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2023
Contents |
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Forward |
| 04 |
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Our 2023 Highlights |
| 06 |
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About the Jersey Care Commission |
| 08 |
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Our Vision |
| 09 |
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Our Purpose |
| 09 |
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Our Values |
| 09 |
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What we do |
| 10 |
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How we work |
| 10 |
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Our Structure in 2023 |
| 11 |
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Performance Report |
| 12 |
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Chief Inspector s Report |
| 14 |
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Our Strategy |
| 16 |
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Performance Analysis |
| 17 |
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Accountability Report |
| 41 |
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Corporate Governance Report |
| 42 |
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The Commissioners |
| 52 |
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Staff Report |
| 63 |
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Sustainability Report |
| 67 |
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Finance Report |
| 70 |
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Appendix |
| 73 |
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| 3 |
2
Forward
by the Chair of the Board of Commissioners
Our fifth Annual Report provides a detailed overview of the work of the Jersey Care Commission (the Commission) for 2023. It describes the Commission's activities and
the impact of its work on the regulation of Jersey's
health and social care provision.
The Commission was established by the the Standards and our inspection handbook Regulation of Care (Jersey) Law 2014 as an and methodology, surveying people who use independent arm s-length body with perpetual children's services and those who work in the succession. It came into being in January 2019. sector and reviewing strategic and managerial The Commission is accountable to the people of oversight of these services. The first inspections Jersey through the Minister for the Environment. of CAMHS, and Social Work Services and
Independent Reviewing Officers took place in Our Commissioners are people with lived
2023. Other inspections, including fostering and experience of health and social care.
adoption, will follow in 2024.
Some are experienced professionals with
successful careers in senior managerial The Commission has commenced preparations positions, including experience in delivering to extend regulatory reach further, including
and regulating health and social care in other the hospital, ambulance and adult mental jurisdictions. One Commissioner lives on Island health provision. It has developed a partnership and was appointed specifically because of her arrangement with the Care Quality Commission experience of being a carer. (CQC) to facilitate this work.
Our remit was extended in 2023 to include The Commission held an engagement
the regulation of care for children and young event with care sector representatives in people, including Child and Adolescent Mental May 2023. This was an opportunity to hear Health Services (CAMHS). The preparations directly from care providers on the receiving for inspections of children's services continued end of inspections, and we look forward throughout the year. This included developing to another similar engagement in 2024.
4
Commissioners visited care providers on In 2023 two Commissioners, Alison Allam and the Island and found it beneficial to see how Sian Walker -McAllister, who each made a front-line services are being delivered in various significant contribution to our work, ended their care settings. second successive terms in office, and we bade
them farewell.
Throughout the year, the Board met with people
at the highest levels of Government, including This year, we welcomed two new Commissioners, Ministers and senior officers. These informative Kathryn Chamberlain OBE and Gordon Pownall, sessions allowed Commissioners to hear about appointed following an open recruitment significant policy developments in Jersey. process overseen by the Jersey Appointments
We continued to meet quarterly with Government Commission. Three Commissioners whose representatives through the Strategic Policy, first terms in office ended in December 2023 Planning and Performance (SPPP) department. have each been appointed by the Minister for These meetings provided an opportunity to the Environment for a second three-year term, discuss performance and to provide assurance providing much-needed continuity at a significant as to the appropriate use of public funds. time in our development.
The Commission's work is ably led and facilitated by Becky Sherrington, Chief Inspector,
" The Commission assisted by a team of regulation officers and undertook workshops administrative support staff. The Commission
throughout the year to relies on the team to deliver robust, agile and effective regulation in Jersey. Throughout 2023,
delve into matters that Regulation officers delivered more than one directly impact the work hundred inspections of regulated activities,
including care homes, children's homes, home of the Commission. " care and day care services. The reports of these
inspections are published on the Commission's website.
The Commission undertook workshops
As you read this report, I trust you will be throughout the year to delve into matters that
assured by the evidence of the Commission's directly impact the work of the Commission.
work promoting best practice, challenging In September, we looked at our governance
poor performance and driving up the quality arrangements and devised a single assurance
of health and social care provision in Jersey. framework to improve governance and
accountability.
Glenn Houston
Chair of the Jersey Care Commission
5
6
7
About the Jersey Care Commission
The Commission was established by the Regulation of Care (Jersey) Law 2014. The Law sets out our functions, powers, duties and responsibilities, along with detailed provisions about the Commission's appointment, resources, and funding.
A Board of Commissioners oversees the work of the Commission. The Commissioners appoint officers to carry out the duties of the Commission. The Executive Team structure is shown on page 11. The Commission engages independent contractors to deliver specific projects requiring additional skills and expertise.
8
Our Vision
Providing independent assurance, promoting best practice and improving health and social care outcomes for the people of Jersey.
Our Purpose
We were appointed as a Health and Social Care Commission to:
provide the people of Jersey with independent assurance about the quality, safety and effectiveness of their health and social care services
promote and support best practice in the delivery of health and social care by setting high standards and challenging poor performance
work with service users, families and carers to improve their experiences of health and social care and to achieve better outcomes
register a range of health and social care professionals and take steps to assure ourselves and the people of Jersey that all registered professionals are fit to practise.
Our Values
A person-centred approach we put the needs and the voices of people using health and social care services at the heart of everything we do
Integrity we are objective and impartial in our dealings with people and organisations
Openness and accountability we act fairly and transparently and are responsible for our actions
Efficiency and excellence we strive to continually improve and provide the best possible quality and value from our work
Engagement we work together with, and seek the views of, those using, providing, funding and planning health and social care services in developing all aspects of our work.
9
What we do
We regulate and inspect services for adults and children to ensure that people receive high-quality, safe, and effective care.
The services we regulate include care homes providing nursing and personal care, care provided to people in their own homes, adult day care services, and residential and other services for children and young people.
We are also responsible for:
registering health and social care professionals
protecting the public from infection risks by regulating piercing and tattooing businesses
registering and inspecting premises which use lasers for cosmetic purposes
registering and inspecting Yellow Fever Centres.
How we work
We embrace the "Right-touch" regulation principles outlined by the UK s Professional Standards Authority. These state that regulation should be:
Proportionate: regulators should only intervene when necessary. Remedies should be appropriate to the risk posed, and costs identified and minimised
Consistent: rules and standards must be joined up and implemented fairly
Targeted: regulation should be focused on the problem and minimise unintended consequences
Transparent: regulators should be open and keep regulations simple and user-friendly
Accountable: regulators must be able to justify decisions and be subject to public scrutiny
Agile: regulation must look forward and be able to adapt to and anticipate change.
10
Board of Commissioners Chair and x6 Commissioners
Business Support Team Leader
Business Support Regulation Pharmacist Team Admin x2 Officer x8 Inspector
11
Performance Report
The Commission is an independent organisation partly funded by fees, but much of the Commission's income is received from the Government.
As a public regulator, the Commission has a role in helping the Government deliver its objectives. The long-term aims of the Government of Jersey are set out in the Jersey Performance Framework and the Island Outcome Indicators, which measure progress towards the Government's
sustainable wellbeing goals.
Sustainable wellbeing is a way of measuring the progress of a society. It is a holistic concept and uses different tools to measure how well society is doing across the key areas contributing to human wellbeing. The Government of Jersey focuses on three key areas set out in the Jersey Performance Framework.
Community wellbeing Environmental wellbeing Economic wellbeing
the quality of the quality of the how well the economy people s lives natural world around us is performing
12
TAL
N
E Built Children M environment
N
Health & O wellbeing
R
I
V Natural
N environment
E
Safety & security
JERSEY'S
PERFORMANCE
Sustainable FRAMEWORK
resources Vinclusive ibrant & community
Affordable Jobs & living growth
Business environment
OMIC
The Commission directly contributes to community wellbeing, and the Government has set out specific objectives for the Commission:
- people are provided with independent assurance about the quality, safety and effectiveness of Island services through the Commission
- all providers deliver high standards of care, and where care is poor, this is readily identified so that services can be supported to improve or are subject to appropriate interventions
- there is public confidence in the Commission, that it is seen as effective, relevant and provides value for money.
13
Chief Inspector s Report
In 2023, the Commission took on responsibility for a much wider remit across children's social care, including CAMHS, Social Work Services, Secure Children's Homes, Care in Special Schools, Contact Centres, Family and Community Nursing Services, and Independent Reviewing Officer (IRO) Services.
Expanding its responsibilities to oversee safety of care delivered in care homes
children's social care represents a significant and in the community is generally good,
step forward since the publication of the with some examples of providers delivering Independent Jersey Care Inquiry report in 2017. exceptional care. Where we have concerns
This has been a crucial and demanding aspect that care is below the required standards,
of the Commission's work in 2023. Despite the we have challenged providers by highlighting considerable challenges, we remained dedicated underperformance and have followed up to
to our core mission and principles, using our establish the provider s progress in making the influence and authority to enhance the wellbeing necessary changes.
of Islanders.
Throughout the year, we acknowledged the
The Commission has effectively implemented efforts of registered providers and managers thorough inspections of registered care providers involved in the Commission s work. In addition to of particular aspects of children s health and our inspection programme, we initiated regular social care, using the published standards and and routine dialogue with the sector. This has regulations and continues to publish its findings. included several in-person and online events, These efforts will positively impact and enhance which were well attended and have received children's and young people's lives. positive reviews.
Adult Social Care also remains a large part of We also launched a communications campaign our role; people in Jersey expect to receive #CareConversation, inviting care receivers and safe and effective social care, now and for providers to share their views of what regulation future generations. In 2023, we carried out has meant to them. This was then shared on
117 inspections and subsequently published social media as part of the Care Conversation the inspection reports. Throughout 2023, on the Commission s LinkedIn, Facebook,
the Commission established that the quality and and X (formerly Twitter) channels.
14
This includes the recruitment of a pharmacist
into the team, which has already seen a positive impact. Staff recruitment has also included people with specialist skills in inspecting children's social care. We have also benefited from a positive partnership with the Royal College of Psychiatrists in the inspection of CAMHS.
We have invested in international, and UK-based
training for our permanent regulation officers
and will continue to build on external support for
the next phase of our regulatory transformation
work. This is one part of our workforce strategy I would like to acknowledge and thank the which seeks to mitigate the most significant risk following, including providers who took part to progress in this area, that is recruitment and
in the campaign: retention of staff.
A service user from Positive Steps We are committed to improving inspection quality while ensuring our resources are used effectively.
Chief Executive Officer from
Over the past year, our financial performance Family Nursing & Home Care
has been well managed. Despite considerable
Chairman of Sanctuary Trust uncertainty, we have delivered our business
Home Manager from plans and objectives within budget.
St. Joseph s Care Home
As you will see from this report, the Commission
Chief Officer from Children, Young People, is making great strides both in consolidating Education and Skills (CYPES). its core activities and stretching to meet new
We also hosted several online events in and ever more challenging objectives. collaboration with the Disclosure and Barring It will be challenging not only for us but
Service (DBS) and Jersey Office of the for those new to inspection and regulation. Information Commission (JOIC), both of However, the Commission will continue to
which were well attended. ensure that Islanders are provided with
independent assurance as to the quality and
As our remit expands, any inspection safety of the services provided on their behalf. arrangements introduced will only be as Like those we inspect, we are accountable to effective if we ensure high quality and the Islanders. As the Commission continues its
right skills within the inspection workforce. development, our rolling business plan for
This annual report points to the important changes 2024 2027 will continue to show our
being made in this area. For example, we have commitment to a person-centred approach, successfully recruited new staff members with openness, accountability, efficiency
diverse professional skills and backgrounds, on and engagement.
both a permanent and temporary basis.
Becky Sherrington
Chief Inspector
19 April 2024
15
Our Strategy
Our strategic aim is to develop a comprehensive and effective regulatory infrastructure that protects and promotes the rights of people who use the services we regulate.
