Citizens Regulations, 2021

L.N. 322 of 2021

SOCIAL CARE STANDARDS AUTHORITY ACT

(CAP. 582)

Social Regulatory Standards for Residential Services for Senior

Citizens Regulations, 2021

IN EXERCISE of the powers conferred by article 30(5) of the

Social Care Standards Authority Act, the Minister for Senior Citizens

and Active Ageing, has made the following regulations

The title of these regulations is the Social Regulatory Title.

Standards for Residential Services for Senior Citizens Regulations,

2021.

(Regulation 2)

Standard 1: Residents’ Rights

Standard Statement

This standard aims to ensure that the residents’ fundamental

human rights to dignity and respect are safeguarded whilst preventing

discrimination, promoting active participation, ensuring a holistic and

dignified approach to care and respecting the residents’, relatives’ and

legally appointed representatives’ decisions and feedback.

Quality Indicators

1. The service provider shall assist the prospective residents,

their relatives, and their legally appointed representative in taking a

decision on whether the residential care home is appropriate for their

needs.

2. The service provider shall ensure that the residents are

treated equally with respect, dignity, and privacy.

3. The management and the staff shall support the residents to

maintain existing relationships and develop new relationships.

These regulations shall by means of the Schedule, elevate Scope.

the Social Regulatory Standards for Residential Services for Senior

Citizens, to the status of subsidiary legislation under the Social Care Cap. 582.

Standards Authority Act.

In these regulations, unless the context otherwise requires

Interpretation.

""Act" means the Social Care Standards Authority Act;

"Authority" means the Social Care Standards Authority

(SCSA) as established by virtue of article 5 of the Social Care Cap. 582.

Standards Authority Act;

"challenging behaviour" means behaviour of such an

intensity, frequency, or duration exhibited by residents, that is

triggered by intrinsic or extrinsic factors, that has the potential to

cause physical, emotional and, or psychological harm to the

residents themselves or to other persons around them. This

behaviour is likely to limit or deny access to certain services or

facilities without adequate support;

"civil rights" means rights conferred on persons by the

Laws of Malta.

"competent person" means a person who has the

appropriate theoretical and, or practical knowledge and, or

experience which render him capable and, or authorized to

implement specific activities, in accordance with national

legislation, standards or directives issued by the applicable

authorities;

"comprehensive geriatric assessment" means a process

which includes a multidimensional assessment of a person with

increasing dependency, including medical, physical, cognitive,

social and spiritual components. Can also include the use of

standardized assessment instruments and an interdisciplinary

care team to support the process.

"facility" means premises that have been purposely built or

adapted to accommodate senior citizens with varying levels of

care needs on a long-term basis. The premises shall have fittings

and equipment specifically suited for the holistic provision of the

residents’ care and wellbeing.

"holistic assessment" means the process by which the staff

identifies the needs and aspirations of community members in

relation to their health, personal, emotional, spiritual, and

psychological care, protection and social networking and family

support; which services should be delivered to satisfy these needs

and aspirations; "

"interdisciplinary team" means a team made up of a number

of professionals from a range of disciplines working

collaboratively to deliver comprehensive care that addresses the

needs of individuals availing themselves of the service. The team

works for a common purpose, shares common goals and

responsibilities, and mobilises resources to fulfil its role;

"legally appointed representative" means a person that may

be nominated by the residents to be kept informed about the

residents’ personal affairs and take decisions or act on the

residents’ behalf. Such persons cannot be part of the

management or staff of the service provider. The residents may

also be assigned a guardian by the Guardianship Board in which

case certain decisions shall be taken by the guardian in

accordance to the Civil Code;

"management" means persons who act on behalf of the

service provider to provide leadership to staff and to oversee and

control the proper functioning of services offered to the

residents;

"performance indicator" means an active descriptor of what

service providers need to do to ensure service outputs that

support the quality indicators;

"personal care plan" means a document that is based on a

holistic assessment of the resident that specifies how the

resident’s needs and aspirations are going to be met.

This

document shall also include the resources required to meet the

resident’s continuous and long-term needs;

"personalised portfolio" means a document that is based on

the person’s positive and negative experience that will cater for

his specific needs;

"policies and procedures" means documents released by the

management that regulate how the residential care home should

operate;

"quality indicator" means a statement that sets out the

requirements to achieve compliance with a standard;

"resident" means a senior citizen who personally, or

through his legally appointed representative, enters into an

agreement with a service provider for the senior citizen to live in

and make use of services offered by a residential care home;

"residential care home" means premises that have been

purposely built or adapted to accommodate senior citizens with

varying levels of care needs on a long-term basis. The premises

have fittings and equipment specifically suited for the holistic

provision of the residents’ care and wellbeing;

"restrictive care" means any method, physical or chemical,

used to restrict the physical movement of a resident or part of the

resident’s body to protect the resident or others from injury.

Restrictive care, physical or chemical, whenever used, should

follow the guidelines set in accordance with the current local

legislation. All restraints, physical or chemical, must be

prescribed following an interdisciplinary care team meeting

involving the resident, relatives or legally appointed

representative and the rest of the team. Physical or chemical

restraint use is to be documented in the necessary related forms.

