Adult protection and social care
Independent Review of Adult Social Care
A comprehensive and fundamental independent review of adult social care has been established with immediate effect, to report by January 2021. The review will:
- Recommend improvements to adult social care, focused on the outcomes achieved by and with people who use services, their carers and families, and the experience of people who work in adult social care.
- Take a human rights-based approach with a particular but not exclusive focus on the views of those with lived experience, about what needs to change to make real and lasting improvements.
- Set out how adult social care can be reformed to deliver a national approach to care and support services, using the powers available to the Scottish Parliament.
- Include consideration of a national care service.
The Terms of Reference for the Review are available on the Scottish Government website.
Social care support reform
The Scottish Government and COSLA have launched a programme for reform of the adult social care system.
A Shared Vision for adult social care support sets out what social care support will look like in the future and is made up of statements organised into five groups:
- The way we value and understand social care support describes ourhuman rights based approach to social care. It applies to the statements in all the groups.
- The way people access support describes how people will access support.
- The way people are supported describes how people will be supported.
- Our system, processes and decision making describes how system and processes will be organised and how decision will be made.
- Our support across Scotland describes how people's experiences will be consistent across Scotland.
A Programme Framework sets out priorities and workstreams for delivery of the programme.
Programme for Government 2020-21
In its Programme for Government 2020-2021, the Scottish Government included the following improvements, to be taken forward with immediate effect:
- Set standards for how adult social care assessments and allocation of resources are carried out, so that people accessing support are fully involved in decision making and experience greater consistency and transparency.
- Complete a review of care services definitions. This will involve the development of new definitions for registered services and care roles, to enable social care support services and workers to be more flexible and responsive to people’s needs, to work more autonomously, and to work with others across professions.
- Work with Integration Authorities and Local Authorities to ensure planning and purchasing of social care support is focused on flexible and person-centred support.
The Adult Support and Protection (Scotland) Act 2007 was introduced to ensure a legislative response was available for people and situations not covered by the Adults with Incapacity (Scotland) Act 2000 and the Mental Health (Care and Treatment) (Scotland) Act 2003. It allows local authorities to make inquiries where they would otherwise have no power to do so.
A Code of Practice was published alongside the Act for local authorities and practitioners which provides guidance on when and where it would normally be appropriate to use these powers.
The Scottish Government also published its Adult Support and Protection Improvement Plan: 2019 – 2022. It is designed “to complement and strengthen local adult support and protection (ASP) improvement activity, provide assurance and identify future areas for improvement so that adults at risk of harm in Scotland are supported and protected”.
Adults with Incapacity (Scotland) Act 2000
The Adults with Incapacity (Scotland) Act 2000 provides ways to protect and safeguard the welfare and finances of adults who lack capacity to take some or all decisions for themselves because of a mental disorder or an inability to communicate. The Act also aims to support the involvement of adults with incapacity in making decisions about their own lives as far as they are able to do so.
Anyone authorised to make decisions or take actions on behalf of someone with impaired capacity must apply five specific principles: benefit to the person; least restrictive option; taking account of their wishes; consultation with relevant others; and encouraging the person to use existing skills as well as develop new skills.
Under the Act a number of public bodies are involved in the regulation and supervision of those authorised to make decisions on behalf of a person with incapacity, including the Office of the Public Guardian (Scotland), the Mental Welfare Commission for Scotland, the courts and local authorities.
The Office of the Public Guardian (Scotland) has produced Frequently Asked Questions in relation to the Power of Attorney and other issues related to the Public Guardian’s powers.
In September 2017, Ministers announced that a review of the scope of reform required to the Adults with Incapacity legislation would take place as part of the 2017-18 Programme for Government. However, following a consultation it was decided to proceed with a programme of non-legislative changes to practice and guidance. Incapacity legislation will be considered as part of a review of mental health legislation currently underway.
Health (Tobacco, Nicotine etc. and Care) (Scotland) Act
The Health (Tobacco, Nicotine etc. and Care) (Scotland) Bill was introduced to the Scottish Parliament on 4 June 2015 by the Cabinet Secretary for Health and Wellbeing and was passed by the Scottish Parliament on 3 March 2016.
