Support services are all those services which currently come under the heading of 'day care'. They do not include care at home and housing support which are covered by separate standards. Day care services can be provided in a variety of settings, by staffed services or volunteer services. They range from services that are offered within a care home or centre to those provided directly in the community and not based in a centre. Carers see day care, wherever it is provided, as an important respite resource (breaks for carers).
Support services can help a wide range of people, from those who need support with very complicated needs to people who need time-limited support at different points in their lives.
The main goal of support services is to allow you to plan and achieve your preferred lifestyle. To achieve this, support services should:
- work with you to provide an appropriate level of care and support when you want it;
- provide the support that you need to help you develop; and
- provide the guidance, direction and assistance you need to help you work towards your personal goals in all aspects of your life.
These standards reflect an approach which makes sure you have control of your life and develop personal skills and independence, and makes sure that the provider shapes the service to meet your needs and preferences and, when appropriate, your carer's.
The traditional model of day care is a service that is usually provided between 9 am and 5 pm, Monday to Friday, and is based in a building. There are more and more examples of a person-centred approach which is in line with the policy of social inclusion, for example the growth in befriending services. This aims to encourage people who use support services to be active members of the community. by helping them to take part in a range of activities, including paid employment, educational opportunities and leisure and recreational services. At the same time, more premises that are used for support services are being made available and accessible to the general public.
The principles set out by the Independent Living Movement have also influenced the standards for support services. These are:
- that all human life is of value;
- that anyone, whatever their impairment, is capable of exerting choices;
- that people who are disabled by society's reaction to physical, intellectual and sensory impairment and to emotional distress have the right to assert control over their lives; and
- that disabled people have the right to participate fully in society.
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 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 support service. These are as follows.
Before using the support service (standards 1 to 6)
1 Informing and deciding
2 Management and staffing arrangements
3 Your legal rights
4 Support arrangements
5 Your environment
6 First meetings
Using the support service (standards 7 to 12)
7 Using the support service
8 Making choices
9 Supporting communication
10 Feeling safe and secure
11 Exercising rights and responsibilities
12 Expressing your views
Day-to-day life (standards 13 to 16)
13 Lifestyle - social, cultural and religious belief or faith
14 Daily life
15 Eating well - where the support service provides meals
16 Keeping well
Leaving the support service (standard 17)
17 Leaving the support service
Using the national care standards
If you are thinking about using a support service, you will want to refer to the standards to help you decide. If you already use a support service, you may use the standards when discussing the service you receive with:
- staff and managers;
- your social worker or care manager, if you have one; or
- someone acting on your behalf, for example, a family member, carer or 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 12).
Providers will use the standards to find out what is expected of them in offering support services. The standards make it clear that everything about the support service should lead to you enjoying a good quality of life. They should guide the provider about:
- any building requirements;
- who to employ; and
- how they should manage the support service.
The principles behind the standards
The standards are based on a set of principles. The principles themselves are not 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 have rights.
The main principles
The principles are dignity, privacy, choice, safety, realising potential and equality and diversity.
Your right to:
- be treated with dignity and respect at all times; and
- enjoy a full range of social relationships.
Your right to:
- have your privacy and property respected, and to receive the time, the space and the facilities you need and want; and
- be free from intrusion as long as it is safe for you and everyone else.
Your right to:
- make informed choices, while recognising the rights of other people to do the same;
- know about the range of choices; and
- get help to fully understand all the options and choose the one that is right for you.
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.
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 live in an environment which is free from bullying, harassment and discrimination; and
- be able to complain effectively without fear of victimisation.
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 support 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 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 support 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 at a cost of £7.95 a copy. 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).
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
Primary & Community Care Directorate
St Andrew's House
Tel: 0131 244 3520
Fax: 0131 244 4005