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Care home briefing 93 – As the dust settles on re-registration, are you complying with the new regime?

The re-registration of providers under the Health and Social Care Act 2008 (the Act) was completed last year. However the Act also brings into force a new system of compliance with the regulatory framework. The old National Minimum Standards have gone, to be replaced by new Regulations and the Essential Standards of Quality and Safety. These are not just new rules as they also signal a new approach. Each Regulation is underpinned by 48 Outcomes. CQC inspection and review will focus on those Outcomes, not just the systems in place.

It is no longer, for example, simply a matter of producing Care Plans and Policies to show compliance with the Regulations.  These remain important but there will also be a need to demonstrate positive outcomes for service users. The new approach will mean that it will be necessary to be able to show how providers are actually achieving the outcomes required. That will mean that it will be necessary to be able to produce evidence to demonstrate compliance with the required outcomes.

This evidence is likely to include:

  • Feed back from residents, relatives and advocates
  • The results of user surveys
  • Comments from Commissioners and external Agencies such as the Local Safeguarding Authority
  • Evidence from complaints procedures
  • Untoward incident investigations

It will therefore be even more important than before to ensure that complaints and untoward incidents are properly dealt with. Further, these should then be used as learning experiences and the necessary changes made to policies and procedures. However, it will be important to ensure that the process does not end there. Providers will need to be able to demonstrate that they have audited and tested the changes to evidence that they have achieved the positive outcomes from this that are now required.
CQC reviews in the future will require a careful consideration of this evidence. Providers should focus in particular on the 16 key Outcomes (see table below) and would be well advised to put in place a regular regime of selfassessment followed up by action to address any deficiencies identified.


Outcome  Title and summary of outcome
4 Care and welfare of people who use services
People experience effective, safe and appropriate care, treatment and support that meets their
needs and protects their rights.
16 Assessing and monitoring the quality of service provision
People benefit from safe, quality care because effective decisions are made and because of the management of risks to people’s health, welfare and safety.
7 Safeguarding people who use services from abuse
Safeguarding people who use services from abuse People are safeguarded from abuse, or the risk of abuse, and their human rights are respected and upheld.
8 Cleanliness and infection control
People experience care in a clean environment, and are protected from acquiring infections.
9 Management of medicines
People have their medicines when they need them, and in a safe way. People are given
information about their medicines.
5 Meeting nutritional needs
People are encouraged and supported to have sufficient food and drink that is nutritional and balanced, and a choice of food and drink to meet their different needs.
10 Safety and suitability of premises
People receive care in, work in or visit safe surroundings that promote their wellbeing.
11 Safety, availability and suitability of equipment
Where equipment is used, it is safe, available, comfortable and suitable for people’s needs.
1 Respecting and involving people who use services
People understand the care and treatment choices available to them. They can express their
views and are involved in making decisions about their care. They have their privacy, dignity
and independence respected, and have their views and experiences taken into account in the
way in which the service is delivered.
2 Consent to care and treatment
People give consent to their care and treatment, and understand and know how to change
decisions about things that have been agreed previously.
17 Complaints
People and those acting on their behalf have their comments and complaints listened to and acted on effectively, and know that they will not be discriminated against for making a complaint.
21 Records
People’s personal records are accurate, fit for purpose, held securely and remain confidential.
The same applies to other records that are needed to protect their safety and wellbeing.
12 Requirements relating to workers
People are kept safe, and their health and welfare needs are met, by staff who are fit for the job
and have the right qualifications, skills and experience
13 Staffing
People are kept safe, and their health and welfare needs are met, because there are sufficient
numbers of the right staff.
14 Supporting workers
People are kept safe, and their health and welfare needs are met, because staff are competent
to carry out their work and are properly trained, supervised and appraised.
6 Cooperating with other providers
People receive safe and coordinated care when they move between providers or receive care from more than one provider.

Andrew Parsons
© RadlifeesLeBrasseur


This briefing is for guidance purposes only. RadcliffesLeBrasseur LLP accepts no responsibility or liability whatsoever for any action taken or not taken in relation to this note and recommends that appropriate legal advice be taken having regard to a client's own particular circumstances.