Anne's Law and Health and Social Care Standards consultations: analysis of the responses

Introduction

This report presents an analysis of a two-part consultation on Anne's Law which took place between September and November 2021. There are around 1,000 care homes for adults and 33,000 residents aged 18 years and over in care homes in Scotland. Throughout the pandemic, the overriding priority in care homes has been to safeguard and protect staff and residents from infection, many of whom are particularly vulnerable to the impact of COVID-19 due to their underlying multiple long-term medical conditions as well as frailty. However, at times, that meant that residents were unable to see their loved ones as they would have liked, causing anguish for many.

Social connections and meaningful activity are important for the wellbeing and quality of life of people living in adult care homes as well as their friends and family. Guidance for the care home sector recognises the importance of enabling people to connect with their loved ones and care homes are encouraged to take steps to facilitate opportunities for connection using all the protections in place to do this safely.

The consultation on Anne's Law sought views on the Scottish Government's proposals to ensure that people who live in adult care homes have rights to see and spend time with the people who are important to them.

The consultation was in two parts. Part 1 sought views on the Scottish Government's proposals for strengthening the Health and Social Care Standards to enable people living in adult care homes to maintain family and friendship connections to support their health and wellbeing. Part 2 sought views on the Scottish Government's proposals for delivering Anne's Law in primary legislation, to ensure that people who live in adult care homes have rights to see and spend time with the people who are important to them.

The development of Anne's Law follows a Care Home Relatives Scotland Petition: PE01841 which was lodged by Natasha Hamilton, who was unable to see her mother, Anne Duke, for prolonged periods during the height of the pandemic. The petition called on the Scottish Parliament to urge the Scottish Government to allow a designated visitor into care homes to support loved ones.

A commitment to developing Anne's Law was outlined within the Fairer, Greener Scotland: Programme for Government 2021-22 published on 7 September:

We will strengthen residents' rights in adult residential settings and bring in 'Anne's Law' – giving nominated relatives or friends the same access rights to care homes as staff while following stringent infection control procedures, as called for by Care Home Relatives Scotland

One of the main drivers for introducing legalisation to cement the rights of residents to see friends and family is a recognition that families and friends play an essential role in the health and wellbeing of people who live in care homes (in terms of both practical and emotional support). Prolonged isolation from family and friends is likely to be detrimental to the welfare of the resident.

Introducing legislation takes time and therefore the Scottish Government proposed short term measures to support the commitment including the strengthening of the Health and Social Care Standards. A consultation on strengthening the Standards was launched on 16 September and closed on 2 November (Part 1). This was followed by a consultation on delivering Anne's Law which launched on 24 September and closed on 5 November (Part 2).

This document presents the results of both Part 1 and Part 2 Consultations.

Part 1 Consultation - Strengthening the Health and Social Care Standards

Within the consultation, the Scottish Government proposed to strengthen the Health and Social Care Standards to enable people who live in adult care homes to have rights to see and spend time with the people who are important to them.

The Health and Social Care Standards set out what people should expect when experiencing health, social care, or social work services in Scotland. The Standards are used by services and support organisations as a guideline for how to achieve high quality care. They are also taken into account by the Care Inspectorate, in relation to registration and inspection of care services.

The Scottish Government noted in the consultation that strengthening the Standards around ensuring that people can spend time with their loved ones would allow regulators to refocus certain inspections practices in support of the wishes of care home residents and their nominated family or friends. The consultation paper acknowledged that there are many Standards which already contain references to connection with others (see below). However, the Scottish Government proposed that one or more new standards will be required to strengthen the rights of residents which would allow immediate work to support the Anne's Law commitment.

Existing standards

1.10 I am supported to participate fully as a citizen in my local community in the way that I want

2.18 I am supported to manage my relationships with my family, friends or partner in a way that suits my wellbeing

2.19 I am encouraged and supported to make and keep friendships, including with people my own age

2.22 I can maintain and develop my interests, activities and what matters to me in the way that I like

5.15 If I am an adult living in a care home I can choose to see visitors in private and plan for a friend, family member or my partner to sometimes stay over.

Part 2 Consultation - Delivering Anne's Law

The consultation on delivering Anne's Law outlined an aspiration that people who live in adult care homes will be able to have direct contact with people who are important to them in order to support their health and wellbeing, regardless of circumstances. The consultation indicated that legislative provisions on Anne's Law could be included in the National Care Service Bill for which a consultation was underway at the same time. Within the consultation for Anne's Law, views were invited on the potential aims of and proposals for legislative provisions to support Anne's Law.

The respondents and responses to Parts 1 and 2

This section of the Consultation Analysis presents an overview of the number of responses received by respondent type and the format of those respondents.

Responses received

This consultation was in two Parts. The first part explored views on strengthening the health and care standards around human rights and a right to visits in care homes while Part 2 addressed the issues around the implementation of Anne's Law and the associated benefits, challenges, and risks. The response breakdown is as follows:

	Number
Part 1 Health and Social Care Standards
Citizen Space responses	156
Non-standard responses	1
Workshops/engagement meetings	3
Total	160
Part 2 Delivering Anne's Law
Citizen Space responses	283
Non-standard responses	1
Workshops/engagement meetings	5
Total	289

These figures include responses to the Easy Read questionnaire which were inputted by the Scottish Government into Citizen Space.

The respondents and the responses

In total, there were 156 Citizen Space responses to Part 1 of the Consultation, 127 (81%) of these responses were from individuals and 29 (19%) were from organisations. There was one further non-standard written submission.

There were 283 Citizen Space responses to Part 2 of the Consultation, 247 (88%) of these were from individuals and 35 (12%) were from organisations. There was a further non-standard response provided.

Organisations that responded to these consultations included: care home providers, health and social care partnerships, local authorities, care home provider representative groups, professional representative organisations, academics, third sector organisations, and family representative groups.

There were also three engagement events held in September and October 2021 as part of the Part 1 consultation process and five events for Part 2. The discussions at these meetings are summarised in Appendices 1 and 2.

Please note that the overall figures include some Easy Read responses that were data entered by the Scottish Government into the main dataset. Please also note that figures in this report may not sum to 100% due to rounding.

Comments on the Consultation

Overall, 55% of the respondents to Part 1 and 56% of respondents to Part 2 stated that they were satisfied with the consultation process, approximately a third in each case said neither/nor and 14% and 12% respectively said they were dissatisfied. Comments raised included the need for more publicity around the Consultation and difficulties in ranking the proposed standards in terms of preference.

The Scottish Human Rights Commission highlighted that the period for the consultation was short at five weeks and that it was difficult to comment in the absence of an analysis of the issue.