National care standards: short breaks and respite care services for adults

1-6 Before using the service (standards 1 to 6)

1 Informing and deciding
2 First meetings
3 Your legal rights
4 Positive experiences
5 Management and staffing arrangements
6 Individual agreement

Introduction to standards 1 to 6

Informing and deciding

A short break or respite care should be a positive experience for you and your carer (if you have one). It improves your quality of life by providing an opportunity to have a break from your usual routine. You make a positive and informed decision about the break, helped by the quality and accuracy of the information you receive.

Most breaks last from a few hours to a few weeks. Some breaks support you if you have more complex needs, with longer planned breaks, or as an introduction to independent living. The pattern of breaks may change to allow for your changing needs. While most breaks are planned, emergency care is sometimes needed, and standards reflect this. This may be the case if the short break relates to family stress or illness rather than long-term disability.

You must have proper information to help you reach a decision. You can expect it to be up to date and reliable, in a format and language that you can easily understand and keep. Information about the services should be backed up by details that give you confidence that the break will meet your support and care needs.

First meetings

Being able to meet a representative of the service, or to visit the accommodation or to have someone visit you, is essential to making a positive choice about using the service. You may sometimes want your family, carer, friends or representatives to be able to be involved in these meetings as part of helping you to decide. You can expect that the people who will be giving you support and care will respect your need to have enough time to make a decision.

Positive experiences

Whatever the nature of your break, you can expect to enjoy a range of positive experiences. For example, if the break is away from your own home it will accommodate you and any equipment you need in a way which supports your right to privacy and dignity. If the break is in a care home with permanent residents, the standards will be carefully applied to make sure that your rights and choices and those of the permanent residents are respected and that the experiences in both cases are positive.

Your wellbeing and safety are most important in whatever environment you are in.

Management and staffing arrangements

You must be confident that the service is managed properly and gives those providing it the support and training they need to provide good quality care, in line with relevant legislation and guidelines.

You must also feel confident that the respite care you receive is tailored to fit your individual needs and those of your carer. An 'individual agreement' records your hopes of the service and your needs, and how the provider will meet these. You can expect that, with your permission, those providing your care and support will know all the relevant aspects of the agreement. You can also expect to be able to discuss your needs with your care manager and service provider beforehand.

Informing and deciding

Standard 1
You have all the information you need, in a format that you can easily understand, to help you decide about taking a short break or using respite care.

1 You receive advice and support to make sure that the information reflects your own situation and need.

2 Your carer's need for information, advice and support will be respected and responded to.

3 You have unbiased information about the possible benefits or disadvantages of a short break or respite service. Your carer's needs are taken into account when considering the possible benefits of the service.

4 You and your family, carer or representative can discuss your choice of service with staff from the short breaks and respite care service.

5 You have detailed information about the service in a language and format that you can easily understand. The information covers:

• the aims of the service;
• the kind of service it provides;
• the cultural needs it caters for;
• the basic cost of the service and the likely charge to you;
• your rights and responsibilities as someone who uses the service;
• insurance cover for you and your belongings;
• risk assessment procedures;
• arrangements that need to be made if the service closes or if there is a change of ownership; and
• the complaints procedure and how to use it.

6 Where the short break and respite service includes an overnight stay away from your own home, your information includes:

• living arrangements and lifestyle;

• the physical layout and design of the accommodation;
• details of the accommodation, including the number and type of rooms;
• visiting arrangements;
• personal belongings (including pets);
• any restrictions on smoking and alcohol;
• policies and procedures about the possession of unauthorised alcohol or drugs during your stay; and
• arrangements with local health and social work services.

First meetings

Standard 2
You can visit or be visited by a representative of the services which you feel might be suitable and discuss your needs before making any choice.

1 You can meet a representative of the short break or respite care service at least once, to help you reach a decision about the service at your own pace.

2 If you want, family members, friends or your independent advocate (representative) may be involved in these visits.

3 If the break is to be in your own home you can meet the person who will provide your care, to discuss your needs.

Your legal rights

Standard 3
You can be confident that the service has written policies and practices (for example, on data protection and health and safety) covering the key areas for standards for short breaks services. These are updated in line with legislation and policy developments.

1 You have a written signed agreement ('individual agreement') with the service provider which defines how the service will provide for your needs.

