- Introduction
1.1 Law drafting is required to develop definitions of health and social care services to be included as regulated activities under Schedule 1 of the Regulation of Care (Jersey) Law 2014 (the “2014 Law”).
1.2 The 2014 Law provides a legislative framework for the independent regulation of health and social care in Jersey. It is underpinned by a series of Regulations, covering each regulated activity listed under the law.
1.3 The 2014 Law established the independent Jersey Care Commission. Regulations providing for the regulation of domiciliary care, adult day care and care home services, including children’s residential homes, were adopted by the States Assembly in October 2018 and came into force on 1st January 2019.
1.4 Once new regulated activities have been defined, Regulations will be introduced in stages between 2020 and 2025 so that, by the end of the period, each service will be subject to relevant statutory regulatory controls. These services have been grouped into six broad categories:
1.5 There are practical reasons for introducing the Regulations in phases over several years. This is to allow the Care Commission to gradually adapt and to prepare for the significant increases in its workload over a reasonable period.
1.6 These law drafting instructions are limited to the first category of regulated activities – children’s social services and CAMHS. Recommendation 3 of the Independent Jersey Care Inquiry (IJCI) Report of July 2017 stated that the independent regulation and inspection of children’s environments should be introduced, while the Inquiry’s follow-up Report, published in September 2019, stated that statutory inspection of the Government of Jersey’s Children’s Service should happen as soon as possible. This is the Government’s intention.
1.7 Policy officers have determined the regulated activities which should be subject to regulation and inspection within this category. Set out below are details of these services, which the Legislative Drafting Office (LDO) is requested to define for inclusion under Schedule 1 of the 2014 Law.
- Law Drafting Instructions
2.1 Within the category covering children’s social services and CAMHS, there are ten separate regulated activities to be defined. They have been separated into these categories because it has been determined that each is a distinct service which should be regulated separately.
2.2 The eight services to be defined include:
- adoption services;
- fostering services;
- social work services for children and young persons;
- a child contact centre;
- a residential family centre;
- CAMHS;
- a special school; and
- children and family community nursing services.
- Adoption Services
3.1 The intention is to capture all adoption services provided by the Government of Jersey as well as those services which may be operated by adoption agencies or even carried on by individuals. The following captures the essence of the services the Government intends to regulate:
An “adoption service” is a service which is maintained by the Minister under Article 2 of the Adoption (Jersey) Law 1961; or is provided by a person other than the Minister and which consists of, or includes, the making of arrangements for or in connection with the adoption of children (whether the person functions generally or in relation to some service maintained, or to be maintained, as part of the Adoption Service).
3.2 The language used above is largely based on Section 2(11) of the Regulation of Care (Scotland) Act 2001.
3.3 While it is currently the case that the Fostering and Adoption Service is responsible for all adoption services, it is important to ‘futureproof’ the definition and ensure that any other provider of adoption services will have to register and can be properly regulated. Examples of potential providers of adoption services are charities and religious groups.
- Fostering Services
4.1 The intention is to capture all fostering services provided by the Government of Jersey and the role of its employees in making fostering arrangements. The following captures the essence of the services the Government intends to regulate:
A “fostering service” is a service which is provided by the Minister under Article 20(1)(a) Children (Jersey) Law 2002 (the “2002 Law”); and the functions exercised by the Minister or any fostering arrangements made as part social work service for children and young persons in relation to privately fostered children under Part 8 of the 2002 Law.
“Social work service for children and young people” is discussed in section 5, below.
4.2 The language used above is largely based on Section 2(14) of the Regulation of Care (Scotland) Act 2001.
4.3 Part 8 of the 2002 Law covers private fostering. The Children’s Service have stated that, in practice, this is used – in the absence of other statutory provisions – as a mechanism through which they are able to deliver assistance to children in need. However, regardless of the use that is made of the law, the fact that Part 8 of the 2002 Law includes functions in relation to fostering means this cannot be excluded from the definition.
- Social Work Services for Children and Young Persons
5.1 The intention is to capture all social work services provided mainly but not entirely by the Government of Jersey for children and young people – apart from those social work services provided in connection with adoption or fostering. The following captures the essence of the services the Government intends to regulate:
A “social work service for children and young people” is a service provided by a social worker or a person under the supervision of a social worker which includes the assessment of a person’s social care needs and providing, arranging or making referrals to services that meet those assessed needs. This only includes all such services provided to children and young people up to the age of 18 or those aged between 18 and 25 who received this service before the age of 18 and for whom there is ongoing provision of this service after the age of 18.
