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What are domiciliary care standards?
Home care providers in the UK are bound by their regulators to uphold national minimum standards for domiciliary care. These ensure their clients receive the quality care they have the right to expect.
These standards of care underpin the quality assurance frameworks which regulators, such as the Care Quality Commission in England, use to determine whether care providers and agencies meet the requirements to provide domiciliary care, also known as home care.
Putting your trust into someone else to care for your loved ones can be daunting. Especially as you want to make sure they receive the best support possible and that they are treated with dignity and respect.
To ensure that everyone who is in need of care receives the level of care they require, the regulators of domiciliary care agencies in each UK country have, in collaboration with their governments, developed a set of standards that care providers must not fall below.
Who regulates domiciliary care providers in the UK?
- England: Care Quality Commission (CQC)
- Wales: Care Inspectorate (CIW)
- Scotland: The Care Inspectorate (CI)
- Northern Ireland: Regulation and Quality Improvement Authority (RQIA)
The regulatory bodies are responsible for domiciliary care quality assurance, by monitoring and inspecting the quality of home care providers and other health and social services. Following inspections, they publish reports which are made publicly available.
If a care provider is found to operate below national minimum standards, the regulators take action to force improvement, and in some cases closure.
England
When domiciliary care agencies register with the CQC, they must show how they will meet, and continue to meet the fundamental standards of care. They must also explain how they will ensure their service is safe, effective caring, responsive and well led, which are the five domains assessed by the CQC during inspections.
The CQC’s fundamental standards of care outlines the standards that no domiciliary care provider must fall below, and what people have the right to expect.
The fundamental standards of care
- Person-centred care: care must be tailored to each individual
- Dignity and respect: service users must be treated with dignity and respect
- Consent: consent must be given before any care or treatment is provided
- Safety: risks to health and safety must be assessed and staff must have the competence, qualifications, skills and experience to keep service users safe
- Safeguarding from abuse
- Food and drink: service users must have enough to eat and drink to maintain good health
- Premises and equipment: Equipment must be clean, suitable, used and looked after properly
- Complaints: Providers must have a complaints system in place and investigate thoroughly
- Good governance: Providers must have plans in place to meet these standards
- Staffing: Staff must be qualified and competent enough to meet these standards
- Fit and proper staff: Staff must be able to provide care and treatment appropriate to their role, and providers must carry out relevant checks e.g. DBS checks
- Duty of Candour: Providers must be open and transparent
- Display of ratings: Providers must display their CQC rating and make reports available to service users
Following their inspections, the CQC gives each provider a rating to help people make informed decisions about their own or their loved one’s care.
Providers are given a rating of Inadequate, Requires Improvement, Good or Outstanding.
Wales
Domiciliary care agencies in Wales must maintain the National Minimum Standards outlined in the Guidance for providers of care home and domiciliary support services. The guidance was put in place by ministers and Inspection of Social care to ensure care providers in Wales uphold the standards of care that people have the right to expect.
By upholding these standards, care providers make sure they deliver high quality care and the support their service users need to achieve their personal outcomes.
When the CIW inspects care providers, they assess client Well-being, Care and Development and Leadership and Management based on the standards.
Domiciliary care requirements and standards in Wales include:
- Providers must establish clear arrangements for an ongoing cycle of quality assurance and review to make sure they operate in line with legal requirements and are supporting individuals appropriately
- Providers must ensure that their service is provided with sufficient care, competence and skill
- Providers must ensure there are effective arrangements in place for monitoring, reviewing and improving the quality of care and support
- The time allocated for each visit must be sufficient to enable care and support to be provided to the individual in accordance with their personal plan
- Care and support must enable an individual to meet their personal outcomes
- Provision of staff with the knowledge, skills and competency to meet well-being needs of individuals
- Providers must ensure their services are delivered in a dignified and respectful manner in which staff have meaningful interactions and positive and caring attitudes towards individuals
Scotland
In Scotland, domiciliary care providers must meet the national standards of what people should expect when using health, social care or social work. The CI is responsible for regulating and inspecting care services to ensure they meet the right standards.
The Health and Social Care Standards (the Standards) outline what people in Scotland should expect when they access domiciliary care services.
There are five overarching standards:
- I experience high quality care and support that is right for me.
- I am fully involved in all decisions about my care and support.
- I have confidence in the people who support and care for me.
- I have confidence in the organisation providing my care and support.
- I experience a high quality environment if the organisation provides the premises.
Each of the Standards have been developed to improve social care provision in Scotland. They seek to provide better outcomes for people in need of care and support. The Standards aim to ensure that each individual is treated with respect and dignity and that their basic human rights are upheld.
The Standards are underpinned by five principles. These reflect how everyone should expect to be treated.
- Dignity and respect
- Compassion
- Be included
- Responsive care and support
- Wellbeing
During inspections, the CI looks at four areas and gives quality grades, scoring each area from 1 to 6. The four areas are Care and Support, Staffing and Management and Leadership.
Northern Ireland
Each domiciliary care provider in Northern Ireland has a legal responsibility to ensure its services meet a required standard, as set out in the Quality standards for health and social care.
The standards reflect the absolute minimum to ensure safe and effective practices. It is essential that all care providers uphold them.
The RQIA is responsible for the registration, inspection and regulation of domiciliary care services in Northern Ireland and assesses service quality.
The Health and Social Care standards are made up of five key quality themes:
- Corporate leadership and accountability of organisations
- Safe and effective care
- Accessible, flexible and responsive services
- Promoting, protecting and improving health and social well being
- Effective communication and information
The national minimum standards for domiciliary care agencies:
- The views of service users and their carers/representatives shape the quality of services provided by the agency.
- Prospective service users are provided with information on the services provided by the agency.
- Referral arrangements ensure the service user’s identified needs can be met by the agency.
- Each service user has a written individual service agreement.
- All activities undertaken in relation to the service user’s care plan are recorded. Relevant information is communicated to the appropriate people.
- The agency contributes to the review of the service user’s care plan.
- The agency has arrangements in place to ensure that care workers manage medicines safely and securely.
- Management systems and arrangements are in place that support and promote the delivery of quality care services.
- There are policies and procedures in place that direct the quality of care and services.
- Clear, documented systems are in place for the management of records in accordance with legislative requirements.
- Staff are recruited and employed in accordance with relevant statutory employment legislation.
- Staff are trained for their roles and responsibilities.
- Staff are supervised and their performance appraised to promote the delivery of quality care and services.
- Service users are protected from abuse.
- All complaints are taken seriously and dealt with promptly and effectively.
- The agency has systems that ensure safe and healthy working practices.
Always check inspection reports
When choosing a home care provider, it is essential to read their reports to make sure you feel confident that they uphold the standards you expect.
Read our guide to finding domiciliary care that is right for you or your loved one, including what to look for and questions to ask providers.
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