In a recent article for Caring Times, Amanda Narkiewicz provides care home operators with an overview of CQC’s new fundamental standard on visiting arrangements.
Since 6 April 2024, care homes, hospitals and hospices in England are required to comply with the Care Quality Commission’s new fundamental standard on visiting and accompanying. The Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2023 make significant changes to the rules for visiting arrangements at these settings. The text of the new framework is set out at Regulation 9A and CQC has published guidance to support providers with implementation. The new Regulation appears to signal an end to visiting times and reinforces the positive duty on care home operators to facilitate visits and reflects the important role providers play in resident wellbeing.
The Regulation aims to ensure:
- People staying in a care home, hospital or hospice can receive visits from people they want to see;
- People living in a care home are not discouraged from taking visits outside the home; and
- People attending appointments in a hospital or hospice, that do not require an overnight stay, can be accompanied by a family member, friend or advocate if they want someone with them.
So, what does it mean for care home providers?
- Operators have a general duty to facilitate visits for residents and not be discouraged from taking visits out of the care home.
- Unless there are “exceptional circumstances” residents must be facilitated to receive visits at their care home.
- The way in which residents are to be facilitated to receive visits, so far as is reasonably practicable, reflects the preference of the residents as opposed to the care home’s policy.
- Care needs to be taken to ensure resident needs and preferences are used to guide decision making regarding visits (and in consultation with family, friends and advocates) supported by risk assessments and care planning.
- Any decision to restrict visits should be proportionate – the least restrictive option necessary to achieve the aim. CQC guidance notes if restrictions on in person visits are necessary, ways to mitigate risk should be considered. Decision making on restriction should factor the risk to the health, safety or welfare of the resident while balancing the rights of the resident. Regular reviews of restrictions are essential, with prompt removal when circumstances allow. The restriction must be communicated with the resident and their family, friends and or advocate as appropriate.
- Even where care and treatment does not involve an overnight stay, hospital and hospices users must be “enabled” to be accompanied by a family, friend or supporter.
CQC enforcement action
The new regulation will enable the CQC to specifically inspect providers against the standard, and more easily identify a breach of the visiting and accompanying requirement as the regulation sets out specific points regarding visiting and accompanying that a provider must now comply with. While breaching Regulation 9A is a not a criminal offence, the CQC can take civil enforcement action against a breach. This could include issuing requirement or warning notices, imposing conditions, suspending a registration, or cancelling a registration.
It is therefore important for providers to ensure the decision-making process is clearly documented, along with a risk assessment dealing with this. Providers are strongly encouraged to avoid blanket bans on visiting arrangements for residents and look to consider ways to mitigate any risk and evidence the process.
This article first appeared in the issue of the Caring Times.