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Nursing Home Regulations

If you are thinking of setting up a care home you should meet with a solicitor to identify the latest laws and regulations that you will need to adhere to to stay within the law and implement best practice. The law changes over time so the following may become out of date over time… The main piece of legislation overseeing all residential care homes in England is the ‘The Care Homes Regulations 2001’. The significant aspects of the legislation that potential care home owners should investigate in detail are as follows:-

  • Roles and Responsibilities – the legislation firstly defines the various care based individuals, owners, employees and other interested stakeholders paid or unpaid. It also defines the types of organisations qualify to be bound under the Act.
  • Statement of Purpose – the ‘registered person’ shall compile in relation to the care home a written statement consisting of a statement of the aims and objectives of the care home; a statement as to the facilities and services which are to be provided by the registered person for service users; plus a huge array of additional information in Schedule 1. The registered person must also produce a ‘service guide’ which consists of a summary of the statement of purpose; the terms and conditions to be provided for service users, including as to the amount and method of payment of fees; contract for the provision of services and facilities by the registered provider to service users; most recent inspection report; and lastly a complaints procedure.
  • Registered Persons – the registered provider must be ‘fit person’. This part of the legislation covers all aspects of character and capability including qualifications, physical and mental health, convictions and financial stability. A care home Manager must be appointed by the Registered Provider. He or she must meet standards set out in the regulations. The registered provider and the registered manager shall, having regard to the size of the care home, the statement of purpose, and the number and needs of the service users, carry on or manage the care home (as the case may be) with sufficient care, competence and skill. The registered manager shall undertake from time to time such training as is appropriate to ensure that he has the experience and skills necessary for managing the care home.
  • Conduct of Care Home – the legislation states that the registered person shall ensure that the care home is conducted for the health and welfare benefits of residents and to make to make proper provision for the care. Also that treatment, education and supervision of residents be provided taking into account their wishes and feelings. The Manager must also take care of their staff and good personal and professional relationships with each other and with residents. Similarly they need to encourage and assist staff to maintain good personal and professional relationships with residents.
  • Health & Welfare– the Registered Person must also monitor all aspects of health and welfare including be registered with a general practitioner of their choice. Also they must make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Likewise they must make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. They must also make suitable arrangements for the training of staff in first aid.

The above represent the fundamental aspects of the Act but there are many other areas where the Registered Person needs to comply with more detailed regulations in the areas of resident assessments, service plans, facilities and staffing issues, records, premises, quality, financial procedures and more.

The main bodies responsible for ensuring regulations are enforced and standards are kept high is The Care Quality Commission. This has evolved from previously consolidations of other organisations; The National Care Standards Commission was established in England under the Care Standards Act 2000, in response to the recommendations of the Royal Commission on Long Term Care in 1999. In 2004, this body was replaced by two organisations, the Commission for Social Care Inspection (CSCI) and the Commission for Healthcare Audit and Inspection (CHAI). In 2009, these two bodies were replaced by the Care Quality Commission. The Care Quality Commission (CQC) is a new independent body which from April 2009 became exclusively responsible for the inspection, monitoring and regulation of health and social care in England.

In June 2009 the CQC launched a consultation on guidance outlining what health and adult social care services will need to do in order to meet new legally enforceable registration standards. It is expected that by October 2010, all nursing homes will be subject to these arrangements. The guidance targets provide constructive goals for people receiving care and what providers should be doing to meet expected results. The criteria to be published in the guidance will be used to choose whether a service provider should be registered or an existing care organisations’ registration maintained.

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