This Staffing Method Framework will support providers and managers of care home services for adults and older people with the implementation of the of the Health and Care (Staffing) (Scotland) Act 2019. To improve readability we may also refer to this legislation as the Act or HCSA.

Taking account of the views of staff and people who use services, being open about decisions on staffing and promoting multi-disciplinary services are part of the guiding principles of the HCSA. The Scottish Government has produced statutory guidance for the HCSA.

This Framework will therefore also be of interest to people experiencing care, their families and carers, staff working in care homes, external professionals who support care homes and other stakeholders, such as commissioners.

Inspectors may also refer to this framework as part of the inspection process for adult care homes.

The Health and Care (Staffing) (Scotland) Act 2019

The aim of the Act is to provide a statutory basis for the provision of appropriate staffing in health and care services, enabling safe and high-quality care and improved outcomes for service users and people experiencing care. This requires the right people, in the right place, with the right skills, at the right time.

 

The guiding principles of the Act state the main purposes of staffing for care services are:

To provide safe and high-quality services to ensure the best care outcomes for service users   

“Staffing for care services is to be arranged while: 

  • improving standards and outcomes for service users
  • taking account of the needs, abilities, characteristics, and circumstances of different service users
  • respecting the dignity and rights of service users
  • taking account of the views of staff and service users
  • ensuring the wellbeing of staff
  • being open with staff and service users about decisions on staffing
  • allocating staff efficiently and effectively
  • promoting multi-disciplinary services as appropriate”

 

The Act makes it a duty for care service providers to ensure appropriate staffing. This means that a provider of a care service must ensure that at all times suitably qualified and competent staff are working in the care service and that the number of staff is appropriate to support “the health, wellbeing, and safety of service users, the provision of safe and high-quality care, in so far as it affects either of those matters, the wellbeing of staff.”

The Act will also promote open, transparent and participatory approaches to staffing. It aims to ensure that people experiencing care, their family and professional carers are informed and involved in the processes and decisions around staffing in a care service.

In doing so, this builds on existing standards and regulations for staffing in Scotland. When using this staffing method framework, providers should therefore also refer to other relevant guidance. Two essential pieces of guidance to take into consideration for the assessment and planning of staffing in relation to high quality care and good outcomes for people are the Health and Social Care Standards and our Quality Frameworks. Both documents also provide guidance relating to staff skills and training, involvement, participation and transparency.

 

Health and Social Care Standards: My support, my life

The Health and Social Care Standards: My support, my life set out what we should expect when using health, social care, or social work services in Scotland.

In relation to staffing, they describe the importance of having confidence in the people who provide support and care. Examples include:

  • 2.9 I receive and understand information and advice in a format or language that is right for me.
  • 2.11 My views will always be sought and my choices respected, including when I have reduced capacity to fully make my own decisions.
  • 3.14 I have confidence in people because they are trained, competent and skilled, are able to reflect on their practice and follow their professional and organisational codes.
  • 3.15 My needs are met by the right number of people.
  • 3.16 People have time to support and care for me and to speak with me.
  • 3.17 I am confident that people respond promptly, including when I ask for help.
  • 3.18 I am supported and cared for sensitively by people who anticipate issues and are aware of and plan for any known vulnerability or frailty.
  • 3.19 My care and support is consistent and stable because people work well together.
  • 4.14 My care and support is provided in a planned and safe way, including if there is an emergency or unexpected event.
  • 4.25 I am confident that people are encouraged to be innovative in the way they support and care for me.
  • 4.27 I experience high quality care and support because people have the necessary information and resources.

Our Quality Frameworks have been created to support care services with examples of very good and weak practice and further information to support services to self-assess their performance. Inspectors use the quality frameworks to evaluate outcomes for people as part of the inspection process.

Another important piece of guidance, published by the Scottish Government in 2022 is My Health, My Care, My Home – healthcare framework for adults living in care homes. This document includes guidance and advice for maintaining a skilled and sustainable workforce.

 

The Staffing Method Framework for adult care homes as part of The Health and Care (Staffing) (Scotland) Act 2019

The Act allows Scottish Ministers to make regulations to develop, test and recommend staffing methods for other types of care services in the future

A staffing method sets out a framework or process to be followed by a care service provider to determine what appropriate staffing is in any particular care service and setting. This includes the use of staffing level tools and a range of other considerations such as where and how the service is being provided.

This staffing method framework for adult care homes includes all elements of the staffing method outlined in the Act and supports providers to meet the legislation when assessing and making decisions about workload planning and workforce capacity.