Care Home NOTES for APPLICANTS

Care and Social Services Inspectorate Wales

Notes for applicants applying to register to carry on a care home - for older people and younger adults These notes for applicants are relevant to both individuals and organisations that wish to apply to carry on a care home. In relation to an application from an organisation, (defined as body corporate), the ‘responsible individual’ who will be responsible for supervising the management of an establishment will need to be identified. It is important that the responsible individual has been made fully aware of the responsibilities associated with the role when making an application on behalf of an organisation.

If the care home is carried on by an unincorporated body e.g. an unincorporated charity, the application(s) to register need to be made by an individual or individuals.

We hope that these notes will assist you in: -

 understanding what you need to think about before deciding to apply for registration.  becoming familiar with the Care Homes (Wales) Regulations 2002 and the relevant National Minimum Standards, which must be taken into account by CSSIW in registration decisions.  Understanding the value and importance of developing a clear Statement of Purpose for the service you propose to offer.

When you have read these notes and the other documents provided we hope you will have an outline of: -

 what needs to happen before you will be ready to lodge your application.  what we will do when we get your application. and  what we are looking for.

The most important part of our work is to see that potentially vulnerable people receive high quality services that are both safe and reliable. Vulnerable individuals who require care and support may be at potential risk from harm. Therefore, great care needs to be taken to check that everything is as it should be before a service is permitted to begin to operate. This process is a necessarily detailed and intrusive one. We therefore want you to know that, if you do apply, the information you provide, including your personal details, is treated with care and other than when the law allows, will not be disclosed outside of Welsh Government.

Care Home Applicant Notes Page 1 of 7 09/2013 Why am I required to register? Anyone who provides accommodation and nursing or personal care, for defined categories of people is regulated by law.

The purpose of regulation is to:-  make sure that you are suitable to fulfil this responsibility.  check that you have the knowledge and resources needed to provide and sustain a good quality of service.  ensure that you will engage and support staff with the appropriate qualifications, experience, knowledge and skills to safely meet the needs of the users of the service you intend to provide.  see that your premises are safe and appropriately adapted to meet the needs of all persons using the service.  make sure that the way you go about managing and developing your service is of a good standard.  make sure that you keep appropriate and accurate records. (You are required by law to keep certain records. These will help us in the future to check the quality of the service you are providing.)

Taking each of these points in turn:

How do we set about deciding if you are fit to be registered? Working with information collected through the application form and the papers we ask you to complete at the same time,

 We will check that prospective responsible individuals and registered persons are who they say they are, by the checking their birth certificate, passport, marriage certificate (where applicable) and any other relevant documents.  We will look into applicant’s background. We will undertake checks with the Disclosure and Barring Service and take up personal, professional and financial references as necessary.  Where required we will undertake checks with the Care Council for Wales and any other relevant professional bodies.  We will check that applicants are physically and mentally fit to carry on or be responsible for supervising the management of the care home. We will send to an applicant’s doctor a copy of any medical history they provide to us and also ask the doctor for his/her comments. Sometimes we might need to contact further specialists but we would always discuss this with the applicant first.  We will carry out a ‘fit persons’ interview to test out an applicant’s knowledge of the prospective service area, how you will develop the service and explore your values and beliefs.

Statement of Purpose We view the Statement of Purpose as the key document for the service and this will help form our view of you and the service you propose to provide. All registered services are required to develop and maintain a Statement of Purpose which sets out their aims and objectives including details of the care planning process; ownership, management and staffing arrangements, fire safety arrangements and how to make a complaint among other things.

Care Home Applicant Notes Page 2 of 7 09/2013 We will use this document to clearly establish the type and range of service you intend to provide and post-registration we will continue to compare the service you deliver with what is described in your Statement of Purpose.

Rehabilitation of Offenders Act 1974 Rehabilitation of Offenders Act 1974 says that, for most purposes, and after a fixed time, people no longer have to declare their convictions. You should note however, that this registration application does not include a requirement to disclose offences. Disclosure and barring service checks will ensure that all relevant offences are included in the certificate issued by DBS. Further information on the filtering out of old and minor offences is available from the Disclosure and Barring Service. If the responsible individual or proposed manager have any convictions, we will need to make a judgement about whether this has any implications for the care home application. It is possible to approve applications in this situation and an interview will take place to discuss any information disclosed by the DBS certificate.

If someone is dishonest in order to obtain registration they may be regarded as unsuitable.

