Care home regulations and insurance

Looking after the vulnerable brings many regulations and responsibilities - here’s what you need to know to ensure your care home passes inspection

The wellbeing of your residents should be the primary concern of you and your staff when running a care home.

Keeping this front and centre will ensure your business has a good reputation and continues to attract clientele.

There are organisations and legislation responsible for monitoring the standard of care in the sector that you should be aware of.


Registering with the Care Quality Commission

According to Mancier, as well as “plethora of legislation applicable to all businesses, when operating in the care home sector there is an additional raft of care home regulations.”

As the care home owner, you will need to be deemed a “fit and proper person” by the Care Quality Commission (CQC), meaning your suitability will be assessed on whether you meet the following criteria: capability, qualifications, financial standing, physical and mental health, any relevant prior convictions and financial stability.

You will have to demonstrate this with “sufficient documentation”.

The CQC was established in 2009 to regulate, inspect and ensure care in care homes, in people’s own homes, hospitals, dentists, and ambulances is safe and of a high quality.


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Your care home must meet “fundamental standards of quality and safety”.

These fundamental standards include:

  • Person-centred care – you must tailor your care to meet the needs of the individual
  • Dignity and respect – you must treat your resident with dignity and respect. This means privacy when needed or requested, equal treatment for all and support to help them remain independent and involved in community
  • Consent – the resident or anyone legally acting on their behalf must give consent before any treatment is given to them
  • Safety – you must assess the health and safety risks of your resident before giving any treatment and any staff giving treatment must have the necessary qualifications, skills and experience to keep them safe
  • Safeguarding from abuse – residents must not suffer any abuse or improper treatment including neglect, degrading treatment, unnecessary restraint, or inappropriate limits to freedom
  • Food and drink – residents must have enough to eat and drink to keep them in good health
  • Premises and equipment – equipment must be clean, suitable, maintained and secure
  • Complaints – there must be a system in place to allow your residents to complain. You must investigate any complaint and take action if necessary
  •  Good governance – as care provider you are responsible for making sure these needs are met
  • Staffing – any staff must be competent and experienced and receive the support, training and supervision they need to do their job
  • Fit and proper staff – you must have strong recruitment procedures in place and carry out relevant checks such as criminal records and work history
  • Duty of candour – you must be open and transparent about the care you provide and explain, provide support and apologise if anything goes wrong
  • Display of ratings – you must display your CQC rating in a visible place, include the information on your website and make the organisations latest report on your service available

Mancier says that you will need to appoint a registered manager (appointed by the Registered Provider) who is personally responsible for meeting the relevant standards set out in the regulations.

“The registered manager must manage the care home with sufficient care, competence and skill having regard to the size of the care home and the number and needs of the care home residents. There is also a requirement for the registered manager to undertake continued training to ensure they are on top of the relevant skills and experience necessary to fulfil this role on an on-going basis.”

You can expect your care home to be regularly monitored and inspected by the CQC.

The score you receive from the organisation can have a significant impact in two ways says Mancier:

  1. “Paying care home fees (where for example local authorities may insist that the care home maintains a minimum score whilst it has residents placed there).
  2. “In relation to potential private fee-paying residents who may shop around for a suitable care home based on the scoring within the most recent inspection report – often preferring to go with a care home with a higher score.”

If you fail to meet the set standards or commit serious breaches you’re likely to be met with requirement notices or warning notices form the CQC which you must comply with.

Mancier: “The CQC can also impose restrictions on your care home licence (for example reducing the number of residents you are allowed to take) or even put your care home in ‘special measures’ where the quality of care is more closely and intensively monitored.”

For even more serious offences, you could be met with fines or prosecution action through the courts.

However, this isn’t the be all and end all of care home law warns Mancier: “This is a complex ever changing area of law where legal and other professional advice is always required.”


Care home insurance

The care home sector has its own specific risks that that could leave your business vulnerable to financial damages.

That’s why it’s vital you take out a policy that will provide adequate cover in the event of a crisis or calamity. A standard business policy won’t do the trick. Many providers offer specialist insurance that’s tailored to meet the needs of a care home business.

When choosing a care home insurance policy, check it protects against the following:

  • Public liability – this will cover you in the event that a member of the public is injured whilst on your business premises. It is not a legal requirement but certainly a good idea
  • Employers liability – this is legally required even if you only have one employee and will cover you in the event one of your employees is injured or becomes ill whilst working for you. You must have at least £5m worth of cover
  • Building – this will cover the cost of repairing damage or rebuilding your main building or any outbuildings. Just make sure your policy covers the actual value of the building
  • Contents – a care home insurance policy can protect the equipment and items belonging to your business from theft or damage. Residents’ and employees’ belongings can also be covered on this policy though very high value items may have to be insured separately
  • Business interruption – this will cover you for any loss of income suffered if disaster prevents or changes the normal running of your business
  • Medical malpractice –as your residents will rely on medication and other treatments, this will cover you if your staff do anything wrong such as administer the wrong dosage

Most policies will include public liability cover of £5m as standard but, should you need it, many will include limits up to £10m. Assess your individual needs to determine whether you need a higher value of cover.

The above is not an exhaustive list of the cover you could get as a care home owner but will protect you in the event of most scenarios.

Once you’ve made sure you’re complying with the necessary regulations it’s time to start thinking about marketing your care home. How do you come up with a good care home name?

And how can you stand out from the competition?

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