The Health Tobacco Nicotine etc and Care Scotland Act 2016 What does it mean for me Duty of Candour New law applies to all health and social care organisations Organisational duty of candour provision ID: 722055
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Slide1
Statutory Duty of
Candour
The Health (Tobacco, Nicotine etc. and Care) (Scotland) Act 2016
What
does it mean for
me
?Slide2
Duty of
Candour
New law applies to
all
health and social care
organisations
Organisational duty of candour provision
Health (Tobacco, Nicotine
etc
and Care) (Scotland) Act 2016 (The Act)
The Duty of Candour Procedure (Scotland) Regulations 2018
Underpins the Scottish Government’s commitment to openness and learning – safe, effective and person-centred health and social care.
Implementation
date was 1 April 2018Slide3
Who is responsible?
New statutory duty for organisations within health and social care.
The ‘responsible person’ as defined in the act is not a person but the organisation/provider
Organisations will need to decide themselves who is responsible for taking the lead on this work
Many
individuals within health and social care have a professional duty in their Codes Of Practice.
e.g. SSSC
CoP 3.6- be open and honest with my employer, people who use services and carers when care has or may have caused physical, emotional, financial or material harm or loss. Slide4
Duty of
Candour
The relevant person is the person who has been harmed or a person acting on behalf of the person that has been harmed.
The relevant person should be told
when things have gone wrong
.
The responsible person should acknowledge
that something has gone wrong, apologise and tell the relevant person the facts.The responsible person should tell the relevant person what steps will be taken to avoid this happening to someone else.
It is important that the
responsible
person remembers
the person behind the process. Slide5
Apology
An
apology or other step taken in accordance with the duty of candour procedure
does not
of itself amount to an admission of negligence or a breach of a statutory dutySlide6
When does the duty apply?
When, in the reasonable opinion of a registered health professional,
there has been incident that has resulted in
unintended or unexpected harm
to an individual receiving a health or care service
.
The registered
health professional should not have been involved with the provision of the care The registered health professional should confirm that the activation of the duty of candour procedure is necessary.
The procedure start date is the date the organisation receives confirmation from this Health Professional that the duty of candour procedure should be activated.
The
specific considerations that responsible persons will need to consider
is
outlined in guidanceSlide7
What do we mean by harm?
death of the person
a permanent lessening of bodily, sensory, motor, physiologic or intellectual functions
an increase in the person’s treatment
changes to the structure of the person's body
the shortening of the life expectancy of the person
an impairment of the sensory, motor or intellectual functions of the person which has lasted, or is likely to last, for a continuous period of at least 28 days, .
the person experiencing pain or psychological harm which has been, or is likely to be, experienced by the person for a continuous period of at least 28 daysOr;the person requiring treatment by a registered health professional in order to prevent-(i)the death of the person, or .(ii) any injury to the person which, if left untreated, would lead to one or more of the outcomes mentioned above.Slide8
What the duty requires
Organisations must
follow procedure set out in
regulations
The responsible person (
i.e.
health board/ social work service/ organisation/ provider) is required to
undertake training as stipulated in the regulations, and;Provide training, supervision and support to any person carrying out any part of the procedure on behalf of the responsible person (i.e. knowledge of procedure, delivering an apology, having difficult conversations)Duty to produce an annual report including number and nature of incidents where the duty of candour has been implementedSlide9
Key stages of the procedure
The key stages of the procedure include:
(a) to notify the person affected (or family/relative where appropriate)
(b) to provide an
apology
(c) to carry out a review the circumstances leading to the incident
(d) to offer and arrange a meeting with the person affected
(e) to provide the person affected with an account of the incident (f) to provide information about further steps taken(g) to make available, or provide information about, support to persons affected by the incident(h) to prepare and publish an annual report on the duty of candourTimescales for these are included in the regulationsSlide10
The Review
The responsible person must carry out a review of the circumstances which it considers led or contributed to the incident.
