The Nursing Homes Regulations (Northern Ireland) 2005

Made: 23rd March 2005

Coming into operation: 1st April 2005

The Department of Health, Social Services and Public Safety in exercise of the powers conferred on it by Articles 23(1), (2)(a) to (d) and (f) to (j), (3), (5), (7)(a) to (h), (j) and (l), 25(1), 30, 31(1), 32 and 48(2) of the Health and Personal Social Services (Quality, Improvement and Regulation) (Northern Ireland) Order 2003[^f00001] and of all other powers enabling it in that behalf, having consulted such persons as appropriate, as required by Article 23(8) of that Order, hereby makes the following Regulations:

PART I — GENERAL

Citation, commencement and extent

1

These Regulations may be cited as the Nursing Homes Regulations (Northern Ireland) 2005 and shall come into operation on 1st April 2005.

Interpretation

2

• (1) In these Regulations –

• “bankruptcy restrictions order” means an order made under Schedule 2A to the Insolvency (Northern Ireland) Order 1989 or Schedule 4A to the Insolvency Act 1986;

• “clinical trial” has the same meaning as in the Medicines for Human Use (Clinical Trials) Regulations 2004[^f00002];

• “debt relief order” means an order made by the Official Receiver under Part 7A of the Insolvency (Northern Ireland) Order 1989, or Part 7A of the Insolvency Act 1986;

• “debt relief restrictions order” means an order made under Schedule 2ZB to the Insolvency (Northern Ireland) Order 1989, or Schedule 4ZB to the Insolvency Act 1986;

• “ethics committee” means a group of persons which assesses the ethics of research involving individuals and which is recognised for that purpose by or on behalf of the Department of Health, Social Services and Public Safety;

• “Fire Authority” means the Fire Authority for Northern Ireland within the meaning of the Fire Services (Northern Ireland) Order 1984[^f00003];

• “general medical practitioner” means a medical practitioner providing primary medical services;

• “health care professional” means a person who is registered as a member of any profession which is regulated by a body mentioned in Section 25(3) of the National Health Service Reform and Health Care Professions Act 2002[^f00004] or who is a clinical psychologist or child psychotherapist;

• “inspection report” means a report prepared in relation to the nursing home under Article 42(7) of the Order;

• “nurse” means a person registered in the register maintained under Article 5 of the Nursing and Midwifery Order 2001[^f00005] by virtue of qualification in nursing or midwifery as the case may be;

• “the Order” means the Health and Personal Social Services (Quality, Improvement and Regulation) (Northern Ireland) Order 2003;

• “organisation” means a body corporate or any unincorporated association other than a partnership;

• “patient” means a person for whom nursing is provided in, or for the purposes of the nursing home;

• “patient’s guide” means the guide compiled in accordance with regulation 4 (1);

• “patient’s plan” means the written plan prepared in accordance with regulation 16(1);

• “the register” means the register of social care workers maintained by the Northern Ireland Social Care Council under section 3(1) of the 2001 Act;

• “registered manager” in relation to a nursing home, means a person who is registered under Part III of the Order as the manager of the nursing home;

• “registered person” in relation to a nursing home, means any person who is the registered provider or registered manager in respect of the nursing home;

• “registered provider” in relation to a nursing home, means a person who is registered under Part III of the Order as a person carrying on the nursing home;

• “relative” in relation to any person, means –the person’s spouse;any parent, grandparent, child, grandchild, brother, sister, uncle, aunt, nephew or niece of his or his spouse;the spouse of any relative within sub-paragraph (b) of this definition,and for the purpose of determining any such relationship a person’s step-child shall be treated as his child, and references to “spouse” in relation to any person include a former spouse and a person who is living with the person as husband or wife;

• “the relevant part” means that part of the register referred to in section 3(2) of the 2001 Act which is most relevant to that person, taking into account their current employment;

• “representative” means in relation to a patient, a person other than the registered person or a person employed at the nursing home, who with the patient’s express or implied consent takes an interest in the patient’s health and welfare;

• “responsible individual” shall be construed in accordance with regulation 7(2)(c)(i);

• “social care worker” has the meaning as defined in Section 2 of the HPSS Act (Northern Ireland) 2001[^f00006];

• “staff” means persons employed by the registered person to work at the nursing home but does not include a volunteer or a person employed under a contract for services;

• “statement of purpose” means the written statement compiled in accordance with regulation 3(1).

• (2) In these Regulations, references to employing a person include employing a person whether or not for payment and whether under a contract of service or a contract for services and allowing a person to work as a volunteer.

Statement of purpose

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• (1) The registered person shall compile in relation to the nursing home a written statement which shall consist of –

• (a) a statement of the aims and objectives of the nursing home;

• (b) a statement as to the facilities and services which are to be provided by the registered person for patients; and

• (c) a statement as to the matters listed in Schedule 1.