This includes:
- Assessments for the purpose of children, young people or their families receiving financial support; or
- Arrangements for safeguarding children and young people at risk of harm; or
- Health care assessments carried out by a registered health care professional or medical practitioner (under the Health Care (Registration) (Jersey) Law 1995 or Medical Practitioner (Registration) (Jersey) Law 1961) employed or contracted by the Minister as part of this social work service; or
- Services related to functions of the Minister under relevant legislation
- Arrangements for independently monitoring any safeguarding or child protection arrangements made by the Minister under the enactments above (functions of Independent Reviewing Officers)
This does not include health care assessments and health services.
“Social worker” means individuals registered as such under the Health Care (Registration) (Jersey) Law 1995.
“Social care” is defined under Article 1(1) of the 2014 Law.
Revisions to the definition of “health care” under the 2014 Law are requested in section 13, below.
5.2 While the primary purpose is to regulate the Children’s Service, it is important that social work services which may be provided to children by companies and the third sector are also encompassed in the definition. The definition should capture services which are delivered by or through a registered social worker. This means that work done by professionals such as family support workers, as part of a social work service, should be encompassed.
5.3 It is acknowledged that the Children’s Service only has a statutory duty to provide services to children up to 18 years of age. However, if there are cases when services are provided to young people over the age of 18 – either on a non-statutory basis or in future, on a statutory basis – it is important that the Care Commission has the power to regulate these services. The Care Commission must be able to regulate all services provided – not just statutory services and those which are currently provided under legislation. Legislation will change, and it is important to ensure the definition captures services provided, for example, to care leavers which are likely to be provided for in statute at some stage in the future. For these reasons, the definition should cover services provided in the age range as set out above.
5.4 In general, health care assessments and general health care services are excluded. However, a health care assessment, performed as part of a social work service, should be encompassed within this service definition – ostensibly, health care assessments for looked after children. This is because the Children’s Service must undertake these assessments – it is a core service.
5.5 The legislative provisions – Articles 9(1)(b), 26, 27, 29, 36(8), 42 and Part 3 of the 2002 Law – have been included because these are statutory services provided by the Minister for Children and Housing. There may be other statutory services which could be included in the definition. Equally, the LDO may deem it unnecessary to include any reference to statutory enactments in the definition. These have been provided to assist.
- Child Contact Centre
6.1 The following captures the essence of a child contact centre:
A “child contact centre” is a service which is provided for the purpose of facilitating contact between children and parents who do not reside with them or other persons connected with the child who do not reside with them.
6.2 The primary service it is intended to regulate is Milli’s Child Contact Centre.[1] The definition should encompass the specific services offered by the Centre. It should be sufficiently narrow only to include this type of service, but it should not be exclusive. Other child contact centres – or places which provide this service and are not referred to as contact centres – may exist or may be established in future. The Care Commission must be able to regulate all such services under this category.
- Residential Family Centre
7.1 The following captures the essence of the services the Government intends to regulate:
“Residential family centre” means any establishment at which accommodation is provided for children and their parents; the parents' capacity to respond to the children’s needs and to safeguard their welfare is monitored or assessed; and the parents are given such advice, guidance or counselling as is considered necessary.
“Parent”, in relation to a child, includes any person who is looking after them. This does not include services to parents and their children where the service provider does not have responsibility for the care of the child.
The does not include the provision of a care home service under Schedule 1(1) of the 2014 Law.
7.2 The language used above is largely based on Section 4(2) of the Care Standards Act 2000. Residential family centres do not currently operate in Jersey, but it is important to be able to regulate them, should any be established in future. In discussions with the Children’s Service it was noted that such a service may well be established in future as the range of services it provides grows and develops. This is a well-established provision in other jurisdictions.
7.3 This definition does not encompass services aimed at parents – such as a women’s refuge. A women’s refuge and similar residential services are different to a residential family centre because it is the parent who is primarily in receipt of the service. In these cases, a parent and child may be present in the refuge, but the parent retains responsibility for the child. In effect this is a service provided for adults which is why it should not be included.
