Healthwatch Kent

Enter & View Policy

Page 1 of 24

Healthwatch Kent

Page 1 of 24

Version 2.1

March 2013

Contents

Executive Summary

1Introduction

2Healthwatch powers of Enter and View

3‘Enter and View’ Authorisation Process

4Authorised Representatives

5Procedures for the Appointment of Authorised Representatives

6Training

7Developing a Programme of visits

8Announced Visits

9Unannounced Visits

10Arranging a visit

11Undertaking a visit

12After a Visit

13Circumstances in which a visit can be refused or terminated

14Complaints made about an authorised representative

15Exclusions

16Conduct

17Health, safety and Infection Control

18Further Guidance

Appendix 1

Appendix 2

Executive Summary

Introduction

This policy explains the purpose, powers, process and benefits of the Healthwatch Kent’s statutory role of Enter and View. It also sets out the limitations of this remit.

The policy is written primarily for Healthwatch Kent staff and is intended to serve as a reference and best practice document, and a training aid.

What is ‘Enter and View’?

The Health and Social Care Act 2012 and associated regulations enable the ‘Enter and View’ provision for Healthwatch.‘Enter and View’ is the opportunity for Healthwatch Kent to conduct an objective and independent visit into health and social care premises that is funded by the NHS or Kent County Council. The purpose of these visits is to examine the nature and quality services; and the environment in which they are provided.

It is a means to collect views from patients, service users and residents about good and poor practice at the point of care and service delivery; and to include the views of carers, family and friends.

The ‘Enter and View’ is carried out by Authorised Visitors who are trained, DBS checked and briefed fully on the role and the exact purpose of the visit. They interview and observe during the visits (using all their senses) and report the views and experiences of the service users.

This information is collated into an evidence based report which includes formal recommendations and examples of good practice to providers, CQC, Local Authority and NHS commissioners, Healthwatch England and the public.

The purpose of ‘Enter and View’

The aim of ‘Enter and View’ is to ensure that users’ voices are heard, their experiences are acknowledged and recorded; and that this evidence is used to highlight and promote existing good practice or make recommendations for improvements in the of quality of care and practice.

‘Enter and View’ activities are carried out in response to local community concerns or intelligence gathered. They are never undertaken on the basis of individual complaints or concerns.

Key requirements of an Authorised Visitor

Skills, Knowledge and Experience:

  • Good communication skills (reading, written and verbal)
  • Good observational skills
  • Ability to take accurate notes and have a good memory for detail
  • Computer literacy, regular access to the internet and communicate by email
  • Ability to present only the views of those you represent (clearly separate your experiences from other peoples issues)
  • An ability and experience in working as part of a team
  • Report writing skills

Attitudes and Values:

  • Committed to impartial reporting of facts in a non judgemental manner
  • Able and committed to maintaining confidentiality
  • Committed to equal opportunities
  • Reliable, discrete and trustworthy
  • Respect for others

1Introduction

1.1 There is a duty (with some exemptions) on health and care providers to allow representatives of Local Healthwatch organisations to enter and view premises and carry out observations.

1.2 This policy describes the arrangements for members of Healthwatch Kent ‘Enter and View’authorised representatives to enter and view premises providing health and social care services to Kent residents for the purpose of observing the nature and quality of services.

1.3 The Enter and View authorised visitors will observe and assess the nature and quality of services, obtain the views of people using those services, validate evidence already collected and gather information from staff, services users and carers. Visits cannot be carried out in response to individual complaints, issues or concerns.

1.4The Health and Social Care Act 2012 and associated regulations replicate the Local Involvement Networks’ (LINks’) ‘Enter and View’ provisions for Local Healthwatch. All Enter and View activities will be in response to local community concerns or intelligence gathered.

