Regulations for service providers and managers

Page last updated: 7 August 2024

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Regulation 9: Person-centred care

Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 9

The intention of this regulation is to make sure that people using a service have care or treatment that is personalised specifically for them. This regulation describes the action that providers must take to make sure that each person receives appropriate person-centred care and treatment that is based on an assessment of their needs and preferences.

Providers must work in partnership with the person, make any reasonable adjustments and provide support to help them understand and make informed decisions about their care and treatment options, including the extent to which they may wish to manage these options themselves.

Providers must make sure that they take into account people's capacity and ability to consent, and that either they, or a person lawfully acting on their behalf, must be involved in the planning, management and review of their care and treatment. Providers must make sure that decisions are made by those with the legal authority or responsibility to do so, but they must work within the requirements of the Mental Capacity Act 2005, which includes the duty to consult others such as carers, families and/or advocates where appropriate.

Please see the glossary for important clarification of the terms "appropriate care and treatment"; "needs"; "preferences"; and "relevant person".

CQC cannot prosecute for a breach of this regulation or any of its parts, but we can take regulatory action. See the offences section for more detail.

CQC must refuse registration if providers cannot satisfy us that they can and will continue to comply with this regulation.

The regulation in full

9.—

  1. The care and treatment of service users must—
    1. be appropriate,
    2. meet their needs, and
    3. reflect their preferences.
  2. But paragraph (1) does not apply to the extent that the provision of care or treatment would result in a breach of regulation 11.
  3. Without limiting paragraph (1), the things which a registered person must do to comply with that paragraph include—
    1. carrying out, collaboratively with the relevant person, an assessment of the needs and preferences for care and treatment of the service user;
    2. designing care or treatment with a view to achieving service users' preferences and ensuring their needs are met;
    3. enabling and supporting relevant persons to understand the care or treatment choices available to the service user and to discuss, with a competent health care professional or other competent person, the balance of risks and benefits involved in any particular course of treatment;
    4. enabling and supporting relevant persons to make, or participate in making, decisions relating to the service user's care or treatment to the maximum extent possible;
    5. providing opportunities for relevant persons to manage the service user's care or treatment;
    6. involving relevant persons in decisions relating to the way in which the regulated activity is carried on in so far as it relates to the service user's care or treatment;
    7. providing relevant persons with the information they would reasonably need for the purposes of sub-paragraphs (c) to (f);
    8. making reasonable adjustments to enable the service user to receive their care or treatment;
    9. where meeting a service user's nutritional and hydration needs, having regard to the service user's well-being.
  4. Paragraphs (1) and (3) apply subject to paragraphs (5) and (6).
  5. If the service user is 16 or over and lacks capacity in relation to a matter to which this regulation applies, paragraphs (1) to (3) are subject to any duty on the registered person under the 2005 Act in relation to that matter.
  6. But if Part 4 or 4A of the 1983 Act applies to a service user, care and treatment must be provided in accordance with the provisions of that Act.

Guidance

This sets out the guidance providers must have regard to against the relevant component of the regulation.

9(1) The care and treatment of service users must – (a) be appropriate, (b) meet their needs and (c) reflect their preferences

9(2) But paragraph (1) does not apply to the extent that the provision of care or treatment would result in a breach of Regulation 11.

9(3) Without limiting paragraph (1), the things which a registered person must do to comply with that paragraph include–

9(3)(a) carrying out, collaboratively with the relevant person, an assessment of the needs and preferences for care and treatment of the service user;

9(3)(b) designing care or treatment with a view to achieving service users' preferences and ensuring their needs are met

9(3)(c) enabling and supporting relevant persons to understand the care or treatment choices available to the service user and to discuss, with a competent health care professional or other competent person, the balance of risks and benefits involved in any particular course of treatment;

9(3)(d) enabling and supporting relevant persons to make, or participate in making, decisions relating to the service user's care or treatment to the maximum extent possible;

9(3)(e) providing opportunities for relevant persons to manage the service user's care or treatment;

9(3)(f) involving relevant persons in decisions relating to the way in which the regulated activity is carried on in so far as it relates to the service user's care or treatment;

9(3)(g) providing relevant persons with the information they would reasonably need for the purposes of sub-paragraphs (c) to (f);

9(3)(i) where meeting a service user's nutritional and hydration needs, having regard to the service user's well being