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Position on 16 to 18 year olds providing personal care in care homes

We have agreed with the Department of Health that a more flexible approach can be taken regarding the care home standards covering 16 – 18 year olds providing personal care.

What do the national minimum standards for care homes say about 16 to 18 year olds providing personal care in care homes?

The Department of Health National Minimum Standards (NMS) for care homes expect that "Staff providing personal care to service users are at least aged 18" [NMS 27.6 Care Homes for Older people and NMS 33.10 Care Homes for Adults (18-65)].

Additionally NMS 32.4 (care Homes for Adults 18 -65) expects that "Trainees (including all staff under 18) are registered on a Sector Skills Council standard training programme, work only under the direct supervision of qualified staff and do not undertake intimate personal care tasks."

Why has CSCI sought a more flexible approach ?

We have received enquiries from service providers and educational establishments that have highlighted a number of concerns about this restriction :

  • It places unnecessary barriers to attracting new staff into social care positions at a time when recruitment and staff turnover is a particular challenge.
  • The restriction applies to care homes but not to certain other social care or health services. For example, there is no equivalent within the domiciliary care agencies national minimum standards where potentially care workers may have less direct supervision than in a care home setting.
  • Unless the restriction within the NMS is deemed to be a “genuine occupational requirement” it could be considered to be a discriminatory practice under the Employment Equality (Age) Regulations to exclude 16 to 18 year olds from these posts on grounds of age.
  • The quality of care provided by an individual worker is a matter of their competence following appropriate training and supervision rather than a function of their age.

What agreement has been reached about a more flexible approach?

We have raised the issue with the Department of Health signalling that in response to the issues raised with us we would like to adopt a more flexible approach to these particular standards.

The Department of Health have confirmed that the current national minimum standards will not be reviewed in advance of the new regulatory framework under which the Care Quality Commission will operate. They indicated that they are nevertheless content with the more flexible approach sought by the Commission provided that:

  • the Care Homes regulations are being satisfied
  • people delivering the personal care are suitably trained/competent and appropriately supervised where necessary, and that
  • the person receiving the care has their choices respected (as far as possible) with regards to who performs this task for them

The relevant regulations include for example:

  • Regulation 12, health and welfare of service users, which includes requirements to provide care in a manner which respects the privacy and dignity of service users and to maintain good personal and professional relationships
  • Regulation 18 staffing, which includes requirements in relation to training and supervision
  • Regulation 19 concerning the fitness of workers

We will update our guidance logs to reflect the more flexible position.

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