Any personal information we have on file about you including Disclosure and Barring Service checks, medical information, personal/professional references and financial references will only be retained for as long as is necessary and in line with the requirements of the Data Protection Act 1998.

The registered persons must demonstrate that there are robust procedures in place for recruiting staff, including DBS checks. In order to do this the agency may register with the DBS. They can be contacted at either, Disclosure and Barring Service, PO Box 165, Liverpool. L69 3JD or via their DBS website: Registration with the DBS is likely to take some weeks and – if you have not already done so - you should apply for registration as soon as you have decided to begin to prepare your CSSIW application. Alternatively you may register with an “umbrella” body which is DBS registered and make your checks via them. Your National or local Care Homes Association should be able to give you details of any local arrangements.

CSSIW may at any time require you to demonstrate that you have checked all staff backgrounds to the required standard. You should also be aware of the provisions of Part VII of the Care Standards Act 2000 and the Protection of Children Act 1999, in relation to the barred lists, kept by the DBS, of individuals who are considered unsuitable to work with vulnerable adults or children. It is an offence to knowingly offer work, apply for work, offer to do work, accept work or do any work in a care position if an individual is included on these lists.

How will we check on your knowledge and resources? As you will appreciate there are standards set for the experience, qualifications, knowledge and skills that registered persons and any staff must have.

Working from information provided in your Statement of Purpose, both parts of your application form and a formal interview we will;

Care Home Applicant Notes Page 3 of 7 09/2013  ask you to provide a full record of what you have done since leaving school. This will include any periods of study, unpaid work and qualifications you have undertaken.  check with previous employers as necessary even if you have not given them as referees to establish what relevant skills and experience you have.  look at any training courses you have attended and, where necessary, check on the detail of what was taught. Where any qualifications are involved we will want to see your certificates and may check details with the body that awarded them.

If you lack the required experience and qualifications to be registered to be in day to day charge yourself, or do not wish to manage the home yourself, you may employ a manager to undertake this task. The manager will be required to submit an application and will be required to demonstrate that they are registered with the Care Council for Wales.

Some of this checking will be done through the interview process. A formal decision about whether you are to be registered and what, if any, conditions might apply to your registration will not be made until all checks have been completed.

How will we ensure you engage and support staff with the appropriate qualifications, experience, knowledge and skills? The range and numbers of staff along with the relevant qualifications, experience, knowledge and skills will be dependent upon the nature and size of service you intend to provide, but will also be determined by the individual and collective needs of people who use your service. Regulations and standards set out, in general terms, what these must be. You will need to demonstrate that the particular staffing proposals for your home will at all times ensure a safe and consistent level of support for people who use your service. The inspector will discuss with you your proposed numbers and skill mix of staff.

If you intend to provide nursing care at your home, you must make provision for a skill mix of staff, and employ appropriately qualified and registered nurses to care for the service users throughout every 24 hour period. You will need to demonstrate that the particular staffing proposals for your home will at all times ensure a safe and consistent level of nursing support for people who use your service. The inspector will discuss with you your proposed numbers and skill mix of staff including the numbers and qualifications of registered nurses.

The provision of nursing care at the home will need skilled management and leadership to ensure that service users receive care that is appropriate to their assessed need, is of a quality standard and is clinically effective. It is recommended that the proposed manager has the relevant nursing qualifications and experience, is currently registered in that respect at first level with the Nursing and Midwifery Council, and can demonstrate previous, preferably recent experience in managing that type of care.

Alternatively, depending on the type of service you provide, if the registered manager does not have a nursing registration appropriate to the nature of the care you intend to provide at the home, you must appoint a suitably qualified first level registered nurse meeting the criteria set out in the above paragraph. This person must be accountable for and responsible for directing the nursing service, and play an active

Care Home Applicant Notes Page 4 of 7 09/2013 role in the management team, including full involvement in multi-disciplinary working arrangements.

How will we go about checking the premises? Working from information supplied in the application form and a site visit or visits to the building you intend to use: we will:

 check to see that you have sufficient control over the premises you intend to use to ensure the safety and freedom of choice of the individuals who you may care for.  check that you will be able to continue to provide a service for a sustained period of time as the people using your services should expect security and stability.  assess how safe the premises are for their intended use, both inside and out.  want to be assured you have the necessary range of facilities and equipment to care for service users, including any provision you may make for dependent nursing patients.  check that the proposed premises are in line with the requirements of the Regulations and National Minimum Standards.

