Dying and engagement with the this.
received.
Health and Social Security Committee on the What more needs to happen? The matter will remain under review.
Review of Maternity Services. The Commission is aware of the demands which
its operations may place on the Law Officers
KEY PERFORMANCE INDICATORS (KPI S)
In 2021, 26 new KPIs were introduced. The KPI s for 2022 will reflect the learning achieved in 2021.
The following indicators, linked to our strategic and business objectives, described above, were used in 2021:
Planning
Priority 1: Regulation Formulate a three-year financial plan. & Inspection
It is a statutory requirement that each regulated activity will receive at least one How successful has this been so far? What more needs to happen? inspection within 12 months of having become registered.
The BDO Advisory Audit identified this as an area The Commission will continue to work with the
where significant development is required. This Government of Jersey, via SPPP and Treasury, to
matter is currently being discussed with SPPP and address the need for a comprehensive three-year
KPI 1
Treasury, as the Commission is only able to plan on financial plan. .
a 12 monthly cycle at present.
Develop operational links with local stakeholders that have a shared interest in the areas regulated by the Commission.
How successful has this been so far? The Commission has attended all meetings of the The Commission maintains informal links with a Jersey Regulators Forum, which has membership range of local stakeholders, including the Jersey across the various regulatory bodies throughout the Care Federation and the Jersey Disability Forum. island.
The Commission has signed a Framework What more needs to happen?
Agreement with the Government of Jersey. The Commission will continue to strengthen links The Commission has a Memorandum of with a range of key stakeholders, including the Understanding (MOU), with the Office of the various UK professional regulatory bodies and with Children s Commissioner and a draft MOU has other UK system regulators. .
been developed with the Safeguarding Partnership
Board.
The Commission will complete 100% of inspections in respect of each of the following regulated activities, as required in law:
Care Homes for adults
Children s Homes
Home Care services
Adult Day Care Centres
A total of 105 inspections were undertaken in 2021. Seven continued into early 2022.
The Commission is required in law to undertake one annual inspection of each regulated activity. It may undertake more than one inspection, at its discretion.
In 2021, two services were inspected more than once.
Four pre-inspection visits were undertaken to services which were newly registered in 2021. Of these services, one closed in 2021, two were inspected and one will be inspected again in 2022.
In total, the Commission undertook 97% of inspections of all regulated activities in 2021.
KPI 2 KPI 6
The Commission will ensure that no more than 50% of its inspections The Commission will revisit areas for improvement in 100% of subsequent are announced. inspections.
This was difficult to achieve in 2021, as a consequence of the ongoing infection control guidance in place. As Prior to each inspection, Regulation Officers review all documentation pertaining to the service, this includes restrictions eased, it became more feasible to undertake some unannounced inspections, from middle of the the most recent inspection report. Any areas for improvement which were identified in the inspection report year onwards. A total of 16 (22%) inspections in care homes were unannounced*. are reviewed during the subsequent inspection.
The Commission will record the length of time each inspection took to bring to completion and the length of A sample of ten inspection reports demonstrated that in each case, the Regulation Officer reviewed time taken to both issue and publish (on the Commission s website) inspection reports. In accordance with the previous inspection report and examined whether any areas for improvement had been thoroughly the Commission s Inspection Policy, it will commit to producing, in draft form, an inspection report within 28 addressed.
days of concluding an inspection.
KPI 3 KPI 7
The Commission will measure the number of escalation and enforcement The Commission will ensure than at least 80% of its inspection reports are actions taken.
completed in draft form, within 28 days of an inspection having concluded.
Over the course of 2021, the Commission undertook escalation and enforcement action on seven
Of a total of 91 completed inspections, 87 were ready in draft form within 28 days of the inspection having occasions. The type of action taken varied and included letters of escalation, mutual agreement that two concluded. This represents 97% of inspection reports. Therefore, the Commission has achieved this target. services would close, the issuing of an Improvement Notice and the convening of a Representation Panel.
KPI 4
The Commission will publish 100% of its inspection reports within 7 days of them being considered final.
This target has been comprehensively met, with 100% of inspection reports published within 7 days of being considered final.
KPI 5
The Commission will finalise applications for registration (of providers of regulated activities) within 4 weeks of a complete application having been received.
Of a sample of six applications for registration received in 2021, all were completed within 2 weeks.
Improvement Plans are created following an inspection, where there is evidence that Regulations and/or Standards are not being met.
* KPI 2 does not relate to home care services on the basis that it is not practicable to undertake inspections of these services unless a degree of notice/announcement is provided).
Priority 2: Professional Registration
KPI 8
The Commission will ensure that no more than 50% of its inspections are announced.
This was difficult to achieve in 2021, as a consequence of the ongoing infection control guidance in place. As restrictions eased, it became more feasible to undertake some unannounced inspections, from middle of the year onwards. A total of 16 (22%) inspections in care homes were unannounced*.
The Commission will record the length of time each inspection took to bring to completion and the length
of time taken to both issue and publish (on the Commission s website) inspection reports. In accordance
with the Commission s Inspection Policy, it will commit to producing, in draft form, an inspection report
within 28 days of concluding an inspection.
KPI 10
The Commission will complete 100% of registration applications from KPI 9 piercing and tattooing practitioners within 3 days of a completed
application being received.
The Commission will complete 100% of renewal applications from health This target was achieved in 2021. Typically, such applications are processed on the day they are and social care professionals within 7 days of a completed application received.
being received. The Commission will complete 100% of registration applications relating to both piercing and tattooing premises and laser premises within 4 weeks of a completed application being received.
This target was ambitious and was not achieved in 2021. These applications are more challenging to process because they involve a physical inspection of the Applications for renewals of registration are received in October each year and continue to be received premises. However, this target was achieved in 2021.
until the end of the year (with a small number of applications being received in the first weeks of the
following year).
The overwhelming majority of applications for renewal were processed by the end of 2021. KPI 11
The period of 7 days would be more appropriately expressed as no more than 7 working days between
the date of application and date of renewal , and the KPI for 2022 will be adjusted to reflect this. The Commission will complete 100% of annual inspections of Although this target was challenging at the outset of the renewals process, it became much easier Designated Yellow Fever centres, as required by law.
to achieve over time, and by December most renewals were being completed on the day they were
received. Inspections of Designated Yellow Fever centres are desktop inspections, as opposed to physical
inspections of premises. The Commission ensures that all documentation relating to these services is complete and up to date, including training records and that a registration fee is submitted. There are nine such establishments in Jersey.
At of the end of 2021, each of the applications for renewal of registration was in the process of being finalised but had not achieved completion. This is partly associated with the invoices for fees being sent out towards the end of each year. It was also associated with access to face-to-face training having become limited on account of the ongoing restrictions relating to the pandemic.
The renewals process continued into 2022, with four services completing renewal in January. The remaining five are on schedule to complete their renewal by the end of Quarter 1, 2022.
Priority 3: Priority 4: Public Engagement Information Governance
The Commission is committed to engage with the public about its role and & Reponsiveness
function and to raising its profile.