To achieve our aim in 2023, we identified six strategic objectives:
1 drinee glJiuvelreasrte iayonn eafnfedc itnivsep seycstitoenm o off 4 moinf arJieenlrtesaveiaynn at nh eaaclctuhr aanted r seogciisatel r
health and social care services care professionals working 2 erkenepgyra segtsaee kneefthfaetocilvtdieveser olsy ft otwh dieteh v elop the 5 icamanpdpa riconivtteyel lttihog eeg nCactohem errem,g iainsrtsdeiorinpngr se t
Government of Jersey and other and respond to information
regulations, standards and robust regulated activities and
methodologies for inspection registered persons
of services new to regulation
3 rCwaohismoe umthsiees sapinordonfi pbleryo ocvfoi dntheseu s letrinvgic es 6 egthnreos uwprlteah nfi fnnoerad nt hceiexa tCle snotsmaibomnili iotsysf itaohnnod ts oe
and engaging with people deliver its core functions and and other stakeholders in all functions to other health
aspects of our work and social care services.
16
Performance Analysis
Our Performance Framework comprises six business priorities to bring operational focus to our strategy along with Key Performance Indicators (KPIs) which align to our priorities.
Regulation Professional & Inspection Registration
Public & Stakeholder Information Management Engagement & Responsiveness
Governance Planning Framework
The performance analysis looks at the Commission s performance against these priorities.
17
Performance Analysis
Priority 1 - Regulation and Inspection
Develop and implement a growth plan alongside the approved associated budget build to enable the expansion of the core team to deliver an effective regulatory regime for Jersey which supports best practice and drives continuous improvement.
HOW SUCCESSFUL These changes to our workforce and structure HAS THIS BEEN? are underpinned by a budget plan to ensure the
Commission has the necessary resources to
In anticipation of the Commission's expanding remit, deliver its remit.
we made structural changes to the leadership team
towards the end of 2022, replacing the Head of WHAT MORE NEEDS
Governance, Policy and Standards role with two new TO HAPPEN?
posts: Deputy Chief Inspector and Head of Business
and Performance. The Commission has made excellent progress in
developing the team to meet the expanded workload In 2023, these posts provided effective and focused
in 2023 and in preparation for introducing new areas operational and corporate support to the Chief
of regulatory activity throughout 2024 and 2025. Inspector. They enabled the Commission to deliver
To support new staff, the Commission reviewed
on its ambitions of improving operational delivery
and improved its induction process, making sure and introducing robust and structured corporate
it prepares staff for the Commission's new roles. governance processes to support the Commission
This programme of induction and orientation has
in its expanding role.
evolved throughout 2023 and will continue into The Government Plan 2023-2026 included funding 2024 as new staff are appointed.
for changes needed to enable the Commission to Some recruitment of regulation officers has been fully deliver on its commitments. In implementing our deferred, partly to ensure new staff can be supported growth plan, in 2023 we were successful in recruiting appropriately and partly to ensure the Commission two additional regulation officers and a Pharmacist recruits staff with the right skills and experience. Inspector. The Pharmacist Inspector enables the The Commission understands the need to continue Commission to directly undertake inspections of to increase the team's scope and range of skills and medicines management, administration, expertise, especially in areas new to regulation.
and disposal. Given the challenges of drafting
and consulting on the Standards for areas new to
regulation, and reviewing and revising the existing
standards, the Commission recruited an experienced
professional to lead this work.
18
Maintain an effective system of regulatory oversight by undertaking a planned annual programme of announced and unannounced inspections of all regulated services and activities for adults and children in Jersey, with the associated inspection findings published on our website.
HOW SUCCESSFUL Failure to comply with an Improvement Notice HAS THIS BEEN? is an offence which could result in prosecution.
The Commission did not issue any Improvement
The Commission has delivered its annual programme Notices in 2023 but on five occasions the Commission and completed all scheduled inspections in 2023. imposed discretionary conditions to help manage the In total, 105 regulated services were inspected during risks where issues of compliance with regulations and 2023. An additional 12 Inspections were carried standards were identified.
out, bringing the total to 117. Additional inspections
are usually those scheduled to check progress on WHAT MORE NEEDS
recommendations but can also include inspections TO HAPPEN?
of unregistered services where it is believed a
regulated activity is being to be carried out. The Commission will continue to carry out its planned
annual inspection programme to maintain an effective When the Commission identifies a service that is not regulatory system. Additional inspections beyond the
fully or consistently meeting the required standards, scheduled programme will be completed as and when areas for improvement are recorded in the inspection required. The Commission will face the challenge in report. The regulation officer usually agrees a specific 2024 of continuing the programme of inspections timescale for delivery to ensure that the provider has of children's services that are new to regulation and sufficient opportunity to make the required changes. preparing the way for hospital, ambulance service,
Depending upon the type and seriousness of the and adult mental health service inspections in 2025. breach or shortfall, the Commission may undertake The process of planning and preparation has already further inspections to ensure the provider addresses commenced to meet this challenge.
the issues. The Commission has the power under the
Law to impose discretionary conditions on a provider. TinhcereCaosmedmaiss ss iuor na nisc ae l sthor eo xu pg lh o ri in ns gp wec at yio s n tos, p in roc vlu idd ein g
It can also issue a formal Improvement Notice which developing methods to measure the effectiveness of sets out the exact action a provider must take along inspections and processes to monitor outcomes.
with a timescale for compliance.
19
Performance Analysis
Key Performance Indicator (KPI) 1 Regulation and Inspection
KPI 1.1 The Commission will complete 100% of
inspections in respect of each of the regulated activities, as required in Law:
TARGET In 2023, 117 inspections were carried out; 105 were annual inspections 100% of registered providers required by the Law. Ten services relating to
Children's social services were required to register for the first time in 2023. OUTCOME They had until 30 June to register, and the Law requires the Commission
to ensure they are inspected within 12 months of this deadline.
100%
KPI 1.2 Twahtilelle e Cansostmu 8r0me%tishsoaitfon 80%
its inspection INSPECTION
TARGET reports are REPORTS ARE
80% COMPLETED
completed in
OUTCOME draft form within
28 93% 28 days of an
inspection having DAYS concluded.
KPI 1.3 The Commission will publish 100% of its inspection reports within seven working days of reports being considered final.
A total of 95% of inspection reports were published on the Commission's TARGET website within seven working days of being finalised. The 5% gap was
caused by technical and process issues. The Commission is reviewing the 100% measure to consider if the 100% target is achievable in future.
OUTCOME
95%
20
Performance Analysis
Apply the Regulations and Standards for all regulated activities as a framework to measure the quality, safety and effectiveness of these services.
HOW SUCCESSFUL WHAT MORE NEEDS HAS THIS BEEN? TO HAPPEN?
The Commission applied the Regulations and The main challenge in 2024 will be to expand our Standards throughout 2023 and provided narrative capacity to cope effectively with the increasing range findings on quality, safety and effectiveness in the of services subject to regulation. We successfully inspection report. In most cases, any improvements launched new standards and an inspection handbook identified were resolved through the 'Areas for for Children's Health and Social Care services.
Improvement' section at the end of the relevant We will now need to do the same for acute hospital, inspection report. On five occasions the ambulance, and adult mental health services. Commission imposed discretionary conditions We are working with the Care Quality Commission which are applied to help mitigate risks. to help develop these new standards and inspection
Failure to comply with an Improvement Notice methodologies.
is an offence which could result in prosecution. As happened in 2023, with services new to regulation, The Commission did not issue any Improvement the Commission will need to engage with and Notices in 2023 but on five occasions the Commission support services that are due to become regulated imposed discretionary conditions to help manage to enable them to prepare effectively for regulation the risks where issues of compliance with Regulations and inspection.
and Standards were identified.
Review the effectiveness of the existing standards, incorporating the views of people who use and provide services.
HOW SUCCESSFUL WHAT MORE NEEDS HAS THIS BEEN? TO HAPPEN?
The Commission recognises the importance of Once the new standards and inspection reviewing the existing standards and incorporating approaches have been embedded, the
the views of people who use and provide services. Commission will set a revised timeframe for In 2023, as it implemented one set of new standards reviewing existing standards alongside
for children s social work services and began to a review of the effectiveness of the
develop another set for the regulation of the hospital, new approaches. This will enable a ambulance and adult mental health services, robust and informed analysis to
the Commission decided to delay the review of be carried out.
standards. This is so that it can undertake a proper
comparison of the benefits of different approaches
and to learn from other regulators.
21
Performance Analysis
Work with the Government of Jersey and operational leads in implementing new Regulations and Standards relating to children's social work and associated activities and Child and Adolescent Mental Health Services, ensuring the Commission can absorb the additional developmental work relating to these activities.
HOW SUCCESSFUL WHAT MORE NEEDS HAS THIS BEEN? TO HAPPEN?
The new Regulations relating to children s social work The children s services inspection programme is
and other areas new to regulation were enacted on underway and scheduled to continue into 2024.
1st January 2023. The Commission successfully All services new to regulation will undergo their first introduced the new regulatory framework. It carried inspection by the end of June 2024, with those who out the inspections of children's social work services were inspected for the first time in 2023 having an including the Independent Reviewing Officer service, annual inspection in the second half of the year.
and CAMHS in 2023, working with the Royal College
of Psychiatrists and other experienced independent
regulators to deliver these inspections.
Develop new inspection methods to deliver robust annual inspections of the services new to regulation across children s social care.
HOW SUCCESSFUL WHAT MORE NEEDS HAS THIS BEEN? TO HAPPEN?
In consultation with providers and working with Now that the initial inspections have been completed, contractors with experience of conducting these the Commission has contacted providers for feedback inspections, the Commission developed specific so that areas for improvement are identified and
sets of standards, and an inspection methodology, addressed. This will continue throughout 2024, supported by an inspection handbook. These were and any lessons learned will be fed back into successfully applied during the initial inspections of developing standards for hospital, ambulance, children's services. and adult mental health services.
Develop new standards and consider inspection methods for acute hospital, ambulance and adult mental health services.
HOW SUCCESSFUL WHAT MORE NEEDS HAS THIS BEEN? TO HAPPEN?
The Principal Standards Officer (PSO) has been We will continue working with providers and appointed and has begun developing the new experienced partners to develop standards, inspection standards. The PSO is working closely with the CQC in methods, and an inspection handbook. We will ensure England in developing our standards but has ensured that learning from introducing new standards in 2023 that these are designed specifically for use in Jersey. is used to inform our regulatory practice going forward.
22
Performance Analysis
KPI 1.4 Inspections KPI 1.5 Identified Areas and Inspection for Improvement
reports to meet have an agreed TARGET 100% of quality TARGET action plan 100% assurance 100% and agreed criteria. timescales for
OUTCOME OUTCOME delivery.
100% 100%
KPI 1.6 Improvement and action
plans are
TARGET reviewed by the 100% Commission within agreed
OUTCOME timescales.
100%
KPI 1.7 Consult directly with care receivers, relatives/
carers, staff members and external professionals in 100% of inspections.
TARGET In some cases, a regulation officer may have valid concerns about the 100% appropriateness of seeking feedback from family members. In these circumstances the regulation officer can decide not to consult with
OUTCOME relatives. In all other cases, consultation was carried out.
100%
KPI 1.8 Seek post-inspection feedback on annual inspections
with providers and managers of regulated activities. Publish a summary of responses.
TARGET A feedback survey is issued to all registered providers following all 30% inspections. Over 55% of care providers submitted feedback.
Results are available on our website.
OUTCOME
55%
23
Performance Analysis
Registration of Regulated Services
A significant part of the Commission s function is managing the registration and changes to registrations for regulated services. The Commission has set challenging targets to ensure that all registrations and changes are made promptly.
