The national minimum standards apply to the wide range of residential and nursing homes which exist in England. It is necessary to achieve a balance between drawing up standards which are specific enough to avoid the need for local negotiation, but which are broad enough to apply to the diverse nature of the clientele catered for (eg those who are physically frail; those who have dementia). Drawing up standards for staffing exemplifies some of the greatest difficulties of this kind. Where residents have a high level of physical dependency (in relation to capacity to perform the activities of daily living), staffing levels will need to reflect the needs of those residents. Where they require significant nursing attention, the skill mix of the staffing establishment must be adjusted accordingly. Residents with dementia also require care from appropriately skilled staff – and so on. In determining appropriate staffing establishments in all care homes, and in nursing care homes in particular, the regulatory requirement that staffing levels and skills mix are adequate to meet the assessed and recorded needs of the residents at all times in the particular home in question must be met.
This section, therefore, does not lay down detailed specifications for staffing to cover all situations but it does set out some baseline standards which should apply as minimum to all settings. Each home must then determine the appropriate staffing levels and skills to meet the assessed needs of its own particular residents, which will then be approved by the National Care Standards Commission (NCSC).
See: Burton, J (1998); Payne, C (1994); Residential Forum (1997).
27.1 Staffing numbers and skill mix of qualified/unqualified staff are appropriate to the assessed needs of the service users, the size, layout and purpose of the home, at all times.
27.2 A recorded staff rota showing which staff are on duty at any time during the day and night and in what capacity is kept.
27.3 The ratios of care staff to service users must be determined according to the assessed needs of residents, and a system operated for calculating staff numbers required, in accordance with guidance recommended by the Department of Health.
27.4 Additional staff are on duty at peak times of activity during the day.
27.5 There are waking night staff on duty in numbers that reflect the numbers and needs of service users and the layout of the home. In care homes providing nursing this includes registered nurse(s).
27.6 Staff providing personal care to service users are at least aged 18; staff left in charge of the home are at least aged 21.
27.7 Domestic staff are employed in sufficient numbers to ensure that standards relating to food, meals and nutrition are fully met, and that the home is maintained in a clean and hygienic state, free from dirt and unpleasant odours.
Service users' needs are met by the numbers and skill mix of staff.
28.1 A minimum ratio of 50% trained members of care staff (NVQ level 2 or equivalent) is achieved by 2005, excluding the registered manager and/or care manager, and in care homes providing nursing, excluding those members of the
care staff who are registered nurses.
28.2 Any agency staff working in the home are included in the 50% ratio.
28.3 Trainees (including all staff under 18) are registered on a TOPSS-certified training programme.
Service users are in safe hands at all times.
29.1 The registered person operates a thorough recruitment procedure based on equal opportunities and ensuring the protection of service users.
29.2 Two written references are obtained before appointing a member of staff, and any gaps in employment records are explored.
29.3 New staff are confirmed in post only following completion of a satisfactory police check, and satisfactory check of the Protection of Children and Vulnerable Adults and UKCC registers.
29.4 Staff are employed in accordance with the code of conduct and practice set by the GSCC and are given copies of the code.
29.5 All staff receive statements of terms and conditions.
29.6 The recruitment and selection process for any volunteers involved in the home is thorough and includes police checks.
Service users are supported and protected by the home’s recruitment policy and practices.
30.1 The registered person ensures that there is a staff training and development programme which meets National Training Organisation (NTO) workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users.
30.2 All members of staff receive induction training to NTO specification within 6 weeks of appointment to their posts, including training on the principles of care, safe working practices, the organisation and worker role, the experiences and particular needs of the service user group, and the influences and particular requirements of the service setting.
30.3 All staff receive foundation training to NTO specification within the first six months of appointment, which equips them to meet the assessed needs of the service users accommodated, as defined in their individual plan of care (see Standards 3 and 7).
30.4 All staff receive a minimum of three paid days training per year (including in house training), and have an individual training and development assessment and profile.
Staff are trained and competent to do their jobs.
36.1 The registered person ensures that the employment policies and procedures adopted by the home and its induction, training and supervision arrangements are put into practice.
36.2 Care staff receive formal supervision at least 6 times a year.
36.3 Supervision covers:
• all aspects of practice;
• philosophy of care in the home;
• career development needs.
36.4 All other staff are supervised as part of the normal management process on a continuous basis.
36.5 Volunteers receive training, supervision and support appropriate to their role and do not replace paid staff.
Staff are appropriately supervised.
For more detailed information about legislation and standards, you can visit the Department of Health website, www.doh.gov.uk