2 Healthwatch powers of Enter and View

2.1Healthwatch Kent has the power to enter and view care services provided by:

  • NHS Trusts
  • NHS Foundation Trusts
  • Clinical Commissioning Groups (CCGs)
  • Local Authorities
  • a person providing primary medical services (e.g. GPs)
  • a person providing primary dental services (i.e. dentists)
  • a person providing primary ophthalmic services (i.e. opticians)
  • a person providing pharmaceutical services (e.g. community pharmacists)
  • a person who owns or controls premises where ophthalmic and pharmaceutical services are provided
  • Bodies or institutions which are contracted by Local Authorities or NHS Trusts, CCGs or Strategic Health Authorities to provide care services.

2.2Commissioners have a responsibility to ensure that any contracts with independent contractors/providers allow authorised representatives to enter and view.

2.3The purpose of the Enter and View power is to:

  • observe and assess the nature and quality of services
  • obtain views of the people using these services
  • consider the standard and provision of care services
  • consider how they may be improved.

3‘Enter and View’ Authorisation Process

3.1 The Deliberations and Direction Group (DaD) is the body that makes the decision to instigate a Healthwatch Kent ‘Enter and View’ activity. The DaD will instruct the Chief Executive of Healthwatch Kent to undertake the activity on its behalf.

3.2The Chief Executive of Healthwatch Kent will convene and Chair an ‘Enter and View’ group. The group will comprise of the Volunteer Manager, Programme Manager and at least two lay members. This group will be responsible for maintaining an overview of the projects, ensuring they run efficiently and effectively and that all Authorised Representatives’ behavior and activities are in accordance with Healthwatch Kent Governance structures and with other the relevant protocols established by Healthwatch England and the Healthwatch Contract as set out by the Kent County Council.

3.3A team of Authorised volunteers will be appointed to each Enter and View project, dependant upon the nature of the project.

3.4An Enter and View team must comprise no less than 2 persons and normally no more than 4. The number of teams should reflect the number of places to be visited, their geographical spread and the time interval allowed for the visits. If a location is to be re-visited it is better to have a different team undertaking the second visit.

3.5Authorised representatives are subject to all Healthwatch Kent policies and procedures and Code of Conduct. This includes obtaining a Disclosure Barring Service (DBS) certificate. Healthwatch Kent must make publicly available a list of its authorised representatives. All authorised representatives must receive appropriate Enter and View training.

3.6 First draft Enter & View Reports will be reviewed by the Decision and Direction Group, and a draft copy to be sent to the provider for factual amendments. Once the amendments are agreed and finalized the Report returns for ratification the Decision and Direction Group and is signed off by the Chief Executive of Healthwatch Kent. The Report is then made public – and is sent to the participating providers, Commissioner(s) and all other relevant parties.

3.7Healthwatch Kent will manage and provide indemnity insurance to all authorised enter and view members.

3.8Reasonable volunteer expenses incurred will be reimbursed in accordance with the Healthwatch Kent’s Expenses Policy.

4Authorised Representatives

4.1 The Local Authorities legislation 2013 (Public Health Functions and Entry to premises by Local Healthwatch) states that only ‘authorised representatives’ can conduct a visit.

4.2An authorised representative is an individual member of Healthwatch Kent who participates in Healthwatch’s Enter & View activities.

4.3All Enter and View visits are conducted by people who have been trained and who visit health and social care services to observe and assess the service being provided; write individual or group reports with suggestions for improvements. This will form the substance of a public document; and will usually have recommendations.

4.4 Key tasks

These will include some or all of the following:

a)To take part in timely and repeated (if necessary) training sessions relevant to the Enter and View programme.

b)Participate in all pre-visit briefings, fact finding and debriefing sessions.

c)To prepare for group visits to health and social care services by researching and reading set background information about the service being visited. (e.g. CQC Reports).

d)To take part in the visit looking at all aspects of the service provided, observing and noting relevant information, and talking to staff, relatives and service users about the service. Such visits are always undertaken as part of a team comprising at least two members, one of whom will take the role of team leader.

e)There is an expectation that representatives will contribute as required to the written report that is produced within a specified timescale.

f)To take part in any follow-up visits, after an initial visit has taken place, where significant recommendations were made.

g)To contribute to the development of the Enter and View programme.

