Use of anti-psychotic medication in care homes

Social Care Wales’ response to the
National Assembly’s Health, Social Care and Sport Committee inquiry

Gerry Evans,
Director of Regulation
Social Care Wales
South Gate House
Wood Street
Cardiff
CF10 1EW

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1. Social Care Wales works with partners to make care and support better for people in Wales. We have powers to regulate and support the training of the social care workforce. We have a new remit to support improvement and research in the field. Until 31 March 2017 we were known as the Care Council for Wales.

2. We have been responsible for the professional regulation of adult care home managers since 2011. In that time we have not received referrals relating specifically to the inappropriate use of anti-psychotic medication. However, we will continue to monitor the situation. Should people or organisations become aware of specific instances of registered social care workers engaged in such practices they should contact Social Care Wales.

3. The Code of Professional Practice for Social Care[1] and The Social Care Manager: Practice Guidance for Social Care Managers[2] emphasises person centred approaches as fundamental to the social care profession. These documents are the foundation on which the regulation and training of social care workers and social care managers is built. Both documents are used in assessing a member of staff’s fitness to practice should they be called before a Social Care Wales panel. The Practice Guidance for Social Care Managers includes a specific section on medication which reads:

“You must comply with the relevant law, statutory regulations and professional guidance regarding medication. If you are responsible for developing a medication policy and procedure this should specify the circumstances in which a staff member may administer or assist in the administration of medication. It should include procedures for the safe administration, recording, handling, safekeeping and disposal of medication. If you are responsible for implementing medication policy and procedure, you should ensure that the policy is adhered toby you and your staff. You should address any concerns about the safety of the medication policy and procedure or its implementation.[3]”

4. The inquiry’s terms of reference asks us to consider the “training for health and care staff to support the provision of person-centred care for care home residents living with dementia.” In our view, it is vital that each care home is staffed by people who are sufficiently skilled to provide person centred and preventative approach to care. To support this aim, we have produced a range of training materials. Furthermore, we are working to improve the qualifications required to work in the care profession.

5. In November 2016 we published the Dementia Learning and Development Framework for Wales alongside NHS Wales. The new resource aims to change the way in which dementia care is provided in Wales by creating a single, shared vision for health and social care workers to provide the best possible care and support for those living with dementia. The framework has people with dementia at its heart and recognises that people with dementia, their families and carers should all be central to the care and support they receive[4].

6. We are working with Qualifications Wales on a new set of qualifications for health and social care from 2019. These have a strong emphasis on person centred care, with a specific pathway for the skills needed to care for people with dementia. People who work in the care profession will be required to hold these qualifications, so their reform is a significant step. Person centred practice has been strengthened in the revised induction framework for health and social care. We will be conducting a consultation on the changes to the framework in late spring.

7. We also produced a learning resource called Positive Approaches : Reducing Restrictive Practices in Social Care[5]. The resource aims to provide an understanding of how to work using positive and proactive approaches and reduce the use of restrictive practices in social care. The focus of the resource is on enabling and ensuring best practice using examples and scenarios for illustration. It can be used in supervision; as part of induction; training sessions; appraisals and to inform policy; protocols; audit; quality assurance and commissioning.