This guidance explains what CQC means by ‘service user bands’ and when these apply.
It supports other guidance on registration and on statutory notifications by explaining when and why you need to tell us about certain specialisms.
What we mean by a ‘service user band’
The regulations require that in your statement of purpose you describe the range of peoples’ needs that your service intends to meet. People using services may have various needs resulting from physical, sensory or cognitive impairment, their health, their background (for example, their culture or religion) or other life events (such as service veterans or victims of domestic abuse). While we expect you to be able to demonstrate that you can meet all the needs of every person using your service, some needs will require you to have specific knowledge, skills, training or facilities in order to care for those people appropriately and safely.
It is helpful to think of these specific needs as ‘specialisms’. We use ‘service user bands’ to capture information about a range of specialisms. It is important that you tell us what service user bands you intend to provide so that we can make sure you can meet these needs. The service user bands are listed in your application form. Examples include dementia, physical disability, sensory impairment, mental health, learning disability or autism.
Not all providers will offer one of the specialisms covered by CQC’s service user bands. For example, a residential care home for older adults may only intend to provide for peoples’ general needs resulting from age-related frailty. Our service user bands therefore also include age categories (for example, Adults aged 65+), which help us to know who you intend to provide a service to.
You may also intend to meet needs that fall outside of CQC’s list of service user bands. For example, you may specialise in meeting the cultural and religious needs of elders from an ethnic minority group, service veterans, or the needs of people with an acquired brain injury. You must tell us in your statement of purpose about all the needs that your services intend to meet.
A service user band is not about any one person’s individual needs but refers to the specialist services you offer at or from a location. It represents the specific needs of people who you intend to provide a service to. If you select a service user band you must show that you can meet those needs throughout the time that a person requires your service. For example, a person living with dementia will experience a decline in their cognitive abilities. This may cause them to experience anxiety or distress and can lead to behaviour changes. You must have the skills and experience to understand and respond to each person's experience of dementia and its progression.
Why we have service user bands
CQC uses service user bands to capture data about a range of specialisms that we want to know about. They help us to identify any specialist services you intend to provide, so that we can make sure you can meet those needs. We will check during our registration, ongoing assessment, and inspection activities that you provide appropriate facilities and your registered manager and staff have the knowledge and skills to meet any specialist needs.
We also show details of service user bands against each location on our website. This helps people who use services to identify and choose a service that can meet their own needs.
Your statement of purpose must accurately describe all the needs your service intends to meet and be updated if they change. Service user bands should be kept up to date as they form part of CQC’s ‘register’ of information that we publish.
When service user bands apply
Service user bands apply at location level only. They relate to the range of specialist care needs of people who you intend to provide a service to at (or from) that location. You should only agree to provide a service to someone whose current presenting need(s) at the point the service starts (the reason they require that service) fall within the service user bands you have told us you intend to meet. If a person’s needs cross several specialisms, you must make sure that the specific reason(s) for them needing the service is covered by the location’s service user bands. You must assess that you can meet any additional needs the person has, but you do not need to add other service user bands unless you intend to specialise in them.
For example, a person living in a supported living setting has a learning disability and a diagnosed mental health condition. They need support with personal care and daily living activities because of needs arising from their learning disability, not because of their mental health. You must tell us in your statement of purpose that you provide services to people with a learning disability where this is their presenting need. The category of learning disability will be added to your service user bands. You do not need to add the service user band for mental health unless you also intend to specialise in this area. However, we would expect you to have the knowledge and skills to support that individual with all their needs.
Similarly, if while receiving a service a person develops needs outside your specialisms, you do not need to change your service user bands to reflect this. Service user bands are not used to reflect all the potential needs of every person receiving a service at any point in time. But when we inspect, we will expect you to demonstrate that staff have the knowledge and skills to meet all individual needs of everyone using your service, including any needs arising since someone’s service started, or have made sure people receive appropriate care elsewhere.
If in an exceptional one-off circumstance you want to provide a service to someone whose presenting need is outside your service user bands, you must still update your statement of purpose to describe the change in specialist needs that the service is now meeting. You must notify CQC of this update but don’t need to add the additional service user band unless you intend to offer services to other people with that specialist need. In this one-off scenario we will not usually add the service user band to your location but will seek reassurance that you can meet the person’s specialist needs.
As not all scenarios are clear-cut (for example, a person’s presenting needs may be complex or unclear), you may want to contact enquiries@cqc.org.uk to discuss whether certain service user bands apply.
If a service is provided for the whole population (for example an acute hospital or a GP practice), it will generally be rare that additional service user bands should be selected (only if a specialist service is also provided). Where you select ‘Whole Population’, you are expected to have the intent, knowledge and skills to meet the general healthcare needs of the population.
Adding or removing service user bands
At the point of registration, you must tell us what service user bands (specialist needs) your service intends to meet. You do this by selecting the relevant service user bands within your application form and must also describe these in your statement of purpose, together with any other needs your service intends to provide for. When we receive an application, we always check that the service user bands selected in the application form match those included in the statement of purpose.
Once you are registered, it is important that service user bands are kept up to date. If the specialisms provided at or from any location change, you must update your statement of purpose to reflect the change in the needs that your location intends to meet. Under Regulation 12 of the 2009 Regulations, you must notify CQC whenever your Statement of Purpose is amended. We may ask you for further information about how you will meet those specialist needs, and check your staff have the knowledge, skills and facilities to meet any new specialist needs through our ongoing assessment and inspection activity.
Specialist services for people with a learning disability or autistic people
If you plan to provide specialist care to people with a learning disability or autistic people you must meet our guidance for these services. We will assess your application to register with CQC or to make changes to your registration against this guidance. (See services for autistic people and people with a learning disability). This is to ensure that your planned model of care is in line with national policy and current best practice.
Applications received from 1 September 2022
If you:
- Do not intend to provide a service for people with a learning disability or autistic people
AND
- Plan to provide any of these regulated activities:
- Accommodation for persons who require nursing or personal care
- Personal care
- Assessment or medical treatment for persons detained under the 1983 Act
we will impose a routine condition at each location.
This condition states that you must not provide a specialist service to people whose need for care or treatment is as a direct result of a learning disability and or autism.
This means that, if you later want to provide this specialist service at or from any location, you must apply to have this condition removed. We will then assess you to ensure your service meets our guidance and best practice. You cannot just notify us of a change to your service user bands. We explain this in our guidance on applying to be a new provider.