A. GENERAL DETAILS AND PURPOSE |
1 | PROPOSED TITLE OF LEGISLATION The Regulation of Care (Jersey) Law 200- |
2 | NATURE OF LEGISLATION (Law, Regulation, Order etc) Law and associated Regulations / Orders |
3 | PLEASE PROVIDE A SHORT SUMMARY OF THE AIM OF THIS LEGISLATION (MAXIMUM OF 50 WORDS). The current legislation regulating health and social care provision is no longer fit for purpose and does not provide an adequate level of protection required by the most vulnerable sections of the population. It is proposed to combine and amend two existing Laws, the Nursing and Residential Homes (Jersey) Law 1995 and the Nursing Agencies (Jersey) Law 1978 to ensure Jersey enjoys high quality health and social care services. |
4 | IS THE REQUEST FOR NEW, OR FOR THE AMENDMENT OF EXISTING LEGISLATION? New Legislation. |
5 | (A) STATE THE ISSUE OR PROBLEM TO BE RESOLVED 1. The current legislation is limited in terms of the requirements for pre employment checks on staff. This can, and has, led to inappropriate people being recruited to look after very vulnerable people. It is intended to make an explicit requirement that all staff must have satisfactory enhanced police checks, adequate references, appropriate training and qualifications to work in the sector. 2. Currently the onus is on the Minister to prove that the person registered is a ‘fit’ person and fitness is not well defined. It is proposed that in the new legislation the onus will be on the applicant to prove fitness and the requirements for registration as a manager will be made explicit. 3. At present the Minister can make Orders for the provision of facilities and services under the care home legislation, however there is no provision for the minister to set out explicit and enforceable standards. It is proposed that the new Law will enable the Minister to specify the standards expected from health and social care providers. 4. While most premises meet current minimum standards for facilities, there are a small number that do not. There are still multi occupancy rooms of up to four residents and double rooms where residents have no choice but to share. In some premises, the bedroom accommodation does not meet the current minimum standard and in one in particular residents have a dedicated living space of eight square metres with no ensuite facilities. 5. Currently there are two Orders under the Nursing and Residential Homes Law, setting different requirements for long term nursing care and long term residential care. This is confusing and cumbersome for operators who may need to be registered under both categories. It is the intention to have a single category care home, under the same general statutory regulation with additional requirements that will pertain if the home provides nursing. 6. The existing regulation of acute hospital services, operating theatres, x-ray facilities, endoscopy, laser treatment, acute nursing etc, is inadequate and does not meet current safe practice standards. The Jersey Nursing and Residential Homes Laws was adopted in 1995 from exiting UK legislation dating back to 1984. Over the intervening period standards of care, practice and governance have changed considerably and this needs to be reflected in legislation. Failure to do so puts the public at significant risk. 7. The regulation of domiciliary care is currently restricted to Nursing Agencies and the power of the Minister, limited to the inspection of records of fees charged to clients and salaries paid to staff. The Law does not include any standards for care, quality of staff, or evidence of good practice. The Law does not extend to personal care agencies of which there are at least four on the island. These agencies are currently supplying non nursing care staff to vulnerable people in their own homes without any regulatory monitoring of standards. (B) STATE THE EXPECTED BENEFIT OF THE MEASURE This provides an opportunity to develop a comprehensive and consistent regulatory framework for health and social care provision. The proposed legislation will: 8. Ensure that those working with vulnerable people have appropriate qualities, skills and expertise to be safe practitioners. 9. Ensure that registered managers of health and social care facilities and services have the appropriate qualities, knowledge, skills and expertise. 10. Ensure that there are clear, enforceable standards based on identifying and meeting the needs of service users. 11. Ensure that premises providing health and social care are fit for purpose. 12. Bring the regulation of domiciliary care up to the same standard as that of residential and nursing care. 13. Provide a single category care home that will streamline the registration process for providers who can offer a home for life to service users. 14. Bring the requirements for acute hospital services up to safe and current standards. |
