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Referrals and Admissions in Care Homes (England) Policy

Policy Statement

This policy sets out:

• how the home handles referrals of prospective residents in line with current standards and regulations
• to make sure that everyone involved in the person’s care and support arrangements is satisfied that the home will meet their needs
• to organise the admission in ways which give the new resident the best possible start to their life in their new home.

{{org_field_name}} works on the basis that much of the success of a period of residence lies in making the correct decisions and taking appropriate action at the time of a resident’s referral and admission. It adopts a person-centred approach throughout the referrals, applications and admissions procedures.

This policy should be read in relation to other relevant policies, eg Needs Assessment, Information Provision for Prospective Service Users, Trial Visits, Residents Bringing Private Property into the Home, Service Users’ Contracts and Key Workers.

The home will also follow all government guidance in respect of applications for admission during the Covid-19 emergency situation, including those referred through the NHS Hospital Discharge Service. It might be necessary to modify some of the procedures that are described below to ensure compliance.

Policy on Referrals and Admissions

Referrals and Applications*

*The sources of a given home’s referrals and applications will vary according to the type of home and local factors.

1. Referrals from people following local authority/health services assessments — The home could receive enquiries or applications from or on behalf of people:
   a. whose care and support needs have been assessed by their local authority and/or relevant health services
   b. who have met national eligibility criteria
   c. who have a care and support plan that indicates that a care home will be the best way of meeting their needs
   d. who have agreed that the local authority should arrange their care
   e. who could be receiving local authority funding to meet their care needs.
   Note:
   Such applications will usually be made to homes that have been contracted or commissioned by a local authority/CCG to provide care to its specifications by being on an approved list or direct contract. Such applications might also be made for people needing care and/or continuing nursing care following discharge from hospital. Local procedures will apply in these different circumstances.
   In the event of any referral by these means, {{org_field_name}} manager will give an immediate reaction on the vacancy position, time scales and so on, and if appropriate, request information from their care and support plan, which should enable the home to assess its capacity to meet the person’s needs.
   If the referral appears suitable, the home will then ask for the full written needs assessment (if not already supplied). For its part, the home will provide any information requested or needed by the applicant. A meeting with the prospective resident, preferably in the form of a visit accompanied by his or her local authority social worker, a relative/friend and/or lawful representative — as appropriate — will then be arranged. If the service user would like us to meet them in his or her own home or at another location, for example, hospital that can be arranged if practical.
2. Referrals made independently of the local authority — A prospective resident who intends to pay for his or her own care or is being funded independently might not have had a full needs assessment by his or her local authority although, in line with the Care Act 2014, he or she is fully entitled to one. Where the prospective resident prefers not to have his or her needs assessed by the local authority and is acting independently of it, the home will employ a qualified person to carry out its own needs assessment equivalent to that provided by the local authority.
   With all applications, it is important that the home is fully aware of the person’s needs and has the resources to meet them. The home will decide about admitting the person in principle based on this assessment and terms and conditions and/or a contract can then be agreed.

Procedures following a decision to consider admission

1. Pre-admission assessments Where a pre-assessment is required in a person’s own home the manager or team dealing with the application will:
   a. check that it has all available information from the referral to enable it to proceed, including such matters as the urgency of the potential admission and that it lies within the home’s scope and eligibility criteria
   b. arrange with the prospective service user and / or person(s) who are lawfully representing the person dates and times for the assessment visit(s)
   c. check that the person is giving their consent to the assessment /has been given through a best interests assessment in line with Mental Capacity Act 2005 requirements
   d. check if there are any safety risks to the people carrying out the assessment and put appropriate measures in place if there are, for example, for assessor and/or the prospective service user to be supported throughout the assessment
   e. check if there are any specific requirements to enable the assessment to be carried out eg if the person has communication difficulties
   f. check the assessment on completion that it is sufficiently comprehensive including risk assessments to enable both parties take informed decisions about the proposed care and support arrangements
   g. check if any agreed move is with the consent of the person or if the person cannot give their informed consent that any decision taken meets the requirements of the Mental Capacity Act 2005
   h. if the person is being deprived of their liberty because of the move that the decision is fully authorised in line with current requirements.
2. Pre-admission visits — We will try to give every prospective resident as full and honest an impression of the home as possible. They will have the chance to talk with the manager and other appropriate staff, to speak with other residents, to take a meal with residents, to view the house and grounds, and then to talk privately with their relative or lawful representative. We understand that they may be visiting more than one home and we want a resident to make a positive choice to come to {{org_field_name}}.
3. Meeting needs — In line with its registration requirements, the home must be satisfied that it has the capacity to meet the needs of any prospective resident before agreeing to an admission. We will discuss this issue with the prospective resident, their relatives or local authority social worker as appropriate, and if it is necessary to decline to admit someone who wishes to come to the home we will frankly tell them the reasons. We believe that clarity at this stage can avoid a much more painful breakdown of a placement later.
4. Trial visits — We offer every prospective resident the possibility of a trial visit or period of residence and will discuss and agree the terms and conditions of the “trial period” with the person and their representatives as appropriate.
5. Admissions — If everyone is satisfied that an admission to {{org_field_name}} is the right step, we will arrange for the service user to be admitted. We suggest that, if possible, they should be accompanied by a friend or representative on the day of admission. We will allocate staff at the appointed time to make the new resident welcome, to introduce them to other staff and residents, to help them settle into their room providing whatever help is required, and to be a point of reference for any further information the resident needs.
6. Emergency admissions — We try to avoid unplanned and emergency admissions, but recognise that situations sometimes arise which make rapid action necessary. In these instances, we will apply the procedures governing planned admissions and gather and supply all necessary information as soon as practically possible. (See separate Emergency/Unplanned Admissions Policy.)
7. Mental Capacity — The home assumes that prospective residents will give their written consent to their moving into the home and to its provisions. Where the person is unable to give their formal consent because of lack of mental capacity, the home will ensure that all due Mental Capacity Act processes have been followed and will ascertain if there will be any deprivation of liberty that requires safeguarding.
8. Settling in — We will provide all possible help to make the new resident’s introduction to the home as comfortable an experience as possible, will introduce them gradually to the home’s policies and procedures, and will set in motion as soon as possible the drawing up of their service user plan, which will be developed from their needs assessment.

Training

All staff receive training in line with their roles and responsibilities in the handling of referrals, needs assessments and admissions.

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