Legislation and guidance

On completion of this section you should have an understanding of:

The Health and Social Care Act 2008
Laws, regulations and guidance which help to keep people safe
Medicines regulations which help to keep people safe
Confidentiality and data protection
Person-centred care regulations

Health and Social Care Act 2008

The Health and Social Care Act 2008 - This Act is one of the most important affecting your work and your organisation. The Act created an independent regulator, the Care Quality Commission (CQC), for health and adult social care in England. The CQC inspect and monitor services against the requirements set out by government regulations.

Click on ▶️ to watch a short video clip about CQC and what it does.

Transcript

CQC Questions – Transcript

Everyone will need to be cared for at 00:08

some point in their life, when we are 00:10

born, if we're ill, injured or suffer from a

00:13 mental health issue, when we need a

00:15 Dentist, when we are old or frail and

00:17 even when we die. This is true for all of

00:20 us, everyone we know, everyone we love and

00:23 when we need that care, we want it to be

00:26 right, we want to feel safe, we want start

00:28 to be caring and we want care that meets

00:31 our needs.

00:32 The reason the Care Quality Commission

00:34 exists is to make sure health and social

00:37 care services provide this type of care

00:39 that means hospitals, GPs, dentists, Care

00:44 homes, care provided in the home, mental

00:46 health services and some other services

00:48 as well. During inspections, our chief

00:51 inspectors and their teams will ask five

00:54 main questions, Is this care safe? for

00:57 example, is it clean and our infection

01:00 rates low? Is this care effective for

01:03 example how good are they at making

01:06 people better or making sure their

01:08 quality of life is the best it can be?

01:10 Is it caring? Are the staff compassionate

01:14 and do they treat people as human beings?

01:17 Is this organisation well led? Do the

01:20 staff have direction and purpose and are

01:23 they running the service properly? Is the

01:26 organisation responsive to people's

01:28 needs?

01:29 Is it listening to complaints and

01:31 comments and acting on them

The CQC make sure health and social care services provide people with safe, effective, compassionate, high-quality care and encourage care services to improve.

Health and Social Care Act 2008 regulations 2014

Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 :

These regulations introduced the fundamental standards. The fundamental standards are the standards below which care must never fall.

Your organisation must meet these fundamental standards when providing care.

There are 13 fundamental standards and all the standards apply to all aspects of care. Everybody has the right to expect the standards shown in the image on the right.

The fundamental standards are the standards below which your care must never fall.

Everybody has the right to expect the following standards:

Activity: Read the information below from CQC for service users on what they can expect when they need care

Person-centred care

You must have care or treatment that is tailored to you and meets your needs and preferences.

Dignity and respect

You must be treated with dignity and respect at all times while you're receiving care and treatment.

This includes making sure:

You have privacy when you need and want it.
Everybody is treated as equals.
You're given any support you need to help you remain independent and involved in your local community.

Consent

You (or anybody legally acting on your behalf) must give your consent before any care or treatment is given to you.

Safety

You must not be given unsafe care or treatment or be put at risk of harm that could be avoided.

Providers must assess the risks to your health and safety during any care or treatment and make sure their staff have the qualifications, competence, skills and experience to keep you safe.

Safeguarding from abuse

You must not suffer any form of abuse or improper treatment while receiving care.

This includes:

Neglect
Degrading treatment
Unnecessary or disproportionate restraint
Inappropriate limits on your freedom.

Food and drink

You must have enough to eat and drink to keep you in good health while you receive care and treatment.

Premises and equipment

The places where you receive care and treatment and the equipment used in it must be clean, suitable and looked after properly.

The equipment used in your care and treatment must also be secure and used properly.

Complaints

You must be able to complain about your care and treatment.

The provider of your care must have a system in place so they can handle and respond to your complaint. They must investigate it thoroughly and take action if problems are identified.

Good governance

The provider of your care must have plans that ensure they can meet these standards.

They must have effective governance and systems to check on the quality and safety of care. These must help the service improve and reduce any risks to your health, safety and welfare.

Staffing

The provider of your care must have enough suitably qualified, competent and experienced staff to make sure they can meet these standards.

Their staff must be given the support, training and supervision they need to help them do their job.

Fit and proper staff

The provider of your care must only employ people who can provide care and treatment appropriate to their role. They must have strong recruitment procedures in place and carry out relevant checks such as on applicants' criminal records and work history.

Duty of candour

The provider of your care must be open and transparent with you about your care and treatment.

Should something go wrong, they must tell you what has happened, provide support and apologise.

Display of ratings

The provider of your care must display their CQC rating in a place where you can see it. They must also include this information on their website and make our latest report on their service available to you.

NICE guidance

As well as the legislation there is NICE guidance (National Institute for Health and Care Excellence) published to help organisations and staff provide the best care possible. Your organisations policies and procedures must reflect this guidance and take account of any recommendations within the guidance when providing services.

The guidance gives recommendations on things like your training, skills and competency, supporting people to take medicines, keeping accurate records, covert administration, safeguarding.

NICE's role is to improve outcomes for people using NHS and public health and social care services.

They set out care and services suitable for most people with a specific condition or need, and people in particular circumstances or settings, NICE guidelines help health and social care professionals to:

Prevent ill health
Promote and protect good health
Improve the quality of care and services
Adapt and provide health and social care services.

