National Care Standards: Adult Placement Services

Introduction

Adult placement services

Adult placement services provide or arrange accommodation for vulnerable adults (aged 18 or over) in the homes of families or individuals, together with

• personal care;
• personal support; or
• counselling or other help, provided other than as part of a planned programme of care.

The adult placement services recruit people living in the community and approve them as adult placement carers. The adult placement carer takes you (as the vulnerable adult) into his or her home where you will be part of the household, and provides your support and care for an agreed fee.
The service continues to make sure that both you and the adult placement carer receive support and help. The adult placement carers are self-employed.

The range of placements cover:

• long-term placements and short breaks which may:
• be regular, one-off or emergency placements; and
• last from a few hours to a few weeks;
• different levels of contact with your own family and adult placement carers (which may support your family's role or replace it);
• different care groups (people with learning disability, physical or sensory impairment, mental health problems or dementia);
• different age groups;
• paid-for services and services that rely on volunteers;
• placements provided by individual adult placement carers and by families;
• statutory, voluntary and private providers;
• stand-alone services and those with a range of services;
• short-break services set up to offer holiday cover for long-term placements; and
• rehabilitation and prevention.

The adult placement differs from a small residential home in:

• its family setting;
• the process for checking the whole family;
• your access to the whole house;
• the care ratio (rarely more than one adult placement carer for every two people);
• the matching process;
• the emphasis on community links; and
• the role of the adult placement service to support and guarantee the quality of the placements.

The adult placement carer is the person you go to stay with. The adult placement worker is the person who is employed by the service to arrange, supervise and support placements.

The national care standards

Scottish Ministers set up the National Care Standards Committee ( NCSC) to develop national standards. The NCSC carried out this work with the help of a number of working groups. These groups included people who use services, their families and adult placement carers, along with staff, professional associations, regulators from health and social care, local authorities, health boards and independent providers. Many others were also involved in the consultation process.

As a result, the standards have been developed from the point of view of people who use the services. They describe what each individual person can expect from the service provider. They focus on the quality of life that the person using the service actually experiences.

The standards are grouped under headings which follow the person's journey through the service. These are as follows:

Before using the service (standards 1 to 6)

1 Informing and deciding
2 First meetings
3 Your legal rights
4 Your environment
5 Management and staffing arrangements
6 Support arrangements

Day-to-day life (standards 7 to 16)

7 Starting to use the service
8 Making choices
9 Feeling safe and secure
10 Exercising your rights
11 Expressing your views
12 Lifestyle
13 Keeping well
14 Private life
15 Daily life
16 Supporting communication

Leaving the adult placement service (standard 17)

17 Moving on

Using the national care standards

If you are thinking about starting an adult placement, you will want to refer to the standards to help you decide about it. If you are already in a placement, you may use the standards when discussing the service you receive with:

• the adult placement carer or adult placement worker;
• your social worker or care manager, if you have one; or
• someone acting on your behalf, for example, your carer, a relative or friend, your lawyer or other independent representative.

If things go wrong, you can refer to the standards to help you raise concerns or make a complaint. ( See 'Expressing your views', standard 11.)

The adult placement service will use the standards to find out what is expected of them in offering support and care services. The standards make it clear that everything about the service should lead to you enjoying a good quality of life. They should guide the service over who to employ and how they should manage the service.

The adult placement carer will use the standards as a guide to the support and care you will expect. The standards will also show the adult placement carer what support he or she can expect from the adult placement service.

The principles behind the standards

The standards are based on a set of principles. The principles themselves are not care standards but reflect the recognised rights which you enjoy as a citizen. These principles are the result of all the contributions made by the NCSC, its working groups and everyone else who responded to the consultations on the standards as they were being written. They recognise that services must be accessible and suitable for everyone who needs them, including people from black and ethnic minority communities. They reflect the strong agreement that your experience of receiving services is very important and should be positive, and that you and your family have rights.

The main principles

The principles are dignity, privacy, choice, safety, realising potential and equality and diversity.

Dignity

Your right to:

• be treated with dignity and respect at all times; and
• enjoy a full range of social relationships.

Privacy

Your right to:

• have your privacy and property respected; and
• be free from unnecessary intrusion.

Choice

Your right to:

• make informed choices, while recognising the rights of other people to do the same; and
• know about the range of choices.

Safety

Your right to:

• feel safe and secure in all aspects of life, including health and wellbeing;
• enjoy safety but not be over-protected; and
• be free from exploitation and abuse.

Realising potential

Your right to have the opportunity to:

• achieve all you can;
• make full use of the resources that are available to you; and
• make the most of your life.

