The Care Standards Act 2000 established a major regulatory framework for social care to ensure high standards of care and will improve protection of vulnerable people. Implementation led to the establishment of the independent National Care Standards Commission (NCSC). Link to published legislation and access DH standards and regulations in regard to the Act.
The Care Standards Act 2000 creates a new regulatory framework for all currently regulated social care and independent health care services. This circular provides detailed guidance as to how service providers currently regulated under the Registered Homes Act 1984, The Children Act 1989 and the Nurses Agency Act 1957, will have their current registration or licence transferred into registration with the National Care Standards Commission(NCSC).
The Order also sets out the following: · What, if any, additional information providers must give before their registration can be transferred; · What happens where a decision to cancel registration has been taken or other enforcement action is ongoing; · The process for transferring some applications for registration from current regulators to the NCSC where these cannot be completed before 1 April 2002; · The process whereby managers, in certain provision, who were previously exempt from registration must make applications to the NCSC, and; · The process by which previously exempted provision must make applications to the NCSC for registration. 2. Action 2.1 Local authorities and Health Authorities are responsible for the completion of the Transfer of Registration Form, to go to providers and the exchange of other data about current regulated provision which is required by the NCSC during the transitional period. This is required to provide information about finance issues, dates of inspections and such things as outstanding enforcement action. To facilitate this exchange the Department has already provided registration and inspection units with an electronic database and detailed information as to how the database works. Registration and inspection units will decide on what new type and category of registration individual service providers will be placed in under the Care Standards Act. They are also responsible for the transfer of applications for registration that cannot be completed before 1 April to the NCSC and the handling of cases where a decision to cancel a registration or licence has been made. The attached guidance provides detailed information on the completion of the form and the allocation of type and category. 2.2 Authorities are required to take action according to the attached guidance and to the timetable set within it. We will also be sending you a copy of the final Transitional Order in due course.
Those services previously regulated, including residential care homes for adults, nursing homes and children's homes continue to be registered and inspected but the powers of registration and inspection were removed from local and health authorities and passed over to a new national public authority called the Commission for Social Care Inspection.
For the first time previously unregulated care services will be brought under the regulatory umbrella including:
Domiciliary social care providers Independent fostering agencies Residential family centres Boarding schools
Another aspect in which the old and new contrast is the prescriptive nature of the new provisions. The 1984 Act left a great deal of room for manoeuvre. Words such as "adequate , "sufficient and "suitable proliferated enabling home owners and Registration Authorities to negotiate over particular standards in particular geographical areas and circumstances. Much of this flexibility and, it has to be said, ambiguity is sought to be swept away by the new order. In providing for detailed Minimum Standards, applying nationally rather than locally, thereby also attempting to dispense with variations we have encountered between different registration areas hitherto.
Greater certainty and less ambiguity is to be welcomed but home owners have found that the legislation severely curtails their rights and, essentially decides many areas of potential dissent in advance but against them by giving absolute power to the new regulatory body, the Commission for Social Care Inspection ("CSCI").
Homeowners who felt inspection officers were too powerful before have discovered that, although the description "omnipotence" may be going too far, their regulatory armoury is far greater than before and their hand is evident in drafting much of the Act and, of course, the standards themselves.
The CSA creates many notable new powers for inspectors, some of which caused a few raised eyebrows. For example:
"S.31(1) The registration authority may at any time require a person who caries on or manages an establishment or agency to provide it with any information relating to the establishment or agency which the registration authority considers it necessary or expedient to have for the purposes of its functions under this Part."
"(3) A person authorized by virtue of this section to enter and inspect premises may:
a) Make any examination into the state and management of the premises and treatment of patients or persons accommodated or cared for there which he thinks appropriate
b) Inspect and take copies of any documents or records (other than medical records) required to be kept in accordance with regulations under this part section 9(2) the Adoption Act 1976, section 23 (2)(a) or 59(2) of the 1989 Act or section 1(3) of the Adoption (Intercounty Aspects) Act 1999.
c) Interview in private the manager or the person carrying on the establishment or agency."
"(6) The person so authorised may, with the consent of the person mentioned in subsection (5)(b) examine him in private and inspect any medical records relating to his treatment in the establishment The powers conferred by this subsection may be exercised in relation to a person who is incapable of giving consent with or without the person's consent."
"S32(2) A person so authorised may require any person to afford him such facilities and assistance with respect to matters within the person's control as are necessary to enable him to exercise his powers under section 31 or this section."
"(3) A person authorised by virtue of section 31 to inspect any records shall be entitled to have access to, and to check the operation of; any computer and any associated apparatus which is or has been in use in connection with the records in question."
The minimum standards were settled some time ago.
Legal Minimum Standards for care providers are an innovation. Previously local "guidelines" or the like did not have any force of law so that they were all capable of challenge. This is a very important aspect of the new legislation in that it provides a whole raft of new legislative provisions with which care providers must comply or risk prosecution or cancellation proceedings.
The CSA dawns a new age in care. It is right that this should happen now given the demographic outlook over the next 30 years but the central question remains - will funding be sufficient to provide for the excellence to which we all aspire?