A requirement of making an application is that all necessary information and supporting documents are submitted. The target timeframe for completion of the registration process begins once the Commission receives a completed, fully documented application.
Key Performance Indicator (KPI) 2 Registration of Regulated Services
KPI 2.1 Finalise KPI 2.2 Finalise requests
applications for changes
for registration to registration TARGET of providers TARGET (for example 100% of regulated 100% Directors, activity within registered
OUTCOME four weeks OUTCOME manager, type 100% of receiving 100% of service, or
all required numbers of documentation. care receivers)
for providers
of regulated activities within four weeks.
KPI 2.3 Finalise KPI 2.4 Undertake requests for annual
changes to reviews and TARGET conditions of TARGET registrations
100% registration 100% of designated within four Yellow Fever
OUTCOME weeks. OUTCOME Centres, as 100% 100% required by Law.
24
Performance Analysis
Priority 2 - Engagement with the public and stakeholders
Revise the Communications Plan to support the Communications Strategy.
HOW SUCCESSFUL This was only completed towards the end of the year HAS THIS BEEN? and the results will be analysed once sufficient data is
available.
The Commission's communications plan has been
kept under regular review both for its effectiveness WHAT MORE NEEDS
and to id entify any additional required initiatives TO HAPPEN?
throughout the year.
The Commission remains committed to seeking
In 2023 the Commission launched its
further opportunities to engage with the public #CareConversation campaign. Its success in
and professionals and to enabling them to provide engaging with service users and providers
feedback. It is currently considering the opportunities exceeded our expectations.
to improve engagement by working with a range of Another prominent initiative was enabling users to provide community groups.
feedback on their experience of using the website.
Ensure that the voices of people who use and provide services, their carers and representatives, are heard throughout the Commission's work.
HOW SUCCESSFUL It has exceeded expectations and provided
HAS THIS BEEN? measurable data about the effectiveness of
our engagement.
The Commission mainly engages directly with care
receivers and their families through the inspection WHAT MORE NEEDS
process. Regulation officers speak to a range of TO HAPPEN?
people at each inspection, and their feedback is
included in inspection reports where appropriate. Following on from the success of the
This is not always possible; feedback often includes #CareConversation campaign, the Commission highly personal or sensitive data. will continue to seek new ways to engage with the
public, and especially with care receivers and their The #CareConversation campaign is part of our families. We are also continuing to explore other
communications strategy which aims to broaden the more traditional options to increase engagement ways we engage with care receivers and providers. through surveys and through the website.
25
Performance Analysis
Provide the public with access to relevant information about the Commission's activities on the Commission's website and, for those who cannot use a website, provide access to other appropriate methods of contacting the Commission.
HOW SUCCESSFUL WHAT MORE NEEDS HAS THIS BEEN? TO HAPPEN?
All inspection reports, policies and guidance are Enhancing engagement with the public remains a available to the public through the Commission's key objective, and with this in mind, the Commission website. Minutes and agendas of Board meetings is keen to understand what else it can do to provide are also available, in keeping with the requirements of members of the public with the information they
our publication scheme. The Commission provides require. To do this, we continue exploring options for alternative methods to access documents on request. improving our feedback channels and mechanisms.
Following the introduction of a limited amount of
TtehleepChoomnemqisuseiorine so pa erera atnesswae dreudty p or ffiomcep stl oy. t hIna ta ddition, information in child-friendly and plain English
formats, we will be increasing the range of information especially in complex matters, the Commission is
available and providing more information in an always ready to engage directly with the public by
easy-to-read format.
appointment in face-to-face meetings. This is actively
encouraged when resolving complaints. In 2023,
the Commission also began to make some key
information available in Easy Read formats.
PUBLIC ACCESS
TO RELEVANT INFORMATION
26
Performance Analysis
Key Performance Indicator (KPI) 3 Public Engagement
KPI 3 The Commission will improve and expand engagement
with the public by introducing new channels to engage with the public and seek feedback.
OUTCOME
Achieved
KPI 3.1 The Commission will work with the supplier to enhance
the use of website statistics and consider feedback mechanisms to understand public engagement.
TARGET This was implemented in 2023, and towards the end of the year we began 100% to receive feedback, Early indications are that while most users easily
find the information they require this is not the case for all users. Once we OUTCOME have collected more data, we will seek to ensure all users can finds the
information they need.
100%
KPI 3.2 Engage with care receivers and families during
inspections and provide an opportunity for them to give feedback on their experience of inspections.
TARGET This was achieved in all instances where the Regulation Officer deemed it 100% appropriate to seek engagement. Anonymised comments received from care receivers and their families are included in inspection reports where
OUTCOME consent is given, and where this can be done without infringing privacy.
100%
27
Continue to raise the profile
of the Commission with the organisations it regulates and with
those who receive services and their carers/representatives, through a planned programme of engagements.
HOW SUCCESSFUL WHAT MORE NEEDS HAS THIS BEEN? TO HAPPEN?
The Commission has continued to engage directly with The Commission will continue to hold further providers and organised a successful engagement sector-wide engagement events in 2024 and explore event in May 2023. Feedback confirmed that other meaningful ways to engage care providers attendees found the event valuable and would and service managers. This will enable providers to welcome similar events. share experiences of regulation and will offer further
opportunities to provide feedback about the work of The Commission organised two online seminars for the Commission.
care providers with key partners. The Disclosure
and Barring Service (DBS) and the Jersey Office of Following the success of the seminars with key
partners, the Commission will consult with providers to the Information Commissioner (JOIC) spoke about
ensure we continue to identify other subjects
their work and provided guidance and support to
of interest.
participants. Both seminars were well received
by attendees.
Establish effective links with other UK regulatory bodies with shared responsibilities for overseeing professional regulation in Jersey, including developing Memoranda of Understanding.
HOW SUCCESSFUL WHAT MORE NEEDS HAS THIS BEEN? TO HAPPEN?
During 2023 the Commission worked with The Commission will continue to work with UK several regulatory bodies to agree Memoranda professional regulatory bodies to agree and regularise of Understanding (MOUs) and working practices working practices so that the public can be assured focussed on keeping the people of Jersey safe. that health and social care professionals working in Two MOUs were finalised in 2023 with the Nursing Jersey are appropriately registered and regulated. and Midwifery Council (NMC) and with the Health Work with UK professional regulators will also seek Care Professions Council (HCPC). Other MOUs are to ensure the necessary agreements are in place being progressed. Discussion so far has enabled so that outcomes of fitness to practise committee
investigations are communicated and taken into
the Commission and other professional regulatory
consideration in maintaining an accurate register bodies to agree effective working practices and clarify
in Jersey.
the lawful basis for data sharing. This has promoted
effective joint working, pending the agreement of
formal MOUs.
28
Performance Analysis
Work with the Government of Jersey policy leads to prepare for the implementation of the new Registration of Professionals Law.
HOW SUCCESSFUL WHAT MORE NEEDS HAS THIS BEEN? TO HAPPEN?
The Commission has worked closely with the The Commission will continue to prepare for any Government of Jersey in its drafting of the proposed changes in the law to ensure the transition to a new Registration of Professionals Law. In preparation the regulatory framework is as smooth as possible. Commission has undertaken the Digital Registration The Commission will also publicise the changes project to ensure it can handle any increase in the and new requirements for professional registrants.
volume of registrations following any legislative
changes. The Commission supports the Government
of Jersey plans to replace existing laws with a single
registration law that standardises requirements across
all health and social care professionals.
Work with Policy Leads within the Government of Jersey on developing regulations and standards for assisted dying.
HOW SUCCESSFUL Should the Government of Jersey enact legislation, HAS THIS BEEN? the Commission will be prepared to fulfil any
consequential additional regulatory requirements. The Board receives regular updates from the
Government of Jersey policy lead on the Government s WHAT MORE NEEDS
intentions regarding assisted dying. As part of the TO HAPPEN?
European Partnership for Supervisory Organisations
in Health Services and Social Care (EPSO), the The Commission will continue to work with the Commission has sought advice and information from Government of Jersey to ensure that a system of other regulators with experience in this specialist area. effective regulation will be implemented to support
any changes in the law. The Commission will
The Chief Inspector now chairs an EPSO working also continue to work with international partners group on regulatory issues around assisted dying and to ensure that regulation of Assisted Dying in provides relevant information to the Government of Jersey follows international best practice and Jersey for its consideration and, where appropriate, takes into consideration experiences of other
to incorporate into its plans. jurisdictions where Assisted Dying is lawful.
29
Performance Analysis
Key Performance Indicator (KPI) 4 Stakeholder and professional engagement
KPI 4 The Commission will increase engagement with the sector and stakeholders such as States and Government of
Jersey departments, Jersey based arm s-length bodies, OUTCOME and UK regulators.
Achieved
KPI 4.1 Consult with the sector to organise a sector-wide
engagement event for providers
The Commission organised a sector-wide engagement event OUTCOME using feedback from providers about previous events.
Achieved
KPI 4.2 Facilitate engagement events or training events on specific
subjects relevant to providers
Two such events were held with the Disclosure and Barring Service and OUTCOME the Jersey Office of the Information Commissioner.
Achieved
KPI 4.3 Develop additional feedback mechanisms to enable a
greater range of feedback to be provided by the sector
In 2023, the Commission made significant changes to its post-inspection OUTCOME feedback process to improve the information received and the ability to analyse
responses. In addition, the Commission introduced an annual survey of registered Achieved providers to capture feedback about other aspects of the Commission's work.
KPI 4.4 Use Website traffic and feedback surveys to monitor use
and satisfaction with the website and information provided
Towards the end of 2023 the Commission deployed a survey to enable users to OUTCOME provide feedback. In addition, the Commission enhanced the data it collects
about website use to help it better understand what information and documents Achieved users access most frequently and so that we can ensure users can access the
information they require.
30
Performance Analysis
Priority 3 - Professional Registration
The Commission will complete professional registrations and renewals within agreed timeframes, subject to receipt of completed applications that include all required documentation.
HOW SUCCESSFUL WHAT MORE NEEDS HAS THIS BEEN? TO HAPPEN?
The Commission operates a successful registration The Commission has been developing a digital online programme for health and social care professionals registration system to prepare for a possible increase who are required to register with the Commission to in activity and to future-proof the registration process. work in Jersey. There are currently 3,637 registered While much of the work to develop the new system professionals permitted to work in Jersey. took place in 2023, the system is expected to go live Proposed changes to the legislation underpinning in 2024.
professional registration could increase the volume
of registrants, particularly with respect to renewals,
as currently not all professionals need to re-register
every year.
" The Commission has been developing a digital online professional registration system for health and social care professionals"
31
Performance Analysis
Key Performance Indicator (KPI) 5 Professional Registration
KPI 5.1 Creogmisptrlaettieon KPI 5.2 Complete renewal
applications applications
from health from health
TARGET TARGET and social care
and social care
100% 100% professionals
professionals
within seven OUTCOME within three OUTCOME
100% days of
working days 100%
receiving a
of receiving
completed
a completed
application. application.
KPI 5.3 Complete registration
applications
TARGET from piercing 100% and tattooing
practitioners OUTCOME within three
100%
working days of receiving a completed application.
3 DAYS
COMPLETE
REGISTRATION APPLICATIONS
32
Performance Analysis
Priority 4 - Information Management and Responsiveness
The Commission is committed to ensuring its internal systems are robust, fit for purpose and capable of managing the complexity and volume of information it handles.
Strengthen the Commission's internal administrative systems to ensure they are sufficiently robust to manage and process the complexity of information received from the public and from regulated activities.
