Learning Disability Residential Care

Summary

The requester sought policies on non-essential activities and staffing directives for learning disability residential care, receiving minutes and reports detailing severe staffing shortages, a recruitment freeze, and operational risks instead of specific policy documents.

Key Facts

• Manx Care has implemented a 'no recruitment, no placement' moratorium due to chronic staffing shortages.
• The service is currently covering 640-800 hours of care per week using existing staff working excessive overtime.
• There are approximately 17 to 22 vacant Full-Time Equivalent (FTE) roles, representing around 14% of the workforce.
• Operational Care Quality Group meetings identified the current service model as unsustainable without recruitment.
• Proposed actions to manage the crisis include reducing residential capacity by 4 beds and consolidating services.

Data Disclosed

• 17 FTE vacancies
• 22 vacant residential support worker FTE
• 14% vacancy rate
• 640-800 hours per week
• 800 hours per week
• 10% vacancy level
• 18 RSW
• 20 vacant roles
• 3 months of agency staffing
• 4 beds reduction
• 1 Tier 3 home
• 140 FTE
• 16 July 2024
• 20 August 2024
• 2 September 2024
• 23/04/2024
• November

Original Request

I am writing to request information under the Isle of Man Freedom of Information Act 2015. I would be grateful if you could provide the following details: 1) Policy and Definitions of Non-Essential Activities for those with learning disabilities in Residential Care - A copy of Manx Care's / DHSC policy, directive or any other official documentation that defines or describes "non-essential activities" for individuals with learning disabilities residing in residential care facilities. - Any internal definitions or criteria used by Manx Care to determine what constitutes a "non-essential activity" for those with learning disabilities in residential care. 2) Emails and Directives Relating to Overtime, Safe Staffing, Critical Staffing, and Non-Essential activities - Any emails, memos, or staff directives issued in the last two years to the present relating to the following: - The use of overtime in residential learning disability care settings. - Safe staffing levels in learning disability residential care facilities. - Critical staffing or staffing emergencies within learning disabilities residential care. - The continuation or suspension of non-essential activities in the context of learning disability residential care. Please let me know if you require any clarification or further details regarding my request. Thank you for your assistance, and I look forward to your response within the statutory timeframe.

Data Tables (1)

Full Response Text

Operational Care Quality Group Minutes – meeting took place on 16 July 2024

Minute 148/24 ASC Learning Disabilities:

The report was taken as read.

elaborated the point that 17 FTE vacancies is not sustainable without recruitment and noted that there will be operational challenges. The service as it stands is not sustainable and will need reduction. This has caused some upset and the implications from this reduction are being managed. Staff welfare is a concern due to hours being worked by staff to keep the 17 FTE. encouraged to keep the conversation open.

Operational Care Quality Group Minutes – meeting took place on 20 August 2024 Minute 155/24 ASC Learning Disabilities – re-evaluation of risk ID 806

This risk continues to be a high rated risk.
indicated that there have been further resignations since the ALDS service area report was written and the vacancies are at a high level which is affecting service provision. The current staff team across the service were noted to be covering 800 hours per week, which is causing a higher demand on the workforce. made known that there are a number of staff who will possibly be transferring to the service from Reayrt ny Baie, but it is uncertain when they will be moving. On a positive note, there has been 3 months of agency staffing agreed amidst the recruitment freeze. stated that the service area are prioritising keeping the current service users safe, whilst being mindful of those who require the service.

Operational Care Quality Group Summary Reports

April 2024 – Emerging Issues

Residential Support Worker Recruitment – there is no change to the circa 10% (18 RSW) (circa 20 vacant roles) vacancy level. A further round of recruitment is in progress with 20 candidates shortlisted, interviews taking place week commencing 23/04/2024

Senior Residential Support Worker- Recruitment – 3 successful internal candidates appointed as LTA- development opportunity. Further recruitment out for SRSW waiting for approval to fill 1 permanent vacancy.

July 2024 – Emerging Issues

ALDS and recruitment freeze

ALDS consistently carries 17-22 vacant residential support worker FTE (circa 14% of 140 FTE). This equates to circa 640-800 hours of care/support to cover per week (excluding sickness absence, training and annual leave cover) - we have a core group of staff working excessive additional hours to keep the service going. This situation is not sustainable from a staff wellbeing or service user experience perspective.

Given that the current vacancy rate will grow with workforce turnover, , ALDS is exploring / considering the following actions to strategically contract and maintain the service: • Encourage support worker redeployment from OPS/RNB • Transfer 3 FTE from an identified overprovided ALDS service • Consolidate Supported Living and Respite to cover vacant Senior role • Reduce complex needs day services capacity if no transfer into vacant support worker post (capacity not currently available) • Reduce residential capacity by 4 beds (1 Tier 3 / moderate needs home) • Moratorium on any new residential placements

the over-riding priority and concern is continuing to deliver a safe and sustainable service for existing Service Users

August 2024 – Emerging Issues

ALDS CIP savings and recruitment freeze

ALDS continues to carry 17 FTE in residential vacancies but can reduce this to 10 FTE with consolidating staffing from over-staffed service areas and

. This 10 FTE could then be covered by agency until RNB staff transfer in Nov.

