NEW DELHI: More than 4,500 care homes, including old age homes, hospice care and differently-abled living facilities, exist in India. As the market continues to grow, without any checks, the NABH has framed standards to ensure the quality and safety of residents.
These standards have been framed for the first time for both public and private care homes that focus on the quality and safety of residents in care, said Dr Atul Mohan Kochhar, CEO of the National Accreditation Board for Hospitals and Healthcare Providers (NABH), which has been set up to establish and operate accreditation programme for healthcare organisations.
These norms will also cover specialized care facilities; assisted living facilities, transition living facilities, palliative care facilities, and technical care facilities.
Noting that the mushrooming of care homes in India has “always been a concern,” Dr Kochhar said, “This market is unregulated, and it is need of the hour to give attention so that the quality and safety of residents is not compromised.”
“NABH standards for care homes will be instrumental in regulating the market in India,” he told this paper.
The NABH Accreditation Standards for Care Homes, which are voluntary, lay thrust to setting up a mechanism to report a violation of resident’s rights, the procedure for reporting, handling and responding to complaints and feedback related to service and infrastructure and ensuring the protection of residents against all forms of abuse, including physical, financial, material, psychological and sexual, with a whistle-blower policy in place.
The rules, which have been shared with the stakeholders, also stipulate that these care homes should hire staff that is adequately trained in evacuation, quality and safety procedures, are police verified and medically fit, have an emergency evacuation, provide minimum daily calorie and nutrient requirement of an average senior citizen of that age, gender and which is certified by a nutritionist and are displayed.
The norms also mention in detail the key features of such facilities, including easy-to-grip door knobs; toilet with grab bars; staircase designed and provided as per disability standards; bathing facility to have wheelchair space; storage space for personal belongings; gender separation of sleeping facilities, except for family staying together and round the clock availability of potable water and electricity.
It also lists access to mental health support and rehabilitation services for the residents.
As many of these care homes house the elderly and those battling serious illnesses, the standards also mention that these organisations should have a “clearly defined procedure for handling situations of death.”
It also stresses resident engagement and wellness. It lists regular programmes for activities and events, like games and cultural programmes, physical exercise, and the availability of newspapers, TV and radio in common areas.
Though these standards focus on quality and safety issues of the residents, and cost is not under NABH purview, it, however, mentions that such facilities should provide clear terms and conditions detailing services provided and cost to residents and their families.
It also says that these should be documented in an agreement/ form, and all complaints and feedback must be documented and monitored by management with timelines.
Kochhar said the aim of the accreditation standards is “to achieve an acceptable level of performance to improve public trust and community confidence that the organisation is concerned for resident safety and the quality of care.”
The need was also felt that these institutions listen to their residents and their families, respect their rights, and involve them in the care process as partners, he added.
Also, to ensure that they provide a safe and efficient work environment that contributes to staff satisfaction and improves overall professional development so that they follow a patient-centred approach.
The accreditation standards for care homes have a total of six chapters, 23 standards and 92 objective elements. This accurate methodology will aid care home organisations in a stepwise progression to mature quality systems over the full accreditation cycle, added Dr Kochhar.
The scoring methodology is in a graded scheme to help recognize every progressive effort by the organisation in the implementation of the standards.
The accreditation will be a four-year cycle with a midterm surveillance assessment at two years, said Dr Kochhar.
The first edition of NABH accreditation standards came out after the Lok Sabha introduced “The Maintenance and Welfare of Parents and Senior Citizens (Amendment Bill 2019) in December 2019. Following this, the Ministry of Social Justice and Empowerment initiated the formation of rules under this bill in October 2021. NABH, which is a constituent body under the Quality Council of India (QCI), was invited as a member of the expert committee to define the draft minimum standards to be maintained by senior citizen’s homes.