KPI 15
KPI 12 The Commission will monitor and retain a record of the number of duty calls received throughout the year, including nature of the contact and
The Commission will maintain a record of the number and outcome the response.
of consultations completed in respect of operational documentation, Most of the duty correspondence relates to registered services. Each service e.g., a care home, has a including Standards. creolarrteinsgp oton dainn gin delievicdt uroanl sic e frovil cd ee r is w rheiccohr dinecdo rinp othraist efos l da ec ro. n Tt ha ec t R r ee gc uo lr ad t; i oa nll c Oa ffills c ea rn ad l lo ot ch ae ter dco torr e es ap co hn sd ee rn vic ce e
can monitor this correspondence, to determine whether there is a reason to make further enquiries, or to
The Commission is in the process of completing a set of Standards associated with the regulation of take any other action.
ten areas of activity relating to statutory children s services. It has commenced a period of informal
consultation pertaining to the draft Standards and this process will continue into 2022 when it will be
concluded. KPI 16
KPI 13
The Commission will consult directly with care receivers, relatives/carers, staff members and external professionals in 100% of inspections.
A sample of ten inspection reports demonstrated that this consultation takes place routinely across all inspections. Where it is not possible to consult with relatives during inspections, Regulation Officers make contact separately by telephone. The feedback is fully incorporated within inspection reports.
KPI 14
The Commission will, as part of its quality assurance process, undertake post-inspection consultation from 10% of its annual inspections with providers/managers of regulated activities. It will publish a summary of
The Commission values feedback from the regulated sector about all aspects of its work and particularly about the inspection process.
Questionnaires were sent out to every provider/manager following an inspection in 2021. A total of 24 replies have been received. A summary of these responses has been provided as an appendix to this report.
The Commission will monitor and retain a record of the number of notifications received throughout the year, including the nature of correspondence and whether a response from the Commission was warranted.
The number and types of notifications received by the Commission are presented in the following table:
Adult Care Homes Day Centres Home care services Children s homes Notifications received in total 1164* 3 553 494
22 fractured 1 fractured neck of femur neck of femur
15 fractures of 4 fractures of
Incidents where harm occurred other bones 0 other bones 36
153 where other 46 where other injuries injuries such as skin such as skin tears, tears, bruises, grazes bruises, grazes have have occurred occurred
Pressure ulcer notification
1164** 0 310 0 (grade 2 and above)
Significant Restriction on Liberty
(SRoL) notifications (where significant
restrictions were lawfully imposed 201*** 0 10 0 in line with the Capacity and Self-
Determination (Jersey) Law 2016
Young Person missing from care home Not applicable Not applicable Not applicable 335
* NB doesn t include death notifications. NB The Commission has also received notifications of which include deterioration of care receivers health conditions, outcome of GP reviews, palliative care pathways, transfer of care environment etc
** NB not always reflective of pressure ulcers developing in the care home. This relates to the number of notifications made to the Commission. This number incudes
pressure ulcers which have been identified upon admission to the care home, which developed in other care settings including the hospital
*** Including urgent and standard authorisations
KPI 17
The Commission will, in 100% of cases, respond to any complaints received within 3 working days.
No formal complaints about the Care Commission were received in 2021. Whilst this might be perceived as encouraging, there is also a possibility that it relates to the Commission needing to raise its profile with care receivers, their families and members of the public. As a result, the Commission will undertake work relating to raising its profile and enhancing its communications throughout 2022.
No formal complaints were received in 2021 relating to regulated activities, however, several concerns relating to the quality of care provision were received. The Commission was able to respond to and resolve many of these matters at an informal level.
Where intelligence relating to individual activities, e.g., a care home, was received, this enabled
the Commission to determine whether additional unannounced inspections were warranted. The Commission was able to undertake unannounced inspection visits and to discuss concerns with registered managers. Generally, this approach enabled the Commission to determine whether there was evidence to substantiate the concerns, and to take appropriate remedial action accordingly.
KPI 18
Priority 5: Governance Framework
KPI 20
The Commission will retain a record of the number of occasions on which legal advice and guidance has been sought and will differentiate between independent input and input from the Law Officers Department.
The Commission has sought independent legal advice on three separate occasions. It has done this in instances where there would have been a perceived or actual conflict of interest, had the Government of Jersey s Law Officers Department been asked to provide this input.
Where there is no such conflict, the Commission continues to enjoy good working relations with the Law Officers Department, who provide legal advice as needed. The Commission sought advice from the Law Officers Department on approximately ten occasions and has needed to contact the Attorney General s Office on one occasion.
The Commission will retain a record of the number of data breaches
recorded within each year and will differentiate between those made by KPI 21
Commission staff and those made by others. It will also retain a record
of the number of data breaches referred to the Jersey Office of the The Commission will, in line with its Supervision Policy, provide formal Information Commissioner. supervision to each of its staff members every 6 weeks.
The Commission maintains a Data Breach Register. In 2021, there were seven reported instances of a data The Commission met this target fully until the departure of the previous Chief Inspector in August.
breach. Each of the breaches was considered to represent a low level concern, with minimal impact. Thereafter, an interim arrangement was agreed whereby the Chair of the Commission undertook regular Four were internal errors and three were external (errors made by third parties). Of the four internal one-to-one meetings with each staff member. In addition, informal and group supervision was provided breaches, all related to emails which were inadvertently sent to the incorrect recipient. In each case, until the end of the year. The typical pattern of regular, formal supervision will resume from the beginning of immediate remedial action was taken to ensure that data was not shared further. Equally, in none of the 2022.
instances was the nature of information shared or the potential impact serious enough to warrant a referral
to the Office of the Information Commissioner.
KPI 22
KPI 19 The Commission will undertake an Annual Appraisal with The Commission will retain a record of the number and outcome of each of its staff members.
reports about health and social care services requested by the relevant This target was met in full and all staff had an annual appraisal in 2021. Minister or panel (or initiated by the Commission itself).
Throughout 2021, there were no requests made of the Commission by Ministers. However, the Commission was asked to respond to specific areas of development within the health and care sector and submitted such responses accordingly.
KPI 23 Priority 6: Planning
The Commission will identify training and development needs as part of
Annual Appraisals and will formulate structured plans in respect of each KPI 25 staff member to address these needs.
The Commission will meet with Treasury at least quarterly. Training and development needs are reviewed in formal supervision and annual appraisals. Where the need
for training is identified, the Commission has taken and will continue to take the appropriate steps to ensure The Commission has benefitted from consistent support from Treasury and has met with a these needs are comprehensively met. representative of this department on at least a bi-monthly basis throughout 2021, with additional
unscheduled meetings taking place as required.
KPI 24 KPI 26
The Commission will retain a record of the number of occasions when the The Commission will retain a record of the proportion of fee support of an Independent Complaints Reviewer has been sought. income received within statutory timescales.
The Commission did not require the support of an independent complaints reviewer in 2021. The Commission continues to retain these records and this target has been fully achieved.
A DAY IN THE LIFE ACCOUNTABILITY REPORT FIONA MCLAUGHLIN CORPORATE GOVERNANCE
I have been working in the field of learning disabilities for 31 The Commission has both a strategic and an operational structure. Its work years. I qualified as a registered learning disability nurse in is overseen by a Board of Commissioners who have a range of professional 1993 and moved to Jersey shortly afterwards. My roles have and carer/service user experience. The role and responsibilities of the been varied during my career and in more recent times I have Commission are set out in Schedule 2 of the Regulation of Care (Jersey) Law worked in social care settings. 2014. The Board usually meets six times a year. These meetings are open to
the public, although this has been made difficult to achieve on account of the Safe, effective care which is truly person- managers to develop and improve service
centred has been my motivation throughout provision. This careful sourcing of information pandemic and the increased reliance upon virtual meetings.
my career and it is this commitment which about the quality-of-service provision is
prompted me to join the Commission as a critical in enabling Regulation Officers to
Regulation Officer. The role of Regulation produce detailed inspection reports. This Towards the end of 2020, three additional with the Government of Jersey is described in a Officer is an integral part in ensuring that all forms a large part of the inspection process, Cthoemrem wisesreiosneevresnwCeroemremcirsusiitoende, rws hinictho tmale. aInn 2tt0h2a1t, the pre-existing Memorandum of Understanding.
