The Draft Regulations for Providers of Home Support Services – The Required Approach for Compliance
Introduction
In June 2022, the Department for Health (DoH) released the Draft Regulations for Providers of Home Support Services. When enacted, these regulations shall support the establishment of a licensing system for providers of home support services by setting out the minimum licensing requirements. The purpose of the licensing system will be to ensure that home support services are of consistently high quality as well as to safeguard service-users.
In this blog we discuss what the regulatory model for Home Support Services might look like and detail some of the expected outputs HIQA may look for under the governance section of the regulations.
What can we expect the regulatory model to look like?
When the regulatory requirements are released, they will form one part of the broader regulatory framework model for home support services. Guidance documents will also be released from the DoH to provide guidance on the licence application processes, compliance, inspections and conditions for licence to be revoked.
HIQA will also release a set of National Standards to compliment the regulations. These will provide a set of high-level outcomes that describe how the services can achieve safe, quality, person centred care and support. It is also important for providers of home support services to be mindful that they will have to implement existing National Standards that are applicable to home support services, such as the National Standards for the prevention and control of infection in community services (2018), National Standards for Adult Safeguarding (2019) and the National Standards for the Conduct of Reviews of Patient Safety Incidents (2017).
Once these standards come into effect, HIQA will monitor and manage compliance with the regulatory requirements and standards.
Examples of compliance with the Draft Regulations for Providers of Home Support Services
Below are examples of outputs HIQA might look for when inspecting a home support service, in relation to Corporate Governance and Corporate Oversight.
Corporate Governance – 14. Management of the Service
(3) The service provider shall ensure that there is a clearly defined management structure that identifies lines of authority and accountability, and specific roles and responsibilities.
Expected Outputs
- Organisational Chart (with designates in place for all managerial roles)
- Comprehensive job descriptions for all roles, that include specific responsibilities as defined by the regulations
- Code of Conduct for professional services
- Terms of reference and agenda listings in place for all team and committees
- Minutes of team/committee meeting minutes, providing evidence of follow up.
- Training records available for staff in relevant roles, including management
Corporate Oversight – 21.Governance, Management and Quality Assurance
(5) The service provider shall have risk management policies and procedures in place which enable the effective identification of risks to the service provision, including escalating risks, and shall ensure that he or she is able effectively to respond to identified risks.
Expected Outputs
- Documented, comprehensive and effective Risk Management Policy and Procedure
- Roles and responsibilities for individuals/teams regarding risk management and ongoing review defined and documented.
- Defined, up to date risk registers, identifying risks associated with:
- Corporate Governance
- Service Provision
- Health and Safety
- Process for individual risk management of service users
- Defined process for the documentation and escalation of risk to management for all staff.
- Full training completed with relevant staff on the risk management processes.
Corporate Oversight – 21. Governance, Management and Quality Assurance
(1) The service provider shall establish procedures for quality assurance for the purposes of establishing and maintaining the quality of services provided.
Expected Outputs
- Policies and procedures that are reflective of requirements, best practice and actual practice and assure consistent provision of services.
- Appropriate training programme in place to ensure staff competency.
- Processes to review and monitoring of the care provided to service users, including:
- Service User records
- Supervision of care provided
- Service User / support person feedback
- Appropriate teams and committees in place to provide overview of the service provided
- Comprehensive, documented audit process
- Address ALL aspects of the service’s compliance to the Regulations AND to its own internal policies and procedures
- Drives effective action to address the non-conformances identified during audit
- Trained, competent auditors with the appropriate skill to lead effective audit practice
- Process for monitoring of complaints, incidents, risk hazards, to identify trends that may affect the quality and safety of the service provided.
- Appropriate Key Performance Indicators identified across the service to benchmark performance
Corporate Oversight – 21. Governance, Management and Quality Assurance
(2) The service provider shall establish a system for continuous quality-improvement which shall be underpinned by relevant HIQA national standards.
Expected Outputs
- Quality Improvement Project processes, i.e., a process that identifies specific projects to drive improvement within the service based on:
- best practice / guidance
- audit/inspection findings (internal and external)
- staff/service user/support person feedback.
- Defined process to support learning by staff in response to internal and external incidents / complaint.
Corporate Governance – 14. Management of the Service
(1) The service provider shall have in place system and processes to ensure compliance with these regulations.
Expected Outputs
- Defined, comprehensive and compliant Policies and Procedures
- Effective audit module that incorporates the review of all policies and procedures as well as all requirements
- Annual review of the quality and safety of service being provided (as per the regulations)
- Roles and responsibilities of staff reflective of compliance requirements
What to do next to prepare for statutory licensing?
The next step is to benchmark your service against the Draft Regulations. This can be done by completing a Gap Analysis of your service against the Draft Regulations for Providers of Home Support Services. This assessment will help you understand your current position, how your services processes currently stack up against what is required, and it will give you a detailed understanding on whether your processes are comprehensive, if they are effective and if they are person centred.
Once you know the gap between current practice and required practice, a plan for compliance can be developed. This may require the development of new processes or the update of current models.
How can HCI help?
HCI has been working with health and social care organisations over 17 years, supporting them in building Quality and Safety Management Systems that fulfil regulatory requirements and drive improvement in their services. We are currently working with a number of Home Support organisations to conduct Gap Analysis against the Draft Regulations for Providers of Home Support Services. We use our knowledge and understanding of HIQAs approach to develop a comprehensive report that will detail areas of good practice and areas of non-compliance against the Draft Regulations. This report can be used to support the development of a compliance plan that will put you in a good position as you move forward within the regulatory framework model.