OG Status:

Partially Open

Author Section:

Public Services Sector – Health & Social Care Services Unit

Target Audience

Local Authority Health and Safety Enforcement Managers and Health and Safety Regulators

Summary

This revised SIM updates the national arrangements for liaison and coordination of large independent corporate care providers in England, Wales and Scotland as described in Public Services Sector SIM 07/2008/02.

Background

1  Over the last few years, a small number of corporate social care providers have significantly grown in size with many having premises located throughout the UK.  With the exception of BUPA, no central approaches had been made.  In order to engage more effectively with these providers, FOD were asked to establish lead PI/Inspector arrangements with a selection of them.  During the 2008/09 work year FOD set up 6 nominated lead Inspectors for corporate care providers and their details are contained in Annex A, along with the completed proforma outlining the approach to be taken.

Nature of the problem

2  Several large corporate social care providers have had interventions by HSE and or LAs simultaneously across the UK. In the absence of formal national lead PI arrangements, it has been difficult to monitor and coordinate ongoing enforcement activities and take forward issues with national significance. Moreover, it has been difficult to assess and measure the corporate health and safety management arrangements of these large corporate social care providers.

3  Due to the diversity of the corporate providers it has not been possible to extract accurate RIDDOR data. Therefore the table below details the number of injuries to members of the public and employees involved in all care home activities as reported by RIDDOR to all enforcing authorities:

	2006/07				2007/08p
	Fatal	Major	Over 3 day	Total	Fatal	Major	Over 3 day	Total
Employee	-	724	3757	4481	2	738	3763	4503
Member of Public	19	992	-	1011	15	1034	-	1049

4  In 2007/08 the most prevalent causes of injury to employees were attributable to handling (32%), physical assault (24%) and slips and trip (23%).  The most prevalent major injury to the public arose from slips, and trips and falls. The causes of the 15 fatal injuries were varied and arose from slips, trips and falls, drowning, asphyxiation, and contact with harmful substances.

5  Each year a number of investigations are undertaken and several result in prosecutions, for example:

• BUPA Care Homes (CFC Homes) Ltd were fined £23,000 and ordered to pay costs of £12,607 for failing  to implement their national bed rail policy, resulting in poor risk assessments, inadequate staff training and unsuitable bed rails being used at one of their care homes (February 2007)
• Southern Cross Care Homes Ltd were fined £70,000 and ordered to pay costs of £10,103 following the death of a service user who was left unattended and was subsequently strangulated by the lap belt restraint on a reclining chair (November 2007).

Lead PI approach

6  Annex A provides a list of the largest corporate providers of social care in the UK with information on:  the number of employees, the services provided and contact details (broken down into HSE divisions and based on information current at the time of production) and the lead inspectors currently nominated.  The headquarters of the largest providers are all located in England, but for completeness, the largest providers have been included for Scotland and Wales.  FOD are asked to continue with this work  during the 2009/10 work year and where resources permit  provide lead PI arrangements for  additional corporate care providers.

7  The arrangements for establishing the lead PI role are within the discretion of the divisions but should be focused on delivering the following outcomes

• the company has the opportunity to meet the lead PI and understands the scope of that role with relation to their own company;
• HSE and LA Inspectors have a point of contact to exchange information about their respective interventions. This will encourage and facilitate better communications where there may be simultaneous interventions with a provider.
• dialogue is initiated with the CSCI Provider Relationship Manager (PRM) (through the local CSCI contact) with responsibility for the corporate care provider to allow for the exchange of information as necessary.  An explanation of their role can be found in the Working Arrangements Protocol between CSCI, HSE and LACORS (signed in November 2008) and is available on the PSP communities web pages.  Each PRM publishes an annual performance report for their respective corporate care providers.  These are available on CSCI website.

8  Divisions may also decide to undertake a programme of local inspections to establish how well the company is currently managing health and safety and in particular the risks arising from, MSD, slips and trips and challenging behaviour. Key risks affecting service users continue to be falls from windows, hot water, hot surfaces and bed rails. Guidance on these issues can be found in the references at paragraph 14. Strategic Partnership managers should be notified of any local intervention plan as many premises owned by the company will be LA enforced for the purposes of HSWA.

9 Where inspections are undertaken please also refer to the instruction entitled ‘Health and safety in care homes’ SIM 07/2009/03.

Action for Lead PIs

10  For this approach to be effective, any additional lead PI arrangements will need to be communicated to FOD and LA inspectors.  In order to facilitate this Lead PIs are asked to complete the proforma at Annex B and return to the publicservicessector@hse.gsi.gov.uk email account.

11  The completed proformas will then be published on the Public Sector on-line Community Site and the extranet (for LAs) along with a revised Annex A which will include contact details of the lead PI.

Action for HSE and LA inspectors

12  All inspectors are asked to provide the lead PI with:

• early notice of any significant intervention activity. In particular fatal, major accident investigation, or intended prosecution with updates as appropriate;
• outcome of any prosecutions/and or inquests;
• copies of enforcement notices, letters etc;
• issues arising from an intervention which may have national implications e.g. poor manual handling training, lack of equipment maintenance etc.

Diversity

13 Inspectors should be aware of who (in terms of diversity e.g. men, women, disabled etc) is the target group in the sector they are dealing with. Give consideration to, and factor into the approach, any issues that may surround this audience such as literacy issues, English as a second language and disability (access needs).

The Diversity pages give more information on these areas.

Feedback

14  The sector would welcome any feedback about this approach.  Please email publicservicessector@hse.gsi.gov.uk with the details.

Further information

15 Guidance on the key causes of accidents to service users can be found in:

• SIM 07/2007/09 – Burning risks from hot surfaced in health and social care
• SIM 07/2007/08 – Scalding risks from hot water in health and social care
• SIM 07/2007/07 – Falls from windows in health and social care
• SIM 07/2007/06 – Bed rail risk management

16  Guidance on these and other health and safety risks can be found in the HSE publication ‘Health and Safety in Care Homes (HSG 220).

Annex A – Corporate Social Care Provider List  (FOI qualified exemption under section 30)

(FOI qualified exemption under section 30)

Annex B - National Leads for Corporate Care providers proforma

Name of Corporate Care Provider organisation
FOD Region & Office
Lead PI inspector / Contact
Approximate timing of first contact
Proposed approach (please provide details or alternatively attach any plans produced for local planning purposes)
Structure of organisation. When available, provide details on the structure of company to assist with COIN records

Please return by email to publicservicessector@hse.gsi.gov.uk.