Residential and Nursing Homes: Accessing Length of Stay Records
This report supports the Ministerial Decision requesting access to data held in records maintained by registered care homes in Jersey. This data includes information on the length of stay of care home residents. These records are required to be kept under the Nursing and Residential Homes (Jersey) Law 1994.
Background
Modelling work is currently under way on a proposed long-term care benefit scheme, for implementation in Jersey in 2014. A key requirement is to know how long individuals remain in care in Jersey. This is essential to understand the financial implications of the scheme in terms of the cost and the contributions required to fund it.
Information on length of stay and age of admission in Jersey is available through the records that registered homes in Jersey are required to keep as part of the Health & Social Services, Public Health Department’s registration and inspection regime.
The Nursing and Residential Homes (Jersey) Law 1994 requires Nursing and Residential homes in Jersey to keep “records and notices in respect of persons received into such homes” (15(2)f). These records are specified in more detail in Orders (Appendix A: Excerpt from Residential Homes (General Provisions) (Jersey) Order 1995 and Appendix B: Excerpt from Nursing Homes and Mental Nursing Homes (General Provisions) (Jersey) Order 1995).
The Social Security Department has already made efforts to obtain length of stay and age of admission information to inform policy decisions:
(a). Data on length of stay for BUPA care homes[1] in the UK; however, while very useful as an indicative measure, this data is not Jersey-specific;
(b). While the Social Security Department could use its own information on individuals in receipt of financial support through the Income Support Residential Care scheme, this scheme has not been running long enough to make accurate assumptions based on this data and does not take into account those individuals who do not currently require financial assistance; and
(c). In September 2012, the Social Security Department conducted a census of care homes which holds information on length of stay and age of admission; however, this data is only a snap-shot of length of stay and is skewed to only reflect those residents who are in receipt of care at a particular point in time – on the date of the census.
In order to make informed policy decisions regarding the long-term care benefit scheme, there is a need for Jersey-specific data. This data exists and should not be overlooked. The new scheme is likely to involve contributions from the majority of the island’s population and it is imperative therefore that the basis for the funding arrangements is correct: hence the need for this highly relevant local information.
The Social Security Department has no statutory basis on which to ask for the information or require the care homes to provide it. By documenting the need for the information and providing the assurances of confidentiality within this document, the Minister is asking the care homes to support releasing the information contained within these to nominated Social Security staff.
The records themselves contain sensitive personal data (e.g. religion and health information) and access to this information will:
(a). require the Social Security Staff to view data that is not relevant to determining length of stay and age of admission; and
(b). to view information that ‘current’ residents may not wish to be known (i.e. medical conditions)
Therefore, the data needs to be treated as Schedule 3 (sensitive data) as defined in the Data Protection (Jersey) Law 2005 (Appendix C: Excerpt Data Protection (Jersey) Law 2005, Part 1, Article 2).As such, to process personal data, the Social Security Department must:
(a). satisfy both Schedule 2 (Article 5) and Schedule 3 (Article 7) (Appendix D: Excerpt Data Protection (Jersey) Law 2005 Schedule 2 (Article 5) and Schedule 3 (Article 7)) to ensure there is a public need for this information; and
(b). ensure that the processes of obtaining this data comply with Schedule 3 (Article 8) (Appendix E: Excerpt Data Protection (Jersey) Law 2005, Schedule 3 (Article 8)) and that the nominated individuals collecting this data and completing the analysis will apply the same confidentiality/standards as if they were accessing as a health care professional.
Decision
A Ministerial Decision to request access to these records has been made because:
(a). there is a public need for this information to inform important policy decisions for the long-term care benefit scheme in Jersey;
(b). it will provide assurance to the care homes and Data Protection Commissioner (DPC):
- that the data gathered will only be used for the purpose of determining length of stay and age of admission in care homes as it relates to policy decisions that inform the implementation of Long-Term Care (Jersey) Law and as it relates to the Income Support Residential Care scheme; and
- during the data collection and analysis process:
- all data will be kept securely
- treated with complete privacy and confidentiality
- any data used for analysis will be anonymous, kept securely and the privacy and confidentiality of the information will be maintained.
It is the intention that under the Long-Term Care (Jersey) Law there will be a statutory basis to request such anonymous information from the care homes in Jersey, including length of stay and age of admission, to inform and allow the States to review/consider the full impact of changes to any policy that affects the long-term care scheme.