HOW SUCCESSFUL the Commission detected two data incidents, which HAS THIS BEEN? were notified to the relevant data subjects and to the
Jersey Office of the Information Commissioner (JOIC). The Commission processes a broad and complex JOIC investigated the incidents and took no further
range of information from care providers, individual action, confirming they were satisfied with the actions professionals, and the public. In 2023, it introduced taken by the Commission to manage the incidents. new ways to gather and manage that information using All Commission staff and Commissioners have existing technologies. These improvements simplified received data protection training, and are supported
the process for those submitting information and for by an experienced Data Protection Officer.
Commission staff managing and analysing data.
The Commission's Business Support team ensures a WHAT MORE NEEDS
prompt response to all enquiries, with a duty officer to TO HAPPEN?
deal with any complex inquiries requiring knowledge
of the Regulation of Care (Jersey) Law 2014 or the Aansdth me arannaggee da nbdy cthoemCpolemximtyi sosfi oinnfo inrmcr ae taios ne s re, wcee i va ered associated Regulations and Standards. looking at options to improve our data processing Complaints are managed in line with our complaints functions to make it easier to submit information
policies. This includes meeting face-to-face with and for the Commission to receive and process that complainants where requested. While we have targets information appropriately.
for responding and keeping complainants informed, We plan to introduce an online registration system we do advise complainants that complex issues can allowing professionals to register, renew, and make take time to resolve. payments online. Following this, we will identify
further opportunities to strengthen our systems to The Commission also takes seriously its responsibility
make the submission of information by providers, to uphold data subject's rights under the Data
professionals, and the public easier, and to ensure Protection (Jersey) Law. During the year, data protection compliance.
Continue to provide prompt and detailed responses to consultations, correspondence from the Chief Minister, Ministers, and States of Jersey departments, as required.
HOW SUCCESSFUL WHAT MORE NEEDS HAS THIS BEEN? TO HAPPEN?
The Commission responds to all requests for information The Commission will continue to work closely with from the States of Jersey and to consultations on a the Government and States of Jersey to enable the case-by-case basis, accepting that a neutral position Government s planned legislation programme to
is appropriate as an independent regulator in some be delivered. Improvements in data collection and cases. In 2023 the Commission responded to the management will enable more detailed and quicker Government s public consultation on assisted dying. responses to some consultations.
33
Performance Analysis
Key Performance Indicator (KPI) 6 Information Management
KPI 6.1 Number, outcome, and time to respond to duty
calls and public enquiries.
Due to a change in telephony systems during the year, the Commission lost the TARGET ability to fully measure all aspects of this KPI. A call management system that
could provide data is not considered cost-effective, considering the volume of 80% calls received. The current process means calls and enquiries are answered by
the duty officer on the day they are received unless it is considered appropriate
OUTCOME to pass them to a specific regulation officer. In this case, if the regulation
100% officer is unavailable, the enquirer is informed when they will be contacted.
All calls relating to specific care providers are logged and outcomes noted.
KPI 6.2 Number of notifications received.
No target is set for this indicator.
The Commission recorded 4231 notifications from registered providers during 2023. We are currently exploring options for tracking notifications and to provide more data about the type of notifications received and how they are managed.
KPI 6.3 Number of complaints and percentage managed
within timescales set out in complaints policies.
In 2023 the Commission received three formal complaints about the provision TARGET of regulated services and one formal complaint about the Commission itself.
The Commission has a separate policy for managing and responding to each 100% type of complaint. All complaints have been managed in line with the policies
and the timescales set out.
OUTCOME
100%
KPI 6.4 Number of data incidents and percentage managed within
timelines set out in data breach handling guidance.
The Commission managed two data incidents in 2023. Both were TARGET acknowledged, reported, and managed within required timeframes.
In both cases, the initial investigation to identify causes, mitigation, 100% and prevent recurrence was completed within five days
OUTCOME
100%
34
Performance Analysis
Priority 5 - Maintain an effective governance framework
Continue to make sure that the Commission's Governance Framework and financial oversight are robust.
HOW SUCCESSFUL The Framework covers the full range of governance HAS THIS BEEN? areas and has significantly enhanced controls.
More information about the Commission's governance The Commission's key accountability and governance is provided in the Corporate Governance Report
arrangements are set out in its Constitution and in the in the Accountability Section of this Annual Report. Framework Agreement with the Government of Jersey.
Following a request from the Board of Commissioners, WHAT MORE NEEDS
an external assurance audit of the Commission's TO HAPPEN?
governance framework was undertaken in 2021
by BDO on behalf of Internal Audit. As the Commission's remit has continued to expand,
we recognise that we must ensure that our
All remaining outstanding recommendations governance framework remains sufficiently robust within the direct control of the Commission were and well-developed to mitigate new risks, and to
fully implemented by the end of 2023. Others support effective decision making.
recommendations for example, would require changes
to the Regulation of Care (Jersey) Law 2014 and these In addition, the Commission intends to benchmark
are being considered by the Government of Jersey. its governance arrangements against similar organisations and regulators and review best
The Board undertakes an internal review of its practices for arm s-length organisations.
effectiveness on an annual basis, and this review
The Commission's accounts are currently audited identifies opportunities to strengthen governance
controls. In 2023, the Commission implemented an aasc cpoaurtnotsf, t dhees wp hit oe l eth oe f Rthe eg Gul oa vti eo rn n omf eCnat r oe f ( JJ ee rr ss ee yy ) Integrated Assurance Framework to provide assurance Law 2014 requiring the Commission to separately
that all necessary controls are in place, or that there publish audited accounts. The Commission has
is an appropriate plan in place to address any gaps worked with the Government of Jersey to review these or areas where weaknesses in controls are identified. arrangements. Current proposals are that is expected
to be addressed by a change in the Law in 2024.
35
Performance Analysis
Key Performance Indicator (KPI) 7 Governance Framework
KPI 7.1 Ensure that the Board of Commissioners meets at least six times per year and that papers are produced to the
appropriate standards and promptly to enable the Board OUTCOME to discharge its responsibilities.
Achieved
KPI 7.2 Undertake a review of the effectiveness of the Board of
Commissioners annually.
The Board conducted a review of its effectiveness during the September OUTCOME 2023 workshop.
Achieved
KPI 7.3 The Commission will ensure a monthly review of risks is undertaken by Commission staff with oversight from the
Board at each meeting. A review of the effectiveness of OUTCOME the risk framework will be conducted annually.
Achieved The Commission's Executive Team reviews risks at least monthly. The Board
receives a report on risks and reviews risks at each Board meeting. The annual review of the effectiveness of the risk framework takes place each January.
KPI 7.4 Develop a performance framework and monthly dashboard to
assist the Executive Team and Board to manage performance.
A new performance dashboard was developed in 2023 for use by the OUTCOME Board and the Executive Team. This has helped the Executive Team regularly monitor progress towards delivering key objectives and has
Achieved provided assurance about performance to the Board.
KPI 7.5 Undertake a review of all corporate policies and ensure a
robust schedule is in place.
The Integrated Assurance Framework sets out the review schedule for OUTCOME all key policies and documents. In 2023 reviews were undertaken of all
policies and documents as scheduled.
Achieved
36
Performance Analysis
Priority 6 - Planning
Having undertaken a comprehensive review of internal infrastructure, devise a revised organisational structure and workforce plan and formulate a detailed business plan based upon the approved budget.
HOW SUCCESSFUL WHAT MORE NEEDS HAS THIS BEEN? TO HAPPEN?
The Commission reviewed its organisational structure, We remain committed to improving business planning implemented a new structure, and developed a and organisational development. In 2023, the new workforce plan to support the expansion of the structures were embedded; however, with further Commission s remit. Planned recruitment to key plans to expand the Commission's remit in 2024 posts such as the Principal Standards Officer, and 2025, the structures will be kept under review to Pharmacist Inspector and additional regulation ensure they continue to enable the Commission to officers took place successfully. For some roles such deliver its core objectives.
as regulation officers, recruitment has been phased
to help manage staff onboarding and to align with
expected workloads from areas new to regulation.
The budget to support this expansion was agreed in the 2023-2026 Government Plan.
37
Performance Analysis
Risk Management
An essential part of delivering the its Risk Management Framework with that of Commission's objectives is managing risks. the Government of Jersey. This enables the The Commission has a robust Risk Management Commission to escalate complex risks which Framework, which is reviewed annually. go beyond its ability to manage entirely.
The Framework describes how the Commission
The Board is ultimately responsible for ensuring identifies, assesses and manages strategic
risks are effectively managed. The Board
and operational risks impacting the delivery
discusses risks, controls, and mitigation at
of its mission and purpose.
every meeting. Commission staff discuss risks The Framework identifies the four most common monthly to ensure all staff are aware of existing risk categories: public protection, financial, risks and to facilitate early identification of any reputational and delivery. It details the risk emerging risks.
appetite the Commission has in each category.
Analysis shows a healthy turnover of risks
It also describes the roles and responsibilities
and active progress on controls, mitigation,
of the Board and officers in managing risks.
and risk ratings.
Although independent of the Government,
as a public body, the Commission has aligned
Summary of key risks, mitigation actions and progress during 2023
Risk Controls Progress and Rating
and Mitigation change during year and Trend
WORKFORCE, CAPACITY Phased rollout of new Taking on new areas of regulation
AND CAPABILITY legislative changes to take is a key risk for the Commission. In
risks into account. 2023, this was related to Children's
Increasing demands, especially social care, but the risk remains
from areas new to regulation Planned growth of team with further new regulatory areas.
and where the Commission and skills required set out in
needs to develop additional workforce plan. However, planned recruitment
expertise, could impact the Relationships being built is progressing well, and the
Commission's capacity and with UK-based regulators Commission has forged effective High capability to conduct its core to provide access to strategic partnerships with
delivery programme, potentially additional inspection organisations
causing it to fail to conduct resources and to help such as the CQC.
statutory inspections. develop additional skills. Overall, the risk remains stable.
DIGITAL
The Commission has mainly
manual processes for
managing registrations, Systems and business processes
registering providers, and A programme is in place to must be changed or risk significant
collecting fees. These address underlying issues impacts on the Commission's
processes must be regarding professional objectives and legal obligations.
strengthened to meet the registration. A digital solution is underway to
expected annual demand Discovery planned for early address professional registration,
from proposed changes to 2024 to identify options and a Discovery is planned to
professional registration and and priorities for business identify options to address wider Medium regulations, which could impact transformation to make issues. However, whether the
the delivery of objectives. sure the Commission Commission can secure the
In addition, expanding the can successfully meet resources necessary to address
Commission's remit creates challenges. the additional issues identified
an additional requirement for needs to be clarified.
data and analysis capability
to deliver the core inspection
programme effectively.
38
Performance Analysis
Risk andC Monittirgoaltsi on chanPgroe gdruerssin agn yde ar anRda Ttirnegn d
Following the initial assessment,
a full data governance review
DATA GOVERNANCE occurred in 2023. Several
AND CYBER SECURITY Npreowc eITs s se ys s twei mll fso allnodw data strengthening actions were
A partial assessment of identified and undertaken.
protection by design
the Commission s data principles. Scheduled reviews are in place to
governance provided limited ensure controls remain adequate
assurance of the effectiveness A comprehensive review and effective and are followed as
of controls. of data governance took expected.
place in 2023.
Data governance controls The digital registration project
must be strengthened to A schedule is in place will address additional areas of
ensure that data is fully to ensure all existing concern. Medium protected and that controls Data Protection Impact A planned digital Discovery will
comply with the highest Assessments, identify further areas where
standards and best practices. Data Sharing Agreements improvements could be made.
and Memoranda of
The Commission could be Understanding are
Some risks have been mitigated
effectively, and there are likely to
exposed to broader data reviewed regularly and be opportunities to strengthen
rsiuskbsjeacntsd' rriisgkh tbsr.eaching data updated. systems further. However, the risk
remains extant and may increase
with further digitisation of services.