Provisions in the Act include the following measures:
- Duty of Candour – The Act includes a duty of candour on health and social care organisations. This creates a legal requirement for health and social care organisations to inform people (or their carers/families) when they have been harmed as a result of the care or treatment they have received.
- Ill-treatment and wilful neglect – The Act establishes a new criminal offence of ill-treatment or wilful neglect which would apply to individual health and social care workers, managers and supervisors. The offence also applies to organisations.
Duty of Candour
Introduced by the Act above, the duty of candour is a legal requirement for health, care service and social work organisations to inform people (and their families) when they have been harmed (either physically or psychologically) as a result of the care or treatment they have received.
The Act describes the incidents which would give rise to duty of candour procedure and also states that a registered health professional must decide whether the incident resulted in a certain outcome, a list of which is also set out in the Act.
The duty of candour procedure, which covers actions to be taken by ‘responsible persons’, will be set out in regulations. However, the Bill sets out the actions the regulations may make provision about, including meeting with, apologising to and providing support to those involved, as well as providing support and training to those carrying out the procedure.
Among others, the term ‘responsible person’ covers Health Boards, local authorities or any other person (other than an individual) who provides a care service or a social work or health care service, or an an "individual who provides a care service and who employs, or has otherwise made arrangements with, other persons to assist with the provision of that service."
Ahead of the Act's implementation on 1 April 2018, the Scottish Government published guidance on the organisational duty of candour. The guidance focuses on the implementation of the new procedure for all organisations that provide health services, care services or social work services in Scotland. Following an unintended or unexpected incident, organisations are encouraged to follow the guidance in implementing the processes outlined, to help ensure consistency of approach and equity of response across organisations.
Offences of wilful neglect or ill-treatment
Part 3 of the Act establishes offences relating to the wilful neglect or ill-treatment of adults receiving health care or social care. There are two main offences in this part: an offence that applies to care workers, and an offence that applies to care providers.
'Care worker’ is defined as:
- an employee who provides adult health care or adult social care (as defined in the Public Services Reform (Scotland) Act 2010);
- a volunteer who provides adult health care or adult social care;
- an individual who supervises or manages employees or volunteers providing adult 30 health care or adult social care; or
- a director or similar officer of an organisation whose employees or volunteers provide adult health care or adult social care.
The offence is committed where a care worker is providing care for another person and ill-treats or wilfully neglects that person. If providing that care is only incidental to the worker‘s other activities (for example, where the worker is a cleaner) then such a person would not fall within the definition.
Domestic Abuse (Scotland) Act 2018
The Domestic Abuse (Scotland) Act 2018 creates an offence with respect to the engaging by a person in a course of behaviour which is abusive towards that person's partner or ex-partner.
The new law covers not only spouses, civil partners and cohabitants but also people in intimate personal relationships who do not live together.
As well as physical abuse, the Act covers other forms of psychological abuse and coercive and controlling behaviour that could not be easily prosecuted under previously existing law.
Disclosure (Scotland) Bill
A Bill designed to “deliver a range of positive and proportionate reforms to the disclosure regime in Scotland” has been introduced to Parliament by the Scottish Government. Key provisions in the proposed Disclosure (Scotland) Bill include:
- reducing four main levels of disclosure (basic, standard, enhanced and PVG) to two (Level 1 and Level 2), with the ten different types of disclosure certificate offered under the current structure reduced to four
- a mandatory PVG Scheme for people working with vulnerable groups
- replacing the concept of ‘doing regulated work’ with a list of core activities giving rise to ‘regulated roles’ that trigger mandatory PVG membership
- providing clarity on disclosure arrangements for individuals directly employing a PVG scheme member, e.g. personal care
- providing new referral powers for Police Scotland, councils and integration joint boards.
The Bill is currently being considered at Stage 1 by the Education and Skills Committee at the Scottish Parliament.
A library of publications by the Scottish Government and other national bodies setting out relevant policy developments or direction
A resource celebrating the amazing difference being around and caring for animals makes for many children and adults using a range of care services
The Health and Social Care Standards set out what we should expect when using health, social care or social work services in Scotland
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A weekly bulletin produced by our policy team providing an update on the key developments in adult social care and health