Care Inspectorate Scotland: Guidance for providers on the assessment of staffing levels in premises-based care services

We taken taken this information from the Care Inspectorate Scotland to help and support you with the changes to “assessment of staffing levels in premises-based care services“

Introduction

This guidance has been designed to support providers of care homes, premises-based support services, school care accommodation, secure care and premises-based offender accommodation. This is to make sure the appropriate assessment and provision of staffing to meet the needs of people in their care, following the removal of staffing schedules and in preparation for the implementation of the Health and Care (Staffing) (Scotland) Act 2019.

Inspectors may also refer to this guidance on inspection, for instance where intelligence may lead us to believe that staffing levels are not being appropriately assessed. Examples of this may be evidence of poor outcomes for people, an increase in incidents, number of complaints, staff absence, or a complaint investigation.

Useful Resources

Current Legislation

We regulate staffing under regulation 15 of the Public Services Reform Act 2010.
The legislation states that:
A provider must, having regard to the size and nature of the care service, the statement of
aims and objectives and the number and needs of service users:

ensure that at all times suitably qualified and competent persons are working in the care service in such numbers as are appropriate for the health, welfare, and safety of service users; and
ensure that persons employed in the provision of the care service receive:
(i) training appropriate to the work they are to perform; and
(ii) suitable assistance, including time off work, for the purpose of obtaining further qualifications appropriate to such work.

New legislation

The Health and Care (Staffing) (Scotland) Act 2019 (legislation.gov.uk) brings into legislation requirements and guiding principles for staffing by the NHS and providers or care services. This comes into effect from April 2024, after which Regulation 15 of the Public Services Reform Act 2010 will be revoked.

The guiding principles of the Act state the main purposes of staffing for healthcare and care services are:

to provide safe and high-quality services to ensure the best healthcare or (as the case may be) care outcomes for service users
staffing for health and care services is to be arranged while:
– improving standards and outcomes for service users
– taking account of the needs, abilities, characteristics, and circumstances of different service users
– respecting the dignity and rights of service users
– taking account of the views of staff and service users
– ensuring the wellbeing of staff
– being open with staff and service users about decisions on staffing
– allocating staff efficiently and effectively
– promoting multi-disciplinary services as appropriate.

The Act also states there is a duty on care service providers to ensure appropriate staffing:
Any person who provides a care service must ensure that at all times suitably qualified and competent individuals are working in the care service in such numbers as are appropriate for:

• the health, wellbeing, and safety of service users
• the provision of safe and high-quality care
• in so far as it affects either of those matters, the wellbeing of staff.

The Health and Social Care Standards

The Health and Social Care Standards Health and Social Care Standards: My support, my life (www.gov.scot) set out what we should expect when using health, social care, or social work services in Scotland. In relation to staffing, they describe the importance of having confidence in the people who provide support and care.

This includes:

3.14 I have confidence in people because they are trained, competent and skilled, are able to reflect on their practice and follow their professional and organisational codes.
3.15 My needs are met by the right number of people.
3.16 People have time to support and care for me and to speak with me.
3.17 I am confident that people respond promptly, including when I ask for help.
3.18 I am supported and cared for sensitively by people who anticipate issues and are aware of and plan for any known vulnerability or frailty.
3.19 My care and support is consistent and stable because people work well together.

Guidance

To support the assessment of staffing, we recommend that services consider our guidance.

Records that all registered care services (except childminding) must keep and
guidance on notification reporting (careinspectorate.com) and/or

Records that all registered children and young people’s care services must keep
and guidance on notification reporting

For staffing level and deployment, the guidance above states:

For everyone using the service, a provider shall keep individual records of four weekly assessments of physical, social, psychological and recreational needs and choices and as to how they will deliver their care. Record this in each care plan as this will inform the direct care hours for the individual.
In respect of the delivery of the service, a provider should keep a record of the assessment that identifies the minimum staffing levels and deployment of staff on each shift over a four-week period. This will take into account aggregated information of the physical, social, psychological and recreational needs and choices in relation to the delivery of care for all individuals, also taking into account the physical layout of the building, staff training and staff supervision needs.
The overall assessment of staffing level and deployment must be available to any visitors to the service and everyone using it

• Section A: The assessment of need for people who use services

• Section B: Assessment of staffing

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