OG Status:

Fully open

Issue date

May 2012

Author Section:

DCE/OPSTD/Public Services Sector/Health and Social Care Team

Target audience:

FOD and LA Inspectors

Summary

The guidance updates FOD and Local Authority Inspectors on HSE’s national arrangements for liaison and coordination with large multi site independent companies providing social care and health services. It replaces SIMs 07/2004/11 and 07/2008/06, now withdrawn.

Introduction

The UK has many large, independent, multi site social care and health services companies. The largest of these organisations employ between 5000 and 30,000 people each, and provide services to a much larger number of residents, patients, and service users. With effective liaison arrangements, HSE can have a significant impact by;

• helping organisations secure and maintain good corporate management arrangements;
• discussing and taking forward important issues of national significance;
• monitoring performance standards and coordinating ongoing enforcement activity by HSE and LAs; and,
• where appropriate, effectively targeting resources if poor performance is identified.

Changes to some of these companies mean that existing arrangements for head office liaison require updating. HSE has also now agreed a Sector Intervention Plan for Social Care that endorses the role to be played by Lead Inspectors.

An up to date list of the largest multi site employers of social care and health services in GB for which HSE has the sole or lead enforcement responsibility is provided in SIM 07/2012/03 (closed). The list provides information on; the employer details, the number of employees; the number of homes/ sites, the nominated lead inspector; and the COIN numbers.

FOD should establish lead inspector arrangements for these dutyholders during 2012/13 in line with the expectations in the agreed Sector Intervention Plans.

Actions for the HSE lead inspector

The overall aim is to have a co-ordinated national approach to the company, and to maximise the efficient use of HSE resources in helping ensure that the company secures and maintains effective health and safety management arrangements. Lead Inspector relationships typically include:

• an initial meeting to give the organisation the opportunity to understand the scope of the lead inspector role and the benefits to them;
• an agreed plan to assess, influence and feedback on corporate health and safety performance, this could be done through:
  • engagement with the health, safety and risk manager, advisors and worker representatives;
  • annual meetings with senior managers / directors;
  • sight of health and safety strategies, plans, annual health and safety reports; and,
  • discussion about relevant data including reports of investigation and near misses, internal audit arrangements etc.
• keeping the company up to speed with relevant health and social care issues, including new guidance, safety alerts etc;
• activities by which the company can show leadership within the sector (eg by hosting SHADs locally for smaller, independent Homes);
• criteria and mechanisms for intervening with poorly performing sites;
• liaising with other relevant regulators, for example CQC and Monitor. This could include:
  • contacting the regulator best placed to deal with identified issues -for example, concerns about patient care.
  • sharing information where it is relevant to the regulators’ assessment of the organisations quality and safety performance.
• acting as central point of contact to exchange information with FOD and LA inspectors. This will encourage and facilitate better communications where there may be simultaneous interventions with an organisation; (Also see Primary Authority heading below)
• monitoring and maintaining accurate COIN records. See ‘Work Recording’

Action for HSE and LA inspectors

All inspectors are asked to provide the relevant Lead Inspector with information about significant interventions. In particular:

• fatal and major incident investigations;
• enforcement action and intended prosecution, with updates as appropriate;
• any issues arising from an intervention which may have national implications, e.g. poor manual handling training, lack of equipment maintenance or concerns over the general management of health and safety; and,
• significant liaison with other regulators about the organisation in question.

Background - LA Primary Authorities (PA) approach

The Primary Authority (PA) approach was introduced by the Local Better Regulation Office (LBRO) as a statutory scheme for businesses regulated by Local Authorities (LA’s) who trade across 2 or more LA boundaries.

The scheme is similar to HSE’s lead inspector scheme, in that it is designed to:

• support the improvement of dutyholder performance;
• encourage regulator consistency;
• allow consideration of wider context resulting in better informed enforcement decisions; and,
• allow intelligent targeting of resources and selection of the right interventions to secure compliance.

The PA scheme does not just cover health and safety regulation by LAs. A number of other regulatory categories are also within the scope covering a range of LA functions such as food safety and hygiene. More information about PA partnerships can be found on the LBRO website. Or contact the Local Authority Unit (LAU) at HSE.

Businesses with a PA partnership for health and safety are identified on COIN with details of the Primary Authority included in the profile information on the COIN client page. As at March 2012 none of the health and social care organisations identified in the Annex are included in a partnership scheme covering health and safety.

If a LA has set up arrangements outside the scope of the PA approach to act as a lead authority, and if HSE has some enforcement authority for that organisation, e.g. an organisation with 30 residential care homes and 5 nursing homes, then the LA is invited to inform HSE’s Health and Social Care Services Unit so that this information can be shared within HSE.

Work recording

Reporting should be through normal COIN arrangements.

The lead inspector should ensure COIN records are accurate for the organisation, and record central engagement meetings on a master case titled National Engagement / Lead inspector.

Further information / links

Guidance on health and safety risks in social care and health services can be found on the HSE health and social care website

Contact point(s) for further information

The Health and Social Care Unit would welcome any feedback about this approach or receive information on exceptionally good or poor practices. Please email publicservicessector@hse.gsi.gov.uk