6.3 Regulatory frameworks presenting conflicting requirements

Course: NVQ Level 5 Diploma In Leadership & Management for Adult Care

Unit 2: Governance and regulatory processes

LO6: Understand wider ranges of regulatory requirements that apply to services

6.3 Regulatory frameworks presenting conflicting requirements

There may be occasions when the regulatory frameworks for different services present conflicting requirements. This may arise when there is ambiguity in the framework or it is necessary to make a choice between equally valid interpretations. Some examples of conflicts are included below.

The potential for duplication of regulatory activities by local councils and national regulators

Local authorities and the Care Quality Commission (CQC) may sometimes request the same information from a service provider. If the service provider complies with both requests, this may increase costs and place an unnecessary administrative burden on the service provider. To avoid such duplication it is important both for national regulators to understand the remit of local authorities and vice versa. The Local Government Association (LGA) has developed a memorandum of understanding with the CQC to avoid unnecessary work duplication.

Lack of coordination of information by the regulator and local care commissioners

Implementing effective partnership working between agencies is essential for a successful care delivery system, including shared goals and values. Lack of coordination can be attributed to the fact that both regulator CQC as well local CNHSs (Commissioners) have sought to reduce this by sharing information with each other in order to achieve their respective roles more effectively.

In some cases, information sharing between the regulator and local authorities has been impeded by a reluctance on the part of councils to share data. This has been attributed to a general lack of trust of CQC due to concerns over patient confidentiality, reporting quality, and consequences if something goes wrong. There is also an unwillingness on the part of providers who are reluctant to share the information which could potentially damage their reputation.

Health and safety responsibilities versus person-centered planning

There may be occasions when the regulatory framework for health and safety comes into conflict with the person-centered planning framework. The Health and Safety at Work Act 1974 sets out a number of general duties that must be complied with in order to ensure the health, safety, and welfare of employees. These include a duty to assess risks, take precautions against potential dangers, and provide information, instruction, and training.

The Care Act 2014 places a responsibility on local authorities to ensure that there is a person-centered planning process in place which takes into account the individual’s needs, wishes, and preferences. This process must be coordinated with other interventions such as social care, health, and education.

The Health and Safety at Work Act 1974 has many responsibilities for employers, including protecting staff from harm. However, it also requires them to provide person-centered care that is in line with an individual’s needs or preferences if they wish to participate in certain activities associated with risks; this can present a conflict between what the client wants versus how dangerous said activity may be.

The risk assessment process allows us to identify potential hazards involved when balancing these two competing interests – providing safety while respecting personal beliefs/choices.

Safeguarding

Safeguarding is a process for protecting people from harm. It means intervening early to reduce the risk of abuse, neglect, or other harm.

There are times when safeguarding may be required on the part of the regulator in order to safeguard vulnerable service users who are potentially at risk of being exploited by their care providers, but this can come into conflict with the principle of independence, where it may be necessary for service users to participate in certain activities which could present a health and safety risk.

Safeguarding can also come into conflict with person-centered planning because safeguarding is often associated with coercively imposing restrictions on an individual and their rights and freedoms without due consideration or reference to their wishes, feelings, or best interests.

Safeguarding may cause the regulator to feel under pressure to act in cases where they are not necessarily obligated given that their primary role is regulating all care providers equally, regardless of the level of harm involved.

The Care Act 2014 places a responsibility on local authorities to ensure that there is an effective safeguarding process in place which takes into account the individual’s needs, wishes, and preferences. This process must be coordinated with other interventions such as social care, health, and education.

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