To do this we will:

 check on your tenancy, lease arrangements or ownership of the premises you propose to use to provide the service and that there is planning permission in place that allows you to operate your service from the premises.  ensure that the building, the services supplied (electricity, gas, water etc.) and all the appliances used; (boilers, fires, cookers, fire detection/alarms and call system etc.) are of adequate design, regularly inspected and maintained.  check that you have had fire safety training and that you have followed or are committed to following the advice provided by the Fire Officer.  ensure that you have obtained the necessary technical and/or specialist advice where appropriate.  work with you to ensure that common hazards inside the buildings, such as hot surfaces, hot water temperatures, non safety glass, trip/fall hazards, electricity sources, dangerous chemicals etc. are identified and suitable risk management measures put in place.  work with you to ensure that common and specific sources of hazard outside the building are identified and suitable risk management measures put in place.  check that your arrangements for providing First Aid are satisfactory, that your staff will receive suitable training and that your plans for responding to an emergency are well thought out.

How will we check your proposed way of working? We will carefully consider what you say you will do to meet the Regulations and National Minimum Standards and we will use a formal “Fit Person” interview or interviews to discuss any of your answers where we feel we do not have enough information to make a decision or we need to discuss an issue with you further.

 We will look closely at the Statement of Purpose for your proposed service; this should tell ourselves and others exactly what sort of service will be provided and how.

Care Home Applicant Notes Page 5 of 7 09/2013  We will look at how you will meet the Regulations and each of the National Minimum Standards, which will be collected using Part 2 of the application form.  We will examine your proposals to assess whether the information you have supplied adequately upholds the Statement of Purpose.  We will look in detail at how you intend to assess, select and prepare staff and the records you intend to keep in relation to them.  We will look at the way in which you intend to assess and support individuals in your care and the records you intend to keep in relation to them.  We will look at how you intend to involve people who use your service in its day to day operation and in maintaining and developing its quality.  We will examine the documents and information you intend to supply to service users and purchasers and how you intend to use them.  We will carefully assess the suitability of the policies you intend to use.  We will consider how you intend to manage the records you are required to keep in relation to the environment.  We will look at how you intend to use your time and that of your staff and at the range of activities, opportunities and choices you intend to provide for service users.  We will look at how you intend to deal with concerns and complaints, including those which arise from a whistle blower.  We will look at how you will manage, monitor, control and develop the quality of all aspects of the service you provide.

Next steps We suggest that you now take a close look at the relevant Regulations and National Minimum Standards for the services you propose to provide. Both of these can be accessed through the CSSIW website at: www.cssiw.org.uk Once you have done this we anticipate that the structure, purpose and requirements of the attached application forms will all become clear. The forms are: if you are an individual applying for registration:  Part 1 if the application is made on behalf of an organisation;  Part 1B.  Part 1A (Manager) will also need to be completed if the application is made on behalf of an organisation.

For both individuals and organisations:

 Part 2 (evidence of ability to meet the relevant Regulations and NMS),  DBS request  Medical declaration  Financial enquiry.

In relation to an organisation, checks will be carried out on the responsible individual and manager and additional information about the organisation will be required.

Should you have any questions at this stage about the requirements and process we would be glad to discuss these. You should however note that it is for you to prepare and structure your application and you should be prepared to obtain Care Home Applicant Notes Page 6 of 7 09/2013 advice from your own independent sources. It is also up to you to demonstrate that you will be able to meet the relevant Regulations and National Minimum Standards and maintain these standards. You must provide evidence for this purpose. It would clearly be inappropriate for your future regulator to become involved in advising on the detailed nature of your business decisions, choices and risks.

Conclusion As you can see, the process is complex, demanding and detailed. Preparing a satisfactory application can involve a considerable initial investment of time and some unavoidable expense. An application that has been well thought through and contains all necessary supporting information will require less time and effort to process it to the point of determination. An application which has not been thought through and contains little supporting information will take longer to process and runs a higher risk of refusal.

Nonetheless, as we said at the outset of this explanation, we believe that the process of preparing for and securing registration provides an opportunity to lay a sound foundation for the future regulatory relationship between registered provider(s) and CSSIW. We will endeavour to do all we can to make the process and requirements clear and the basis of the regulatory process transparent.

We hope that you will find this to be the case and we look forward to working with you if you decide to proceed.

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