2 You have a copy of this written agreement in a format you can understand.

3 If your short break is in a care home, you have full information on your legal position about your occupancy rights in the care home. This will include:

• the terms and conditions of accommodation and residence;
• payment arrangements; and
• arrangements for changing or ending the agreement.

4 You can ask for, and be given, a full list of the service provider's policies and procedures which show how it complies with all relevant legislation guidance and standards relating to fire, health and safety procedures and risk management.

Positive experiences

Standard 4
You can expect to enjoy a range of positive experiences during your short break or respite.

1 You know that the service ensures your wellbeing and safety, whatever setting you are in.

2 If the break is away from your own home, the environment will accommodate you and any equipment you need in a way which supports your right to privacy and dignity.

3 If the service is provided in a care home you can be confident that you will be staying in a comfortable and homely environment and that the care home meets the standards for environment for care home services.

4 If the break is away from your own home, your views, and those of your carer or representative, about your room, will be listened to.

5 Where the service is provided alongside facilities for long-term care, there is separate accommodation for people using respite care. The people using the service will be of a similar age to yourself.

Management and staffing arrangements

Standard 5
You experience good quality support and care. This is provided by management and staff whose training and expertise allows them to meet your needs. The service operates in line with all applicable legal requirements and best-practice guidelines.

1 You know that those providing your care and support are actively encouraged to take part in training.

2 You know that those providing your care and support have public liability insurance and appropriate car insurance.

3 You can be confident that those providing your care and support are supported at all times by skilled and experienced professionals who have the time to do so.

4 You know that those providing your care and support are all recruited and selected through a process which includes:

• taking up references;
• criminal records checks, where appropriate; and
• cross-reference to the registers of the Scottish Social Services Council, NMC or other professional organisations, where appropriate.

5 You can be confident that those providing your care and support are trained and supported to meet your needs without damaging your health or theirs.

6 You are supported by sufficient staff who will help you in your agreed activities without unreasonable risk to yourself or others.

7 You can be assured that the service has policies and procedures which cover all legal requirements, including:

• staff and training;
• administration of medication;
• health and safety;
• 'whistle-blowing';
• environmental health;
• fire safety;
• managing risk; and
• proper record-keeping, including recording accidents, incidents and complaints.

8 You can be confident that staff know how to put these policies and procedures into practice. They have regular training to review this and to learn about new guidance.

9 You can be confident that those providing your care and support will not use restraint at all unless it is permitted by law and even then, restraint will not be used until other interventions have failed. If you are ever restrained, this will be recorded and you can expect to be supported after any episode of restraint.

Individual agreement

Standard 6
As far as possible, the individual agreement covers your own and your carer's wishes of the service and what is to be provided. It records an assessment of your needs that is carried out by the provider. The agreement is in a language and format that you can easily understand.

1 The individual agreement includes:

• a record of the agreed service, including what the service is, how long it will last, how often it is provided, its purpose and cost;
• a record of your hopes and your carer's hopes of the service and how the provider will meet them;
• arrangements for reviewing the service being provided;
• what you prefer to be called;
• a record of your individual choices and preferences, including social and recreational activities;
• for a break away from your own home, a record of your preferred accommodation;
• your personal care needs;
• your food preference and any special dietary needs;
• the management of medication and any other medical procedures;
• cultural, faith, religious and spiritual needs;
• risk-taking;
• contact details; and
• procedures to be used in emergencies.

2 You can meet a member of staff to discuss your needs before agreeing any service. With your permission, information will be made available to the provider to help them decide if they can respond to your needs.

3 You can invite anyone you want to support you in making your needs known.

4 Your carer or representative can contribute to any discussions about your needs in relation to what the service can offer.

5 You have your wishes listened to, and respected, over the purpose of the short break service. The needs and wishes of your carer or representative are taken into account.

6 You can be confident that the service provider records the views of your carer or representative separately and considers them when finalising details of the service that will be provided.

7 If your views and those of your carer about the delivery of the service are different, you will both be helped to reach an acceptable compromise.

8 You know that the individual agreement takes account of the other services that are provided as part of your care package.

9 A copy of your individual agreement is given to you, and also to your carer or representative if necessary, and with your permission.