FUNDING ALLOCATION The Commission has
The Growth Plan agreed sound financial controls
in 2022 to enable the and monitors expenditure
Commission to undertake a as closely as possible to This was a risk that the Commission
broader regulatory remit had identify any had expected to reduce during
no contingency. issues promptly. 2023 following the allocation of
While the Commission All expenditure undergoes funding in
a rigorous value for the 2023-2026 Government Plan to
scuhcaclleenssgfeusll yo fn avigated the money assessment, and enable the Commission to deliver
new areas of regulation in alternatives are considered. its expanded remit.
2023, those areas coming In 2024, with the However, in the 2024-2027
under regulation in 2024 and recruitment ongoing, there Government Plan debate, changes High 2025 are opportunities for non- were made to the funding allocation
are even more challenging. recurring cost avoidance which must be managed in 2024
Reductions to the funding measures. and beyond.
allocation mean this is The Commission will need This is expected to remain a
even more challenging and to consider the impact challenge.
could impact the inspection of funding reductions on
programme or other Business delivery plans for 2025 and
Plan objectives. beyond.
39
40 | Performance Analysis Risk Profile Changes in 2023 The Commission uses a four-point overall Agreement on the funding to be allocated as part risk rating from Extremely High to Low. of the 2023-2026 Government Plan to enable the There were no Extremely High risks during 2023. Commission to deliver its expanded role initially Overall, the risk landscape has been mostly led the Commission to assess its financial risk stable, and the key risks for the Commission as reducing. However, following the 2024-2027 remain around resourcing and managing the Government Plan debate, the Commission was expanding role and remit. notified of reductions to departmental budgets and a consequent reduction to the Commission s A comprehensive, properly informed and budget. The financial section of this Annual implemented workforce plan is critical to Report shows that the Commission reported a mitigating the Commission s key risks in the surplus of income over expenditure at year end. medium term. However, to manage the demand The Commission has identified opportunities in the short term and to ensure that key skills to make non-recurring savings in 2024 that will are available when needed, the Commission has not adversely impact on its core activities. The successfully partnered with organisations such Commission will keep under consideration the as the CQC in England. It has also secured the impact of this budget reduction on the ability to services of independent inspectors. These two deliver the planned programme of inspections initiatives help manage the risk. and to achieve break even. Another significant risk is not having the The Board also carefully considers the overall appropriate systems and processes to deal with exposure to risk. While there are risks from additional work, especially the additional data the expansion of the Commission's remit, the Commission expects to process and analyse. the Board has been appropriately cautious This has been summarised as the Digital Risk. and delayed taking on additional risk where The key mitigation is a digital Discovery to possible and sensible. For example, where help develop a Digital Strategy in 2024. requests have been made to support partners However, while addressing some existing in other jurisdictions the Board decided to defer risks, the Commission is mindful of the support at a time of uncertainty. new risks that digitisation creates. The data governance and cyber security risk captures some of these additional risks. While there are risks, there are opportunities to introduce systems with built-in enhanced privacy and security, which could reduce the risk over time. Furthermore, the Commission has conducted a detailed assessment of its data governance controls and introduced a new Integrated Assurance Framework, which has helped reduce the risk in 2023. |
41
Corporate Governance Report
Chair of the Board of Commissioners Report
The Jersey Care Commission was established The Commission came into being in January
in statute by the Regulation of Care (Jersey) 2019 and is celebrating five years of continuous Law 2014. The Law states there shall be a operation. The Commission exists to preserve Health and Social Care Commission, a body the integrity of independent regulation of health corporate with perpetual succession, consisting and social care services in Jersey, to identify
of not less than four and not more than eight and address poor practices and to drive up the Commissioners. There are currently seven quality of services. The Board of Commissioners serving Commissioners, including the Chair. supports the team in discharging its duties and
responsibilities under the Law, Regulations and The Jersey Appointments Commission oversees
Standards, such as registering and inspecting Board-level appointments, but the authority
regulated activities in Jersey. The Commission to appoint the Chair and other Commissioners
must undertake annual inspections of all
rests with the Minister for the Environment.
regulated activities and regulated health and
The profiles of the existing Commissioners
social care provision. The Commission must
are included elsewhere in this report and are
also maintain a register of health and social care available on the Commission's website.
professionals employed in Jersey.
42
Commissioners have significant experience and Business Plan; monitoring progress against working in the wider health and social care strategic and business objectives, including context in the UK, and some have previous KPIs; providing support and encouragement experience working in systems of regulation, to the Chief Inspector, regulation officers, and including at the Chief Executive level. They bring the wider staff team in exercising its duties and
an essential challenge function in terms of how responsibilities.
the Commission can account for how it uses its
Other essential functions include protecting resources and how it conducts
its business. All are required to " The Commission independence of thought, action, and decision- abide by the Seven Pof Public Life (also known as rinciples exists to preserve making, particularly around the Nolan Principles). These the integrity of complex or contentious
are selflessness, integrity, independent issues. Commissioners objectivityopenness, honesty and , accountability, regulation of health bring their perknowledge, skill, and sonal
leadership. and social care experwork of the Commission, tise to bear on the The Commission is responsible services in Jersey." ensuring that the
for ensuring that a robust Commission always acts corporate governance system in the best interests of exists and operates effectively. The Commission the people of Jersey and providing strategic
has a governance framework centred on its oversight, scrutiny, and accountability for the Constitution, the Framework Agreement with work of the Commission in general.
the Government of Jersey, and its Scheme
The Commission excels when the Board and
of Delegation. In addition, it maintains a
the team work effectively together. The Chief corporate risk register and a suite of policies and
Inspector and the Head of Business and
procedures which describe how the Commission
Performance attend all Board meetings and conducts its affairs. In 2023, the Commission
make important contributions to the business began working towards an Integrated Assurance
of the Board. During 2023, the team grew Framework, bringing together the various strands
significantly in strength in keeping with the
of accountability into a single matrix.
milestones set out in the Workforce Strategy.
Each year, Commissioners participate in a
The Board meets six times each year. In 2023, self-evaluation of Board effectiveness.
this included four on-island meetings, with The Commission has also been open to
two conducted remotely. Additional time is independent scrutiny by the Comptroller and
invested in workshops centred around Auditor General. It is referenced in published
the on-island meetings and an annual
'Think Piece' reports. In September 2023, the
engagement event with the care
Commission convened a workshop to conduct an
sector. Board meetings are
in-depth review of its governance arrangements.
held in public. Agendas,
Commissioners identified core functions that
minutes, and other Board
fall specifically to the Board to deliver and those
papers are published
delegated to the Chief Inspector and others
on the Commission's
within the team.
website, as set
The Board's functions include: making sure out in the
the organisation fulfils its statutory duties publication
and responsibilities without exceeding its scheme.
legal mandate; setting the strategic direction,
approving the Commission's Corporate Strategy
43
Throughout 2023, the Board addressed a range of important topics, including the preparations for extending regulatory responsibility to include ten areas of children's services new
to regulation. This included the development
of the new Standards, the publication of an Inspection Handbook, a survey methodology devised and administered in conjunction with the Picker Institute and developing partnerships with off-island bodies such as the Royal College of Psychiatrists and other independent experts to assist and support the process.
The Board had strategic oversight of an IT project to improve and simplify the professional registration and renewals process. This new system is subject to user acceptance testing, after which it will be rolled out to health and social care professionals in 2024.
Throughout the year, the Board received
regular updates on inspections carried
out by regulation officers and on associated escalations and enforcements.
There were several changes to the profile of
The Chair and the Chief Inspector meet weekly the Commission in 2023. Two long-serving
to discuss matters affecting the regulation of Commissioners, Alison Allam and
health and social care in Jersey, ensuring a Si n Walker -McAllister left the Commission after clear line of accountability to the Board completing two consecutive terms in office. concerning operational and other issues that
The Minister appointed Gordon Pownall and may have an impact on the Commission.
Kathryn Chamberlain OBE for three-year terms In addition, the Chief Inspector provides a starting in July and in September 2023. The comprehensive report to each Board meeting. remaining Commissioners, Jackie Hall , Noreen Commissioners receive updates via briefing Kent and Angela Parry were offered, and
notes from the Chair between scheduled Board accepted, second successive terms for three meetings and a Chair's Report at every meeting. years in January 2024.
Glenn Houston
Chair
17 April 2024
44
Statement of Responsibilities of the Chair of the Board of Commissioners
The role of the Chair of the Board of Commissioners is to provide leadership and direction to the Commission to ensure, through a process of registration and inspection, that the quality of all regulated activities in Jersey is independently assessed and assured and to deliver improved outcomes for service users. The Chair works with Commissioners, the Executive Team,
and representatives of the Government of Jersey to ensure the effective operation and performance of the Commission.
The Chair is required to:
1 | assemble an effective and complementary Board of Commissioners and encourage members to work together as a team |
2 | chair all meetings of the Commission, set the agenda, style and tone of discussions to promote effective decision making and constructive debate |
3 | provide effective leadership by maintaining a focus on strategy and performance |
4 | work in partnership with the Chief Inspector to achieve the aims of the Commission |
5 | provide strategic direction, including setting and monitoring operational objectives for the Commission, taking into consideration the context and needs of the Island |
6 | set and maintain the values for the organisation, ensuring that its obligations to all stakeholders, including people who use services, are understood and met |
7 | ensure that resources are allocated to strategic objectives |
8 | ensure governance arrangements for the Commission s executive function are effective and kept under review |
9 | ensure the highest levels of probity and integrity are upheld in the way the Commission carries out its functions and for the use of public funds |
10 | ensure the promotion of best practice across the sectors overseen. |
45
Statement of Responsibilities of the Chair of the Chief Inspector
The Chief Inspector is responsible for the day-to-day work of the Commission and, in doing so, works closely with the Chair and Commissioners to provide strategic leadership and expert technical knowledge and skills to ensure the effective and efficient delivery of the Commission's statutory, regulatory and inspection functions, in accordance with legislation.
The Constitution makes clear that the Chief Inspector is not a member of the Commission, or the Board of Commissioners, but is an executive officer of the Commission and is expected to uphold the decisions of the Commission, except where they contradict any requirement or stipulation of the Public Finances Manual or States Employment Board policies and procedures.
The Chief Inspector s duties are to:
4 | ensure that the Commission s overall governance framework and controls assurance structure, including risk management, financial management and policies and procedures are appropriate and effective |
5 | provide regular reports and management information to assure the Commission that it is fulfilling its statutory responsibilities |
6 | lead and manage the Commission s executive functions, including business planning, data protection obligations, performance management, risk management and audit systems, responses to Freedom of Information requests and complaints, individual staff review and appraisal, training and continual professional development to secure continuous improvement in the Commission s performance |
lead and develop the Executive Team in delivering the Commission's corporate plan, ensuring effective regulation of health and social care services
1
and registration of care professionals
build and sustain credibility with the public and registered service providers by promoting a regulatory approach that ensures compliance with Regulations and Standards, challenges poor performance and supports continuous improvement
2
in consultation with the Chair and Commissioners, prepare:
- a Corporate Strategy setting
out the Mission, Vision and Values of the organisation
3 -tohbaejBe Ccuotsimvinemess,i ssos pPioelanrnastsinkeegttyminbgou dsoeiunlt,ess
and performance indicators
- a corporate risk framework, including a risk strategy and risk registers
- an annual report describing progress against the objectives in the Corporate Strategy and Business Plan
46
7 | ensure sound financial management and monitoring of budgets and advise Commissioners on budget planning, income generation and actions needed to maintain expenditure within budget |
8 | 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 |
9 | ensure consistent, high-quality regulatory practice, with a focus on supporting service improvement, monitoring compliance and, where necessary, taking effective enforcement action |
10 | lead and develop the Commission's business and administrative staff to ensure efficient and effective administration of the Commission's regulatory responsibilities |
11 | build capacity and develop staff, ensuring the Commission acquires the necessary skills and resources to respond effectively to the projected extension of the Commission s regulatory reach |
12 | take a lead role in working with the States, Government departments, and other key stakeholders in matters related to the regulation of health and social care services and professional regulation |
13 | positively promote the work of the 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 |
14 | develop and facilitate relationships with people who use services and their families and carers to improve their experiences of health and social care and achieve better outcomes |
15 | lead and support consistent, high-quality practice within the staff team, promoting employees' health, safety and welfare, managing performance, monitoring work standards for all staff and promoting diversity and equality of opportunity. |
47
The Commission and the Board of Commissioners
The Commission is a body corporate with perpetual succession. The Regulation of Care (Jersey) Law 2014 states that the Commission shall consist of not less than four and not more than eight Commissioners. There are currently seven serving Commissioners, including the Chair.
