National Care Standards: Care homes for people with learning disabilities

Before moving in

1 Informing and deciding
2 Trial visits
3 Your legal rights
4 Your environment
5 Management and staffing arrangements
6 Support arrangements

Introduction to standards 1 to 6

Standards in this section are grouped around aspects of the service that are offered before you move in. You need to know what choices are available to you and to receive information about the home to help you judge in advance what your quality of life will be like in a care home.

Deciding to move into a care home, even for a short time, is a big decision, and you must have proper information to help you reach that decision. You can expect the information to be up to date and reliable, and set out in a way that you can easily understand.

Trial visits

Being able to visit the care home and spend some time in it, talking to people who live there and members of staff, is essential to making a positive choice about moving in. You may sometimes want your relatives, friends, carers or representatives to be able to visit as part of helping you to decide. You can expect that providers will respect your need to have time to make a decision.

Your legal rights

You and your carer, relatives or representative must be confident that the home is being managed properly, in line with relevant legislation and guidelines. You must know what would happen in an emergency or if the home closed.

Your environment

Each care home will have its own special features and layout depending on the building and the needs of the people who use its services. The design and layout of the physical environment help to make sure that you can enjoy living in safe and comfortable surroundings. The design and layout of the physical environment should also be accessible to disabled friends or relatives who wish to visit.

The standards in this section do not describe in detail the wide variety of needs of everyone who lives in a care home. The providers must make sure that the statement of function and purpose that they give to the Care Commission when they are applying for registration describes the type of service they want to provide and who they want to provide it for. The Care Commission will make sure that the provider keeps to the statement of function and purpose.

Providers must meet legal requirements, such as those relating to the structure of the building, health and safety matters and fire safety procedures. There are other regulatory organisations which the provider must answer to about these matters. However, the Care Commission and you will want to know that the service meets all the necessary legal requirements.

Scottish Ministers have announced the physical standards for care homes for adults. These are set out in this section. They show the differences between standards for new homes (new build as well as extensions to existing buildings), and existing buildings. Existing homes will not have to meet the standards for new homes even if a change of proprietor triggers a new registration.

Management and staffing arrangements

The standards in this section are about knowing that the people who are responsible for your support and care have all the necessary experience, skills and training to meet your needs. If they are to provide you with the best possible service, they must know what works well and be able to do this for you.

Because your needs may change over time and because every person living in the care home will have their own changing needs, the provider must make sure that the management and staffing arrangements are always sufficient to meet these needs. This is reflected in the standards. They do not set exact requirements about the number and skills mix of the staff but make it clear that the service must always meet the needs of the people using it.

Scottish Ministers know it is important to have enough trained staff in care homes. They have set standards for this which applied from April 2002 onwards. These are set out in this section.

Support arrangements

You will want to know that the care home can meet your particular needs as well as giving you the opportunity to maintain or develop your interests. Personal plans take account of this, and describe the way you will receive the individual support and care that you need. You can expect that the provider will discuss your needs with you before offering you a place in the care home. You can also expect that your personal plan will change as your needs for support change.

Informing and deciding

Standard 1

You have all the information you need to help you decide about moving into, or going to stay in, a care home.

1 You have an introductory pack which clearly explains the moving-in process. Everything is written in plain English or in a language and format that is suitable for you. It should include:

• the care home brochure;
• the charges and the services they cover;
• the accommodation and service provided;
• the number of places provided;
• arrangements that need to be made if private funding runs out;
• the home's philosophy;
• any rules that the home has;
• the complaints procedure;
• the most recent inspection report on the home;
• a statement of your rights and responsibilities as a resident;
• policies and procedures for managing risk and recording and reporting accidents and incidents; and
• arrangements agreed with the Care Commission to be put in place if the care home closes or if there is a new owner.

2 Before deciding about moving into a care home, you can talk it over with the staff and others in the care home.

Trial visits

Standard 2

You have the chance to visit the home and to meet the staff, management and some of the people who live there before you move in.

