The Isle of Man’s Registration and Inspection Unit.

Website in English: www.gov.im/socialcare

Contact person: Mr Mark Campbell Head of Registration & Inspection Unit

Department of Health and Social Care

4^th floor, Markwell House, Market Street, Douglas, Isle of Man IM1 2RZ

email: mark.campbell@gov.im tel: 01624 642410    

 Additional contact person: Trina Bradley, Senior Inspector, Registration and Inspection Unit, Department of Health and Social Care, Corporate Services Division

4th Floor, Markwell House, Market Street

Douglas Isle of Man IM1 2RZ

Telephone: (01624) 642429 E-mail:   catriona.bradley@gov.im Website: www.gov.im/socialcare

 THE STRUCTURE OF THE REGISTRATION AND INSPECTION UNIT

The Unit is led by the Head of Registration and Inspection who reports to Director of Corporate Services and is accountable to the Chief Executive.

The Unit has a Head of Registration and Inspection, a Senior Inspector, 6 full time inspectors and 3 bank inspectors. Inspectors are qualified in health and/or social care professions. The administrative team consists of 3 personnel.

Since 2012 inspectors have increasingly undertaken unannounced inspections. The number of inspections undertaken in 2012/13 was 340. Inspections can take from several hours to several days depending on the size, scale and risk associated with the care service.

Number of services subject to regulation equates to 29 adult care homes, 1 boarding school, 19 children’s homes (small in scale), 115 child minders, 58 child day care services, 27 care homes for adults with learning disabilities, 3 independent clinics, 1 Hospice and 1 nurse agency. 

The Unit is located within the Department of Health and Social Care which has a budget of £239,957,401 gross.

THE SCOPE OF THE REGISTRATION AND INSPECTION UNIT

The Registration and Inspection Unit is responsible for regulating an expanding range of care services. It has introduced a risk-based and proportionate approach to this task by introducing systems aimed at promoting consistency, fairness, effectiveness and accountability with the emphasis on safety and dignity of the individual service user.  

It regulates and inspects adult and children’s homes, secure accommodation for children, non-NHS health care services such as private hospitals and clinics, nurse agencies, child minders, offender accommodation service for adults and child day services. The Regulation of Care Act 2013 has placed an additional duty upon the Unit to regulate adult placement agencies, child care agencies, domiciliary home care services, fostering and voluntary adoption agencies, independent medical agencies and adult day care centres.    

Inspection of the administration, recording and storage of medication in care services is undertaken by inspectors with the assistance of a Pharmacy Advisor. 

METHODS OF INSPECTION

Unannounced inspections. With the exception of child minders all inspections are unannounced. Increasingly inspections are held out of hours, at night and weekends. This approach has been found to be effective and enables inspectors to meet more residents, families and staff members and more accurately gauge care standards in “real time”. 

Care Services risk assessment. Inspections are increasingly being informed through risk assessment. The rationale for risk assessment is set within the context of an acute awareness within the Unit of its requirement to perform effectively and efficiently in the conduct of its work. Services inspected by the Unit are being formally risk-assessed at least on an annual basis by inspectors. Assessment covers such issues as regulatory track record, attitudes of care providers towards the regulator, management of complaints, care standards, staffing levels and responses to safeguarding incidents. 

The results of risk assessment determine the appropriate regulatory response which could include less intense regulatory activity, or alternatively a more intense approach being taken with a service to bring about reduction of that risk and increased assurance as to safety and welfare of service users. Inspectors talk to service providers about their risk assessment and this is also mentioned in their on-line inspection reports. 

Self-assessment. We have introduced self-assessment to deliver more effective inspections with an emphasis on “care quality improvement”. The Unit is keen to revise its own practice in order that it remains an effective regulator and on a par with the best of regulators on the Isle of Man and health and social care regulator in neighbouring jurisdictions. 

The primary legal responsibility for quality of care rests with care providers. Our self-assessment process recognises this. To support this new approach the Unit has developed a self-assessment template to be completed by care providers describing how they are meeting care standards. These are then rigorously validated by inspectors whilst conducting unannounced visits. Inspectors never rely exclusively upon self-assessment in its quest to ensure compliance with care standards. 

WHAT IS THE COMPETENCE OF THE SUPERVISORY ORGANISATION IN YOUR COUNTRY?

The Unit receives its legal mandate from the Regulation of Care Act 2013. It is responsible for processing registration applications for both care providers and managers. It decides upon applications and has the statutory power to refuse applications. When necessary it places registration conditions upon care providers or managers. The Unit can amend, suspend and cancel registrations. In the interests of fairness inspectors follow procedural fairness requirements. These allow care providers to appeal to the Care Services Tribunal who can uphold the Unit’s actions, uphold the appellant’s case or made a separate decision.   

Inspectors are given statutory powers to inspect care premises. They can enter care premises without consent or warrant. They have general powers on entry and can arrange for service recipients to be medically examined. Inspectors have powers to require documents or information on entry. It is an offence to obstruct an inspector. Inspectors have powers to give improvement notices to require care quality improvements. They have powers to issue notices requiring compliance and to remedy the commission of an offence or to prevent it from happening or recurring.  

Legal proceedings for a registration-related offence or care offence may be commenced with the consent of the Island’s Attorney General. Care offences can result in substantial fines and custodial sentences. 

These powers can lead to the registration of care services being amended, by placing conditions upon them, suspended (as a precautionary measure) or cancelled. 

6. INTERESTING ONGOING DEVELOPMENTS IN YOUR COUNTRY/REGION

Registration and Inspection Unit’s Strategic Plan “Strategy for Opportunity and Innovation” 2013-2016 is available to view on our website. 

Public consultation on comprehensive equality legislation for the Isle of Man started on Monday 11 August 2014.

The Equality Bill prohibits discrimination, in the provision of goods and services as well as in employment, on the grounds of specified characteristics including age, disability, gender, race, religion and sexual orientation. There are a range of exceptions, however.

The Bill, which would replace the Disability Discrimination Act 2006 amongst other legislation, also requires organisations to make reasonable adjustments to accommodate the needs of disabled people.