Chamber and committees

Under the Regulationof Care (Requirements as to Care Services) (Scotland) Regulations 2002 care homeproviders are required to keep a record of any occasion where restraint or controlhas been applied to a resident, with details of the form of restraint and control,the reason why it was necessary and the name of the person authorising it.

There is no legalrequirement for care home providers to make public any records detailing occasionswhen restraint or control has been applied to a resident. Care homes are advisedby the Care Commission to make the information available to the next of kin, andthis would be recommended as best practice.

I refer the memberto the answers to questions S3W-5885 and S3W-5886 on 12 November 2007. All answers to written parliamentary questions are availableon the Parliament’s website, the search facility for which can be found at:http://www.scottish.parliament.uk/webapp/wa.search.

The definition usedfor the Influenza Immunisation Programme in 2006-07 is broader than that for 2005-06and similar to that used in the Scottish Directed Enhanced Service for 2006-07.This enables a consistent approach across general medical practice in support ofcarers. However, there is a drafting error in the Influenza Immunisation Programmeguidance in that it does not explicitly mention carers of a relative or friend whois not a child. While in practice such carers are unlikely to be excluded, officialsare acting to clarify the guidance as soon as possible.

In 2006‑07 theJoint Committee on Vaccination and Immunisation recommended influenza vaccinationsfor carers according to the following definition:

Those who are in receiptof a carers allowance, or those who are the main carer for an elderly of disabledperson whose welfare may be at risk if the carer falls ill. This should be givenon an individual basis at the GP’s discretion in the context of other clinical riskgroups in their practice.

Information ServicesDivision has analysed data on approximately 3,600 residents in 123 Care Homes usinga mathematical model. We expect a report in December 2007 on whether the model canbe used to inform staffing levels in care homes.

No guidance issuedin 2004-05 included carer definitions.

Influenza Immunisation Programme guidance for 2005-06recommended vaccination be offered on the basis of theJoint Committee on Vaccination and Immunisation (JCVI) recommendation for:

people who are the main carer for an elderlyor disabled person whose welfare may be at risk if the carer falls ill.

Influenza ImmunisationProgramme guidance for 2006-07 used the definition:

A carer is someone,who, without payment, provides help and support to a partner, child or neighbour,who could not manage without their help. This could be due to age, physical or mentalillness, addiction or disability. A young carer is a child or young person underthe age of 18 carrying out significant caring tasks and assuming a level of responsibilityfor another person, which would normally be taken by an adult.

The guidance goeson to state that vaccination should “embrace the workingdefinition of the JCVI recommendation”.

The Scottish Directed Enhanced Services for 2006-07 usedthe definition:

A person who, without payment, provides help and supportto a partner, child, relative, friend or neighbour who could not manage withoutsuch help due to age, physical or mental illness, addiction or disability.

Guidance on NHS CarerInformation Strategies (HDL 2006/22) uses the definition:

A personof any age who provides, or intends to provide, care on a regular and substantialbasis, as defined in section 12AA of the 1968 act and section 24 of the 1995act. That is, carers of any age caring (or intending to care for) adults or disabledchildren.

Carers were firstincluded amongst the groups to be offered the free flu vaccination in the 2005-06seasonal influenza campaign. This followed a recommendation from the Joint Committeeon Vaccination and Immunisation.

Carers currently qualifyfor free flu vaccinations. The current definition of carer is someone, who, withoutpayment, provides help and support to a partner, child or neighbour, who could notmanage without their help. This could be due to age, physical or mental illness,addiction or disability. A young carer is a child or young person under the ageof 18 carrying out significant caring tasks and assuming a level of responsibilityfor another person, which would normally be taken by an adult.

All recommendationsin respect of the flu vaccination are subject to individual clinical judgement.

Every year since the start of the seasonal flu vaccination programme, the Chief Medical Officer''s letter has recommended that social care organisations should consider offering influenza immunisation to employees directly involved in patient care. The wording of this recommendation was changed from 2006-07 to include specific reference to staff in nursing and care homes who look after older people.

The Joint Committeeon Vaccinations and Immunisation (JCVI), who are responsible for making recommendationsto ministers on the categories of people to be included in the free flu immunisationprogramme, do not include care home workers in their recommendations.

Neverthelessevery year since the start of the programme, the Chief Medical Officer’s letterhas recommended that social care organisations should consider offering influenzaimmunisation to employees directly involved in patient care. From 2006-07 this includedspecific reference to staff in nursing and care homeswho look after older people.

 

The Joint Committee on Vaccinations and Immunisation (JCVI), who are responsible for making recommendations to Ministers on the categories of people to be included in the free flu immunisation programme, do not include care home workers in their recommendations.

Nevertheless every year since the start of the programme, the Chief Medical Officer''s letter has recommended that social care organisations should consider offering influenza immunisation to employees directly involved in patient care.