Framework Agreement, dated May 2020 which replaced services meet the requirements of the Care and it is these reports which enable care one Commissioner resigned, and a replacement was
Standards. receivers, family members and members of recruited, being appointed by the Minister for the Ministerial responsibility for the Jersey Care
the public to be assured that the quality-of- Environment to serve for a three-year term. This has Commission transferred from the Chief Minister to the The main purpose of my role is undertaking Minister for the Environment in 2020.
care provision throughout Jersey remains of a enabled the Board to retain its contingent of seven
annual inspections of Care Homes and Home high standard. members. In 2021, six meetings of the Board of Commissioners Care Agencies. were scheduled to take place in Jersey. In practice,
The Board receives reports from officers employed
The best part of the job is meeting care Of course, I do not undertake my role travel restrictions made this impossible and it was
within the Commission, provides strategic leadership,
receivers and their families directly and entirely on my own. I am well supported by therefore necessary to facilitate some of the meetings
including governance and financial oversight, and
an experienced team of regulation officers, virtually.
hearing their experiences first-hand. Even maintains an integrated risk register of both strategic
when you are faced with negative situations, administrators, and others, who provide and operational risks. The attendance of Board members is shown below
the challenge to address and resolve issues, valuable advice and guidance every day. The Commission is accountable to the Government of (table 1).
to produce better outcomes for care receivers Jersey as an arms-length organisation. The relationship
and their families is worthwhile. I also enjoy
working collaboratively with registered TABLE 1
Glenn Houston 6 out of 6
Alison Allam 6 out of 6
Si n Walker 6 out of 6
Lisa Jacobs 4 out of 4 (see note below) Jackie Hall 6 out of 6
Noreen Kent 6 out of 6
Angela Parry 6 out of 6
Lesley Bratch 1 out of 1 (see note below)
Note: Lisa Jacobs resigned her position in 2021. Lesley Bratch was appointed in 2021.
TABLE 2
Remuneration of Chair and Non Executive Board Members:
Name | Date Appointed | Salary (bands of £5,000) £000 | Benefits in Kind (travel, accommodation and subsistence) | Restated salary 2021 Total (Salary + Benefits) |
Glenn Houston Chair | 01 May 2017 | >£25,000 <£30,000 | <£5,000 | >£30,000 <£35,000 |
Ann Abraham Commissioner | 10 May 2017 | 0 | <£5,000 | <£5,000 |
Alison Allam Commissioner | 10 May 2017 | <£5,000 | <£5,000 | <£5,000 |
Lisa Jacobs Commissioner | 01 July 2017 | <£5,000 | 0 | <£5,000 |
Si n Walker -McAllister Commissioner | 10 May 2017 | <£5,000 | <£5,000 | <£5,000 |
Angela Parry Commissioner | 16 December 2020 | <£5,000 | <£5,000 | <£5,000 |
Noreen Kent Commissioner | 16 December 2020 | <£5,000 | <£5,000 | <£5,000 |
Jackie Hall Commissioner | 16 December 2020 | <£5,000 | <£5,000 | <£5,000 |
Lesley Bratch Commissioner | 1 October 2021 | <£5,000 | <£5,000 | <£5,000 |
NOTES ON TABLE 2
1 Fees are stated in bands of £5,000 for the period from 01 January - 31 December 2021
2 The Chair and six of the Commissioners live outside Jersey and incur additional costs in respect of travel, accommodation,
and subsistence.
3 Commissioners were appointed for an initial term of 3 years.
4 Expenses are rounded to the nearest £100
5 Travel restrictions necessitated that Board meetings in January, March and May 2021 be held virtually. This had the effect
of travel and accommodation expenses being less than might otherwise have been expected. Although the meetings in July, September and November took place in Jersey, various restrictions and personal circumstances meant that some Commissioners attended virtually. This also had an impact on the need for travel and accommodation expenses.
6 The resignation of the Chief Inspector in August, resulted in Commissioners undertaking additional operational duties.
This resulted in an increase in expenses paid to Commissioners for time provided to support the Commission.
7 Ann Abraham was no longer a Commissioner by January 2021 but was due an outstanding subsistence payment which
was paid in 2021. This has been included, in the interests of transparency
The Commission also incurred the following expenses in 2021 which relate to the functioning of the Commission s Board: Hire of rooms: £1659
Training of Commissioners: £1683.
REGISTER OF INTERESTS
Each Board member has completed a Register 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. This information is presented in Table 3 below.
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.
TABLE 3
Jersey Care Commission Register of Board Members Interests
Shareholding
Unpaid office in related to
Board Member Paid employment/consultancy Company Other public appointment charitable/other
Commission
body
business
Glenn Houston Vice - Chair Disclosure and Barring Service Non-executive Chairperson (DBS)
Member, Human Tissue Authority
Date of appointment: None None None None 01/05/2017 Member, Northern Health and Social Care Trust
Member, Board of the Public Prosecution
Service, Northern Ireland
Dr Alison Allam Non-clinical honorary contract, Royal Marsden Trustee for the Non-executive Board Hospital Pseudomyxoma member Survivor Charity.
Date of appointment: Associate at the Professional Records Standard None None None Member of the 10/05/2017 Body (PRSB) management
committee of Chronic Illness Inclusion
Si n Walker -McAllister Independent Chair, Bath & North East Somerset Non-executive Board Community Safety and Safeguarding Partnership, member Bath and NE Somerset Council
Associate, UK Local Government Association (LGA)
Date of appointment: Chair of Dorset, and Bournemouth, Christchurch & None None None None 10/05/2017 Poole Safeguarding Adults Boards (2 Boards)
Joint Convenor of the National Safeguarding Adults Board Network (funding through the Care & Health Improvement Programme
Noreen Kent
Non-executive Board
member Greater Glasgow & Clyde Health Board, Nurse None None None None
COVID-19 Vaccinator (Bank
Date of appointment:
16/12/2020
Angela Parry Commissioning Consultant (APRA Management
Non-executive Board Ltd.) - various UK based H&SC organisations and
member public bodies.
Trainer/Assessor None None None None Date of appointment: National Commissioning for Wellbeing Level 5 Cert.
16/12/2020 Various local authorities and commissioning groups.
Associate, UK Local Government Association (LGA)
Jackie Hall
Tribunal member, social entitlement chamber
Non-executive Board
member Director of social care Chailey Heritage Foundation None (PIP) None None
Tribunal Member Mental Health Review
Date of appointment:
Tribunal
16/12/2020
Lesley Bratch
Non-executive Board
member None None None None Committee member for
Enable Jersey.