In 2023, two Commissioners completed their terms of appointment, and two new Commissioners were appointed. Therefore in 2023, the Board consisted of:
Glenn Houston | Chair of the Board of Commissioners |
Lesley Bratch | Commissioner |
Kathryn Chamberlain OBE | Commissioner (from September 2023) |
Jackie Hall | Commissioner |
Noreen Kent | Commissioner |
Angela Parry | Commissioner |
Gordon Pownall | Commissioner (from July 2023) |
Alison Allam | Commissioner (completed term May 2023) |
Si n Walker -McAllister | Commissioner (completed term May 2023) |
Kathryn Chamberlain OBE was appointed in July but was unable to take up the appointment until September 2023. The Minister for the Environment appoints Commissioners in line with the arrangements set out in the Law.
48
Governance Framework
The Law states that the Commission is Chief Inspector and Executive Team and those independent of the Minister for Health reserved for the Board. This ensures there are and Social Services, The Chief Minister, appropriate boundaries between operational and the Government of Jersey. Although decision-making and corporate governance.
independent of the Government of Good relationships between the Chair,
Jersey, the Commission is funded by a Chief Inspector and Commissioners are crucial combination of public funds and fees for the smooth functioning of the Commission. levied on providers and professionals. The Chair and Chief Inspector meet weekly to
maintain a close working relationship between The Commission is accountable for its the Board (the Commissioners) and the performance and use of public money. Executive Team (regulation officers and
The Commission's Framework Agreement administrative support staff) and to ensure
and Constitution set out the arrangements to effective oversight and delivery of the
ensure the Commission is accountable. Commission's core functions.
The Cabinet Office is responsible for providing The Governance Framework and Scheme of adequate financial resources to the Commission. Delegation ensure that policies and procedures The Chief Officer for the Cabinet Office is the are approved by the Board and brought back to Accountable Officer and is accountable to the the Board for regular review, in line with Government of Jersey for the appropriate use best practice.
of public funds allocated to the Commission. Each year, the Commission approves an
The Accountable Officer is appointed in annual Business Plan and associated budget. accordance with the Public Finances (Jersey) This ensures a clear link between Government Law 2019. The Accountable Officer is policy on the regulation of health and social care responsible for ensuring the Commission and the strategic direction of the Commission. represents value for money.
The Commission receives regular reports on The Accountable Officer delegates the income and expenditure from the Treasury
management of funds to the Chief Inspector in and Exchequer department. It has established accordance with the Department s Scheme of an effective working relationship with the Delegation and the Public Finances Manual. Government of Jersey through quarterly
The Board of Commissioners provides support governance and liaison meetings with the
to the Chief Inspector as well as scrutiny of Cabinet Office. This is the forum in which decisions and oversight of financial performance. discussions regarding fee income and financial
The Constitution and Framework Agreement are support take place.
available on the Commission's Website and are Each year, the Commission must publish an reviewed regularly. They are due to be reviewed Annual Report, which is laid before the States again in 2024. Between them, they set out Assembly. This provides a public account of how the Commission discharges its functions the Commission s overall performance described in the Law and how it is governed. regarding its strategic objectives and key
In addition, a Scheme of Delegation sets out the performance indicators.
decisions the Commission has delegated to the
49
Framework Agreement
The Corporate Governance Framework for the Commission is described in the Framework Agreement with the Government of Jersey. The agreement sets out:
the responsibilities of the Chief Minister and the Minister for Treasury and Resources in providing the necessary resources, services and support to the Commission to ensure its effective operation in accordance with the intentions of the Government
the Commission s responsibilities in demonstrating its accountability to the Government, and to the people of Jersey
the four key principles that underpin the partnership between the Commission and Cabinet Office. These principles mirror those of the UK Cabinet Office's Code of Good Practice relating to departments and arm s-length bodies: Purpose, Assurance, Value, and Engagement.
Government of Jersey s objectives
The Government of Jersey is committed to improving health and social care outcomes for people in Jersey. It seeks to ensure that:
people are provided with independent assurance about the quality, safety and effectiveness of Island services by the Commission
all providers deliver high standards of care, and where care is poor, this is readily identified so that services can be supported to improve or are subject to appropriate interventions. This is in relation to services directly delivered by the Government, as well as other registered providers
there is public confidence in the Commission that it is seen as effective, relevant and provides value for money.
The Framework Agreement sets out the current accountability arrangements. The accountability arrangements reflect the independence of the Commission and the need for the Commission to be accountable to the Minister. It also confirms that the Accountable Officer is ultimately accountable for the use of public funds and fees levied by the Commission.
50
Governance Responsibilities of the Accountable Officer and the Commission
The Accountable Officer is responsible for providing the Government with assurance as to the performance of the Commission and for demonstrating the linkage between Commission and departmental objectives. The Commission supports the provision of this assurance.
The Accountable Officer provides the Government with assurance as to:
achievement of the objectives of the Government of Jersey in relation to the Commission
good governance and value for money.
The Commission prepares an annual Business Where the Commission may require a deviation Plan that reports on performance against the from the requirements of the Manual, the decision previous year s objectives and targets and sets and rationale will be documented, and appropriate out objectives, targets, and KPIs for the coming approval obtained from the Accountable Officer. year. The Business Plan is discussed and agreed
The Accountable Officer requires assurance from with the Accountable Officer.
the Commission regarding financial propriety
The Accountable Officer is accountable for the and regularity, that funds are being used
public funds that flow from the Government to the economically, efficiently and effectively, that there Commission. The Accountable Officer delegates is effective stewardship of any assets controlled or management of these funds to the Chief Inspector safeguarded, and that appropriate systems are in in accordance with the Department's scheme place to identify and manage risks.
of delegation.
The Chief Inspector prepares an Annual
The Chief Inspector ensures that the standard Financial Assurance Statement, approved by the of financial management complies with the Commission, and included in the Annual Report provisions of the Public Finances (Jersey) Law and Accounts.
2019 and the Public Finances Manual.
Appointment of Chair and Commissioners
The Minister for the Environment appoints Commissioners and the Chair of the Commission and within the Law decides the duration of that person's appointment.
The current Chair was initially appointed for a three- The Law states that a term of appointment shall year term from 01 May 2017 until 30 April 2020. be at least three years and not more than five The Chair was reappointed for a second three- years and that a person may be appointed more year term, which expired on 30 April 2023. In the than once. Changes to the Law to set a limit on interests of consistency and stability, the Minister the maximum duration a person may serve as a extended this appointment for a further two years. Commissioner are currently under consideration.
51
Glenn Houston - The Chair
Lesley Bratch
52
Kathryn Chamber lain OBE
Jackie Hall
53
Noreen Kent
Angela Parry
54
Gordon Pownall
55
Functions and Duties of the Board of Commissioners
The key responsibilities required of the Board of Commissioners (the Board) are set out in the Constitution. These are to:
ensure that services are regulated and inspected in accordance with the law so that all care receivers and their families benefit from good quality services that meet their needs
oversee a regulatory regime which supports continuous improvement, as opposed to one which focuses purely on compliance monitoring
provide strategic direction, including setting and monitoring operational objectives for the Commission, taking into consideration the context and needs of the Island
set and maintain the values of the organisation and ensure that its obligations to all stakeholders, including people who use services, are understood and met
ensure that resources are allocated to strategic objectives
ensure governance arrangements for the Commission s executive function are effective and kept under review
ensure the highest levels of probity and integrity are upheld in the way the Commission carries out its functions
promote best practice across the sectors it oversees.
The Board discharges its functions by formally meeting as a Board, by participating in Board workshops and other events, and through the weekly meetings between the Chair and the Chief Inspector.
Frequency and Nature of Board Meetings
The Constitution states that the Board must meet a minimum of four times a year.
The Commission has established a pattern of meeting formally on six occasions each year.
In addition to the formal Board meetings, the Commission meets in workshop format, delving more deeply into issues that are
of significant value or importance to
the Commission.
56
Corporate Governance Report
Attendance at Board Meetings
Glenn Houston (The Chair) | 6 out of 6 |
Alison Allam | 3 out of 3 |
Lesley Bratch | 6 out of 6 |
Kathryn Chamberlain OBE | 2 out of 2 |
Jackie Hall | 6 out of 6 |
Noreen Kent | 6 out of 6 |
Angela Parry | 6 out of 6 |
Gordon Pownall | 3 out of 3 |
Si n Walker -McAllister | 3 out of 3 |
Board Meetings
Board meetings are scheduled in advance, with Commissioners providing both support and and the agenda and Board Papers are shared appropriate challenge.
with Commissioners one week before the
A confidential session at each Board meeting stated date of the meeting. Meetings are
allows members to consider any sensitive
open to the public and are advertised on the
matters, including items considered under Commission's website. Agendas and approved
legal privilege, or anything confidential or of a minutes are published on the Commission's
commercially sensitive nature that cannot be website along with papers specified in the
shared openly.
Publication Schedule.
The Commission does not operate a committee The standing agenda items include review of
structure. There is no requirement to have an minutes and actions of the previous meeting,
Audit and Risk Committee or Remuneration
a report from the Chair and an update from the
Committee. The Board currently deals with Chief Inspector on any significant operational
matters that would come within the purview of matters since the previous Board meeting.
such committees. However, the Commission This includes any enforcement action taken
keeps its governance structure under review, regarding regulated activities.
especially considering its increasing remit Sufficient time is allocated to other important and budget, and may decide in future that matters, including financial reporting and risk committees are required to support the management. Minutes show the Commission Board in discharging its statutory functions. has had detailed discussions on these issues,
57
Work of the Board in 2023
The Board met, as planned, on six occasions throughout the year. Over the year, the Board's achievements include:
approved an inspection method and working with the Policy Lead in respect of handbook for services new to regulation the changes to legislation, consultation, and the proposed regulation of acute
approved the workforce plan and recruitment hospital services, the ambulance service plans to increase the workforce to take on and adult mental health services
new areas of regulation
regular meetings between the Chair
reviewed the Risk Management Framework and the Minister for the Environment
and introduced changes to manage risk
more effectively discussions with senior executives of the
Isle of Man Government to discuss common
considered whether and how the issues around regulation
Commission could assist health and social
care regulators in other jurisdictions reviewed project updates concerning a range
of operational and transformational work,
considered the Commission s role and ensuring progress was satisfactory and that response to the Assisted Dying proposals appropriate risk mitigation was in place
reviewed key policies such as the publication approved the 2023 Annual Report and schedule, the Scheme of Delegation, the 2024 Business Plan and Budget Complaints Policies and the Enforcement
and Escalation Policy ensured Commissioners played an
essential role in the sector engagement
reviewed the Commission s Business event, chairing round table discussions Continuity Plans to ensure they were robust with representatives of regulated services
analysed the Strengths, Weaknesses, at an event in the Town Hall Opportunities, and Threats facing the undertaking visits to care settings in order
Commission and reviewed the governance to engage directly with providers arrangements to ensure they were adequate,
especially considering the Commission's approved a new Integrated Assurance expanding remit Framework as part of ever more robust
governance arrangements
invited to the Board or otherwise met with
the Minister for Health and Social Services, approved new monthly dashboards to
the Minister for Children and Education, improve in-year performance reporting. and the Government of Jersey Policy
lead for assisted dying
58
Corporate Governance Report
Effectiveness of the Board
One of the principal responsibilities of the Chair is to oversee the Commission's effectiveness, especially the work of the Board. The Chair conducts annual appraisals with each Commissioner and reports the outcome to the Accountable Officer.
