The Fundamental Standards are your bible – get a copy, read them and use them!

1st October 2021

Although the Care Quality Commission (CQC) have reviewed their strategy and are implementing a more digital way of inspecting, it’s important to remember that the criteria against which they inspect have not changed and that the Fundamental Standards of Care remain at the core of this.

So, if you want to know how to improve the lives of the people you support and hopefully impress the CQC at the same time – then read the Fundamental Standards and tailor your service to meet those standards.

The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 may sound a mouthful, but regulations 8 onwards that deal with the Fundamental Standards, are actually quite straight forward to follow and you may find lots of quick wins.

These are the key regulations to read:

  • Person Centred Care (9)
  • Dignity and Respect (10)
  • Need for Consent (11)
  • Safe Care and treatment (12)
  • Safeguarding (13)
  • Meeting nutritional and hydration needs (14)
  • Premises and equipment (15)
  • Complaints (16)
  • Good governance (17)
  • Staffing (18)
  • Fit and proper persons employed (19)
  • Duty of Candour (20)
  • Display of performance assessments (20A)

If you’re going to start anywhere, start with Person-Centred Care (PCC). The people you support, their families and the CQC will love you for it.

  • The care and treatment of service users must:

            (a) be appropriate

            (b) meet their needs, and

            (c) reflect their preferences.

Start by appointing some PCC Champions or key workers in your service. Arrange for them to have protected time with each person your service supports to genuinely take the time to find out the person’s preferences, their likes and dislikes, their hopes and dreams. Document and share this information so that everyone in the service knows and can help the person to “live their best life”. Many people may struggle to identify their preferences or lack the capacity to do so, so it’s up to the champions and the service as a whole to identify how to support those people in their decision making and choices. Almost everyone can make simple choices from tea and coffee, curtains open or closed and it’s taking the time to acknowledge those little aspects of a person’s life that really make the difference.

PCC is about your service being someone’s home, not them being in a home.

And then you need to showcase what you are doing to CQC. CQC Inspectors only see what you show them. They can ask to review records and care plans but if you’re doing something a bit special (and every service should be), then make sure you showcase this to your inspector. Show what you’re doing, and how proud you are of it – how it improves the lives of the people you support and importantly how this is an ongoing process – not a one off to try and tick a box.

Regulation 9 sets out nine points to cover when reviewing PCC:

  1. Carry out an assessment of the needs and preferences
  2. Design care or treatment with a view to achieving those preferences and ensuring needs are met
  3. Enable and support to understand care or treatment choices and discuss risks and benefits
  4. Enable and support decision making
  5. Provide opportunities to manage care or treatment
  6. Involve people in decisions relating to the way the service operates
  7. Provide people with relevant information to enable all of the above
  8. Make reasonable adjustments
  9. Have regard to well-being where meeting nutritional & hydration needs

Person-Centred Care means:

  • Caring for people beyond their condition
  • Tailoring your service to suit their individual wants and needs
  • Respecting that they have their own views on what’s best for them, and have their own values and priorities in life
  • Engaging with them to ensure you know what their values are
  • Engaging with them again to make sure those values haven’t changed

Focussing on PCC can help change the whole culture of an organisation and give somewhere a new feel and lease of life. There are some really heart-warming success stories from throughout the pandemic of services going the extra mile to support and enable the people they support to stay in touch and prioritise what’s important to them. Make some simple changes and your service can be another success story too!

If you would like some Person-Centred Fundamental Standards Training in your organisation Hempsons can tailor this to meet your needs. Please contact Philippa Doyle, Partner at Hempsons.

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