The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012

Persons who enter relevant premises or who develop a need for nursing care E+W

28.—(1) Subject to paragraphs (2) and (3), where it appears to a relevant body in respect of a person for whom it has responsibility that that person—

(a) is resident in relevant premises or may need to become resident in such premises; and

(b) may be in need of nursing care,

that body must carry out an assessment of the need for nursing care.

(2) Before carrying out an assessment under paragraph (1), the relevant body must consider whether its duty under regulation 21(2) is engaged, and if so, it must comply with the requirements of regulation 21 prior to carrying out any assessment under this regulation.

(3) Paragraph (1) does not apply if a relevant body has made arrangements for providing the person with NHS Continuing Healthcare.

(4) Where—

(a) the relevant body has carried out an assessment pursuant to regulation 21(2); but

(b) paragraph (3) does not apply because a decision has been made that the person is not eligible for NHS Continuing Healthcare,

that body must nevertheless use that assessment, wherever reasonably practicable, in making its assessment under paragraph (1).

(5) Where—

(a) the relevant body determines that a person has a need for nursing care pursuant to this regulation; and

(b) the person has agreed with that body that that person does want to be provided with such nursing care,

paragraph (6) [F1 or, as the case may be, (6A)] applies.

(6) The relevant body must pay to a registered person for the relevant premises the flat rate [F2 payment] in respect of that person's nursing care unless or until that person—

(a) has their need for nursing care assessed and it is determined that that person no longer has any need for nursing care;

(b) is no longer resident in the relevant premises;

(c) becomes eligible for NHS Continuing Healthcare pursuant to this Part; or

(d) dies.

[F3 (6A) Where the relevant body consents to the arrangement by a local authority, in accordance with section 22(4) and, where applicable, sections 22(5) and 22(9) of the Care Act 2014, for the provision of nursing care in accommodation arranged by the local authority in Northern Ireland or Scotland, the relevant body must pay to the relevant provider in respect of the person receiving nursing care—

(a) £100 per week, where nursing care is provided in accommodation in Northern Ireland, or

(b) £78 per week, where nursing care is provided in accommodation in Scotland,

unless or until paragraph (6B) applies.

(6B) This paragraph applies where a person receiving nursing care in accommodation in Northern Ireland or Scotland—

(a) has their need for nursing care assessed and it is determined that that person no longer has any need for nursing care;

(b) is no longer resident in that accommodation;

(c) becomes eligible for NHS Continuing Healthcare pursuant to this Part; or

(d) dies.

(6C) In paragraphs (6A) and (6B)—

“accommodation” means—

(a)

in relation to Northern Ireland, residential or other accommodation in Northern Ireland of a type which may be provided under article 15 of the Health and Personal Social Services (Northern Ireland) Order 1972 and includes a nursing home within the meaning of article 11 of the Health and Personal Social Services (Quality Improvement and Regulation) (Northern Ireland) Order 2003;

(b)

in relation to Scotland, residential accommodation in Scotland of a type which may be provided under or by virtue of section 12 or 13A of the Social Work (Scotland) Act 1968 or section 25 of the Mental Health (Care and Treatment) (Scotland) Act 2003;

“local authority” has the same meaning as in section 1(4) of the Care Act 2014; and

“relevant provider” means—

(a)

in relation to Northern Ireland, the person registered under Part 3 of the Health and Personal Social Services (Quality, Improvement and Regulation) (Northern Ireland) Order 2003 in respect of that accommodation;

(b)

in relation to Scotland, the person who provides in respect of that accommodation a care service registered under section 59 of the Public Services Reform (Scotland) Act 2010.]

Textual Amendments

F1 Words in reg. 28(5) inserted (1.4.2015) by The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2015 (S.I. 2015/415), regs. 1(1), 3(a)

F2 Word in reg. 28(6) inserted (1.10.2014) by The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) (No. 3) Regulations 2014 (S.I. 2014/1611), regs. 1(1), 3(2)

F3 Reg. 28(6A)-(6C) inserted (1.4.2015) by The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2015 (S.I. 2015/415), regs. 1(1), 3(b)