- Child and Adolescent Mental Health Services (CAMHS)
8.1 The intention is to encompass those services which are currently delivered (and which are likely to continue to be delivered) by CAMHS[2]:
“Child and adolescent mental health services (CAMHS)” means non-residential mental health or psychological assessment, diagnosis and treatment services for children and young people up to the age of 18 or to those aged between 18 and 25 who received these services before the age of 18 and for whom there is ongoing provision of treatment for mental health or psychological conditions after the age of 18 and where they have not been referred into an adult mental health service. This includes services for the family of a child or young person in connection with that child or a young person’s mental health condition. This only includes services provided in the community and does not include inpatient mental health services.
8.2 The intention is not to include inpatient children’s mental health services and outpatient services delivered to over 18s in this definition. Children treated as inpatients for mental health conditions at Robin Ward in the General Hospital, at Orchard House or any place of safety will be covered under hospital service regulations. Hospital services will be defined
8.3 CAMHS does not provide services to those over the age of 18 but, in case it does in the future, the age range should be extended to include young people up to 25 where the provision of the service is ongoing and where there has not been a specific referral to an adult mental health service. The reason for this is the same as that set out in paragraph 5.3, above.
- Special School
9.1 The intention is to regulate the health and social care aspects of – specifically – special schools:
A “special school” is a school which provides a specialist service to children and young people up to the age of 18 who require the provision of nursing care and/or personal care in addition to special educational provision.
“School” is defined as any institution providing full or part-time education under the Education (Jersey) Law 1999.
“Nursing care” and “personal care” are defined under Article 1(1) of the 2014 Law.
“Special educational provision” is defined under Article 4(4) Education (Jersey) Law 1999.
This does not include a “children and family community nursing service” which is set out in section 11, below.
9.2 It is intended to capture the health and personal care services provided at Mont a l'Abbe School[3]. It is not intended to capture, in this definition, specialist centres within mainstream schools or the provision of special education services per se.
9.3 Article 2(3) of the 2014 Law is clear that regulated activities under Schedule 1 must involve or be connected with the provision of health and social care. The 2014 Law does not currently provide the power to regulate education services. However, the provision of nursing care and/or personal care in an education setting should be regulated under the Law.
9.4 The Regulations will, in due course, make clear that regulation and inspection of special schools will only cover the health and welfare aspects of the services provided in a special school.
- Children and Family Community Nursing Services
10.1 The following captures the essence of the services the Government intends to regulate:
A “children and family community nursing service” means nursing care or social care services provided to children and young people up to the age of 18 by or under the supervision of a specialist community public health nurse or a nurse:
- to children and their families in a community setting, their own homes; or
- as part of a school nursing service.
This does not include special schools (details on which are set out in section 10, above).
“Specialist community public health nurse” and “nurse” means an individual registered as such under the Health Care (Registration) (Jersey) Law 1995.
“Nursing care” and “social care” are defined under Article 1(1) of the 2014 Law.
10.2 Ostensibly this definition should cover baby clinics, health visiting services and school nursing services – other than those delivered in a special school. These services are generally delivered by the charity Family Nursing & Home Care.
- Consequential Amendments
11.1 Under Article 1(1) of the 2014 Law “social care”:
“includes all forms of personal care and other practical assistance, and all forms of personal support, provided for individuals who, by reason of their age, illness, disability, pregnancy, childbirth, dependence on alcohol or drugs, or by any other reason, are in need of such care, assistance or support.”
11.2 This definition should be modified so that it includes social work services. The interpretation of social work services is a service provided by or under the direction of a social worker that includes but which is not limited to the assessment of need and safeguarding individuals from risk of harm.
11.3 Mental ill health should be encapsulated within this definition as well. It may be that this could already be covered by “illness.” Whether an explicit reference to mental ill health is required is subject to LDO advice.
11.4 Schedule 1(2) of the 2014 Law should be amended to exclude a service regulated under the “children and family community nursing service” from the existing definition of a “home care service.” This is in order to regulate all of the functions of the Family Nursing and Home Care charity which are provided for children under a single regulated activity – the children and family community nursing service.
- Commencement
12.1 The Regulations should come into force 7 days after they are made.
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