• (2) The registered person shall supply a copy of the statement of purpose to the Regulation and Improvement Authority and shall make a copy of it available for inspection by every patient and any representative of a patient.

• (3) Nothing in regulation 18(1) or 27(1) shall require or authorise the registered person to contravene, or not to comply with –

• (a) any other provision of these Regulations; or

• (b) the conditions for the time being in force in relation to the registration of the registered person under Part III of the Order.

Patient’s guide

4

• (1) The registered person shall produce a written guide to the nursing home which shall include –

• (a) a summary of the statement of purpose including the philosophy of care;

• (b) the terms and conditions in respect of accommodation to be provided for patients, including as to the amount and method of payment of fees;

• (c) a standard form of contract for the provision of services and facilities by the registered provider to patients;

• (d) a summary of the complaints procedure established under regulation 24;

• (e) the address and telephone number of the Regulation and Improvement Authority.

• (2) The registered person shall also provide, on request, access to a copy of the most recent inspection report and information on how to access earlier inspection reports.

• (3) The registered person shall supply a copy of the patient’s guide to the Regulation and Improvement Authority and each patient or their representative.

• (4) Where a HSS Trust has made arrangements for the provision of accommodation and nursing to the patient at the nursing home, the registered person shall supply to the patient a copy of the agreement specifying the arrangements made.

Information about fees

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• (1) The registered person shall provide to each patient, by not later than the day on which he becomes a patient, a statement specifying –

• (a) the fees payable by or in respect of the patient for the provision to the patient of any of the following services –

• (i) accommodation, including the provision of food; and

• (ii) nursing;

and, except where a single fee is payable for those services, the services to which each fee relates;

• (b) the method of payment of the fees and the person by whom the fees are payable.

• (2) The registered person shall notify the patient at least 28 days in advance of –

• (a) any increase in the fees referred to in paragraph (1)(a) and payable by or in respect of the patient;

• (b) any variation in the matters referred to in paragraph (1)(b).

• (3) Where a nursing contribution is paid in respect of nursing provided to the patient, the registered person shall provide to the patient a statement specifying –

• (a) the date payment commenced and the amount of the nursing contribution; and

• (b) the date on which the registered person is to deduct the amount of the nursing contribution from the fees referred to in paragraph (1)(a) or pay that amount to the patient.

• (4) In this regulation “nursing contribution” means a payment by a HSS Trust to the registered person in respect of nursing to be provided to a patient, but does not include a payment where –

• (a) the HSS Trust has made arrangements for the provision of accommodation to the patient; and

• (b) the payment relates to any period for which under those arrangements accommodation is provided to the patient.

Review of statement of purpose and patient’s guide

6

The registered person shall –

• (a) keep under review and, where appropriate, revise the statement of purpose and the patient’s guide; and

• (b) notify the Regulation and Improvement Authority and patients of any such revision within 28 days.

PART II — REGISTERED PERSONS

Fitness of registered provider

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• (1) A person shall not carry on a nursing home unless he is fit to do so.

• (2) A person is not fit to carry on a nursing home unless the person –

• (a) is an individual who carries on the nursing home –

• (i) otherwise than in partnership with others, and he satisfies the requirements set out in paragraph (3);

• (ii) in partnership with others, and he and each of his partners satisfies the requirements set out in paragraph (3);

• (b) is a partnership, and each of the partners satisfies the requirements set out in paragraph (3);

• (c) is an organisation; and

• (i) the organisation has given notice to the Regulation and Improvement Authority of the name, address and position in the organisation of an individual who is a director, manager, secretary or other officer of the organisation and is responsible for supervising the management of the nursing home; and

• (ii) that individual satisfies the requirements set out in paragraph (3).

• (3) The requirements are that –

• (a) he is of integrity and good character; and

• (b) he is physically and mentally fit to carry on the nursing home; and

• (c) full and satisfactory information is available in relation to him in respect of the matters specified in paragraphs 1 to 7 of Schedule 2.

• (4) A person shall not carry on a nursing home if –

• (a) he has been adjudged bankrupt or sequestration of his estate has been awarded and (in either case) he has not been discharged and the bankruptcy order has not been annulled or rescinded; or

• (ab) he is the subject of a bankruptcy restrictions order; or

• (ac) he is a person in relation to whom a moratorium period under a debt relief order applies or he is the subject of a debt relief restrictions order; or

• (b) he has made a composition or arrangement with his creditors and has not been discharged in respect of it.

Appointment of manager

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• (1) The registered provider shall appoint an individual to manage the nursing home where –

• (a) there is no registered manager in respect of the nursing home;

• (b) the registered provider –

• (i) is an organisation or partnership;

• (ii) is not a fit person to manage a nursing home; or

• (iii) is not, or does not intend to be, in full-time day-to-day charge of the nursing home.

