CODE OF PRACTICE

FOR

RESIDENTIAL CARE HOMES

(ELDERLY PERSONS)

October 2005 (Revised Edition)

i

Table of Contents Page Chapter 1 Introduction 1.1

General

1

1.2 Purpose of the Ordinance and the Regulations 2 1.3 Certificate of Exemption and Licence 2 1.4 Certificate of Registration 3 1.5 Insurance Coverage 3 1.6 Closure of Home 4 Chapter 2

Classification of Residential Care Homes for the Elderly

2.1 Classification of Homes 5 2.2 Definition of Types of Homes 5 2.3 Classification of Mixed Homes 6 Chapter 3

Licence

3.1 Application for a Licence 7 3.2 Issue of Licence 8 3.3 Licensing Conditions 8 3.4 Renewal of Licence 8 3.5 Display of Licence 8 3.6 Format of Licence 9 Chapter 4

Building and Accommodation

4.1

General

10

4.2 Lease Conditions and Deed of Mutual Covenant 10 4.3 Restriction on Home Premises 10 4.4 Design 10 4.5 Basic Facilities 11 4.6 Accessibility 11 4.7 Fire Exits 12 4.8 Fire Resisting Construction 12 4.9 Heating, Lighting and Ventilation 12 4.10 Water Supply and Ablutions 13 4.11 Repair 13

ii

Page Chapter 5

Safety and Fire Precautions

5.1

General

14

5.2 Location 14 5.3 Height 14 5.4 Fire Service Installations 15 5.5 Additional Requirements 18 5.6 Fire Precautions 21 Chapter 6

Floor Space

6.1

Area of Floor Space

23

6.2 Number of Residents 23 Chapter 7

Furniture and Equipment

7.1

General

24

7.2 Dormitory 24 7.3 Sitting/Dining Room 25 7.4 Toilet/Bathroom 26 7.5 Kitchen/Pantry 27 7.6 Laundry 28 7.7 Office 29 7.8 Medical Equipment and Supplies 29 7.9 Miscellaneous 31 Chapter 8

Management

8.1

Display of Name of Residential Care Home for the Elderly

32

8.2 Procedures on Admission of Residents to Home 32 8.3 Schedule of Daily Activities 33 8.4 Staff Duty List/Roster and Attendance Records 33 8.5 Record Keeping 33 8.6 Staff Meeting 37

iii

Page Chapter 9

Staffing

9.1

Employment of Staff

38

9.2 Definition 39 9.3 Overnight Staff 40 9.4 Conditions of Service 41 9.5 First Aid and Other Training 42 9.6 Relief Staff 43 9.7 Changes in Staff Employment 43 9.8 Importation of Workers 43 Chapter 10

Health Worker

10.1

Application

44

10.2 Qualification 44 10.3 Registration 45 10.4 Registration Fee 46 10.5 Cancellation of Registration 46 10.6 Job Description of Health Worker 46 Chapter 11

Health and Care Services

11.1

General

48

11.2 Health 48 11.3 Drug Storage and Management 50 11.4 Annual Medical Examination 50 11.5 Personal Care 50 11.6 General Principles of Least Restraint 51 11.7 Principles to be Observed in Applying Physical Restraint 52 11.8 Notes to be Observed in Using Urinary Drainage Catheter 55 11.9 Notes to be Observed in Using Feeding Tube 55 11.10 Other Special Nursing Procedures 56 Chapter 12

Infection Control

12.1

General

57

12.2 Duties of Infection Control Officer (ICO) 57 12.3 Prevention of Infectious Diseases 58 12.4 Management of Infectious Diseases 59 12.5 Other Information 60

iv

Page Chapter 13

Nutrition and Diet

13.1

General

61

13.2 Design of Menu 61 13.3 Meals and Choice of Food 61 13.4 Preparation and Serving of Food 62 13.5 Meal Time 63 13.6 Special Attention on Food Provision 63 13.7 Provision of Water 64 13.8 Monitoring of Nutritional Status 64 13.9 Other Information 64 Chapter 14

Cleanliness and Sanitation

14.1

General

65

14.2 Staff 65 14.3 Residents 66 14.4 Cleaning Schedule 66 14.5 General Sanitation 67 14.6 Pest and Vector Control 67 14.7 Other Information 67 Chapter 15