The Accountable Officer appraises the performance of the Chair.
Commissioners evaluate Board effectiveness (particularly bearing in mind the increased using a structured survey as part of the annual complexity of the Commission's work as it appraisal process. Overall, Commissioners were regulates new areas) these will happen more positive about the conduct of business and the often in 2024.
impact of the Board on key decisions.
Commissioners felt the Board had the
There is consensus that the Board broadly
appropriate strategic focus and maintained the has an appropriate combination of skills and
correct balance of supporting and challenging experience and works well. Commissioners
operational delivery. Commissioners stated that identified opportunities to expand the skill set
in general the Board agendas cover the issues of the Board, particularly in areas where the
that need to be addressed.
Commission is expanding its remit.
Commissioners who attended, greatly valued Commissioners identified that the Board
the engagement session with service providers workshops allowed them to explore complex
and the opportunity to visit providers to engage matters in greater detail and, as a result
directly with them.
" The Chair conducts annual appraisals with each Commissioner and reports the outcome to the Accountable Officer."
59
Remuneration of Chair and Non-Executive Board Members
Commissioners, including the Chair, are not full-time employees. The Chair is contracted to work up to 40 days each year. In the case of Commissioners, while there is no set number of days, attendance and travel for all Board meetings and workshops, including remuneration for travel time, requires 12 days per year.
Name | Date Appointed | Remuneration | Expenses |
| Total Cost 2023 |
|
| (bands of £5,000) | (Travel, accommodation, and subsistence) |
| (Remuneration + Expenses) |
Glenn Houston (The Chair) | 1 May 2017 | £20,000 - £25,000 | <£5,000 |
| £25,000 - £30,000 |
Alison Allam | 10 May 2017 (until May 2023) | <£5,000 | <£5,000 |
| <£5,000 |
Lesley Bratch | 1 October 2021 | <£5,000 | <£5,000 |
| <£5,000 |
Kathryn Chamberlain OBE | 1 July 2023 | <£5,000 | <£5,000 |
| <£5,000 |
Jackie Hall | 16 December 2020 | <£5,000 | <£5,000 |
| £5,000 - £10,000 |
Noreen Kent | 16 December 2020 | <£5,000 | <£5,000 |
| £5,000 - £10,000 |
Angela Parry | 16 December 2020 | <£5,000 | <£5,000 |
| £5,000 - £10,000 |
Gordon Pownall | 1 July 2023 | <£5,000 | <£5,000 |
| <£5,000 |
Si n Walker - McAllister | 10 May 2017 (until May 2023) | <£5,000 | <£5,000 |
| <£5,000 |
60
Corporate Governance Report
Register of Interests
The Commission's Constitution requires that Board Members ensure that no conflict of interest arises, or could reasonably be perceived to arise, between their public duties and private interests.
To assist with discharging this requirement, the Commission maintains a Register of Interests for Commissioners. This lists all outside interests, whether paid or unpaid, and whether held by a Commissioner or a close family member.
Commissioners complete a fresh declaration of interest every year and must provide details of any changes during the year. In addition, at the start of each Board meeting, the Chair asks if there are any additional declarations or conflicts of interest that are relevant to the agenda.
The Register is maintained on the Commission s website. It can be found by searching for the register of interests or at this link:
https://carecommission.je/wp-content/uploads/2024/04/Register-of-Board-Members-Interests-January-2024.pdf
Statement of Assurance
The Commission is taking on a more complex range of duties and responsibilities. Regulation of health and social care has already been extended to cover aspects of social work services for children and young people, such as fostering and adoption, and Child and Adolescent Mental Health Services (CAMHS).
It is expected that during 2024, key elements of healthcare, including acute hospital services, ambulance services, and adult mental health services, will become regulated, with inspections due to take place in 2025.
The Commission needs to be ready and capable for the new inspection regime. Much of this depends on the Commission expanding its direct workforce of skilled and experienced regulation officers whilst forging strategic partnerships with UK regulatory authorities such as CQC and appropriate use of experienced contractors, where necessary, to bolster the Commission's skills and experience.
These developments form part of the regular discussion the Board holds about risk and assurance. As the Commission's role expands, meeting the requirements becomes more complex. To manage this, the Board approved a new assurance framework to ensure controls remain fit for purpose and are regularly reviewed.
As Chair, and informed by the processes described above, my assessment is that current controls, including assurance, planning and risk management, are adequate to manage risks effectively.
61
Financial Assurance
The Commission relies on the timely and accurate financial reports drawn from the States of Jersey's financial systems. These systems are subject to review and scrutiny by the Cabinet Office and by the Treasury and Exchequer department. Since our inception, our accounts have been included in the audit of the whole of Government of Jersey accounts but not separately identified.
The Regulation of Care (Jersey) Law 2014 requires that the Commission include a statement of independently audited accounts in its Annual Report. This is the subject of ongoing discussion with the Accountable Officer. The information in the Finance section has been quality assured by the Treasury and Exchequer department and is accurate and complete.
As Chair of the Board of Commissioners, I am satisfied that appropriate financial controls are in place, value for money is being achieved, and public funds are being used for the purpose intended.
Internal Controls
As Chair, I am responsible for reviewing the effectiveness of the overall internal control system. I carry out my own assessment, research and enquiries. I am assisted by the Board, the Chief Inspector and staff employed by the Commission, as well as through quarterly review meetings with the Cabinet Office, especially about our finances, risks and propriety.
Based on my assessment, the support I received, and the information in this report, I am satisfied with the arrangements for governance, risk, assurance, and internal control.
Significant internal control weaknesses
Other than the discrepancy with the independent auditing of the accounts, there were no significant weaknesses in the Commission's internal controls in 2023 that affected the achievement of
our objectives.
The Corporate Governance Report has been signed on 19 April 2024.
Glenn Houston
Chair of the Board of Commissioners, Jersey Care Commission
19 April 2024
62
Staff Report
As part of the Framework Agreement, staff working for the Commission are appointed to the Commission but are employed by the States Employment Board (SEB).
Commission staff are on SEB standard terms and In 2023, there was a total of fifteen permanent conditions for Civil Servants, including matters members of staff. Two new regulation officers relating to pension, pay and associated pay were appointed in 2023 along with a Principal increments, and flexible working policies. Standards Officer to oversee the development Staff are paid via standard Government of of new standards and the review of existing Jersey payroll arrangements. standards, and a Pharmacist Inspector.
Staff remuneration policy
Staff are paid in accordance with the Civil Service the lower quartile pay and 1.4 times the median pay scales. Pay scales range from Civil Service pay. Views on established benchmarks for fair Grade 6 to Civil Service Grade 15. The Chief pay ratios vary. The Hutton Review of Fair Pay in Inspector is a Grade 15, which in 2023 had a the Public Sector 2010 declined to set a cap or pay range from £96,657 to £106,770. recommended any specific target ratio.
Civil Service pay scales for 2023 can be
However, the report stated that public sector viewed on the Government of Jersey website.
organisations should be transparent about pay The total cost of staff in 2023 was £1,082,155.
differences. The same report found that typically Using pay scales to consider fair pay ratios, the most public sector organisations had a pay highest-paid staff member received 2.85 times ratio from lead executive to lowest paid staff
the pay of the lowest grade of staff, 2.5 times of around 12:1.
63
Gender Pay Gap
The Commission is a relatively small organisation. As the Commission follows Civil
Its gender pay gap is calculated at 7% for the Service policies, staff with similar roles Commission's staff. The small number of staff and responsibilities receive equal pay.
can cause issues when compared with large
An analysis for the Board of Commissioners was scale analysis of gender and pay data.
also conducted following the 2023 changes to However, the average Jersey gender pay gap
the Board.There are only seven commissioners, is 12% according to the Earnings and Statistics
which makes the analysis sensitive to slight Gender Pay Gap Report published in February
differences, with the Chair being one of only 2024 by Statistics Jersey. The Government s
two male Commissioners. Other than the Chair, own Gender Pay Gap 2022 report published in
all Commissioners are remunerated at the December 2023 gives a 15% gender pay gap
same daily rate. The gender pay gap for the across the public sector in Jersey.
Commissioners is 44%.
Gender balance
Gender balance in the Commission tends to As Commission staff are employed by the States favour female staff at all levels. Of seven Employment Board (SEB), the Commission members of the Board of Commissioners, follows all SEB policies, including those
five are female. As at the end of 2023, of the concerning fair and open recruitment of staff. fifteen permanent staff members, thirteen The Commission is committed to increasing the including those holding the two most senior diversity of its staff. However, it is mindful that this positions are female. can be difficult for small organisations to evidence.
64
Use of Contractors and Consultants
Where it is considered that they offer expert knowledge and advice, the Commission aims to effectively use contractors and consultants. Its guidelines for using consultancy and temporary staff mirror those of the Government. This means that use of contingent labour is considered:
where the Commission does not have the skills set required
where the requirement falls outside the core business of the Commission
where an external, independent perspective is required
where there are sound business reasons, for instance, where a contractor is the most cost-effective and efficient way of getting temporary, skilled, or external input.
In 2023, the total cost of contractors was Other significant use of contractors is for project £174,232. These costs include contracted delivery, communications, developing inspection organisations as well as individual contractors. methods and conducting inspections in areas new For instance, the Picker Institute surveyed staff to regulation. In each case, the additional support and families that were using certain Children's required was time-limited and required specialist Services. This was considered an effective use skills. Recruiting permanent staff to undertake the of resources as the Picker Institute also conducts work would not be cost-effective or practical. similar work in the UK, allowing responses to be
compared to established benchmarks.
65
Staff Engagement
In 2022, the Commission undertook a Pulse Survey to establish staff engagement and seek feedback about the organisation. The exercise was repeated in 2023. However, the results of several arm's length bodies were combined in the 2023 survey, meaning a comparison with the 2022 results cannot be made. The Commission has requested its results be disaggregated for future surveys. The 2022 results placed the Commission in the top category.
The Commission has continued to build on this positive baseline to help it meet the challenges associated with regulating new areas of activity. Staff are actively engaged in the Business Planning process especially around delivering the new regulatory frameworks.
New staff have been recruited to help managed the expanded role, and in 2023 and into 2024, the Commission has continued to focus on developing its induction programme and sourcing training for regulation officers and other staff to ensure it has the required skills.
Employee Wellbeing
As an arm's-length body with staff employed by the SEB, the Commission benefits from the Government's wellbeing arrangements, including access to Occupational Health, the health surveillance offer, and the Employee Assistance Programme.
In addition, Commission staff undertake a variety of local initiatives to promote wellbeing among staff such as training staff to be mental health first aiders.