Date of appointment:
1/10/2021
Details of each of the Commissioners is available at: https://carecommission.je/the-commissioners/
STATEMENT OF STATEMENT OF RESPONSIBILITIES OF RESPONSIBILITIES OF THE CHAIR THE CHIEF INSPECTOR
The Chief Inspector works closely with the Chair and Commissioners to The Chair provides leadership and direction to the Commission and
provide strategic leadership and expert technical knowledge and skills to a full list of duties and responsibilities is set out in Appendix 1 of the
ensure the effective and efficient delivery of the Commission s statutory, Framework Agreement.
regulatory and inspection functions in accordance with legislation.
The Chair s principal responsibilities are to:-
ensure that all Board members are fully briefed assess the performance of individual The Chief Inspector s duties are to: and receive appropriate training where required Commissioners on an annual basis; and
lead and develop the executive team on ensure that the Commission s overall
advise the Department of Board vacancies and, make recommendations to the Minister with delivering the Commission s corporate plan, governance framework and controls assurance in conjunction with the Department and the regard to re-appointment and/or removal from ensuring effective regulation of health and structure, including risk management, financial Jersey Appointments Commission, undertake a office. social care services and registration of care management and policies and procedures are recruitment process professionals. appropriate and effective.
build and sustain credibility with the public and provide regular reports and management registered service providers by promoting a information to assure the Commission that it is regulatory approach that ensures compliance fulfilling its statutory responsibilities. with Regulations and Standards, challenges
lead and manage the Commission s executive
poor performance and supports continuous
functions, including business planning, improvement
data protection obligations, performance
in consultation with the Chair and management, risk management and audit Commissioners prepare: systems, responses to Freedom of Information
requests and complaints, individual staff
a Corporate Strategy setting out the
review and appraisal, training and continual Mission, Vision and Values of the
professional development to secure continuous organisation
improvement in the Commission s performance.
a Business Plan setting out the
ensure sound financial management
Commission s key business objectives,
and monitoring of budgets and advise operating model, and performance
Commissioners on budget planning, income indicators
generation and actions needed to maintain
a corporate risk framework, including a expenditure within budget.
risk strategy and risk registers
an annual report describing progress
against the objectives set out in the Corporate Strategy and Business Plan.
Lead and develop a team of specialist and generalist Regulation Officers to ensure the effective regulation of health and social care services to protect, improve and safeguard the health, care and welfare of the local population.
Ensure consistent high-quality regulatory practice, with a focus on supporting service improvement, monitoring compliance and, where necessary, taking effective enforcement action.
Lead and develop the Commission s business and administrative staff to ensure efficient and effective administration of the Commissions regulatory responsibilities.
Build capacity and develop staff, ensuring the Car Commission acquires the skills and resources to respond to the projected expansion of the Commission s regulatory reach.
Take a lead role in working with States and Government departments and other key
stakeholders in matters related to the regulation of health and social care services and professional regulation. Positively promote the work of the Care Commission and act as a focal point of contact to enquiries from Ministers, government officers, care providers, the public, the media, and others, as appropriate.
Develop and facilitate relationships with people who use services and their families and carers to improve their experience of health and social care and achieve better outcomes.
Lead and support consistent high-quality practice within the staff team, promoting the health, safety, and welfare of employees, managing
e
performance, monitoring standards of work for all staff and promoting diversity and equality of opportunity.
THE WORK OF THE BOARD IN 2021
The Board met, as planned, on six occasions throughout the year.
At each of its meetings, the Board received the Received and approved the Independent
following suite of documents: Advisory Audit on the Commission s Governance
arrangements.
Agenda
Contributed to an independent review of fees.
Board Minutes
Received and approved a paper relating to
Minute Summary
investigating complaints and concerns in respect of
Chair s Report registered professionals.
Glenn Houston
Appointed 2017. Reappointed 2020.
Lesley Bratch
Appointed 2021.
Si n Walker -McAllister
Appointed 2017. Reappointed 2020.
Jackie Hall
Appointed 2020.
Noreen Kent
Appointed 2020.
Angela Parry
Appointed 2020.
Chief Inspector s Update
Head of Governance, Policy and Standards Update
Budget Summary Report
Integrated Risk Register
Forward Look schedule
The Board received other documents as required.
Over the course of the year, the Board s achievements included:
Comprehensively reviewed and revised its Risk Management Framework and the format of the Risk Register, to better demonstrate risk mitigation and to effectively measure its impact.
Responded to written questions from States Members and requests for input into consultation exercises. This included consultation in respect of the establishment of an Ombudsman in Jersey, the Ethical Care Charter, Assisted Dying and the regulation of statutory children s services.
Completed a specification for the employment of an Independent Complaints Reviewer.
Engaged with the Children s Commissioner and Chair of the Safeguarding Partnership Board in respect of the Government of Jersey s approach
to safeguarding the rights of children (particularly children who are looked after by the Government of Jersey).
Completed the annual appraisals for all Commissioners.
Appointed one new Commissioner and the Chief Inspector.
Received an update report in the registration of Individual Care Workers.
Met with the Policy Principal in respect of the regulation of statutory children s services and contributed to the associated consultation.
Reviewed the Commission s existing policies and governance framework; approved the Representation Procedures.
Sanctioned a cleanse of the online medical Dr Alison Allam practitioners register.
Appointed 2017. Invited to the Board or otherwise met with, the Reappointed 2020. Director General of the Department for Strategic
Policy, Planning and Performance (SPPP); the Head of Governance (SPPP); the Minister for
the Environment and the Minister for Health; the Children s Commissioner; representatives of the Care Federation, and others.
Details of each of the Commissioners is available at:
www.carecommission.je/the-commissioners/ Undertook engagement with the Care Commission
Team.
Received project updates in respect of a range of operational work and ensured that appropriate risk mitigation was in place.
Supported the Team with operational management and governance in the absence of a Chief Inspector.
Ratified an Information Leaflet, approved a communications plan and committed to a review of the Commission s website.
Approved the 2020 Annual Report, Business Plan and Budget Build documents.
STAFF REPORT
The staff working for the Commission are appointed to the Commission but are employed by the States Employment Board (SEB). The effect of this arrangement is that staff are posted to the Commission and are referred to as Commission staff.
The terms and conditions of employment of Staff are paid in accordance with the Civil Service Commission staff are SEB standard terms and pay scales. Annual salaries range from Civil Service conditions, including matters relating to pension, Grade 15 to Civil Service Grade 6.
pay and associated pay increments, flexible working
The Commission will need to expand its workforce if it policies etc. Staff are paid via standard Government
is to meet the challenges associated with regulating of Jersey payroll arrangements.
new areas of activity. One additional Regulation
In 2021, there were 12 permanent staff members and Officer will be required in 2022 and this is accounted two temporary administrative staff. Two Regulation for in the Budget Build.
Officers were appointed in January and June 2021.
A new Chief Inspector, Becky Sherrington, was appointed in December 2021.
SUSTAINABILITY REPORT
This is the first sustainability report which the Commission has produced. Therefore, it is important to recognise that the Commission is at an early stage in managing its carbon footprint. The Commission intends to set out its intentions and to measure the extent to which it has achieved these on an annual basis.
In 2019, the States Assembly declared a climate and their vehicles, the office accommodation and the emergency and in doing so recognised that climate services which it delivers.
change could have profound effects in Jersey (www.