Data Protection
The Social Security Department will nominate two members of staff to obtain this data from the care homes.
This will:
(a). prevent placing an unnecessary administrative burden on the care homes; and
(b). ensure a level of accuracy and consistency in data collection.
The nominated individuals from the department have already:
(a). sworn an Oath of Secrecy in the Royal Court;
(b). signed an Acceptable Use of Information Systems and Technology agreement (Appendix F: Staff Documents); and
(c). completed the department’s data protection training course (Appendix F: Staff Documents).
The nominated individuals will adhere to all the requirements of data protection.
Data Collection & Analysis
The nominated Social Security staff will arrange appointments with the care homes to obtain access to the records.
The following pieces of data associated only with those records of individuals who have died will be collected from the records and kept in an electronic template (Staff Certificates Appendix G: Data Collection Template):
- Last Name (for those transferring to a Nursing Home)
- Gender
- Date of Birth
- Date of Admission
- Date of Death
- Date of Transfer (if applicable)
- Name of home transferred to (if applicable)
At any point, the care home manager or nominated member of staff may view or receive a copy of the data extracted from the records held by their home.
The last name of any resident who has transferred will be kept temporarily to enable ‘tracking’ of any residents who have moved from a residential home to a separate nursing home. All last names will be removed prior to any analysis being completed.
Once completed, care homes (through the Jersey Care Federation) will be sent a copy of the analysis based on length of stay.
Financial and Manpower Implications
The proposed data collection and analysis has no financial or manpower implications for either the Social Security Department or the care homes themselves.
Appendix A: Excerpt from Residential Homes (General Provisions) (Jersey) Order 1995
Residential Homes (General Provisions) (Jersey) Order 1995, Schedule 2, Article 6
A daily register of all residents (excluding persons registered or persons employed at the home and their relatives) which register shall, where applicable, include in respect of each resident, the following particulars
(a) the name, address, date of birth and marital status of the resident and whether he or she is the subject of any court order or other process
(c) the date on which the resident entered the home
(d) the date on which the resident left the home
(e) if the resident is transferred to a hospital or nursing home, the date of, and reasons for, the transfer and the name of the hospital or nursing home to which the resident is transferred
(f) if the resident died in the home, the date, time and cause of death
Nursing Homes and Mental Nursing Homes (General Provisions) (Jersey) Order 1995, Schedule 2, Part 1
Particulars to be included in the Register of Patients:
1. the name, address, date of birth and marital status of each patient
7. the date on which the patient entered the home
8. if the patient has left the home, the date on which he or she left it
10. if the patient died in the home, the date, time and cause of death
Sensitive personal data
In this Law “sensitive personal data” means, in relation to a data subject, personal data consisting of information as to:
(a) the racial or ethnic origin of the data subject;
(b) the political opinions of the data subject;
(c) the data subject’s religious beliefs or other beliefs of a similar nature;
(d) whether the data subject is a member of a trade union;
(e) the data subject’s physical or mental health or condition;
(f) the data subject’s sexual life;
(g) the data subject’s commission, or alleged commission, of any offence; or
(h) any proceedings for any offence committed, or alleged to have been committed, by the data subject, the disposal of any such proceedings or any sentence of a court in any such proceedings.
Schedule 2 – First Principle: Conditions for Processing of any Personal Data (5), Processing necessary for exercise of public functions:
The processing is necessary for –
- the exercise of any functions of the Crown, the States or any public authority
Schedule 3 – First Principle: Conditions for Processing of Sensitive Personal Data, (7) Public Function
The processing is necessary for –
- the exercise of any functions of the Crown, the States, any administration of the States or any public authority.
Appendix E: Excerpt Data Protection (Jersey) Law 2005, Schedule 3 (Article 8)
Schedule 3 – First Principle: Conditions for Processing of Sensitive Personal Data (8) Medical Purposes
The processing is necessary for medical purposes and is undertaken by –
- a health professional; or
- a person who in the circumstances owes a duty of confidentiality equivalent to that which would arise if that person were a health professional.
In this paragraph “medical purposes” includes the purposes of preventative medicine, medical diagnosis, medical research, the provision of care and treatment, and the management of healthcare services.
Appendix F: Staff Documents
Acceptable_Use_Policy-006-user_signoff.pdf attached.
Staff Certificates attached.
Appendix G: Data Collection Template
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