Restrictive care shall be used only with the consent of the senior

citizen, of the relatives or legally appointed representative;

"risk assessment" means the process of evaluating the

likelihood of adverse effects on residents, staff and third party

safety and health from hazards or the absence of beneficial

influences. It is a systematic examination of all aspects of a

residential care home or an individual’s capabilities that

considers: what could cause injury or harm; whether the hazards

could be eliminated or otherwise, what preventive or protective

measures are, or should be, in place to control the risks;

"senior citizen" means a person over the age of sixty with

varying levels of dependency whose care needs will be

holistically managed on a long-term basis by a residential care

home;

"service agreement" means a written agreement between

the service user and the service provider which sets out, among

other things, services to be provided, associated fees and

charges, if any, the terms and conditions and rights and

responsibilities of both parties;

"service provider" means a person who, or organisation

that, provides and operates a residential care home and

associated care services to senior citizens on a long-term basis.

The service providers shall fulfil any contractual obligations in

force that may apply to them;

"staff" means a person engaged by the service provider,

wherein one of the person’s responsibilities is to provide

residents with support, social and, or health care. Staff members

may also assume administrative duties simultaneously with their

caring roles. Staff members working in the administration of an

organisation or a centre shall oversee the planning and

implementation of organisational plans and actions and the

enforcement of rules and procedures.".

The service provider shall maximise the residents’ capacity

to exercise personal autonomy and choice whilst considering their

mental capabilities, shall ensure that their relatives and legally

appointed representatives are aware of their choice, and shall ensure

that the residents are given enough time when they need to take a

decision.

The service provider shall appoint an events’ coordinator

and shall encourage the residents to actively take part in planning and

participating in social and leisure activities.

The service provider shall ensure that the residents’ legal

rights are protected and shall ensure that the residents, their relatives,

and legally appointed representatives shall be enabled to exercise their

legal rights directly and participate in the civic process, if they want.

The service provider shall ensure that residents, their

families, and other significant persons close to them are provided with

optimal palliative care and support, as well as promote care,

sensitivity, respect, and dignity during palliative care.

Standard 2: Personal Care Plan and Portfolio

Standard Statement

This standard promotes rights that ensure the development,

implementation, and review of a personal care plan and portfolio for

each resident, to establish the holistic care and necessary support

required and set objectives to meet the residents’ needs and

aspirations.

Quality Indicators

1. The service provider shall ensure that the interdisciplinary

care team involves each resident during the holistic needs assessment

process and the comprehensive geriatric assessment upon admission,

and shall ensure in writing that their needs will be met in the

formulation, modification and review of the personal care plan and

portfolio.

2. The service provider shall ensure that the personal care

plan is implemented, and its implementation is documented and

communicated regularly with all stakeholders.

Standard 3: Residents’ Personal Health and Medical Care

Standard Statement

This standard promotes rights that ensure the residents’ personal

health, nutrition, wellbeing and medical care are safeguarded and

promoted. The service provider shall ensure medical coverage of the

residential care home by appointing a medical doctor who would agree

to offer their professional assistance whenever is required.

Quality Indicators

1. The residents shall receive a varied, appealing, wholesome,

and nutritious diet, which is suited to individually assessed and

recorded requirements.

2. The service provider shall promote and safeguard the

residents’ physical and mental health and wellbeing and shall ensure

access to all health care services to meet assessed needs.

3. The service provider shall support and where necessary

assist the residents to obtain the prescribed medication they require in

a safe manner.

Standard 4: Protection and Safeguarding

Standard Statement

This standard promotes rights that ensure the protection,

wellbeing, and safety of the residents.

Quality Indicators

1. The service provider shall ensure that competent persons

carry out an evaluation of hazards and risks within the residential care

home, including individualised risk assessments.

2. The service provider shall ensure that the health, safety and

welfare of all residents and the staff are promoted and protected at all

times.

3. The service provider shall ensure that the residents are

protected and safeguarded from any form of harassment and abuse.

4. The service provider shall ensure that all residents and their

relatives and legally appointed representatives shall be confident that

their complaints shall be listened to, taken seriously, and acted upon

and that they shall be treated confidentially.

Standard 5: Physical Environment

Standard Statement

This standard promotes rights that ensure that the environment is

engaging, welcoming, familiar, pleasant, and meets the needs of the

residents.

Quality Indicators

1. The location, the layout and all the external spaces of the

residential care home shall be appropriate for senior citizens.

2. The service provider shall ensure that the residential care

home shall provide to all its residents accessible, safe, and comfortable

indoor and outdoor communal and private facilities.

3. The service provider shall encourage residents to maintain

the highest possible level of independence.

Standard 6: Service Provision

Standard Statement

This standard promotes rights that ensure that the residents’

transition to the residential care home is facilitated by receiving

information prior to and upon access to the related provision of

services, as well as the identification of alternative services, to meet

the needs and aspirations of the residents.

Quality Indicators

1. The service provider shall provide opportunities to

residents to be in contact with the Authority and shall keep the said

Authority informed whenever the residential care home is refurbished.

The services at the residential care home are to be provided to meet the

residents’ assessed needs upon their admission and when these needs

change.

2. The service provider shall make the transition for senior

citizens to commence living in the residential care home as easy as

possible and ensure that in cases of emergency or discontinuation of

the service there are alternative plans for the relocation of the

residents.

Standard 7: Service Quality Management

Standard Statement

This standard promotes rights that ensure that the service

provider shall be responsible to deliver quality service and support

based on continuous improvement in the most respectful and

transparent manner.

Quality Indicators

1. The service provider shall ensure that the residential care

home is managed by a competent person, of good character and able to

fulfil his responsibilities to the full.

2. The service provider shall implement transparent

recruitment strategies and plan for the continuous development of the

staff and ensure that staff are appropriately, regularly and adequately

trained and supervised.

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