1 You can visit the home at least once to help you decide, in your own time, about moving in.

2 If you want, family members, your carer or your representative may be involved in these visits, and be involved at all stages of the planned move.

3 You can discuss the move with people who know a lot about where you are going including the staff of the care home and other people living there.

4 You can get to know others who may live with you and agree how to share your home.

Your legal rights

Standard 3

You have full information on your legal position about your occupancy rights in the home. You are confident that the home is run in line with all applicable legal requirements.

1 You get a written agreement which clearly defines the service that will be provided. It sets out terms and conditions of accommodation and residence, including your rights to live in the home, payment arrangements, and arrangements for changing or ending the agreement.

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

3 You can ask for, and be given copies of, the care home's policies and procedures.

4 You can ask for, and be given confirmation that, the home meets with all the relevant legislation and guidance relating to fire, food hygiene safety, health and safety procedures, and risk management.

5 You are told by staff about the need to insure your personal belongings and can choose to insure them.

Your environment

Standard 4

Your environment will enhance your quality of life and be a pleasant place to live.

1 You will be able to move around easily in the home and its grounds.

2 You can expect that the home is run in a way that protects you from any avoidable risk or harm, including physical harm and infection. The nature of its design, facilities and equipment also protect you.

3 You can expect that the care home is kept clean, hygienic and free from offensive smells and intrusive noise throughout. There are systems in place to control the spread of infection, in line with relevant regulations and published professional guidance.

4 You can bring personal belongings with you into the care home, including some of your furniture.

5 All bedrooms and public rooms will have windows. You should expect to be able to sit somewhere and have a view out of a window.

6 The door to your room will have a lock which you can use. Staff will be able to open the door if there is an emergency.

7 You can control the heating, lighting and ventilation in your room.

8 You can expect that the rooms and corridors are kept in good decorative order, and that the home and furnishings are well maintained and only essential notices are displayed.

9 You receive information about what to do if there is a fire or other emergency.

When you are moving into an existing home, the following standards will apply.

10 By 2007, you will be able to have a single room if you want.

11 Your room should have at least 10.25 square metres of usable floor space, not including en-suite facilities ².

12 If you choose to share a room, it should have at least 16 square metres of usable floor space, not including en-suite facilities ³.

13 If the provider wants to install en-suite facilities (which may only be a toilet and wash-hand basin) these must be 3.5 square metres or more. If providers want to install a shower or bath, the same conditions as for new care homes apply ⁴.

14 If the provider is upgrading accommodation, they must discuss this with the Care Commission ⁵.

15 The shared space will be 3.9 square metres for each person living in the care home, not including corridors and circulation areas.

16 You will be able to lock the toilets, bathrooms and shower rooms but staff will be able to open the door if there is an emergency.

When you are moving into a new care home the following standards will also apply⁶.

17 You will be able to have a single room if you choose.

18 Your room will have at least 12.5 square metres of usable floor space, not including en-suite facilities.

19 If you and your husband or wife, partner or friend want to share a room, new homes will provide larger bedrooms of at least 16 square metres. All sizes exclude en-suite facilities.

20 You will have your own en-suite bath or shower facilities. The en-suite will include a toilet and wash-hand basin, with a shower or bath. Where the en-suite has a 'wet' floor shower, wash hand basin and toilet, the size will be at least 3.5 square metres. For a shower tray or bath, the size will need to be more than 3.5 square metres.

21 You will enjoy easy access, with all inside doors having a clear opening width of 840 mm, off wide corridors (of at least 1200 mm). Shared space will be at least 3.9 square metres for every person who lives in the home, not including corridors and circulation areas.

22 You will be in a building where there is the capacity to install modern equipment, such as:

• hoist tracking;
• environmental control equipment;
• call systems and alarms;
• specialist communication equipment;
• signs (taking account of individual needs such as sight and hearing difficulties, learning disabilities and dementia);
• grabrails; and
• smart technology.

