Fundamental Standards
The Fundamental Standards are the minimum standards below which care must never fall. They are set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulations 9–20.
Important: These standards came into force on 1 April 2015. The CQC can take enforcement action if a provider breaches the Fundamental Standards. Breaches can result in conditions on registration, suspension, or cancellation of registration. In the most serious cases, the CQC can prosecute.
Person-Centred Care
Care and treatment must be appropriate, meet service users' needs, and reflect their preferences. Providers must consult with service users about their care and act on what they say.
Dignity and Respect
Service users must be treated with dignity and respect at all times. This includes respecting their privacy, supporting their independence, and valuing them as individuals.
Consent
Care and treatment must only be provided with the consent of the service user. Where a person lacks capacity, the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards must be followed.
Safe Care and Treatment
Care and treatment must be provided in a safe way. Providers must assess risks to health and safety, do everything reasonably practicable to mitigate them, and ensure proper medicines management.
Safeguarding
Service users must be protected from abuse and improper treatment. Providers must have safeguarding policies, train staff, and work with local authorities to investigate any concerns.
Nutrition and Hydration
Service users' nutritional and hydration needs must be met. This includes adequate food and drink that meets their needs, preferences, and any special dietary requirements.
Premises and Equipment
Premises and equipment must be clean, secure, suitable, and properly maintained. Providers must ensure facilities are fit for purpose and support the delivery of safe care.
Complaints
Providers must have an accessible complaints system and respond to complaints effectively. Complainants must receive a timely response and information about any action taken.
Good Governance
Providers must have systems and processes to assess, monitor, and improve the quality and safety of services. They must maintain accurate records and use information about safety and quality to drive improvement.
Staffing
Providers must employ sufficient numbers of suitably qualified, competent, and experienced staff to meet service users' needs. Staff must receive appropriate training, support, and supervision.
Fit and Proper Persons (Directors)
Directors or equivalent must be fit and proper persons. Providers must not appoint anyone who has been responsible for malpractice or mismanagement.
Duty of Candour
Providers must be open and transparent with service users about their care and treatment. When something goes wrong, they must apologise, explain what happened, and describe what will be done to prevent recurrence.
Key Points for Care Workers
- 1.You have a personal duty to comply with these standards — they are not just the responsibility of managers
- 2.If you witness a breach of standards, you have a professional and legal duty to report it
- 3.The Duty of Candour (Reg 20) requires honesty and openness when things go wrong
- 4.Person-centred care (Reg 9) means treating each resident as an individual with their own preferences and needs
- 5.Consent (Reg 11) must always be sought and the Mental Capacity Act 2005 followed when capacity is in doubt