6 | WHAT POSITIVE OR NEGATIVE IMPACT DOES THIS LEGISLATION HAVE ON KEY OBJECTIVES OF THE STATES OF JERSEY? (ECONOMY; ENVIRONMENT; STEWARDSHIP; SOCIAL) see attached guidance notes It is expected that this proposal will improve public confidence in that it will deliver services to the public at an appropriate level of quality and standards. It is consistent with the State’s role concerned with the health, safety and the protection of the wellbeing of the population. It is intended to structure the proposed legislation in line with equivalent Laws in the Scotland, England and Welsh legislation. This meets the States objective of providing social services comparable with those in neighbouring countries and within this objective it will provide for the physical and mental health needs of individuals. |
7 | WHAT WOULD HAPPEN IF NO ACTION WERE TAKEN? WHAT RISK WOULD BE RUN AND HOW GREAT WOULD IT BE? If no action were to be taken, there are considerable risks of abuse of vulnerable people, both in their own homes and in institutions. The current legislation is based on UK Law that was found unworkable and inadequate and was replaced by the Care Standards Act 2000 in England and Wales and the Regulation of Care Scotland Act 2001. People requiring care are by their very nature the most vulnerable members of society and therefore require the most protection. It is therefore essential that there is up to date effective legislation. In terms of acute hospital services, there is an increasing acknowledgement that relying on professional practice alone without external scrutiny is inadequate and leaves service users with little protection and recourse to complain. |
8. | IS THE LEGISLATION LIKELY TO BE LONG AND/OR COMPLEX? The legislation would include detailed provision for the registration and regulation of care homes, acute hospital services and domiciliary care. This will include setting out the requirements for registration, regulations and standards, provision of facilities and services, procedures for refusal and cancellation of registration, offences and inspection arrangements. It is therefore likely to be lengthy and complex. There is however comparable UK legislation that may form a useful framework. |
9 | IS THIS A PREVIOUSLY UNIDENTIFIED/URGENT REQUEST? IF SO, PLEASE PROVIDE AN EXPLANATION? No |
B. EXTENT OF DEVELOPMENT OF POLICY |
10 | HAS THE REQUEST RECEIVED THE “IN PRINCIPLE” APPROVAL OF THE STATES OR ANY OTHER RELEVANT BODIES? No |
11 | ARE THE PROPOSALS LIKELY TO BE LEGALLY CONTENTIOUS? (IF SO, HAS THE ADVICE OF THE LAW OFFICERS BEEN SOUGHT?) The proposals are not thought to be legally contentious. During drafting of an amendment to the current Nursing and Residential Homes Law, the department was advised by the assistant Law Draftsman, that the current legislation is not fit for purpose and should be updated. |
12 | IS THERE LIKELY TO BE ANY EXPRESS OPPOSITION TO WHAT IS PROPOSED AND HOW MIGHT THIS MANIFEST ITSELF? It is not expected that there will be any great opposition to this proposal, as this sector is already regulated and this proposal merely simplifies and updates this regulation. |
13 | HAS THERE BEEN CONSULTATION UPON THE PROPOSALS? (Describe the level of consultation generally, indicating organizations consulted, time allowed for consultation and whether or not responses to consultation were in favour of the proposal ) There have been informal discussions with providers of nursing and residential homes over a number of years and there is an expectation that the Law will be updated. This has taken place at inspection, training sessions and at meetings of the Jersey Care Federation. Further consultation is proposed during the drafting period. |
C. THE EFFECT ON BUSINESS |
14 | BUSINESS SECTORS AFFECTED (Please state the business sectors or types of businesses likely to be affected and estimate the number of businesses involved) All currently registered nursing and residential homes and nursing agencies will be affected. In addition approximately four care agencies will be included that are not currently regulated. The department is aware of a number of proposed developments for the provision of new premises. Current facilities and services: · 24 residential homes · 4 nursing homes · 3 dual registered homes · 5 Nursing Agencies · 4 care agencies (not currently regulated) Proposed facilities and services: · 2 operating theatres providers · 1 nursing home · 1 residential home · 1 dual registered nursing and residential home |