23 If the home has more than one floor, there will be a passenger lift which you can use.

24 You will be able to lock the toilets, bathrooms and shower rooms but staff will be able to open them if there is an emergency.

Management and staffing arrangements

Standard 5

You experience good-quality support and care. This is provided by management and staff whose professional 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 can be assured that the home has policies and procedures which cover all legal requirements, including:

• staffing and training;
• administration of medication;
• health and safety;
• 'whistle-blowing';
• environmental health;
• fire safety;
• managing risk;
• proper record-keeping, including recording accidents, incidents and complaints; and
• visits made to the home, including visits by children.

2 You are 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.

3 You are confident that the staff providing your support and care have the knowledge and skills gained from the experience of working with people whose needs are similar to yours. If they are new staff, they are being helped to get this experience as part of a planned training programme.

4 You are confident that all the staff use methods that reflect up-to-date knowledge and best-practice guidance, and that the management are continuously striving to improve practice.

5 You know that the home's staff, managers and volunteers are all recruited and selected through a process which includes:

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

6 You are confident that any volunteers who work in the care home are familiar with all the home's policies and procedures. They receive all the relevant training to help them put these into practice.

7 You are confident that at all times the number of staff who are trained and who have the necessary skills will be sufficient to meet your support and care needs. The levels are agreed between the Care Commission and the home owner or manager.

8 You know that at least 50% ⁷ of the staff directly caring for you are either trained to at least SVQ2 level or equivalent or are working towards achieving the relevant qualification required for registration with the SSSC⁸.

9 You know that the service has a staff development strategy and an effective yearly training plan for all its staff. For staff caring for you directly, this focuses on them achieving the qualifications required for registration with the SSSC⁹.

10 You know that the home has a written policy and procedures on the conditions under which restraint is used, and that staff are fully trained and supported in the use of restraint. If it is necessary to restrain you on certain occasions this will be written into your personal plan and records kept of any incidents involving your restraint. You can expect to be supported after any episode of restraint. (Restraint ¹⁰)

11 If your medicines are being organised for you, you can be sure that the staff who are doing this are knowledgeable and trained to do so, following up to date best-practice guidance. The staff are fully aware of the home's systems for giving medication. They know how to store and administer your medication safely and in the way that suits you best.

12 You can be sure that, whether or not you are organising your own medication, the staff are trained to check this. They will, with your agreement, get advice from your GP if there are any concerns about your condition or the medication.

13 You know that whenever staff are involved in any financial transaction with you or for you, it will be carefully recorded. This will be in a way that can be checked by the Care Commission.

Support arrangements

Standard 6

You can be confident before moving in that the home will meet your support and care needs and personal preferences. Staff will develop with you a personal plan that details your needs and preferences and sets out how they will be met in a way that you find acceptable.

1 Your personal plan reflects your changing hopes, choices, needs and responsibilities. The provider, with your permission, will use the plan to help them decide if the care service can meet your needs.

2 Your personal plan includes information and decisions about:

• what you like to be called;
• what you like to eat and drink;
• how you spend your time and what you like doing;
• any equipment and adaptations you may need;
• who should be involved in reviews of your care;
• any communication needs you may have;
• what communication arrangements you need if your first language is not English;
• your individual health needs and how these should be met (where appropriate, they take account of your ethnic and cultural background);
• your arrangements for taking any medication including any need to inform professionals;
• an independent person to contact if you want to raise a concern or make a complaint; and
• any measures of restraint which staff may have to use for your own safety or for the safety of others.

3 You receive a copy of your personal plan to keep.

4 When moving in, you will have the chance to be assessed for the full range of equipment, adaptations and other services that you require to meet your needs.

5 Your personal plan is reviewed every six months, or sooner if you want.

6 You may choose who should be involved in the development of your personal plan and in its reviews.