Adult social care partners join forces to strengthen roles and responsibilities when care home closure is necessary

A new good practice guide – Managing care home closures – has been published today (Tuesday 26 July) to help minimise the impact on people, and their families and carers, in the event of a care home closing in response to poor care, an emergency or market exit.

The Care Quality Commission (CQC) has worked in partnership with NHS England (NHSE), the Association of Directors of Adult Social Services (ADASS), the Local Government Association (LGA) and the Care Provider Alliance (CPA) to agree the guide which sets out how local and national organisations should work together in order to coordinate action, avoid duplication and prevent confusion for people using services, their families and carers, care home providers and their managers and staff.

The guide has been developed following an event co-hosted by CQC and NHSE earlier this year to explore how unplanned care home closures are managed, learning from the experience of residents and families. At this event it was agreed that the system needs an agreed set of essential principles, underpinned by a framework of actions, to ensure the needs of people using services, their families and carers remain at the heart of the closure process.

Now, when a care home closure situation arises, organisations including local authorities – which have the lead responsibility for people with care and support needs – clinical commissioning groups (CCGs), NHSE, CQC, providers and partners will be expected to use an appropriate and detailed checklist to ensure the process is coordinated well.

Recommendations include:

• Appointing a coordinator within the lead local authority for families, carers or other advocates who will ensure there is an accurate list of all residents and their needs, together with up-to-date names, addresses and telephone numbers of family representatives and who will seek fullest involvement in the relocation process.
• Placing a poster in the care home with key information about the planned closure, including contact details for residents, carers, families and staff to refer queries, questions and complaints to.
• Appointing a transport co-ordinator within the lead local authority to act as a single point of contact and oversee timely moves; e.g. to notify ambulance staff in good time so that residents are not kept waiting for transport outside the home and are helped to move only in daylight hours.
• Assessments of residents’ health and care needs should start to be considered straight away, rather than waiting for an urgent closure legal notice to be served, as arrangements can be explored in the meantime.

CQC’s Chief Inspector of Adult Social Care, Andrea Sutcliffe, said: “Care homes are people’s homes and they have every right to expect to live there for as long as they like. When a home closes unexpectedly, this can be a real shock for people, either for themselves or a loved one, which is why this will never be a decision that is taken lightly. As the regulator, it is CQC’s job to report on the quality of care that we find and our expectation is that providers will swiftly get to grips with any problems we identify.

Sadly, there are sometimes urgent situations when it is absolutely in people’s best interests for us to use our powers so that people can move to a better environment quickly to experience the safe, high quality and compassionate care they deserve. These are rare events but they have to be managed well with the needs of residents, their families and carers guiding the actions of the different organisations and professionals involved.

“Clearly defined roles and responsibilities, consistent communication and making sure people’s wishes and requirements are fully taken into account are vital to ensure the impact on people is as comfortable as possible. I am grateful to everyone who has been involved in developing the guide, particularly those who shared the experience of families affected by previous care home closures.  I am confident that the guide will strengthen how organisations work together in these difficult circumstances for the benefit of those using services.”

Regional Chief Nurse at NHS England, Margaret Kitching, said: “While we encourage people to do all they can to prevent care homes from closing wherever possible, when a care home is no longer able to continue providing a service its closure needs to be managed very carefully. The Care Quality Commission and the NHS, together with local government and others across the independent care sector, have worked to produce this guide to ensure closures are handled sensitively and are well-managed.”

The LGA’s Portfolio Holder for Community Wellbeing, Cllr Izzi Seccombe, said: "Nobody wants to see a care home close, but on the occasions where this happens, it is vital to be prepared so that residents continue to receive quality care and that the highest standards of safety are maintained at all times. This guide is about ensuring this process is managed as smoothly as possible and that the impact to those affected is kept to a minimum. It also highlights how to provide effective communication and about keeping individuals and their families informed of what is happening. Councils will always work closely with their partners to minimise any disruption or distress to residents, with their well-being of paramount importance at all times."

Representing the Care Provider Alliance, Frank Ursell, said: “The CPA welcomes the guidance which should remove some of the uncertainty which can accompany the closure of a care home.”

Chief Executive of Action on Elder Abuse, Gary FitzGerald, said: “Closing a care home is difficult for residents at any time, but even more so when it has to be done at very short notice. If not handled effectively it can be a highly traumatic experience for those frail and vulnerable people affected, and it is therefore critical to get this right. We are consequently very pleased that CQC, and other partners, have acknowledged our concerns about these challenges and have addressed them in such a positive and collaborative manner. We would encourage all agencies to follow both the spirit and intent of this new guide, and we will obviously watch its implementation closely."

The Managing care home closures good practice guide is available to view online here: www.nhs.uk/quickguides. 

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