Social Care

15.1

General

68

15.2 Programmes and Activities 68 15.3 Homely Atmosphere 68 15.4 Adjustment to Home Life 69

v

Table of Annexes

Annex A

Application for a Licence

Annex B

Staff Employment Record

Annex C

Guidance Notes on Submission of Floor Plans

Annex D

Licence of Residential Care Home for the Elderly

Annex E

Medical Examination Form

Annex F

Application for Registration as a Health Worker

Annex G

Training Courses for Health Worker Approved by DSW (as at July 2005)

Annex H

The List of Notifiable Diseases (as at August 2005)

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CHAPTER 1

INTRODUCTION 1.1 General

1.1.1 The Residential Care Homes (Elderly Persons) Ordinance (Cap. 459) came into full operation on 1 June 1996.

1.1.2 This Code of Practice is issued by the Director of Social Welfare under

Section 22(1) of the Residential Care Homes (Elderly Persons) Ordinance (Cap. 459), setting out principles, procedures, guidelines and standards for the operation, keeping, management or other control of residential care homes. The Residential Care Homes (Elderly Persons) Ordinance, the Residential Care Homes (Elderly Persons) Regulation (Cap.459 sub. leg. A) and the Residential Care Homes (Elderly Persons) (Appeal Board) Regulation (Cap. 459 sub. leg. B) which govern the operation of residential care homes for the elderly in Hong Kong can be purchased by calling the Publications Sales Section of Information Services Department at 2537 1910 or visiting the online Government Bookstore at http://bookstore.esdlife.com.

1.1.3 The statutory provisions cited or mentioned in this Code of Practice are

those in force as at October 2005. Readers are advised to check if there are any subsequent amendments to these provisions.

1.1.4 Under Section 2 of the Residential Care Homes (Elderly Persons) Ordinance,

a residential care home for the elderly is defined as :

any premises at which more than 5 persons who have attained the age of 60 years are habitually received for the purposes of care while resident therein.

1.1.5 By virtue of Section 3, the Residential Care Homes (Elderly Persons)

Ordinance shall not apply to :

(a) any residential care home maintained and controlled by - (i) the Government; (ii) the Housing Authority;

(b) any residential care home used or intended for use solely for the purpose of the medical treatment of persons requiring medical treatment;

(c) any residential care home or type or description of residential care

home excluded by the Director of Social Welfare by order published in the Gazette.

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1.1.6 Operators of residential care homes for the elderly should study this Code of

Practice carefully, in conjunction with the Residential Care Homes (Elderly Persons) Ordinance, the Residential Care Homes (Elderly Persons) Regulation and the Residential Care Homes (Elderly Persons) (Appeal Board) Regulation. The Director of Social Welfare may refuse to issue a licence to an applicant under Section 8(3)(c)(iii) of the Ordinance if it appears to him that the premises to be used for a residential care home for the elderly do not comply with any requirements related to design, structure, fire precautions, health, sanitation and safety set out in this Code of Practice. For consultation or advice, please call at 2961 7211 or 2834 7414 to contact with the Licensing Office of Residential Care Homes for the Elderly, Social Welfare Department, at Room 2354, 23/F, Wu Chung House, 213 Queen's Road East, Wan Chai, Hong Kong.

1.1.7 Compliance with this Code of Practice does not release the operator or any

other person from any liability, obligation or requirement imposed under any other Ordinance or common law.

1.2 Purpose of the Ordinance and the Regulations

The Residential Care Homes (Elderly Persons) Ordinance and its subsidiary Regulations provide for the control of residential homes established for the care of elderly persons through a licensing system administered by the Director of Social Welfare. The purpose of the legislation aims at ensuring that residents in these homes receive services of acceptable standards that are of benefit to them physically, emotionally and socially.

1.3 Certificate of Exemption and Licence

1.3.1 Under Section 6 of the Residential Care Homes (Elderly Persons) Ordinance, any person who on any occasion operates, keeps, manages or otherwise has control of a residential care home for the elderly is required to possess :

(a) a certificate of exemption that has been issued under Section 7(2) or

renewed under Section 7(5) of the Residential Care Homes (Elderly Persons) Ordinance in respect of that residential care home for the elderly and is for the time being in force; or

(b) a licence that has been issued under Section 8(2)(a) or renewed under

Section 9 of the Residential Care Homes (Elderly Persons) Ordinance in respect of that residential care home for the elderly and is for the time being in force.

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1.3.2 Nevertheless, the Departments policy is that certificates of exemption are to be granted to residential care homes for the elderly already in operation before 1 April 1995 but which are unable to comply fully with the legislative requirements. All residential care homes for the elderly which come into existence and which want to commence operation on or after 1 April 1995 should be subject to regulation by the issue of a licence rather than the issue of a certificate of exemption. The main reason for the policy is that reg