Care Home

You can find out more by looking at NICE Guidance: Managing medicines in care homes [SC1]

Domiciliary Care

You can find out more by looking at NICE Guidance: Managing medicines for adults receiving social care in the community [NG67]

Laws and regulations which help to keep people safe

There are other laws which protect people receiving care. Click on each of the following to have a brief look at some of these and click on the links below for more information

Mental Capacity Act 2015

Governs decision-making on behalf of adults who may not be able to make their own decisions.

https://www.gov.uk/government/publications/mental-capacity-act-code-of-practice

Everyone caring/supporting someone who is in this position must comply with this Act and its codes of practice. Visit CQC web site for more information.

Deprivation of Liberties Safeguards (DoLS) (Care homes & hospitals

The Mental Capacity Act 2005 includes the Deprivation of Liberty Safeguards (DoLS) – a set of checks that aims to make sure that any care that restricts a person’s liberty is both appropriate and in their best interests.

Visit alzheimers web site to find out more.

Data Protection Act 2018 and

General Data Protection Regulation

The Data Protection Act 2018 controls how your personal information is used by organisations, businesses or the government.

Visit Gov.uk web site for more information.

The Care Act 2014

This Act and supporting guidance place a series of new duties and responsibilities on local authorities about care and support for adults.

Here's link to the web site to view Care Act factsheets.

Equality Act 2010

Legally protects people from discrimination in the workplace and in wider society.

Visit Gov.uk web site to view Equality Act 2010 guidance.

People using services must not be discriminated against in any way and the provider must take account of protected characteristics, set out in the Equality Act 2010. The protected characteristics are age, disability, gender, gender reassignment, pregnancy and maternity status, race, religion or belief and sexual orientation.

Ref - Regulation 10: Dignity and respect, Health and Social Care Act

Covert administration and Mental Capacity Act 2005

Covert administration of medicines is when medicines are given in a disguised form without the knowledge or consent of the person receiving them. Laws, regulations and codes of practice protect people when covert administration of medicines is necessary. Click on the images below to find out more.

A judgement will be made about the person’s ability to make decisions by assessing their mental capacity under Mental Capacity Act 2005.

Covert administration cannot be used if a person has capacity to refuse their medication.

A complex decision which will involve several people including the prescriber and a representative of the person.

Only medicines which are essential should be considered for covert administration. The decision should be clearly documented

The advice of a pharmacist should be obtained to check if the medicines are suitable to be given covertly and how this should be done.

The advice given should be documented including who gave the information and available to staff who are administering medicines.

You must not give medicines covertly unless the legal processes have been followed.

You must not hide medication from people solely on the request of a relative or other staff members. You must follow instructions about how to give medicines covertly as detailed in the care plan.

Medicines regulations which help to keep people safe

We also have laws and regulations relating to medicines, so that we know how to handle medicines with care and safety.

Human Medicines Regulations 2012 - regulate medicines for human use and safeguard public health.

The Misuse of Drugs Act 1971 - provides control and classification of drugs deemed to be 'dangerous or otherwise harmful' when misused.

The medicines you handle (including ordering, storage, transport, preparation, dispensing, disposal and keeping records) are divided into legal categories. Click on each of the images below to find out what they are.

POM

Prescription Only Medicines (POM)

Prescription-only medicines (POMs) need a prescription issued by a GP or other suitably qualified healthcare professional.

P

Pharmacy Medicine (P)

Pharmacy medicines (P) are available from a pharmacy without a prescription, but under the supervision of a pharmacist.

GSL

General Sales List Medicine (GSL)

General sales list (GSL) medicines can be bought from pharmacies, supermarkets and other retail outlets without the supervision of a pharmacist.

Confidentiality and data protection

Protecting the personal information of the people you provide care for during the course of your work is also controlled by laws, regulations and guidance.

You will get to know a lot about the person you provide care for, personal information about them, their life and their family/friends/carers as well as their health issues and treatments - this information is confidential (private)

you must help to keep this information secure, safe and private, don’t leave where other people can see it (This includes care plans and MAR charts).

you must understand and follow your organisations procedures on confidentiality and data protection.

you can only share this information with colleagues and managers who need to know, to help provide safe and personalised care.

you must not share anything about the person you provide care for on social media, to friends or family, chatting e.g. when on public transport or your mobile phone.

Person-centred care regulations

Providing person centred care is one of the fundamental standards. It applies to all care, including the administration of medicines. The organisation you work for must meet these regulations. You have a responsibility to provide person centred care in your work. Here are some of the things that are listed in the Regulations:

Encouraged to participate

People must be given opportunities to manage as much of their care and treatment as they wish and are able to, and should be actively encouraged to do so.

Supported in decision making

People must be actively encouraged and supported to be involved in making decisions about their care or treatment as much or as little as they wish to be.

Treatment Choices

The person using the service must be able to discuss care and treatment choices continually and have support to make any changes to those choices if they wish.

Care updated accordinly

Staff providing care must be kept up to date with any changes to a person's needs and preferences.

Meet care needs/preferences

People who use the service receive person-centred care and treatment that is appropriate, meets their needs and reflects their personal preferences, whatever they might be.

Section 3: Legislation and guidance

In this section we have looked at:

The Health and Social Care Act 2008
Laws, regulations and guidance which help to keep people safe
Medicines regulations which help to keep people safe
Confidentiality and data protection
Person-centred care regulations

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