ALDS continues to have a ‘no recruitment, no placement’ moratorium in place given the continued chronic staffing shortages.

September 2024 – Emerging Issues ALDS and recruitment freeze are there enough vacancies to job match all that will wish to remain.

Social Care Senior Leadership Team (SCLT) – meeting took place on 2 September 2024 Minute 93/24

a)

•

It has been just over 3 months into a complete recruitment freeze across social care and directly provided services which is having a massive impact in terms of our abilities to deliver services in learning disabilities

and the inability to recruit is and causing difficulties. The impact of this is now having an effect with registration and inspections, which are starting to pick up on a number of themes around the safe delivery of services.

Manx Care Noble’s Hospital, Strang Braddan, Isle of Man IM4 4R (01624) 650 000

Our ref: 4134501 24 October 2024

Dear ###

We write further to your request, received 18 September 2024, which states:

"I am writing to request information under the Isle of Man Freedom of Information Act 2015. I would be grateful if you could provide the following details:

1) Policy and Definitions of Non-Essential Activities for those with learning disabilities in Residential Care

• A copy of Manx Care's / DHSC policy, directive or any other official documentation that defines or describes "non-essential activities" for individuals with learning disabilities residing in residential care facilities.

• Any internal definitions or criteria used by Manx Care to determine what constitutes a "non-essential activity" for those with learning disabilities in residential care.

2) Emails and Directives Relating to Overtime, Safe Staffing, Critical Staffing, and Non- Essential activities

• Any emails, memos, or staff directives issued in the last two years to the present relating to the following:

• The use of overtime in residential learning disability care settings.

• Safe staffing levels in learning disability residential care facilities.

• Critical staffing or staffing emergencies within learning disabilities residential care.

• The continuation or suspension of non-essential activities in the context of learning disability residential care.

Please let me know if you require any clarification or further details regarding my request.

Thank you for your assistance, and I look forward to your response within the statutory timeframe."

Our response to your request is as follows: I have detailed below the information that is being released to you.

1. While our aim is to provide information whenever possible, in this instance Manx Care is unable to provide the information you have requested. This is in line with section 11(3)a of the Act, as a practical refusal reason applies; namely we do not hold or cannot, after taking reasonable steps to do so, find the information that you have requested.

However in order to provide advice and assistance it may be useful to note that:

Manx Care does not hold any policy that defines essential or non-essential activity. Each activity for each service user is subject to the individual’s care plan, any risk assessments, best interests and the preferences and wishes of each individual. Activities are encouraged and facilitated in a way that encourages autonomy, wellbeing, a sense of independence, dignity and positive risk taking balanced with care, support and safety.

This aligns with the Minimum Standards applicable under the Regulation of Care Act 2013. Standard 2.15 on Daily Living stipulates that:-
2.15 Opportunities for appropriate activities are provided. Equipment for activities is available, for example board games, computers, books and music etc. An activities programme planned around the people who live in the home makes provision for a minimum of three accessible and stimulating activity sessions per week are contained in the programme.

With staffing pressures, some activities have had to be cancelled to maintain safe staffing levels. Other activities have replaced those cancelled and at no time have any residents taken part in fewer than three activity sessions per week.

1. Please find attached documents as requested in part 2 of your request.

Please quote the reference number 4134501 in any future communications.

Your right to request a review

If you are unhappy with this response to your freedom of information request, you may ask us to carry out an internal review of the response, by completing a complaint form and submitting it electronically or by delivery/post.

An electronic version of our complaint form can be found by going to our website at https://services.gov.im/freedom-of-information/Review . If you would like a paper version of our complaint form to be sent to you by post, please contact me and I will be happy to arrange for this. Your review request should explain why you are dissatisfied with this response, and should be made as soon as practicable. We will respond as soon as the review has been concluded.

If you are not satisfied with the result of the review, you then have the right to appeal to the Information Commissioner for a decision on;

1. Whether we have responded to your request for information in accordance with Part 2 of the Freedom of Information Act 2015; or
2. Whether we are justified in refusing to give you the information requested.
   In response to an application for review, the Information Commissioner may, at any time, attempt to resolve a matter by negotiation, conciliation, mediation or another form of alternative dispute resolution and will have regard to any outcome of this in making any subsequent decision. More detailed information on your right to a review can be found on the Information Commissioner’s website at www.inforights.im. Should you have any queries concerning this letter, please do not hesitate to contact me. Further information about freedom of information requests can be found at www.gov.im/foi.

I will now close your request as of this date.