• (2) Where the registered provider appoints a person to manage the nursing home he shall forthwith give notice to the Regulation and Improvement Authority of –

• (a) the name of the person so appointed; and

• (b) the date on which the appointment is to take effect.

Fitness of registered manager

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• (1) A person shall not manage a nursing home unless he is fit to do so.

• (2) A person is not fit to manage a nursing home unless –

• (a) he is of integrity and good character;

• (b) having regard to the size of the nursing home, the statement of purpose, and the number and needs of the patients –

• (i) he is a nurse; and

• (ii) he has the qualifications, skills and experience necessary for managing the nursing home; and

• (iii) he is physically and mentally fit to manage the nursing home; and

• (c) full and satisfactory information is available in relation to him in respect of the matters specified in paragraphs 1 to 7 of Schedule 2.

Registered person: general requirements

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• (1) The registered provider and the registered manager shall, having regard to the size of the nursing home, the statement of purpose, and the number and needs of the patients, carry on or manage the nursing home (as the case may be) with sufficient care, competence and skill.

• (2) If the registered provider is –

• (a) an individual, he shall undertake;

• (b) an organisation, it shall ensure that the responsible individual undertakes;

• (c) a partnership, it shall ensure that one of the partners undertakes;

from time to time such training as is appropriate to ensure that he has the experience and skills necessary for carrying on the nursing home.

• (3) The registered manager shall undertake from time to time such training as is appropriate to ensure that he has the experience and skills necessary for managing the nursing home.

Registered person: notification of offences

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Where the registered person or the responsible individual is convicted of any criminal offence, in Northern Ireland or elsewhere, he shall forthwith give notice in writing to the Regulation and Improvement Authority of –

• (a) the date and place of the conviction;

• (b) the offence of which he was convicted; and

• (c) the penalty imposed on him in respect of the offence.

PART III — CONDUCT OF THE NURSING HOME

Requirements to ensure quality of nursing and other service provision

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• (1) The registered person shall provide treatment, and any other services to patients in accordance with the statement of purpose, and shall ensure that the treatment and other services provided to each patient –

• (a) meet his individual needs;

• (b) reflect current best practice; and

• (c) are (where necessary) provided by means of appropriate aids or equipment.

• (2) The registered person shall ensure that all aids and equipment used in or for the purpose of the nursing home is –

• (a) suitable for the purposes for which it is to be used; and

• (b) properly maintained and in good working order.

• (3) The registered person shall ensure that –

• (a) where reusable medical devices are used in a nursing home, the registered person shall ensure that appropriate procedures are implemented and adhered to in relation to cleaning, disinfection, inspection, packaging, sterilisation, transportation and storage of such devices;

• (b) the procedures implemented in accordance with sub-paragraph (a) shall be such as to ensure that reusable medical devices are handled safely and decontaminated effectively in accordance with the manufacturer’s guidance, prior to re-use.

• (4) The registered person shall ensure that food and fluids –

• (a) are provided in adequate quantities and at appropriate intervals;

• (b) are properly prepared, wholesome and nutritious and meets their nutritional requirements;

• (c) are suitable for the needs of patients;

• (d) provide choice for the patients; and

• (e) that the menu is varied at suitable intervals.

Health and welfare of patients

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• (1) The registered person shall ensure that the nursing home is conducted so as –

• (a) to promote and make proper provision for the nursing, health and welfare of patients;

• (b) to make proper provision for the nursing and where appropriate, treatment and supervision of patients.

• (2) The registered person shall so far as practicable enable patients to make decisions with respect to the nursing they are to receive and their health and welfare.

• (3) The registered person shall, for the purpose of providing nursing to patients, and making proper provision for their health and welfare, so far as practicable, ascertain and take into account their wishes and feelings.

• (4) Subject to paragraph (5), the registered person shall make suitable arrangements for the ordering, storage, stock control, recording, handling, safe keeping, safe administration and disposal of medicines used in or for the purposes of the nursing home to ensure that –

• (a) any medicine which is kept in a nursing home is stored in a secure place; and

• (b) medicine which is prescribed is administered as prescribed to the patient for whom it is prescribed, and to no other patient; and

• (c) a written record is kept of the administration of any medicine to a patient.

• (5) Paragraph (4) does not apply to medicine which –

• (a) is stored by the individual for whom it is provided in such a way that others are prevented from using it; and

• (b) may be safely self-administered by that individual.

• (6) In this regulation, “prescribed” means –

• (a) ordered for a patient for provision to him under Part VI of the Health and Personal Social Services (Northern Ireland) Order 1972[^f00007]; or

• (b) prescribed for a patient under regulation 214 or 215 of the Human Medicines Regulations 2012