15 | COMPLIANCE COSTS FOR A TYPICAL BUSINESS (Please summarise the total estimated compliance costs regarding a measure for a “typical” business in each concerned sector or the type of business most likely to be affected in terms of recurring and non-recurring costs) Where businesses already provide facilities and services of a satisfactory standard there will be little or no compliance costs. Owners of substandard premises may incur costs that would vary according to the extent of remedial work involved. In the extreme, this may involve the demolition and re building of premises. |
16 | HOW DO THE COMPLIANCE COSTS OF OTHER OPTIONS COMPARE? The other option would be to amend further the unsatisfactory legislation, this would still result in an additional cost for some premises. |
17 | TOTAL COMPLIANCE COSTS (Summarise the total estimated compliance costs for all specific sectors or types of business/individuals likely to be affected) It is not possible at this stage to estimate the total compliance costs for all commercial interests. |
18 | EFFECTS ON INTERNATIONAL COMPETITIVENESS (Describe how any additional costs arising from the measure may affect the competitive position of the Island) It is not envisaged that the proposals will affect international competitiveness |
D. THE EFFECT ON INDIVIDUALS & GROUPS |
19 | WHAT COSTS, IF ANY MIGHT BE INCURRED TO OTHERS (E.G. ISLAND RESIDENTS) AS A RESULT FROM THE LEGISLATION? It is not envisaged that there will be significant costs incurred to others as a result of the legislation as the sector is competitive and fees are self limiting. |
20 | WHO WILL PRIMARILY BENEFIT FROM THE PROPOSAL AND IN WHAT WAY? (FINANCIAL, LIFESTYLE, FREEDOM TO ACT) Service users will be the primary beneficiaries of this proposal, through improvements in quality of care, quality of environment and enhanced rights. |
21 | IF THE MEASURE IS PROPOSED TO BENEFIT A SPECIFIC GROUP OR SECTION OF THE POPULATION, IS ANYONE LIKELY TO BE OTHERWISE ADVERSELY AFFECTED OR DISADVANTAGED IN EITHER FINANCIAL OR OTHER TERMS AND IN WHAT WAY? It is not anticipated that by improving the life of people in receipt of health and social care that any other sector of the population would be disadvantaged. |
E. THE EFFECT ON GOVERNMENT RESOURCES |
22 | a) HOW WILL THE PROPOSED LEGISLATION BE IMPLEMENTED, ADMINISTERED, AND ENFORCED? It is expected that the regulation of care will remain a function of the Health and Social Services Department, administered as at present through Health Protection. Public Health Department. Currently registration and enforcement is delegated from the Minister of Health to the Assistant Director – Health Protection. |
| b) WHAT ARE THE RESOURCE CONSEQUENCES OF EACH OF THESE PHASES, AND HAVE THESE BEEN ACCEPTED BY THE RESOURCE DEPARTMENTS? (Please refer to all resources including ongoing revenue costs, and manpower costs in terms of number of posts (FTE) and actual headcount expected.) It is not anticipated that a change in the legislation will place any more demands on manpower, as other than the four care agencies, there is no intention to increase the number and type of premises or services covered by the legislation. |
| c) WHAT, IF ANY, ARE THE SAVINGS ACHIEVED BY THE PROPOSED LEGISLATION? No savings have been identified. |
23 | WHAT ARE THE POTENTIAL KNOCK-ON EFFECTS TO OTHER DEPARTMENTS OF THIS PROPOSED LEGISLATION IN RESOURCE TERMS? (Please include details of those departments consulted.) There are no expected knock-on effects for other departments |
F. INSTRUCTING THE LAW DRAFTSMAN v (See Law Draftsman’s handbook, “Making New Laws”) |
24 | WHEN WILL COMPREHENSIVE DRAFTING INSTRUCTIONS BE AVAILABLE? December 2006 |
25 | WILL ANY ASSISTANCE BE REQUIRED FROM OUTSIDE THE STATES TO ENABLE THE PREPARATION OF DRAFTING INSTRUCTIONS - IF SO - (a) WHAT ARRANGEMENTS HAVE BEEN MADE TO SOURCE THE ASSISTANCE? None required (b) ARE FINANCIAL RESOURCES AVAILABLE FOR THIS PURPOSE? None Required |
26 | (a) GIVE THE NAME OF THE INSTRUCTING OFFICER (AND PROVIDE DETAILS OF THE ASSISTANCE FROM OUTSIDE THE STATES, IF ANY, THAT IS TO BE USED) Christine Blackwood – Registration and Inspection Manager (b) CONFIRM THAT THE INSTRUCTING OFFICER WILL BE ABLE TO CONSIDER DRAFTS SUBMITTED BY THE LAW DRAFTSMAN’S OFFICE, AND REQUESTS FOR FURTHER INSTRUCTIONS, FULLY AND WITHOUT DELAY The instructing Officer will be considering drafts submitted and requests for further instructions. |
27 | WHEN DO YOU EXPECT TO BE ABLE TO DELIVER INSTRUCTIONS FOR OUTSTANDING MATTERS IN THE 2006 LEGISLATION PROGRAMME? |
Signature: | Designation : Assistant Director, Health Protection |
Date: 20th March 2006 | Chief Executive : ....................................................... |
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