A new CQC Fundamental Standard

The recent addition of Regulation 9A to the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 marks a milestone in codifying the rights and well-being of individuals receiving care. Effective from 6 April 2024, this new CQC Fundamental Standard applies to providers of care homes, hospitals, and hospices, with exemptions for certain regulated activities such as personal care and substance misuse treatment. To assist providers in implementing this new Fundamental Standard, CQC has issued guidance.

The essence of Regulation 9A revolves around enabling individuals to maintain vital social connections and ensuring their comfort and safety when attending appointments outside of a health and care setting. Therefore, under Regulation 9A, service users are entitled to:

• Receive visits at health and care premises, particularly if their care involves an overnight stay.
• Enjoy visits out of the health and care setting without discouragement.
• Be accompanied by chosen individuals to appointments in hospitals or hospices.

Key points in the CQC's guidance include:

• Providers should assume that visits and accompaniment are feasible unless exceptional circumstances dictate otherwise. In cases of identified risks, precautions should be taken to enable visits rather than preventing such visits outright.
• Individual needs and preferences must guide decisions regarding visits, supported by thorough risk assessments and care planning.
• Unreasonable restrictions on visits, or burdensome administrative processes, should be avoided so as not to discourage individuals from exercising their rights under the Regulation.
• Decision-making on restrictions should prioritise the health, safety, and welfare of individuals, maintaining a careful balance of rights and risks.
• Precautions should be the least restrictive options, determined collaboratively with individuals and their support network. Regular reviews of restrictions are essential, with prompt removal when circumstances allow.
• Blanket or long-term restrictions are not permissible, highlighting the need for tailored approaches to each situation.

Moving forward, whilst breaching Regulation 9A is not a criminal offence, it will still form an integral part of CQC’s assessments and ratings of registered providers, with inspectors scrutinising providers' adherence to it. Providers must now review their practices in light of this new Fundamental Standard and the accompanying guidance to ensure compliance and to ensure that they are properly upholding the rights and well-being of those under their care.

For further information and access to Regulation 9A and the CQC Guidance, visit: Regulation 9A: Visiting and accompanying in care homes, hospitals and hospices - Care Quality Commission (cqc.org.uk)

If you wish to discuss any of the issues related to Regulation 9A, or CQC regulation more generally, please contact Carlton Sadler or Siwan Griffiths.