4.5Enter and View Person Specification:

Entry level criteria

  • Willingness to undergo an enhanced Disclosure Barring Service (DBS) background check;
  • Preferably be a local resident or work within Kent;
  • Be 18 years or over

Skills, Knowledge and Experience:

  • Good communication skills (reading, written and verbal)
  • Good observational skills
  • Ability to take accurate notes and have a good memory for detail
  • Computer literacy, regular access to the internet and communicate by email
  • Ability to present only the views of those you represent (clearly separate your experiences from other peoples issues)
  • Good interpersonal skills with the ability to work within a team
  • Report writing skills
  • To possess some knowledge and understanding of health and social care service provision;
  • Ability to observe – take a lay and non-judgemental perspective, engage service users and be able to listen in order to discover their views and experiences of care
  • Ability to work co-operatively with service providers as a ‘critical friend’ without being influenced in any way by personal and subjective interests and agenda;
  • Ability to report findings to Healthwatch Kent in a way which is easily understood and in the manner requested within the Project brief
  • Have the ability to listen courteously, be sensitive to other people’s feelings irrespective of background, nationality, culture, ethnicity, sexual orientation age or gender

Attitudes and Values:

  • Committed to impartial reporting of facts in a non judgemental manner
  • Able and committed to maintaining confidentiality
  • Committed to equal opportunities
  • Reliable, discrete and trustworthy
  • Respect for others
  • Recognise the privileged position of the Enter and View role;
  • Respect for the privacy, confidentiality and dignity of service users and patients;

Time commitments

  • To be able to commit the equivalent of at least 1 day every other month to this role;
  • Commitment to abide by the Nolan principles of public life;
  • To attend all ‘Enter and View’ training required for the role;

5 Procedures for the Appointment of Authorised Representatives

5.1Under the Local Authorities Regulations 2013 Authorised Representatives of Healthwatch may enter and view premises in order to carry out the purpose of the Healthwatch they represent. Before an individual can be authorised, s/he will need to apply, be interviewed and formally selected, DBS and reference checked and trained according to the Healthwatch Kent procedures.

5.2Healthwatch Kent has established a recruitment process which involves potential Authorised Representatives

  • completing an application form;
  • undergoing an interview;
  • providing a written reference;
  • undergoing a criminal records check, undertaken by the DBS, and have a certificate to verify this;
  • completing the agreed ‘Enter and View’ training course.

All representatives must have completed this process.

5.3Healthwatch Kent has not set a maximum for the number for Authorised Representatives it will maintain at any one time. However it is envisaged that all 7 Areas will have a minimum of 10 active and available Authorised Representatives at any given time.

5.4Authorised representatives will act and communicate only with permission and in accordance with the relevant Healthwatch Kent Project brief, code of conduct and project’s time limitation.

5.5The authorisation to be a nominated Authorised Visitor shall expire two years after it is granted. However,Authorised Visitors will be expected to abide by the Code of Conduct at all times. Where this does not happen s/he may be deselected immediatelyand their authorisation revoked by the Chief Executive of Healthwatch Kent. Authorisation only extends to work defined by Healthwatch Kent.

5.6Authorised representatives must abide by the following:

  • At all times treat and speak to staff, service users, residents, patients, their family members, carersand any members of the public with respect, sensitivity and friendliness;
  • Be observant, patient, empathetic and discrete;
  • Be familiar with and always behave in accordance with the Nolan Principles;
  • Adhere to the Healthwatch Kent’s Code of Conduct, confidentiality rules, Safeguarding and Vulnerable Adults policiies;
  • Be accountable for ones’ own actions;
  • Recognise personal limitations and be certain to ask for help when required;
  • Comply with operational or health and safety requirements
  • Wherever possible meet any user, resident, patient, carer or staff requests, unless in so doing anyone’s confidentiality, health, dignity, privacy or safety is potentially or actually compromised;

5.7Selection

Applicants will be appointed following a robust recruitment, selection and interview procedure.

