Health and social care organisations in England must comply with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to maintain their registration with the Care Quality Commission (CQC).
With regard to employing staff, Regulation 19: Fit and Proper Persons Employed applies. The intention of this regulation is to ensure that providers only employ staff who will provide safe, compassionate, and competent care. The regulation must be met for all staff employed, irrespective of the country from which they are recruited and the routes by which they have come to be employed by the care service.
To meet the requirements of the regulation, providers must operate robust recruitment procedures, including undertaking any relevant checks; must have a procedure for ongoing monitoring of staff to ensure they remain able to meet requirements; and should have in place appropriate arrangements to deal with staff that are no longer fit to carry out the duties required of them.
Specific clauses include the following.
- Persons employed for the purposes of carrying on a regulated activity must:
- be of good character
- have the qualifications, competence, skills, and experience necessary for the work to be performed by them
- be able, by reason of their health, after reasonable adjustments are made, to properly perform tasks that are intrinsic to the work for which they are employed.
- Recruitment procedures must be established and operated effectively.
- Information specified in schedule 3 of the regulations must be available in relation to each such person employed, as well as other information as is required.
- Persons employed must be registered with the relevant professional body where such registration is required.
For example, Prompt 19(1)(a) states that providers should make every effort to ensure that all available information is sought to confirm that the individual being recruited is of good character and has:
- not been convicted of an offence in any country which would be considered an offence in the UK, if the offence relates to the conduct required in carrying on a regulated activity
- not been removed or struck off a professional register
- no information about them that would suggest they have been responsible for, privy to, contributed to, or facilitated any serious misconduct or mismanagement in the course of carrying on a regulated activity.
- proof of identity - including a recent photograph
- a suitable criminal record certificate
- satisfactory evidence of conduct in previous employment
- verification of the reason why employment ended where previously employed in a position which involved work with children or vulnerable adults
- evidence of relevant or necessary qualifications
- a full employment history
- satisfactory information about any relevant physical or mental health conditions.
CQC key question test
The CQC uses a five key-question test in its inspections. Key question judgments are made with reference to the Key Lines of Enquiry (KLOE).
The relevant KLOE for staff recruitment is E2: "How does the service make sure that staff have the skills, knowledge, and experience to deliver effective care and support?" This has the following prompts.
- E2.1: Do people have their assessed needs, preferences, and choices met by staff with the right qualifications, skills, knowledge, and experience?
- E2.2: Are staff supported to keep their professional practice and knowledge updated in line with best practice?
- E2.3: Do staff and any volunteers have effective and regular mentorship, support, induction, supervision, appraisal, and training?
Wales and Scotland Standards Requirement
Immigration laws are UK wide and apply to Wales and Scotland as to England. Wales "fitness requirements" are made under the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017 (see Regulation 35: Fitness of Staff). In Scotland care providers must ensure that their procedures are in line with section 4 of the national health and social care standards, My Support, My Life, "4: I have confidence in the organisation providing my care and support".
IWO operates in compliance with these requirements to the full extent required.