To manage its environmental performance and to gov.je)
reduce the impact on the environment caused by its As a result, the Carbon Neutral Strategy was day-to-day operations, the Commission will mirror developed and was agreed by the States Assembly the Government of Jersey s objectives, as set out in in February 2020. The Commission will therefore its annual report (2020).
consider the impact on the environment of its staff
Specifically, the Commission will:
comply fully with the requirements of environmental legislation and approved codes of practice
reduce pollution, emissions and waste arising from our activities
reduce the use of all raw materials, energy and supplies
raise awareness among its staff of environmental matters
encouraging similar environmental standards from all regulated activities
participate in discussions about environmental issues
Transport and carbon emissions
The Commission does not own or lease any vehicles. Staff members use their own vehicles to visit regulated activities for the purposes of inspections and associated work. From 2022 onwards, the Team will consider ways in which to reduce the number and length of journeys by, for example, convening more meetings virtually and combining visits to lessen the number of journeys.
2021 | |
Total distance travelled by air (km) | 14,646 |
GHG emissions (kt CO2 e) | 1,967 |
| |
2020 | |
Total distance travelled by air (km) | 7,614 |
GHG emissions (kt CO2 e) | 943 |
| |
2019 | |
Total distance travelled by air (km) | 25,980 |
GHG emissions (kt CO2 e) | 3,228 |
|
The impact of Covid-19 has been such that journeys by Commissioners residing outside of the island to Jersey have been fewer. This has had the overall impact of reducing the Commission s overall carbon footprint.
The International Civil Aviation Organisation (ICAO), has developed a methodology to calculate the
carbon dioxide emissions from air travel which enables the CO2 emissions per passenger to be calculated (https://www.icao.int/environmental-
protection/Carbonoffset). This has been relied upon to determine the Commission s overall carbon emissions in 2021 and a comparison has been made with the previous two years.
Consumption - Utilities
The Commission relocated to its new office accommodation towards the end of 2021 and cannot present a full years breakdown of heating and water use. It will ensure that this detail is provided in its 2022 report.
Consumption - Paper and Resources
The Commission has reduced its reliance on
the use of paper since it became established in 2019. Increasingly, documents are produced and shared electronically. The Commission s Board
no longer relies on documents being produced in printed format and uses electronic versions. More could be done to reduce the reliance on paper documentation, therefore, records pertaining to new service registrations will no longer be retained in printed format. The Commission aims to recycle paper documents that are no longer required for administrative purposes. Unless there is a pressing reason to retain original documents, these will be scanned and stored electronically, in line with the Commission s Data Retention Policy.
The processes associated with registrations
are being reviewed in order that individuals and organisations can complete the entire registration process electronically.
The Commission will ensure that all printer cartridges are recycled.
Although there is no provision in the Commission s premises to recycle glass, staff are asked to take any glass containers which they bring into the building, home in order that they may be recycled through the
staff member s parish recycling scheme.
FINANCE REPORT
Under the provisions of the Regulation of Care (Jersey) Law 2014 the Commission is required to: -
- keep proper accounts and proper records in The Commission prepares an Annual Business relation to the accounts; and Plan and associated Budget Build setting out objectives, targets and key performance indicators
- prepare accounts in respect of each financial year
for discussion and agreement with the Accountable and a report on its operations during the year.
Officer. The Commission determines areas of
The arrangements governing the use of the expenditure in accordance with its priorities and Commission s financial resources are set out in commitments, as described in its Annual Business paragraphs 19-36 of the Framework Agreement Plan.
between the Jersey Care Commission and the
The Commission cannot commit to any new Department of Strategic Policy, Planning and
expenditure unless it can be met from within available Performance.
funds, or from an additional recurring or non-
The accountability and assurance arrangements set recurring allocation approved by the Government of out in this Framework Agreement are intended to Jersey via SPPP.
reflect the Code of Practice Principles and accord
The Chief Inspector is required to complete an Annual with the Government of Jersey s Public finances
Financial Assurance Statement which should be Manual 2019.
approved by the Commission before being submitted Income forecasts and the expenditure budget are to the Accounting Officer.
agreed at the beginning of each financial year with
The Government of Jersey provides a financial
the Accountable Officer, the Director General of SPPP.
management service to the Commission, including The duties and responsibilities of the Accountable
in relation to its core budget and fee income
Officer in respect of the Commission are set out in
(Commission funds).
paragraphs 25- 29 of the Framework Agreement.
Income Sources
Income is received from two sources. Fees are In addition, the Commission received income from derived from healthcare professionals, regulated fees prescribed by the Chief Minister at the point at activities, individuals, and premises. The which the 2014 Law came into force.
Commission also receives a direct allocation which
These fees include: -
is provided from the Government of Jersey and
specified within the core budget. Making an initial application for registration as a
provider or a manager (Article 4)
The Regulation of Care (Jersey) Law 2014 was
agreed by the States Assembly on the understanding Replacement of registration certificates
that the former Inspection Team s budget would (Article 8)
be grant-funded to the Care Commission and that An annual fee for continued registration (Article 9) this would represent approximately 45% of the total
cost of administering the Law. These monies, the Applying for a variation on conditions of
core budget, were transferred to a dedicated Care registration (Article 17)
Commission business unit for financial accounting Provision of printed copies of Commission purposes. reports (Article 38)
The division responsible for the provision and The SPPP Department provides an HR framework for oversight of adequate financial and other resources supporting staff employed by the Commission. required to support the function of the Commission
The main components of expenditure consist of pay, is the Department for Strategic Policy, Planning and
including staff salaries and pension contributions, Performance (SPPP), within the Government of
and non-pay, including goods and services.
Jersey.
Essential support services including information The Accountable Officer for the appropriate use
technology, payroll and legal services are provided of public funds, including the funding for the
directly to the Commission by the Government of Commission, is appointed in accordance with
Jersey at no direct cost. This represents part of the the Public Finances (Jersey) Law 2019, and is the
Government of Jersey s contribution to the overall Director General for SPPP. It is the responsibility of
operation of the Commission.
the Accountable Officer to ensure the Commission
represents value for money. The Commission is required to complete an Annual
Financial Assurance Statement.
Where the Accountable Officer has concerns relating
to fee income, the Accountable Officer will inform The Commission s accounts for 2021 are audited the Chair and Chief Inspector and may report as part of the whole of Government accounts and those concerns to the Treasury and Exchequer, the are published in the Government of Jersey s Annual Comptroller and Auditor General. No such concerns Report and Accounts for 2021.
arose or were reported in 2021.
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.
JERSEY CARE COMMISSION Statement of Comprehensive
Net Expenditure
2021 Budget 2021 Actual 2020 Actual
£ £ £
REVENUE
Fee Income (325,000) (348,986) (338,432) Total Revenue (325,000) (348,986) (338,432)
EXPENDITURE
Staff Expenditure 611,000 625,077 574,895 Supplies and Services 73,000 170,869 74,308 Administrative Expenditure 5,000 4,574 3,796 Premises and Maintenance 1,000 34,780 2,796 Total Expenditure 690,000 835,300 655,794
Net Revenue Expenditure -
365,000 486,314 317,363 Funding Received from Government of Jersey
The Commission incurred one off and additional expenditure items during 2021, such as contracting external consultants to lead and co-ordinate the search for a new Chief Inspector, administrative support for projects, and office relocation and rental costs. These were discussed and agreed with the Government sponsoring department, Strategic Policy, Planning and Performance and additional funding was made available over and above the annual budget to cover these costs.
