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Care Home Negligence Solicitors

Are care home's eagerness to readmit residents after a hospital stay risking residents' health and safety?

The Care Quality Commission have recently discussed concerns that care home providers will not readmit residents subsequent to an admission in hospital without conducting a full assessment of need.

However, perhaps more startling, we have heard a number of concerns of care home readmits residents after a hospital stay when it is later found or, at the very least suspected, that a nursing home in fact was required.

Whilst the often significant waiting lists for admission into certain care home may cause families concern when a loved one are obligated to temporarily discharged from the home in order to be admitted into hospital, the assessment of need is vital to ensure the care home are capable and suitable of caring and treating a resident.

Whilst assessment needs should be conducted during a resident's initial admission, a person's health and profile may drastically change over time and so it is prudent that updated assessments are carried out. Similarly, whilst we are not medical experts, certain medical conditions or complications may change a person's medical profile the rest of their lives, resulting in that person requiring additional care and treatment.

It must be remembered that care homes and nursing home are two completely different types of care providers. Whilst a care home may be suitable for a person at one point in their life, over the passage of time, a person may develop health complications and require care and treatment that only a nursing home can provide. Sadly, there are occasions where, as the result of inadequate or a complete failure to conduct assessments, care homes readmit residents requiring medical care and treatment that may only be provided by a nursing home. Consequently, otherwise avoidable mistakes occur, the consequences of which can be devastating.

It is important we are aware of the legal requirements surrounding this area. Helpfully, the Care Quality Commission have released guidance discussing the legal requirements around this and offer some best practice guidance. Whilst we have a copy of the guidance below, further information can be found at http://www.cqc.org.uk/content/guidance-needs-assessments-hospital-discharge.

" Regulation 9 of the 2014 Regulated Activities Regulations

This is clear that providers must undertake a needs assessment before providing a service, and do so in collaboration with the person being cared for or someone with legal powers to make relevant decisions.

This is an important requirement and one of the fundamentals of providing good care.

Carrying out a needs assessment for an existing service user

However, while needs assessments of people not previously admitted to a service will normally require face-to-face contact, where an existing service user has been admitted to hospital, regulation 9 does not necessarily require the provider to physically see the person when reviewing their needs and planning the re-start of their care on discharge.

Where a provider is confident that they can rely on information from hospital or care management staff, and that on the basis of this information they are able to meet the person's needs, they do not necessarily need to see them in person. This includes in relation to gaining consent to their care and treatment being transferred back to the care home.

Every decision about a needs assessment requires judgement

The provider's decision about this requires careful judgement, and will need to take into account a variety of variables. They will ultimately need to be confident about:

  • The reliability of the needs-related information supplied by other sources
  • Their ability to meet the person's continuing and any new needs
  • The person's (or someone with valid legal powers') continuing consent to the care they will provide

These elements can be discussed, assessed and concluded by any appropriate means, for example by telephone, email or in person. The mechanisms involved and what was agreed and decided must be recorded.

Ultimately, if a provider is not convinced by or confident in the information provided to them by a third party, they need to undertake their own needs assessment."