CQC Issues Guidance on Hospital Discharge Needs Assessments

The CQC has issued guidance for care homes on Hospital Needs Assessment, following concern that care home providers are not readmitting people after periods in hospital without conducting full, in person assessments of need.

The CQC statement aims to make clear the legal requirements around this subject and offer some best practice guidance. The advice and guidance applies equally to community adult social care services.

Regulation 9 of the 2014 Regulated Activities Regulations makes it clear that providers must undertake a needs assessment before providing a service, and must do so in collaboration with the person being cared for or someone with legal powers to make relevant decisions. This is an important requirement and one of the fundamentals of providing good care.

However, while needs assessments of people not previously admitted to a service will normally require face-to-face contact, where an existing service user has been admitted to hospital, regulation 9 does not necessarily require the provider to physically see the person when reviewing their needs and planning the re-start of their care on discharge.

Where a provider is confident that they can rely on information from hospital or care management staff, and that on the basis of this information they are able to meet the person’s needs, they do not necessarily need to see them in person. This includes in relation to gaining consent to their care and treatment being transferred back to the care home.

The CQC stresses that every decision about a needs assessment requires careful judgement, and will need to take into account a variety of variables. Care providers will ultimately need to be confident about:

• The reliability of the needs-related information supplied by other sources.
• Their ability to meet the person’s continuing and any new needs
• The person’s (or someone with valid legal powers’) continuing consent to the care they will provide

These elements can be discussed, assessed and concluded by any appropriate means, for example by telephone, email or in person. The mechanisms involved and what was agreed and decided must be recorded.

Ultimately, if a provider is not convinced by or confident in the information provided to them by a third party, they need to undertake their own needs assessment.