66
Sustainability Report This is the Commission s third report covering Environmental, Sustainability, and Governance (ESG) issues. In 2019, the States Assembly declared a climate emergency and, in doing so, recognised that climate change could have profound effects in Jersey. As a result, the Carbon Neutral Strategy was developed and was agreed by the States Assembly in February 2020. The Commission therefore considers the impact on the environment of its staff and their vehicles, the office accommodation and the services it delivers. To manage its environmental performance and to reduce the impact on the environment caused by its day-to-day operations, the Commission mirrors the Government of Jersey s objectives, as set out in its annual report. Specifically, the Commission has committed to the following: complying fully with the requirements of environmental legislation and approved codes of practice reducing pollution, emissions and waste arising from our activities reducing the use of all raw materials, energy and supplies raising awareness among its staff of environmental matters encouraging similar environmental standards from all regulated activities participating in discussions about environmental issues. | 67 |
| Sustainability Report |
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| Transport and |
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| visit regulated activities for inspections and |
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| associated work. In 2023, the team continued to |
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| consider ways to reduce the number and length |
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| of journeys undertaken by staff. This included |
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| virtual meetings, combining visits to minimise |
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| trips, vehicle sharing, and, where practical, |
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| conducting visits on foot, using public transport, |
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| and using bicycles. The location of the care settings we visit means these methods are not always practical. The Commission did consider whether measuring progress on these issues was possible. However, the lack of baseline data and difficulties recording every visit meant this was not yet considered feasible. The most significant impact in terms of carbon emissions arises from Board meetings. Six of the seven Commissioners live off Island. The current restrictions on Commissioners previous employment, and the requirement to ensure that Commissioners have the requisite skills, means this is unlikely to change significantly. Two meetings a year are held virtually to reduce emissions, which has successfully reduced the Commission's carbon footprint. The Commission will continue with the blended approach, having a mix of in-person and virtual Board meetings. | The International Civil Aviation Organisation (ICAO) has developed a methodology to calculate the carbon dioxide emissions from air travel, enabling the CO2 emissions per passenger to be calculated online by searching for and using the: ICAO Carbon Emissions Calculator (ICEC) This was previously used to help determine this aspect of the Commission's carbon emissions. A comparison has been made with the previous years, including a pre-pandemic year. Comparing 2023 to 2019, the most recent pre-pandemic year, both air kilometres covered by the Commission and emissions have increased. This is because of additional travel not undertaken in previous years to facilitate the recruitment of two new Commissioners, attendance on courses, other development of staff such as shadowing CQC inspectors, and attendance at the EPSO conference. | Consumption Utilities Currently, the Commission has not been able to determine an effective method for baselining consumption; this is something the Commission will continue to seek to address. Consumption Paper and Resources The Commission has continued to reduce its use of paper by printing as little as possible and promoting electronic production and sharing of documents. The Commission's Board no longer uses printed documents. In future, digital transformation initiatives will enable online completion of forms and reduce the need for applicants for registration to print and submit paper documents. Recycling The Commission increased the range of materials collected at its office for recycling to the full range of recycling available in Jersey. |
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| 2023 | 2022 2021 2020 2019 | Other ESG Initiatives |
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29,418 |
| 22,864 | 14,646 | 7,614 |
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| CO2 (Kg) | 3,962 |
| 3,477 | 1,967 | 943 | 3,228 | The Commission is particularly aware of the human rights of care receivers and their families, especially its obligations under the United Nations Rights of the Child. In addition, towards the |
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| end of 2023, the Commission focused on the need to raise awareness of Modern Slavery issues |
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| Another ESG activity of note is that Commission staff support Every Child Our Future (ECOF), |
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| an educational charity to further the chances of children in Jersey - staff volunteer to help |
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Finance Report
Under the provisions of the Regulation of Care (Jersey) Law 2014, the Commission is required to:
- keep proper accounts and proper records The Commission prepares an Annual Business about the accounts, and Plan and associated budget, setting objectives,
- prepare accounts for each financial year and targets and KPIs for discussion and agreement
a report on its operations during the year. with the Board and Accountable Officer.
The Commission determines areas of
The arrangements governing the use of the expenditure in accordance with its priorities Commission s financial resources are set out in and commitments, as described in its
paragraphs 19-36 of the Framework Agreement Annual Business Plan.
between the Jersey Care Commission and the
Government of Jersey. The Commission can only commit to any new
expenditure if it can be met from within available The accountability and assurance arrangements funds or from an additional recurring or
in the Framework Agreement are intended to non-recurring allocation approved by the
reflect the Code of Practice Principles and Government of Jersey.
accord with the Government of Jersey's
Public Finances Manual. The Chief Inspector drafts an Annual Financial
Assurance Statement, which the Board approves Income forecasts and the expenditure budget before submitting to the Accountable Officer.
are agreed at the beginning of each financial
year with the Accountable Officer, the Chief The Government of Jersey provides a financial Officer of the Cabinet Office. The duties and management service to the Commission, responsibilities of the Accountable Officer including in relation to its core budget and concerning the Commission are set out in fee income.
paragraphs 25-29 of the Framework Agreement.
70
Finance Report
Income Sources Expenditure and Support Services
Income is received from two sources. The main components of expenditure consist Fees are derived from healthcare professionals, of pay, including staff salaries and pension regulated activities, individuals, and premises. contributions, and non-pay, including
The Commission also receives a budget professional fees, rent, goods and services. allocation from the Government of Jersey which
Essential support services, including information in part is intended to meet the costs of regulating
technology (IT), payroll and legal services, services provided by the Government.
are provided directly to the Commission
In 2022, the Government Plan was updated
by the Government of Jersey at no cost.
to reflect the increased budget allocation from
This represents part of the Government of
2023 to 2026 to enable the Commission to
Jersey's contribution in kind to the overall
take on its required expanded remit.
operation of the Commission.
Fees include:
The Commission is required to complete an
initial application for registration as a Annual Financial Assurance Statement. provider or a manager (Article 4 The Commission's accounts for 2023 are Regulation of Care (Jersey) Law 2014) audited and published as part of the whole
replacement of registration of the States of Jersey accounts. certificates (Article 8)
annual fee for continued registration (Article 9)
variation of conditions of registration (Article 17)
professional registration.
Statement of Compr Net Expenditure | ehensive | 2023 Budget £'000 | 2023 Actual £'000 | 2023 Variance £'000 | 2022 Actual £'000 |
REVENUE |
| ||||
Earned through Operations |
| (364) | (371) | 7 | (400) |
Total Revenue |
| (364) | (371) | 7 | (400) |
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| ||||
EXPENDITURE |
| ||||
Staff Costs |
| 1,344 | 1,082 | 262 | 770 |
Other Operating Expenses |
| 615 | 546 | 69 | 235 |
Total Expenditure |
| 1,959 | 1,628 | 331 | 1,005 |
|
| ||||
Operating Net Revenue Expenditure /(Income) |
| 1,595 | 1,257 | 338 | 605 |
* Income is shown as a negative number indicated by brackets ()
71
Finance Report
Performance against budget
The Commission s spend and budget have The underspend on staff costs was because increased since 2022 when the Government budgets for staff were set while scheduling for Plan 2023-2026 included additional money for onboarding of staff was still being confirmed. the Commission to prepare for and implement Onboarding of staff was planned to ensure staff inspection of services new to regulation. were in post and fully trained at the right time to This included inspections of Children s Services begin inspections of services new to regulation. in 2023 and will include preparation for This also had some impact on administrative inspections of acute hospital services, expenses which include Information Technology adult mental health services and the ambulance provision for new staff. It was recognised early service during 2024 and 2025. in 2023 that there would be underspends in
these areas and it was planned to use these The main 2023 budget variances were:
to offset some of the costs of the Digital
additional income from Registration project.
fees of £6,982
The overspend on travel was due to travel
an underspend on staffing which was not expected at the start of
costs of £261,844 the year. This was to facilitate the recruitment
an overspend on of new Commissioners, travel to training and travel of £15,324 development such as attendance on courses
a slight overspend on conference and shadowing UK based partners on
and course fees of £1,344 inspections such as the CQC, and attendance
an underspend on administrative at the EPSO conference.
expenses of £18,167 A significant part of the underspend on
an underspend on professional professional fees was because the budget fees of £73,463 includes an allocation of £50,000 to enable
an overspend on premises the Commission to procure independent
and maintenance of £6,318. legal advice. This was not required in 2023.
Further information about how professional fees are used is provided in the Staff Report
on page 65 in the section on the use of contractors and consultants.
" Onboarding of staff was planned to ensure staff were in post and fully trained at the right time to begin inspections of services new to regulation."
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Appendix - Registrations by type (Professionals and Services) Registrations by type (Professionals and Services) Health Professionals 2021 2022 2023 Ambulance Paramedic 47 67 64 Art Therapist 3 3 5 Biomedical Scientist 145 62 64 Chiropodist 17 13 13 Chiropractor 31 29 27 Clinical Scientist 3 1 1 Clinical Psychologist 19 36 38 Dietitian 7 13 15 Midwife 125 86 92 Midwife Prescribing Practitioner 1 0 0 Nurse 1811 1337 1372 Nurse Independent Prescriber 22 40 39 Occupational Therapist 55 55 52 Operating Department Practitioner 85 42 48 Orthoptist 4 7 5 Osteopath 6 10 9 Paramedic Independent Prescriber 0 1 4 Physiotherapist 110 124 115 Podiatrist 14 17 17 Psychotherapist 13 31 29 Radiographer 113 71 66 Social Worker 417 211 202 Specialist Community Public Health Nurse 46 40 35 Speech and Language Therapist 22 33 29 Totals 3,116 2,329 2,341 | 73 |
| Appendix - Registrations by type (Professionals and Services) | Appendix - Registrations by type (Professionals and Services) |
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| Dental Professionals 2021 2022 2023 | Children s Social Care Services 2021** | 2022** 2023 |
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| Clinical Dental Technician | 1 | 2 | 1 |
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| Adoption | - | - | 1 |
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| Dental Hygienist | 11 | 17 | 14 |
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| Fostering | - | - | 1 |
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| Dental Nurse | 26 | 68 | 62 |
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| Children s Home Service | - | - | 11 |
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| Dental Technician | 4 | 4 | 4 |
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| Care in Special Schools | - | - | 1 |
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| Dental Therapist | 3 | 6 | 6 |
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| Children and Family Community Service | - | - | 2 |
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| Orthodontic Therapist | 0 | 3 | 3 |
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| Social Work Service for Children and Young People | - | - | 2 |
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| Totals | 45 | 100 | 90 |
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| Independent Monitoring and Review Service | - | - | 1 |
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| Child Contact Centre | - | - | 1 |
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| Medical Practitioners 2021 2022 2023 |
| Children and Young People Mental Health Service | - | - | 1 |
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| Residential Family Centres | - | - | 0 |
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Responsible Officer | 0 | 1 | 2 |
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| States Employee | 88 | 188 | 246 |
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| Totals | - | - | 21 |
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| Performer | 63 | 105 | 157 |
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| **Note 2 Other than Children s Home Services which were previously registered as Care Services, other Children s Social Care Services were not registered before 2023. |
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Independent Practitioner | 8 | 14 | 25 |
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| UK Connected Practitioner | 302 | 618 | 698 |
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| Totals | 461 | 926 | 1,128 |
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| Laser Services & Yellow Fever Centres | 2021 | 2022 | 2023 |
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| Laser Services | 8 | 10 | 10 |
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| Care Services | 2021 | 2022 | 2023 |
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| Yellow Fever Centres | 9 | 9 | 9 |
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| Totals | 17 | 19 | 19 |
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| Children s Homes | 7 | 7 | *See Note 1 |
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| Totals | 17 | 19 | 19 |
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| Care Home | 55 | 57 | 46 |
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| Daycare | 5 | 5 | 5 |
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| Piercing & Tattooing (P&T) | 2021 | 2022 | 2023 |
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| Home Care | 34 | 37 | 36 |
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P&T Practitioners | 83 | 87 | 78 |
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| Individual Care Worker | 27 | 23 | 34 |
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P&T Premises | 53 | 67 | 60 |
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| Totals | 128 | 129 | 121 |
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| Totals | 136 | 154 | 138 |
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| *Note 1 There was an amendment to the regulations for 2023. |
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| From 2023 Children's Homes are included in registrations now recorded as Children's Social Care Services. |
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74 |
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