If this is not completed within 3 months an explanation must be provided to the relevant person.
The relevant persons views must be sought and taken account of.
A written report of the review should include:
A description of the manner in which the review was carried out
A statement of any actions to be taken by the responsible person to improve the quality of the service and to share learning with other persons or organisations.
A list of actions taken in accordance with the duty of candour and the date each action was taken. The relevant person should be offered a copy of the written report and any further information about the actions for the purpose of improving the quality of the service. Slide11
What do you need to report?
All organisations must publish annual report to show
:
- number and nature of
DoC
incidents
- assessment of extent to which the duty was carried out
- information about DoC policies and procedures- any changes made to policies as a result of incidents
It is NOT a report for each
incident
There is support
from Care Inspectorate and
Health Improvement Scotland
on aligning existing recording systems with duty of candour requirements and style templates for annual reportsSlide12
Education , training and support
E-learning
module
– case study and scenario
based with knowledge check exercises and prompts to check local procedures
Information and awareness raising materials including
factsheets
Face-to-face trainingFAQs
Webex
sessions and
webinars
Roadshows
and ‘pop-up clinics
’
Train the
trainers pack including case
studies,
service user/ carer stories, presentation materials, signposting
to other resources and
toolsSlide13
What must you do now?
Understand how ready you are to respond – individually, within teams, organisation-wide
Align with existing reporting/recording/incident processes and procedures
Look at what training you have available and build on what you have
to do to embed
the new
Duty of Candour.
Consider who are the right people, with the rights skills to lead for your team/organisation
Engage with
training materials and eventsSlide14
Further information
Dedicated
Scottish Government web
page:
www.gov.scot/Topics/Health/Policy/Duty-of-Candour
Includes a FAQs
page
Any questions email: dutyofcandour@gov.scotSlide15
Social Care Scenario One
Jean is a 79 year old female with complex health problems who lives in a sheltered housing complex. She manages to live independently with some help from home carers, her niece and some extended family. She is estranged from her own family including her son and daughter.
Jean requires medication 4 times per day and this is administered from a blister pack by the home carers when they visit. Jean has a visit from her home carer at 9.30am who also makes her breakfast. She is visited by a different home carer at 12.30pm and medication is administered and her lunch provided.
When a different home carer visits a 5pm they notice that jean is very sleepy and quite disorientated, They realise that Jean’s morning medication dose is still in the blister pack but her lunch time dose for that day and the next day are both missing. It transpires that Jean has been given two doses of her lunchtime medication and no morning medication.
The lunchtime medication contains a significant dose of morphine based medication that jean only normally receives once a day.
The home carer calls her office who ask Jean’s GP for advice. The GP visits jean and advises that she should make a full recovery but may be a bit drowsy and should be checked again in a few hours. The manager for the sheltered housing complex is also advised, Jean is visited by the same home carer 2 hours later and is much brighter but still very tired.
Does the duty of candour apply? Slide16
Social Care Scenario Two
Alexander is an 89 year old man living with dementia who stays in a registered care home. Alexander has a wife and 2 married children and at least one of them visits every day, sometimes with his grandchildren. Alexander enjoys his visits but becomes agitated when they leave.
Following a visit one day, Alexander, who uses a wheelchair due to a previous industrial accident is very agitated and nursing staff are not able to support him to settle. Later the staff help him to get to bed and when they are leaving the room he seems quite settled. They leave his room but forgot to put the bed rails up and forgot to leave him the buzzer to summon help should they need it.
The nursing assistant checks Alexander around 2 hours later and he is lying on the floor in a pool of blood with an obvious head injury. Alexander is admitted to hospital where his is found to have a large bleed on the brain and the consultant has said that there is very little that can be done for Alexander due to the extend to the damage caused by the fall and his underlying health conditions. Alexander dies peacefully in hospital 2 days later surrounded by his family.
Does the duty of candour apply? Slide17