JERSEY CARE COMMISSION Budget Position
| Yr to Dec Budget 2021 | Yr to Dec Actual 2021 | Yr to Dec Bud Var 2021 | Full Year Budget 2021 | Full Year Forecast 2021 | Full Year Forecast Variance 2021 |
L60 - Arm's Length Functions | ||||||
DSH200 - Professional & Care Regs | ||||||
Earned through Operations | - | - | - | - | - | - |
334010-Miscellaneous Income | (286,000) | (324,286) | 38,286 | (286,000) | (324,000) | 38,000 |
Earned through Operations | (286,000) | (324,286) | 38,286 | (286,000) | (324,000) | 38,000 |
Income | (286,000) | (324,286) | 38,286 | (286,000) | (324,000) | 38,000 |
|
|
|
|
|
|
|
Staff Costs | ||||||
411000.100-Civil Service Perm Basic | 507,000 | 511,990 | (4,990) | 507,000 | 516,000 | (9,000) |
411000.310-Civ Service Perm Std OT | 0 | 2,318 | (2,318) | 0 | 0 | 0 |
411000.500-Civ Service Perm Sickness Pay | 0 | (675) | 675 | 0 | 0 | 0 |
411000.900-Civil Service Perm Pension | 74,000 | 81,188 | (7,188) | 74,000 | 74,000 | 0 |
411000.950-Civil Service Perm Soc Sec | 30,000 | 30,256 | (256) | 30,000 | 30,000 | 0 |
Staff Costs | 611,000 | 625,077 | (14,077) | 611,000 | 620,000 | (9,000) |
|
|
|
|
|
|
|
Other Operating Expenses | ||||||
531000-Provisions |
| 76 | (76) |
|
|
|
540110-Hired Services | 0 | 21,720 | (21,720) | 0 | 16,000 | (16,000) |
548010-Other Fees | 0 | 5 | (5) | 0 | 0 | 0 |
549100-Non Pay Coronavirus |
| 28 | (28) |
|
|
|
554100-Computer S/W Purchase | 0 | 1,123 | (1,123) | 0 | 0 | 0 |
554200-Computer H/W Purchase | 3,000 | 3,429 | (429) | 3,000 | 3,000 | 0 |
562010-Equipment Purchase | 0 | 1,054 | (1,054) | 0 | 0 | 0 |
601300-General Stationery | 2,000 | 879 | 1,121 | 2,000 | 2,000 | 0 |
621000-Telephones | 1,000 | 2,497 | (1,497) | 1,000 | 1,000 | 0 |
623100-Postage | 2,000 | 697 | 1,303 | 2,000 | 2,000 | 0 |
627100-Advertising & Publicity | 0 | 29,276 | (29,276) | 0 | 25,000 | (25,000) |
640100-Meals & Entertainment | 0 | 48 | (48) | 0 | 0 | 0 |
641100-Other Travel | 2,000 | 231 | 1,769 | 2,000 | 2,000 | 0 |
641101-Travel - Air Fares | 0 | 206 | (206) | 0 | 0 | 0 |
641300-Mileage Claims | 1,000 | 0 | 1,000 | 1,000 | 1,000 | 0 |
642100-Hotel Accommodation | 0 | 548 | (548) | 0 | 0 | 0 |
643100-Conference & Course Fees | 3,000 | 6,089 | (3,089) | 3,000 | 8,000 | (5,000) |
661010-Other Administrative Costs | 0 | 500 | (500) | 0 | 0 | 0 |
670101-Professional Fees | 10,000 | 52,609 | (42,609) | 10,000 | 61,000 | (51,000) |
725120-Furniture |
| 2,922 | (2,922) |
|
|
|
740100-Rents | 0 | 27,219 | (27,219) | 0 | 30,000 | (30,000) |
750050-General Cleaning | 1,000 | 4,639 | (3,639) | 1,000 | 1,000 | 0 |
Other Operating Expenses | 25,000 | 155,795 | (130,795) | 25,000 | 152,000 | (127,000) |
Expenditure | 636,000 | 780,872 | (144,872) | 636,000 | 772,000 | (136,000) |
DSH200 - Professional & Care Regs | 350,000 | 456,586 | (106,586) | 350,000 | 448,000 | (98,000) |
| Yr to Dec Budget 2021 | Yr to Dec Actual 2021 | Yr to Dec Bud Var 2021 | Full Year Budget 2021 | Full Year Forecast 2021 | Full Year Forecast Variance 2021 | |
DSH201 - Care Commissioner | |||||||
Earned through Operations | - | - | - | - | - | - | |
330430-Other Fees | 0 | (10,315) | 10,315 | 0 | 0 | 0 | |
Earned through Operations | 0 | (10,315) | 10,315 | 0 | 0 | 0 | |
Income | 0 | (10,315) | 10,315 | 0 | 0 | 0 | |
|
|
|
|
|
|
| |
Other Operating Expenses | |||||||
540110-Hired Services | 0 | 1,611 | (1,611) | 0 | 0 | 0 | |
549001-Other Supps & Services | 8,000 | 0 | 8,000 | 8,000 | 8,000 | 0 | |
640100-Meals & Entertainment | 0 | 60 | (60) | 0 | 0 | 0 | |
641100-Other Travel | 18,000 | 1,009 | 16,991 | 18,000 | 3,000 | 15,000 | |
641101-Travel - Air Fares | 0 | 2,489 | (2,489) | 0 | 0 | 0 | |
642100-Hotel Accommodation | 0 | 2,025 | (2,025) | 0 | 0 | 0 | |
643100-Conference & Course Fees | 0 | 1,683 | (1,683) | 0 | 0 | 0 | |
670101-Professional Fees | 28,000 | 44,343 | (16,343) | 28,000 | 47,000 | (19,000) | |
Other Operating Expenses | 54,000 | 53,218 | 782 | 54,000 | 58,000 | (4,000) | |
Expenditure | 54,000 | 53,218 | 782 | 54,000 | 58,000 | (4,000) | |
DSH201 - Care Commissioner | 54,000 | 42,903 | 11,097 | 54,000 | 58,000 | (4,000) | |
|
|
|
|
|
|
| |
DSH202 - Health Professional Regs | |||||||
Earned through Operations |
|
|
|
|
|
| |
330430-Other Fees | 0 | (14,385) | 14,385 | 0 | 0 | 0 | |
334010-Miscellaneous Income | (39,000) | 0 | (39,000) | (39,000) | (26,000) | (13,000) | |
Other Operating Expenses | (39,000) | (14,385) | (24,615) | (39,000) | (26,000) | (13,000) | |
Income | (39,000) | (14,385) | (24,615) | (39,000) | (26,000) | (13,000) | |
|
|
|
|
|
|
| |
Other Operating Expenses | - | - | - | - | - | - | |
540110-Hired Services | 0 | 1,210 | (1,210) | 0 | 0 | 0 | |
Other Operating Expenses | 0 | 1,210 | (1,210) | 0 | 0 | 0 | |
Expenditure | 0 | 1,210 | (1,210) | 0 | 0 | 0 | |
DSH202 - Health Professional Regs | (39,000) | (13,175) | (25,825) | (39,000) | (26,000) | (13,000) | |
Total L60 - Arm's Length Functions | 365,000 | 486,314 | (121,314) | 365,000 | 480,000 | (115,000) | |
REPORT TOTAL: | 365,000 | 486,314 | (121,314) | 365,000 | 480,000 | (115,000) | |
The budget reports an overspend, mainly relating Professional Fees - (42,609) to operating expenditure. The allocated budget was £10k
The overspends relate to each of the following Rent - (27,219)
areas of activity: No designated budget was allocated in 2021
Advertising - (29,276)
No designated budget was allocated in 2021
Hired services - (21,720)
No designated budget was allocated in 2021
APPENDIX 1
Inspections Quality Assurance Summary of Responses
THE FEEDBACK AREAS OF CONCERN... IS POSITIVE...