Selection will be based onthe completion of an application form with references and satisfaction of the DBS certificate.

5.8Interview

This is followed by an interview process where the applicant is matched against personal desired and essential criteria; and also against competencies relevant to the role specification. Where an applicant fails to satisfy the interview panel that s/he fulfils the criteria for appointment, the applicant will be advised of this.

5.9References

All applicants are required to provide a character reference to support their application and suitability to be an Authorised Representative. One referee must be offered for contact before appointment and final authorisation in the role.

6 Training

6.1Successful applicants will be required to attend training workshops prior to their full authorisation and so ensure that they are equipped to conduct Enter and View visits in an effective manner. Refresher courses or further bespoke training may be required for any new projects.

All training ensures that Authorised Representatives are able toundertake their duties effectively, diligently and fully briefed. The training will include the following:

The preparation for, conduct during, and reporting of Enter & View visits:

  • Explain their role and responsibilities when conducting an Enter & View visit;
  • Conduct visits in compliance with the Healthwatch Enter & View Code of Conduct;Nolan Principles and all relevant national, local or professional guidance;
  • Knowledge and familiarity on how to use, interpret and complete the paperwork that is necessary for the preparation, conduct, reporting and follow-up of visits;
  • Guidance and best practice of Equalities and Diversity.

Healthwatch Kent’s Safeguarding Adults Policy:

  • Understand their role and responsibilities with respect to safeguarding vulnerable adults and those of others in a multi-agency context;
  • Be aware of and be able to identify the main types of abuse;
  • Be mindful of the possible causes of and risks associated with abuse;
  • Be familiar with Kent’s safeguarding guidance and procedures appropriately to make referrals, seek advice and information;
  • Where actual or potential cases of abuse is suggested, suspected or witnessed to comply immediately with Healthwatch Kent’s Safeguarding procedure.

Practical skills

  • Interviewing and note taking skills
  • Thematic review and data analysis
  • Report writing

6.2Following appointment and prior to conducting any Enter & View Visit, the authorised representative must:

  • Undergo an enhanced DBS check that is acceptable to Healthwatch Kent;
  • Provide an acceptable character reference;
  • Sign up to Healthwatch Kent’s Code of Conduct;
  • Sign that s/he has read, understood and will comply with all Healthwatch Kent’s policies that relate to Enter and View;
  • Agree to have his/her name published on the list of Healthwatch Kent’s Authorised Representatives
  • Completed all the required Enter and View training;
  • Agree to undertake refresher course and peer review.

6.3Authorised Representatives are accountable to Healthwatch and the community within Kent and at all times will work to the policies and governance procedures of Healthwatch Kent.

6.4Authorised Representatives should only take part in a visit if the team are confident that the Authorised Representative has been provided with and assimilated enough about the type of care provided to understand the methods used in that particular care environment, and with that particular patient/user group. This will enable them to approach the task in an appropriate manner and make an informed assessment of what they hear and observe.

6.5An Enter and View representative should never be alone nor ‘out of the line of sight’with an individual hospital patient, care home resident or any other vulnerable person. If someone wishes to speak in confidence and/or in private this should be done within the line of sight or in the presence of the other Enter and View representative.

7 Developing a Programme of visits

Visits will be carried out in line with agreed Healthwatch Kentactivities.

7.1Healthwatch Kent hasstatutory powers of entry but the purpose, nature and limits of the visit, set by the DaD must be clear to the Visiting Team and communicated to the service in question.

The nature of the visit must be explained to the patients, service users and staff of the premises or services being viewed.