Care Inpectorate

Child Care or Caring About Children?

Stephen Richard — Mon, 06 Sep 2021 06:40:12 +0000

Child Care or Caring About Children?

Primary Author or Creator

Marion Macleod

Stephen Richard Mon, 09/06/2021 - 07:40

Additional Author(s) / Creators

Common Weal

Date Published

Sun, 09/05/2021 - 12:00

Category

Social welfare

Women

Type of Resource

Policy Paper

Fast Facts

Few in politics and in government now dispute the central importance of getting support for children in their early years right if we want to create a wellbeing economy with healthy and productive citizens in the future. But, in reality, Scotland has a system of support for children in their early years which is a patchwork of initiatives, fixes, legacy services and omissions. What we do not have is a single, well thought- through integrated service. This is what Scotland’s children need. This report will highlight the problems in the system as it is and propose how they can be fixed and a comprehensive, integrated system introduced as part of a comprehensive, all-ages National Care Service.

More details

Get the policy context right

― Children’s right to a good start in life should be at the heart of policy with clear and specific entitlements reflecting the articles of the UN Convention on the Rights of the Child

― Optimal child health and development should be the clear purpose of early years service provision – getting parents back to work is secondary

― Integrate governance and delivery of all early years provision from a single department or body at national level holding overall responsibility to holistic centres in all communities through local authorities

― Adapt the European social pedagogy degree for Scotland and incorporate its principles into work with young children and their families

― Upskill the entire early years workforce to degree-level qualification as there is a strong correlation between staff skill and children’s outcomes

― Emphasise secure attachment to primary care giver as central to everything the service does

― Introduce parenting and child development as a part of social education in all schools.

Ante-natal

― Invest in preconception health, education, counselling and care for all prospective parents

― Monitor family provision from first contact to make sure the home context is provided with the resources and support necessary to promote a child’s healthy development and learning

― Focus contact on relationship-building and trust not compliance and enforcement, with a single consistent point of contact throughout the early years

― Establish holistic and integrated family support centres in all communities, providing early education and care, child health advice and support, parent learning and opportunities for play and creativity

― Create residential support centres pre-birth for families with chaotic home lives, providing both stability, wellbeing support and training

― Focus on the rights of the child to a good and equitable early life experience and the role of parents as the primary protectors and safeguarders of these rights

― Ensure a generous parental leave option in both time and money

― Stress the importance of the father’s involvement and make that possible with equitable treatment.

Post-Natal

― Create an integrated system of financial social protection and high quality support services for parents and make sure this service means there are no essentials poor families cannot afford

― Services must be inclusive of all children with additional support needs of any kind

― Focus services on strengthening families so children are only taken into care as a last resort; investment in stabilising home life is more effective and sustainable

― Where taking a child into care is unavoidable minimise the disruption to that child, make the experience consistent and stable and work intensively to improve the home environment so the child can return quickly and successfully

Early Childhood

― All children and parents should have the right to early childhood education and care (ECEC), on up to a full-time basis, from the end of the period of parental leave entitlement, or earlier if family circumstances require this

― Both high quality family based care and group care should be provided; promoting attachment and resilience should be the foundation of any ECEC service and this in turn should provide the foundation for a new National Care Service

― Subsidise ECEC and make the cost to parents income related, with a maximum total cost for any family and free provision for those on the lowest incomes

― The public sector must be the primary provider and outsourcing must only happen where other providers can demonstrate the same quality and effectiveness (including future attainment, confidence, risk management, resilience, pro-social behaviour, cooperation and emotional health)

Kindergarden

― From age three, establish a kindergarten stage which emphasises play, creativity, exploration and social interaction, not formal attainment

― Children should remain in kindergarten until aged seven and commence formal education then; the school starting age should be changed to reflect this, in line with international evidence

Keywords

Convention on the Rights of the Child

Children

Child care

National Child Care Service

Language English

The Predictable Crisis

Stephen Richard — Sat, 04 Sep 2021 11:29:15 +0000

The Predictable Crisis

Primary Author or Creator

Nick Kempe

Stephen Richard Sat, 09/04/2021 - 12:29

Additional Author(s) / Creators

Common Weal

Date Published

Wed, 05/20/2020 - 12:00

Category

Health

Type of Resource

Policy Paper

Fast Facts

Common Weal investigates the impact of Covid-19 in Scottish Care homes and finds that the warnings about the weaknesses in pandemic preparation were repeatedly ignored with the result of causing “The single greatest failure in devolved government since the creation of the Scottish Parliament”

More details

― Based on quality ratings at the outset of the crisis more than one quarter of Scotland’s care homes (those rated adequate or below) could have been expected to be unable properly to protect older people in the event of a pandemic.

― The Care Inspectorate does a professional job but has few enforcement powers and works inside a regulatory regime which is very limited in scope. As an example, in February they simply did not have the power to do what has now (eventually) been done at the Home Farm Care Home on Skye. The Care Inspectorate was incapable of brining Care Homes up to the standard required by the Covid crisis and poor quality care is embedded in the system.

― The result is that six out of ten care homes in Scotland have had a case of Covid and about 45 per cent still have a current case (as of Monday 18 May) – plus 7.4 per cent of care home staff have been absent with Covid compared to just 4.0 per cent of NHS staff

― All of what has resulted was accurately predicted in 2016 but calls to prepare were ignored. In particular there has been a continuing decline in trained medical staff and a rise in unfilled nursing vacancies (52 per cent of private sector Care Homes have nursing vacancies, compared to 15 per cent in the voluntary sector). There is no formal training for Infection Control for non-medical staff in Care Homes in the care SVQ.

― In 1993 the Community Care Act transferred responsibility for providing nursing care for Older People from the NHS to the private sector and for the first eight weeks of the crisis the Scottish Government was adamant that the the Providers (and not the Scottish Government) was responsible for protecting care home residents – until a mid-May U-turn. This effectively represented the privatisation of the responsibility for Older People in Care during the crisis and had the later U-turn been made at the
beginning many lives would have been saved.

― This meant that medical treatments which could have been delivered in Care Homes (such as the provision of oxygen) were not supported by the Scottish Government who left treatment to the discretion of private companies geared around property finance. In addition the nature of the deaths of Care Home residents was not taken to be a government responsibility and so the use of palliative measures (to make deaths as comfortable as possible) was also left to Providers. This almost certainly means many old people faced an absolutely unnecessarily uncomfortable and painful death. Health staff were not instructed to take the clinical lead in Care Homes until 17 May.

― In addition the mental wellbeing of residents was not made a priority, with people being locked in rooms alone for indefinite periods (as a result of Scottish Government advice), with some being told or knowing that they would be likely to die before seeing family members again. A Human Rights approach was not taken, and while individual Care Homes and staff will have done the best they can, no guidance on quality of life was provided.

― But the repeated updating of guidelines and the urgent steps taken to remove traces of the preceding guideline created a confusing impact – between 10 May (when revised guidelines issued two days earlier were withdrawn) and 15 May (when new revised guidelines were issued) there were no official Scottish Government guidelines at all.

― Private operators have extracted tens of millions of pounds of public money dedicated to care as private profit – and even more has been extracted by ‘flipping’ property which is effectively paid for by the public (the biggest profits in the care sector come from property and not from providing care).

― This is all exacerbated not only by the power of private providers and the way they have influenced the decision-making of successive Scottish Governments but also by prevailing management culture which, by emphasising ‘partnership working’, make criticism of the system almost impossible.

Resource Address (URL)

https://commonweal.scot/wp-content/uploads/2020/05/Predictable-Crisis.pdf

Keywords

Language English