In general when areas for improvement ...particularly in relation are identified during an inspection,
to how inspections are these and their associated
undertaken. timescales are perceived to be
reasonable.
24 GENUINE managerswere
BENEFITS
Providers and
RESPONSES able to identify HELPFUL RECEIVED genuine benefits SUPPORT INSPECTOR to the inspection
RECEPTION process. When there has 17 care been a need to homes Feedback contact the
demonstrates that Commission for
Inspectors invariably advice or support 7 home introduce themselves, IMPROVEMENTS outside of
care speak with staff, care inspections, the services receivers & relatives A varied range of Commission is
and spend time with responses were provided perceived as
managers. tpor ohcoews sth me iignhstp beec tion helpful and improved. responsive.
AWARENESS
In most cases, respondents did not believe that the Commission has a high PANDEMIC
enough profile or that its role SUPPORT OPERATING
and function are clearly IMPROVMENTS understood. Although feedback indicates
that individual inspectors Several suggestions
were supportive throughout were provided about
the pandemic, the how the Commission
organisation as a whole is might improve how it LENGTH OF criticised for not being operates or do things
INSPECTIONS sufficiently vocal or differently.
VARIES WIDELY proactive.
The Commission values feedback from the regulated sector about all aspects of its work and particularly about the inspection process. In 2019-2020, the Head of Governance, Policy and Standards undertook a series of visits and virtual discussions with managers and providers, to source feedback. As this became less feasible as a result of restrictions associated with visiting services, a decision was taken to adopt an alternative methodology in 2021.
Questionnaires were sent out to every provider/ homes are provided by the Government of Jersey manager following an inspection in 2021. A total of i.e., it is the same provider who has received the 24 completed questionnaires were received. questionnaires.
Seventeen questionnaires were received from As Regulation Officers are named in the feedback, care homes and seven from home care providers. anonymity has been assured in this report, by
No responses were received from day centres or substituting the word Inspector .
children s residential homes. However, there are
The questions are highlighted in bold type and few day centres, and it is important to note that the
precede a brief analysis and a summary of majority of day centres and children s residential
responses.
Was the inspection announced or unannounced?
Most responses indicate that the inspection was inspection in a home care service than a care home. announced. However, this should be understood Where inspections have been announced, providers in the following context. The Commission has received limited notice (usually 24 hours). continued to operate with an adapted methodology
Providers and managers appear to have reacted on account of the ongoing pandemic; undertaking
positively to the announcing of inspections. Whilst more announced inspections than would usually
this is encouraging, there is a need to balance this be the case, in response to infection-related
against the public expectations that inspections be intelligence. It is also important to note that it
unannounced.
is more difficult to undertake an unannounced
If the inspection was announced, were you able to prepare for the inspection? How did you do this?
It is apparent that managers and providers were able For efficiency, we prepared in advance all the to make use of the period of notice to ensure that required paperwork, evidential records, and HR they were better prepared for the inspection. For files.
example, relevant documentation could be collated. There was nothing to prepare, as all records are on I printed a copy safeguarding and recruitment the computer. I made sure I was available.
policy. I also gave phone numbers of staff and having the inspection announced (meant that) I some clients, as requested. was able to ensure that someone was (present at
Ensured files up to date, reviewed Statement of the) home, also at the time I managed another two Purpose and had relevant documents ready i.e., homes, so I was also able to ensure that I was at mandatory training records (name of care home) for the inspection.
(CONTINUED)
Did the inspector introduce themselves on arrival and explain the purpose of the visit? Did the inspector provide a summary of findings at the end of the inspection?
It is positive to note that the response to this Yes, and also signed into the visitor s book. All respondents said that this happened. Summaries that although it was perceived that the inspector question was unanimous and that this always were provided verbally in most cases although had indicated that there would be no improvements
happened. Responses included: Yes, both introduced themselves fully and outlined occasionally this happened via email (this may have required, the report included two.
how the inspection would be undertaken. been due to the manager not being on site at the
time of the inspection). One concern was noted in
Did the inspector speak with staff/care receivers/relatives?
The responses overwhelmingly indicate that this also contacted other staff members by email Did the inspection report accurately reflect the discussions/summary during the visit? happened, although feedback confirmed this was and made contact with family members after the
sometimes difficult to achieve on account of Covid- inspection. All but one of the respondents indicated that the the inspection report did not fully accord with the related restrictions. Responses included: Yes and also made notes of social workers that report was fully aligned with the discussions during visit, and that further discussion took place via MS Yes spoke to staff on shift and also care have been involved so she could get feedback. the inspection visit. The one exception noted that Teams and emails afterwards.
receivers in the house at the time. The inspector
Was the inspection report well-written? Did it make sense?
Did the inspector speak with the manager of the service?
The feedback was overwhelmingly positive. need to challenge some areas but that this had not The responses were unanimous, and it was apparent Comments included that reports were very resulted in the change which they were wanting. that this took place on every occasion. comprehensive and well-written , well structured ,
articulate . One respondent noted that they felt the
How long did the inspection last and was this length of time appropriate?
The responses varied widely. It is important to note that the types of services which the Commission inspects range from small home care providers to very large care homes. Consequently, it is likely that inspection methodology, including duration, will be tailored according to the needs of the service.
The shortest time cited was two hours. In this instance, the respondent expressed that, for this
Were any areas for improvement identified? Were the timescales for organisation, it was long enough to cover all improvement appropriate?
requirements .
Where such areas were identified, the timescales no consideration was given to the additional costs Tinspections lasted an inorhe feedback does not generdinate length of time, with ally suggest that were considered to be reasonable , appropriate associated with making the improvements.
most respondents commenting that inspections, or manageable . One respondent commented that
lasting a few hours or up to one day, were of
appropriate length. In some cases, inspections
lasted for two or three days. What has been the impact of the inspection upon the service? Was the inspection
process of benefit to the service?
Were any areas of concern noted by the inspector and discussed at the time? A range of responses were provided in answer to Were these findings reasonable? these questions, and these demonstrate that various
positive changes have taken place as a result of the Some inspections did not identify any areas of Yes, two areas of improvement were identified inspection process.
concern. Where some were noted, it appears to be and discussed, these were reasonable areas for Inspection is an important part of the care industry the case that these were regarded and responded to improvement and valuable to maintain standards.
positively by providers and managers, although there Areas of concern were highlighted and discussed
were occasional areas of disagreement. with the Inspector, and these were all reasonable. Gave assurgoal of person focused carance that we are working towards our e for all relatives.
The following comments were received: Yes, Staff needing Advanced course in Autism, Think it s beneficial and highly relevant to ensure No areas of concern, however the inspection and update with Makaton, very reasonable, I am in we are providing safe and effective care.
prompted useful discussions which is helpful to agreement.
me as a new manager.
