MIT Consultancy Blog

Care Home V Supported Living
Monday 16 February 2009

Small Care homes are finding themselves in troubled water, as social services take on CSCI.

Many social services are no longer contracting with a selected number of specialised care homes. They are instead opting for the cheaper and unregulated service of supported living. The credit crunch has forced social service to consider creative methods of saving money. Many local authorities are challenging the funding in care homes for the more able resident in the category of mental health and learning disability. They are arguing that the legislation under the care standards act states that in order to be registered for a care home the home has to provide ‘ personal care’ which is not the case in a number of homes.

The dilemma for care homeowners is that they are unlikely to be able to deregister – and the local authority will not pay the sustainable rate for the resident to maintain the home.

However the local authority and the provider of the supported living scheme run the risk of fined £5000 for proving care without being registered. This fine will be increased to £50000 from April 2009 when the ‘Care Quality Commission ’ takes over from CSCI.  

Following the case of Jeese Moores who died from chocking in a residential care home, it is of the utmost imperative that care homes ensure that staff are trained to deal with chocking risk.

The risk is particularly significant to the categories of residents that suffer from learning disability and mental health. However it is important that managers ensure that this training is provided to all staff regardless of category.

All home should also ensure that they have a nominated first Aid person on each shift. They should be trained to HSE accredited standards.

Legal duties

The Health and Safety (First-Aid) Regulations 1981 require employers to provide adequate and appropriate equipment, facilities and personnel to enable first aid to be given to employees if they are injured or become ill at work. These Regulations apply to all workplaces including those with five or fewer employees and to the self-employed. Detailed information can be found in the Approved Code of Practice and Guidance: First aid at work. The Health and Safety (First-Aid) Regulations 1981 L74

CQC Regisration

From 2010/11, the Care Quality Commission will register all providers of health and adult social care services against a single set of registration requirements that are focused on the safety and quality of care. Without registering with the Care Quality Commission, it will be illegal for health and adult social care organisations to provide services that are in the scope of the new framework. To maintain their registration, providers will need to demonstrate an ongoing ability to meet all the requirements.

In addition, primary medical and primary dental care will also be brought into regulation by the Care Quality Commission. Given the increasing range of services offered in primary care, including minor operations and other services traditionally provided in hospitals, it is important that patients have the same degree of protection, regardless of where they receive their care. This means that, for the first time, all 8500 GP practices and 9000 high street dental practices will be required to register with the Care Quality Commission, regardless of whether they provide solely private, solely NHS services, or a mix of both.

Although GPs and other healthcare professionals are already individually registered by their professional governing bodies, this framework will give further reassurance to patients that they are protected. The Department of Health is working with relevant stakeholders to consider further how the new registration system will interact with existing regulation in this area.

Health Minister, Ben Bradshaw said:
"The way that health and adult social care services are being delivered is changing. The same person may well receive care from both health and social care providers in a range of settings including at their GP surgery, community or residential settings, hospital or from a range of public or independent providers.

"This is the first time that one single registration framework will ensure that the health and adult social care services people receive will be safe and of a high quality regardless of which organisation is providing it."

Cynthia Bower, Chief Executive, Care Quality Commission said:
"We are pleased that the response to the Department of Health's consultation is now published and we can take the draft regulations into our discussions with stakeholders to develop our methods for implementing the new registration system. The new system provides a historic opportunity and we are determined to ensure that we expand on the work done to date by the Department and build a robust framework of assurance of quality across all of health and social care."

This new system replaces the different sets of existing requirements and standards for each different provider - whether they are from the NHS, local authority, independent or voluntary sectors. The registration requirements provide flexibility for care providers, setting out what they must do, but not stipulating how they must do it.

The Department of Health has consulted widely to bring together the most appropriate regulations to enable the system to work effectively for health and adult social care, whilst also reflecting differences in the nature of services delivered by providers, for example, differences between how hospitals and residential care homes provide services.

Subject to Parliamentary approval, the registration system will be introduced from 2010/11. For the NHS, registration with the Care Quality Commission against requirements on healthcare associated infections (HCAI) will be implemented from April 2009.
Notes to Editors:

1. The new registration requirements will replace the core Standards for Better Health (which apply to the NHS), and the National Minimum Standards and Regulations (which apply to social care and independent sector health providers).

2. The Care Quality Commission will develop guidance that clearly sets out how it will judge compliance with the regulations and take appropriate action against those who fail to provide care that meets essential requirements on safety and quality.

3. The Department of Health has consulted widely on the overall regulatory framework. The November 2006 consultation document, The future regulation of health and adult social care in England, set out proposals for aligning the regulation of health and adult social care and making it consistent for providers from all sectors. The Government's formal response was published in October 2007: http://www.dh.gov.uk/en/consultations/closedconsultations/DH_063286

 

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