Today I am talking about… Premises and Equipment
I do realise that the Regulations are not the most exciting However they are important and if you get this right it helps to have a great inspection. CQC are not prescriptive. They love innovation and out of the box thinking although you would think otherwise when you try and navigate their website.
Main part of episode
CQC write in the regulation that ; The intention of this regulation is to make sure that the premises where care and treatment are delivered are clean, suitable for the intended purpose, maintained and where required, appropriately located, and that the equipment that is used to deliver care and treatment is clean, suitable for the intended purpose, maintained, stored securely and used properly.
Providers retain legal responsibility under these regulations when they delegate responsibility through contracts or legal agreements to a third party, independent suppliers, professionals, supply chains or contractors. They must therefore make sure that they meet the regulation, as responsibility for any shortfall rests with the provider.
This means that if you have cleaners coming to your premises you can’t assume they know what they are doing. You are responsible for making sure what the expectations are.
Where the person using the service owns the equipment needed to deliver their care and treatment, or the provider does not provide it, the provider
should make every effort to make sure that it is clean, safe and suitable for use.
A few years ago I went to support an aesthetics clinic and this was around preparing the clinic owner who was also a doctor to meet the requirements of his appraisal but they also wanted help with the operations side of the business. I picked up on poor stock keeping but also not a robust enough cleaning regimen for the equipment. One piece of equipment was full of gunge. I insisted that the pieced of equipment was de- commissioned until it was cleaned and then it must have a cleaning regimen to stop this happening again. In respect to stock keeping I saved him hundreds of pounds . He was not moving stock around so ended up with medical times expired which then could not be sued. These were not cheap items. He had no process for ordering and checking what items needed to be replenished a simple excel sheet for them to use.
Point 1 The CQC outline that
—(1) All premises and equipment used by the service provider must be—
(c) suitable for the purpose for which they are being used,
(d) properly used
(e) properly maintained, and
(f) appropriately located for the purpose for which they are being used.
(2) The registered person must, in relation to such premises and equipment, maintain standards of hygiene appropriate for the purposes for which they are being used.
Point 2 If you are in a rented space and it’s the landlords cleaners you must ascertain he cleaning regimen.
The CQC says Providers retain legal responsibility under these regulations when they delegate responsibility through contracts or legal agreements to a third party, independent suppliers, professionals, supply chains or contractors. They must therefore make sure that they meet the regulation, as responsibility for any shortfall rests with the provider.
o Use appropriate cleaning methods and agents.
o Operate a cleaning schedule appropriate to the care and treatment being delivered from the premises or by the equipment.
o Monitor the level of cleanliness.
o Take action without delay when any shortfalls are identified.
o Make sure that staff with responsibility for cleaning have appropriate training.
Using the appropriate level of security needed in relation to the services being delivered.
Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3)
Guidance for providers on meeting the regulations March 2015 57
• If any form of surveillance is used for any purpose, the provider must make sure that this is done in the best interests of people using the service, while remaining mindful of their responsibilities for the safety of their staff. Any surveillance should be operated in line with current guidance
Premises must be fit for purpose in line with statutory requirements and should take account of national best
• Premises must be suitable for the service provided, including the layout, and be big enough to accommodate the
potential number of people using the service at any one time. There must be sufficient equipment to provide the
• Adequate support facilities and amenities must be provided where relevant to the service being provided. This
includes sufficient toilets and bathrooms for the number of people using the service, adequate storage space, adequate seating and waiting space.
• People’s needs must be taken into account when premises are designed, built, maintained, renovated or adapted. Their views should also be taken into account when possible.
• People should be able to easily enter and exit premises and find their way around easily and independently. If they can’t, providers must make reasonable adjustments in accordance with the Equality Act 2010 and other current legislation and guidance.
• Any alterations to the premises or the equipment that is used to deliver care and treatment must be made in line with current legislation and guidance. Where the guidance cannot be met, the provider should have appropriate contingency plans and arrangements to mitigate the risks to people using the service.
The premises and equipment used to deliver care and treatment must meet people’s needs and, where possible,
their preferences. This includes making sure that privacy, dignity and confidentiality are not compromised.
Reasonable adjustments must be made when providing equipment to meet the needs of people with disabilities, in line with requirements of the Equality Act 2010.
There should be regular health and safety risk assessments of the premises (including grounds) and equipment.
The findings of the assessments must be acted on without delay if improvements are required.
• There should be suitable arrangements for the purchase, service, maintenance, renewal and replacement of premises (including grounds) and equipment. These arrangements must make sure that they meet the requirements of current legislation and guidance, manufacturers’ instructions and the provider’s policies or procedures.
• Providers must have operational policies and procedures and maintenance budgets to maintain their equipment, buildings and mechanical engineering and electrical systems so that they are sound, operationally safe and exhibiting only minor deterioration.
• All equipment must be used, stored and maintained in line with manufacturers’ instructions. It should only be used for its intended purpose and by the person for whom is it provided.
• Providers must make sure that staff and others who operate the equipment are trained to use it appropriately.
Providers must comply with guidance from the Department of Health about the prevention and control of infections: Health and Social Care Act 2008: Code of Practice for health and adult social care on the prevention and control of infections and related guidance.
• Where applicable, premises must be cleaned or decontaminated in line with current legislation and guidance, and equipment must be cleaned, decontaminated and/or sterilised in line with current legislation and guidance and manufacturers’ instructions. Equipment must be cleaned or decontaminated after each use and between use by different people who use the service.
Multiple use equipment and devices must be cleaned or decontaminated between use.
Single use and single person devices must not be re-used or shared.
All staff must understand the risk to people who use services if they do not adhere to this.
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