Absolutely, it gave the residents and staff support, reassurance that the upheaval they had been living through was going to be worth it and that higher standards are being and will continue to be achieved with their effort.
An external review is always of use to us as we are passionate about enhancing lives and continuous improvement of our services.
Yes of great benefit in terms of independent oversight and in providing leverage for implementing improvements.
(CONTINUED)
How can the inspection process be improved? This question generated many varied responses.
One respondent suggested that inspections be undertaken more frequently. Another commented that the inspection process had taken too long and should have been completed within a shorter period.
Other comments included:
Provision of agenda and timings i.e., management discussion, staff interviews, data reporting feedback, summary and feedback of initial findings. (N.B. This respondent felt that the inspection process should be more formalised with a specified agenda and timings for meetings).
Is there anything that the Commission could do to improve how it operates? Is there anything that we should do differently?
I am happy with the inspection process for
my areas. I don t feel there is any need for This question generated a range of responses and Possible meetings which could involve staff to improvement. suggestions, which were generally positive. provide feedback.
I feel that the inspection process works well by No, I think it s important that they function as they In our opinion the balance between the regulatory including the views of the relatives and staff. do to remind Home Care workers / organisations function and providing advice is right.
We feel the process is fair and the communication why the need for regulation. The relationships
between service provider and inspector is good. are perfectly balanced as they are approachable Give a chance to less experienced stafabout their answers, some of staff members f to think
and friendly but also very professional and honest don t understand abbreviations.
ensuring that we are aware of their role and the
importance of regulating services. I am currently happy with the JCC and its ways of
operating, and support provided.
Perhaps more training/information/ open days for
the sector when the pandemic settles.
Have you needed to contact the Commission outside of inspections? Has the Commission been helpful?
Most respondents indicated that they had needed to, on occasions, contact the Commission. Where this had happened, the feedback was overwhelmingly positive.
Yes, I have (made contact with the Commission) several times. I ring for advice and to talk things through, this enhances the care delivery for all.
Yes to ask advice, and yes always get an informative and helpful reply.
I have made contact outside of inspections and have found the Commission to be very helpful and they respond in a timely manner.
Yes, I have several times, this for me is the most useful function of the Commission, to have access to an inspector just to ask their advice.
Yes, at times I have made contact and they have been very helpful with giving information in a professional, friendly manner.
Does the Commission have a high enough profile, and do you feel that people understand its role and function?
This question generated suggestions for improvement. The majority of respondents expressed that the Commission does not have a high enough profile and various respondents concurred that the Commission has not been sufficiently vocal throughout the pandemic. A minority of respondents believed that the Commission either has a high enough profile, or that the situation is improving.
There has been a lack of visible support for the Care Sector from the Commission as a body regarding the challenges service providers faced during the Pandemic. Inspectors leaving the Island to work remotely for months added to this perception.
I don t feel enough residents and relatives are aware of it. At a recent committee meeting with 2
residents and 2 relatives none had heard of it.
No, I believe the general public are not aware that they can contact the Care Commission with any concerns or complaints.
This could be promoted further. Provision of materials to share with staff would be helpful. Perhaps something to be shared on the website (of the organisation which was inspected), and Facebook etc
No, I do not think the role is clearly understood.
A higher profile certainly is needed. Effective communication to the general population and service providers would be seen as positive. Post Pandemic would be an ideal opportunity for this.
APPENDIX 2: Health Care Registration
Occupation | 2021 | 2020 |
Ambulance Paramedic | 23 | 1 |
Art Therapist | 1 | 0 |
Biomedical Scientist | 12 | 13 |
Chiropodist | 1 | 0 |
Chiropractor | 8 | 1 |
Clinical Scientist | 0 | 0 |
Clinical Psychologist | 4 | 3 |
Dietitian | 1 | 1 |
Midwife | 8 | 16 |
Nurse | 164 | 208 |
Nurse Independent Prescriber | 1 | 2 |
Occupational Therapist | 4 | 10 |
Operating Department Practitioner | 12 | 4 |
Orthoptist | 2 | 0 |
Osteopath | 1 | 1 |
Physiotherapist | 22 | 8 |
Podiatrist | 2 | 2 |
Psychotherapist | 9 | 3 |
Radiographer | 16 | 8 |
Social Worker | 37 | 49 |
Specialist Community Public Health Nurse | 5 | 6 |
Speech and Language Therapist | 5 | 2 |
|
|
|
TOTAL | 338 | 338 |
Annual Renewals of Health Care Registrations
Health and Care Professionals are required to complete an annual renewal. Each year, some registrants do not renew (e.g., registrant no longer practising in Jersey).
Registrants renewed 1899 Registrants removed from register 320 Renewals Processed (Total) 2219
Medical Practitioner Registrations
Health and Care Professionals are required to complete an annual renewal. Each year, some registrants do not renew (e.g., registrant no longer practising in Jersey).
2021 Pending Applications 2020
Medical Practitioner 98
127 4
Medical Practitioner Registrations by month:
Health and Care Professionals are required to complete an annual renewal. Each year, some registrants do not renew (e.g., registrant no longer practising in Jersey).
Month | 2021 | 2020 |
January | 9 | 10 |
February | 2 | 11 |
March | 8 | 7 |
April | 6 | 7 |
May | 7 | 1 |
June | 13 | 6 |
July | 15 | 6 |
August | 21 | 24 |
September | 12 | 5 |
October | 15 | 10 |
November | 8 | 5 |
December | 11 | 6 |
|
|
|
TOTAL | 127 | 98 |
Health Care Registrations by month:
Month | 2021 | 2020 |
January | 43 | 16 |
February | 15 | 18 |
March | 31 | 31 |
April | 25 | 41 |
May | 23 | 7 |
June | 27 | 13 |
July | 28 | 21 |
August | 38 | 30 |
September | 29 | 36 |
October | 24 | 28 |
November | 26 | 29 |
December | 29 | 33 |
|
|
|
TOTAL | 338 | 338 |
A(CPONPTEINNUEDDI )X 2 APPENDIX 3
Professions which are registered by the Commission
Dental Registrations
| 2021 | Pending Applications | 2020 |
Dental Nurse | 48 | 1 | 6 |
Dental Hygienist | 4 | 0 | 6 |
Dental Therapist | 1 | 0 | 3 |
Orthodontic Therapist | 0 | 0 | 2 |
|
|
|
|
TOTAL | 53 | 1 | 17 |
Month | 2021 | 2020 |
January | 3 | 2 |
February | 14 | 7 |
March | 21 | 0 |
April | 6 | 0 |
May | 3 | 1 |
June | 2 | 1 |
July | 0 | 3 |
August | 1 | 0 |
September | 1 | 1 |
October | 1 | 2 |
November | 1 | 0 |
December | 11 | 0 |
|
|
|
TOTAL | 53 | 17 |
Piercing and Tattooing:
| 2021 | Pending | 2020 |
Premises | 5 | 2 | 11 |
Practitioners | 19 | 1 | 14 |
|
|
|
|
TOTAL | 53 | 1 | 17 |
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
1st Floor, Capital House, 8 Church Street, St Helier, JE2 3NN
www.carecommission.je
58 | Jersey Care Commission | 2021 Annual Report 58 59