Regulating Social Care – Could the SSSC Do Better?

Regulating Social Care –  Could the SSSC Do Better? Your Help Please...

Colin Turbett - Care Reform Group - 2nd December 2021

The social care and social work workforces in Scotland are regulated by the Scottish Social Services Council (SSSC), a body whose role and remit were clarified and extended in 2010 to bring in more categories of staff than any of their counterparts in England, Wales and Northern Ireland. They are now responsible for the registration of 216,000 workers in Scotland, many of whom must register at their own expense. 

The prime role of the SSSC, according to their own publicity, is to ensure that ‘social work, social care and early years services are provided by a trusted, skilled and confident workforce’.  So far, so good: not much there that anyone might have an issue with. You would assume from this that their main role would be to ensure employers train and support staff to fulfil the codes of conduct that workers must sign up to. This, however, is where it starts to go wrong.

Although the SSSC have a responsibility to uphold the standards of employers, they have no powers to enforce this important aspect of their remit – almost the whole emphasis of their activity is on promoting the individual responsibility of workers to comply with the codes.  Those who are seen to transgress are very regularly subject to Fitness to Practice (FTP) investigations – 286 were completed in 2019-2020 (SSSC Annual Report). The fact that most reports of possible FTP transgressions do not proceed to either investigation or hearing (3971 out of 4122 reported cases and 151 “substantive hearings” according to figures from the 2019-2020 annual report) suggests that employers are shelving their own responsibilities – passing the buck.  

Just over half of the actual investigations proceed to a hearing and that process can take a considerable time – an anxious and demoralising period for anyone. The Scottish Government’s National Care Service consultation suggests that there is at least some recognition of this, and a recommendation is made (quite vaguely!) to revisit the regulator’s responsibility towards employers – although some of this is just to speed up their investigations of employees.  

Workers subject to Hearings (a tribunal with the power to remove professional registration and effectively deny a livelihood to the individual involved), are named and shamed in public: outcomes are published on the website and often reported in the press.  Most of the cases concern low paid social care staff who have been considered dispensable and easily replaced – or at least that was the case in the past. Brexit and immigration controls have reduced the available workforce and social care staff are more of a valuable commodity than they were. This of course is one of the drivers of the National Care Services reforms, and one we in Common Weal heartily support. 

You cannot offer high standards of care if you don’t pay, support and train the workers involved at front line level. Anecdotally we know this is a huge concern to the trade unions involved, who devote resources to ensure their members are well represented at FTP Hearings.  However, many workers in social care, most of which is in private hands, are not organised in trade unions, a factor that needs to be sorted through commissioning processes (or even better, through the abolition of the private care sector). National sectoral bargaining would certainly give the workforce more strength and could improve under-representation if the trade unions rise to the challenge. 

This is also an area that lacks research – especially concerning social care workers.  A paper published in the British Journal of Social Work by Aiden Worsley and colleagues studied UK wide data and found that Doctors and Nurses were more likely to receive supportive disposals than social workers (who were more likely to lose registration).  This possibly reflects societal investment and value of the respective workforces reflected in their registration bodies.  We need to know more about this and the Common Weal Care Reform Working Group would welcome the views of readers and supporters about the SSSC and its functions, especially from anyone with direct experience.   

Common Weal’s Care Reform Working Group included the following in its response to the recent National Care Service consultation. These point to how regulation could be reformed but this will require a lot of pressure as the consultation suggests avoidance of these key matters:

• There is no convincing evidence base to suggest that regulation improves practice; indeed, it has many negative effects on practice and on worker satisfaction and motivation.
• There is no evidence that regulation improves worker skill levels or sense of identity. 
• Direct care workers are particularly vulnerable in respect of fitness to practise processes and this demotivates them and leads to risk-averse practices
• There is insufficient expertise within regulatory bodies to be able to regulate effectively – instead, they revert to risk averse and punitive box-ticking.
• Linked to the above, the nature of care does not lend itself to regulation in the auditing way that regulation exists – care, as we argue in other work is a moral/practical endeavour rather than a technical/rational one, whereas regulatory regimes are invariably based on a technical/rational paradigm. Care is hard to count or measure and can’t be reduced to a tick-box mentality.
• We need a different way of thinking about care, which builds upon the internal motivation and desire for excellence that emerges out of practice.

Colin Turbett
Care Reform Working Group