Equality and diversity

Your right to:

• live an independent life, rich in purpose, meaning and personal fulfilment;
• be valued for your ethnic background, language, culture, and faith;
• be treated equally and to be cared for in an environment which is free from bullying, harassment and discrimination; and
• be able to complain effectively without fear of victimisation.

The rights apply just as much when you are on a short break as when you are staying there more permanently. A separate set of standards covers all types of short breaks. You and your family may also want to refer to them.

The Scottish Commission for the Regulation of Care

The Regulation of Care (Scotland) Act 2001 ('the Act') set up the Care Commission, which registers and inspects all the services regulated under the Act, taking account of the national care standards issued by Scottish Ministers. The Care Commission has its headquarters in Dundee, with regional offices across the country. It will assess applications from people who want to provide adult placement services. It will inspect the services to make sure that they are meeting the regulations and in doing so will take account of the national care standards. You can find out more about the Care Commission and what it does from its website ( www.carecommission.com ).

The Care Commission registers and inspects adult placement services, not individual placement providers. This contrasts with what happens in England, where individual providers are registered as small care homes. The different approach in Scotland recognises the responsibilities of the adult placement service. Where the adult placement has three adults living in it at the same time, it may also have to be licensed as a house in Multiple Occupation under the Civic Government (Scotland) Act 1982 (Licensing of Homes in Multiple Occupation) Order 2000.

The Scottish Social Services Council

The Act created the Scottish Social Services Council ('the Council') which was established on 1 October 2001. It also has its headquarters in Dundee. The Council has the duty of promoting high standards of conduct and practice among social services workers, and in their education and training. To deliver its overall aims of protecting service users and carers and securing the confidence of the public in social services, the Council has been given five main tasks. These are: to establish registers of key groups of social services staff; to publish codes of practice for all social services staff and their employers; to regulate the conduct of registered workers; to regulate the training and education of the workforce; to undertake the functions of the National Training Organisation for the Personal Social Services. The Council has issued codes of practice for social service workers and employers of social service workers. These describe the standards of conduct and practice within which they should work. The codes are available from the Council website ( www.sssc.uk.com ).

How standards and regulations work together

The Act gives Scottish Ministers the power to publish standards which the Care Commission must take into account when making its decisions. It also gives Scottish Ministers the power to make regulations imposing requirements in relation to adult placement services.

The standards will be taken into account by the Care Commission in making any decision about applications for registration (including varying or removing a condition that may have been imposed on the registration of the service). All providers must provide a statement of function and purpose when they are applying to register their service. On the basis of that statement, the Care Commission will determine which standards will apply to the service that the provider is offering.

The standards will be used to monitor the quality of services and their compliance with the Act and the regulations. If, at inspection, or at other times, for example, as a result of the Care Commission looking into a complaint, there are concerns about the service, the Care Commission will take the standards into account in any decision on whether to take enforcement action and what action to take.

If the standards were not being fully met, the Care Commission would note this in the inspection report and require the service manager to address this. The Care Commission could impose an additional condition on the service's registration if the provider persistently, substantially or seriously failed to meet the standards or breached a regulation. If the provider does not then meet the condition, the Care Commission could issue an improvement notice detailing the required improvement to be made and the timescale for this. Alternatively, the Care Commission could move straight to an improvement notice. The Care Commission would move to cancel the registration of any service if the improvement notice does not achieve the desired result. In extreme cases ( i.e. where there is serious risk to a person's life, health or wellbeing) the Care Commission could take immediate steps to cancel the registration of any service without issuing an improvement notice.

Regulations are mandatory. In some cases not meeting a regulation will be an offence. This means a provider may be subject to prosecution. Not meeting or breaching any regulation is a serious matter.

Decisions by the Care Commission on what to do when standards or regulations are not met will take into account all the relevant circumstances and be proportionate.

You can get information on these regulations from the Regulation of Care (Scotland) Act 2001, which is available from the Stationery Office Bookshop. You can also see the Act on-line ( see Annex B for the address).

You can also see the Scottish Statutory Instruments for the Regulation of Care Regulations 2002 on-line ( see Annex B for the address).

Comments

If you would like to comment on these standards you can visit our website and send a message through our mailbox: www.scotland.gov.uk/health/standardsandsponsorship

You can also contact us at:
Care Standards and Sponsorship Branch
Community Care Division
Health Department
St Andrew's House
Regent Road
Edinburgh EH1 3DG
Tel: 0131 244 3520
Fax: 0131 244 4005