Ask Sheila England

Sheila will try to answer as many of your English Social Care questions as possible, giving priority to frequently asked questions and questions regarding current events and trends.

Sheila Scott OBE from National Care Association (NCA). Care is Sheila’s life; she possesses a strong command of the issues facing the care sector informed by her long career as a nursing professional, the owner and manager of a care business and as a leader in the care sector.

Sheila will try to answer as many of your questions as possible, giving priority to frequently asked questions and questions regarding current events and trends.

Please note that Sheila can not offer answers to matters requiring legal advice. If your matter concerns a specific service provider, please contact the CQC.

Latest Questions

Day centres not required to register with CQC

This is prompted by the letter you answered to someone about setting up a day centre, all well and good but 1 member of staff to 20 people is not good.
Why do day centres that provide personal care not come under CQC’s scope of registration? I have clients who visit day centres and have personal care but the day centre is not CQC registered.

Dear Carol, I am also of the view that where personal care is being provided in the way that Day Centres do they should be registered and subject to some form...

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DOLs and family members at end of life

When some one has a DoLS, ACP, and end of life care plan in place, how do we explain to relatives that they will not be allowed to touch their loved-ones when they pass away due to the law and the DoLS when this will be the last experience that they have with there loved ones?

Dear Elizabeth, I think that the best thing that I can do is suggest the following two articles: The first is an article distributed by the Care Provider Alliance -  available HERE. The...

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Commissioning a new residential home

Hi Sheila,
I am commissioning a new residential home, I have all my policy and procedures in place ready, what else will CQC expect me to have in place? Thank you. – Sharon

Dear Sharon, CQC’s website sets out what you need to have in place at: You also need to look at the part about the appointment of a registered manager because that application...

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Setting up a day centre

I would like to set up a day centre in the village where I live for older people. I would be having this as a small business and around 20 people / one member of staff. Would I need inspection for this service? – Helen

Dear Helen, What a wonderful idea to have a day centre in your village. Day Centres are not subject to Registration or Inspection by the Care Quality Commission (CQC). You can see a...

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Registering with CQC and direct payment

Hi Sheila I am a self employed carer in the community. I have asked cqc directly and emailed them and get same reply each time which is not what I have asked. Do I need to be registered with cqc if I’m looking after people on the direct payment. I want to do things right but just need straight forward information which I’m not getting. Please help

Dear Angela, This may be the same response they send to you but if you were employed by someone using their personal budget then registration would be the responsibility of the...

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Advocates signing updated care plans

We provide domiciliary care at people’s homes. When a change to the care plan is required and an advocate is responsible for signing, we have difficulty in getting hold of them to sign the revised care plan within a reasonable time from the date of the review. We have been criticized by CQC for this delay, which is beyond our control. Any thoughts?

Dear Ann, As always I am irritated that any Regulator would try to hold a provider responsible for something that you have no control over. I assume that you do not commission...

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Separate DOLS training for Domiciliary Care

Hello, with domiciliary care, my staff all undergo a mandatory mental capacity 2005 booklet that is accredited, do they have to do a separate dols course? Within the community mental capacity and dols assessment falls under the north somerset professional team, and we are not involved in the dols aspect of this

Dear Emma, Thank you for your question. The Deprivation of Liberty Safeguards (DoLS) are a very important piece of legislation and after a Supreme Court Judgement (the West Cheshire Judgement) last year...

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Financial consultant for care home placement

Hi Sheila
My mother has recently gone into a care home, self funded. She told them that she had funds to pay having sold her house. I asked the question “what happens when -if the money runs out”? I was told “we negotiate and never kick anybody out”. They were very vague when I queried this further and informed them that I lived on benefits and could not fund her care.
Since then she has received phone calls and visits from a financial consultant introduced by the home. I have heard that there are schemes where the home-financial consultant takes all of your money in return for a guarantee to care for life. This smacks of abuse to me, especially with the home having a captive audience of vulnerable people available. What is your take on this as I feel very uncomfortable with the whole idea but she is all for it as the financial consultant “seems a nice man”.

Dear Alison, Thank you for your question. I am not qualified to give advice about funding but there is a very good free resource Care Aware ( which I am sure you...

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Registered manager interview for role

Being a registered manager with CQC, if and when i leave my current home, do i have to go through the interview process again to be the registered manager of the new home if i get another job in another care home.
can you let me know please ASAP

Dear Edward, If you are applying to be registered as the Manager of a different service with a different employer then the answer to your question is yes, you will have...

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Who is responsible for carrying out mental capacity assessments?

At my recent inspection I was told that as a manager it was my place to carryout mental capacity assessments on my residents.

I informed them that I refer my residents via the GP after confirming there is no UTI to the mental health team who come and visit the resident. One of the staff who knows them well along with a family member if they are available will sit in on the visit to support the resident. The mental health nurse practitioner will then talk to the team. She will then talk to others in her team which includes a specialist doctor.

When they have made a plan this is given to us added to the care plan and monitor by staff using ABC charts and daily recording.

I feel that I am not qualified to carry these assessments and that it could be seen as a conflict of interest if I say a person lacks capacity.

What is the correct procedure in this area as I am not sure?


Dear Jill, You have important responsibilities under the Mental Capacity Act which you should not ignore. I would advise you in the first instance to read the Health and Social Care...

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