Care homes for people with learning disabilities
People with learning disabilities have the same rights and responsibilities as other people. National standards are needed to make sure that people with learning disabilities keep these rights and responsibilities when they are staying in a care home.
People with learning disabilities are a very mixed group with different experience and different support needs. Some people only need limited support to lead an independent life. Others need a very high level of support. Many people have other difficulties, including mental health problems and behaviour that challenges services. They may have complicated medical needs that are linked to physical, sight and hearing difficulties.
The Scottish Executive's review The same as you? emphasised that people with learning disabilities should be treated and respected as individuals with the right to decide what kind of life they want to lead. The review emphasised the importance of making sure that everyone who wants to can take an active part in their community and have full access to general services with specialist support provided when it is needed.
The national care standards
Scottish Ministers set up the National Care Standards Committee ( NCSC) to develop national standards. The NCSC carried out this work with the help of a number of working groups. These groups included people who use services, their families and carers, along with staff, professional associations, regulators from health and social care, local authorities, health boards and independent providers. Many others were also involved in the consultation process.
As a result, the standards have been developed from the point of view of people who use the services. They describe what each individual person can expect from the service provider. They focus on the quality of life that the person using the service actually experiences.
The standards are grouped under headings which follow the person's journey through the service. These are as follows.
Before moving in (standards 1 to 6)
1 Informing and deciding
2 Trial visits
3 Your legal rights
4 Your environment
5 Management and staffing arrangements
6 Support arrangements
Settling in (standards 7 to 11)
7 Moving in
8 Making choices
9 Feeling safe and secure
10 Exercising your rights
11 Expressing your views
Day-to-day life (standards 12 to 19)
12 Your lifestyle - social, cultural and religious belief or faith
13 Eating well
14 Keeping well - healthcare
15 Keeping well - medication
16 Private life
17 Daily life
18 Supporting communication
19 Support and care in dying and death
Moving on (standard 20)
20 Moving on
Using the national care standards
If you are thinking about moving into a home, you may want to look at the standards to help you decide which home to choose. If you already live in a care home, you may use the standards when discussing the service you get with:
- staff and managers;
- your social worker or care manager, if you have one; or
- someone acting on your behalf, for example, your representative 1.
If things go wrong you can refer to standards when you raise concerns or make a complaint. ( See 'Expressing your views', standard 11.)
Home owners or managers will use the standards to find out what is expected of them in offering support and care services. The standards make it clear that everything about the service should lead to you enjoying a good quality of life. They guide the owner or manager over:
- building requirements;
- whom to employ; and
- how they should manage the service.
The principles behind the standards
The standards are based on a set of principles. The principles themselves are not care standards but they reflect the recognised rights which you enjoy as a citizen. These principles are the result of all the contributions made by the NCSC, its working groups and everyone else who responded to the consultations on the standards as they were being written. They recognise that services must be accessible and suitable for everyone who needs them, including people from black and ethnic minority communities. They reflect a widespread agreement that the experience of the people receiving services is very important and should be positive, and that you have rights.
The main principles
The principles are dignity, privacy, choice, safety, realising potential, equality and diversity.
Your right to:
- be treated with dignity and respect at all times; and
- enjoy a full range of social relationships.
Your right to:
- have your privacy and property respected; and
- be free from unnecessary intrusion.
Your right to:
- make informed choices, while recognising the rights of other people to do the same; and
- know about the range of choices.
Your right to:
- feel safe and secure in all aspects of life, including health and wellbeing;
- enjoy safety but not be over-protected; and
- be free from exploitation and abuse.
Your right to have the opportunity to:
- achieve all you can;
- make full use of the resources that are available to you; and
- make the most of your life.
Equality and diversity
Your right to:
- live an independent life, rich in purpose, meaning and personal fulfilment;
- be valued for your ethnic background, language, culture, and faith;
- be treated equally and to live in an environment which is free from bullying, harassment and discrimination; and
- be able to complain effectively without fear of victimisation.
The Scottish Commission for the Regulation of Care
The Regulation of Care (Scotland) Act 2001 ('the Act') set up the Care Commission, which registers and inspects all the services regulated under the Act, taking account of the national care standards issued by Scottish Ministers. The Care Commission has its headquarters in Dundee, with regional offices across the country. It will assess applications from people who want to provide care homes for people with learning disabilities. It will inspect the services to make sure that they are meeting the regulations and in doing so will take account of the national care standards. You can find out more about the Care Commission and what it does from its website ( www.carecommission.com).
The Scottish Social Services Council
The Act created the Scottish Social Services Council ('the Council') which was established on 1 October 2001. It also has its headquarters in Dundee. The Council has the duty of promoting high standards of conduct and practice among social services workers, and in their education and training. To deliver its overall aims of protecting service users and carers and securing the confidence of the public in social services, the Council has been given five main tasks. These are: to establish registers of key groups of social services staff; to publish codes of practice for all social services staff and their employers; to regulate the conduct of registered workers; to regulate the training and education of the workforce; to undertake the functions of the National Training Organisation for the Personal Social Services. The Council has issued codes of practice for social service workers and employers of social service workers. These describe the standards of conduct and practice within which they should work. The codes are available from the Council website ( www.sssc.uk.com).
How standards and regulations work together
The Act gives Scottish Ministers the power to publish standards which the Care Commission must take into account when making its decisions. It also gives Scottish Ministers the power to make regulations imposing requirements in relation to care homes for people with learning disabilities.
The standards will be taken into account by the Care Commission in making any decision about applications for registration (including varying or removing a condition that may have been imposed on the registration of the service). All providers must provide a statement of function and purpose when they are applying to register their service. On the basis of that statement, the Care Commission will determine which standards will apply to the service that the provider is offering.
The standards will be used to monitor the quality of services and their compliance with the Act and the regulations. If, at inspection, or at other times, for example, as a result of the Care Commission looking into a complaint, there are concerns about the service, the Care Commission will take the standards into account in any decision on whether to take enforcement action and what action to take.
If the standards were not being fully met, the Care Commission would note this in the inspection report and require the service manager to address this. The Care Commission could impose an additional condition on the service's registration if the provider persistently, substantially or seriously failed to meet the standards or breached a regulation. If the provider does not then meet the condition, the Care Commission could issue an improvement notice detailing the required improvement to be made and the timescale for this. Alternatively, the Care Commission could move straight to an improvement notice. The Care Commission would move to cancel the registration of any service if the improvement notice does not achieve the desired result. In extreme cases ( i.e. where there is serious risk to a person's life, health or wellbeing) the Care Commission could take immediate steps to cancel the registration of any service without issuing an improvement notice.
Regulations are mandatory. In some cases not meeting a regulation will be an offence. This means a provider may be subject to prosecution. Not meeting or breaching any regulation is a serious matter.
Decisions by the Care Commission on what to do when standards or regulations are not met will take into account all the relevant circumstances and be proportionate.
You can get information on these regulations from the Regulation of Care (Scotland) Act 2001, which is available from the Stationery Office Bookshop. You can also see the Act on-line ( see Annex B for the address).
You can also see the Scottish Statutory Instruments for the Regulation of Care Regulations 2002 on-line ( see Annex B for the address).
If you would like to comment on these standards you can visit our website and send a message through our mailbox:
You can also contact us at:Care Standards and Sponsorship Branch
Community Care Division
Primary & Community Care Directorate
St Andrew's House
Tel: 0131 244 5387
Fax: 0131 244 4005