Public Consultation on the Social Residential Homes Bill

Ministry of Social and Family Development (MSF)

Consultation Period: 21 Nov 2024 - 02 Jan 2025

Status: Closed - Summary of Responses

Consultation Outcome

SUMMARY OF KEY FEEDBACK AND RESPONSES

1. The Ministry of Social and Family Development (MSF) invited members of the public to provide feedback on the proposed Social Residential Homes Bill (SRHB) from 21 November 2024 to 2 January 2025. The SRHB aims to uphold quality and consistent standards across all Social Residential Homes (SRHs). It will replace the Homes for the Aged Act (HFAA) that regulates Sheltered Homes. Existing provisions relating to care standards for SRHs in the Destitute Persons Act (DPA) and Children and Young Persons Act (CYPA) will be superseded by the licensing regime in the SRHB.

2. MSF received 34 responses from a range of respondents, including SRH staff, residents, family members of SRH residents, SRH board members and interested members of the public. In general, respondents recognised the need for the regulation of SRHs to ensure the safety and well-being of residents. Majority of the respondents were also supportive of the key provisions in the proposed SRHB. Key feedback from the public consultation, and MSF’s responses are summarised below.

Stronger Safeguards for Residents’ Safety and Well-being

3. Requiring prior approval from MSF before SRHs deploy individuals: Most respondents agreed that this provision is essential for ensuring residents’ safety and well-being, although some expressed concern about reduced autonomy and potential hiring delays. MSF will work closely with SRHs to streamline the approval process, and partner SRHs in recruitment planning.

4. MSF’s ability to intervene in compromising circumstances: Respondents agreed that this provision is critical for ensuring residents’ safety and well-being. They emphasised the need for a clear decision-making framework and investigation process, and recommended collaboration with SRHs to address any challenges. In situations where non-compliance with the licensing requirements endangers residents’ safety or well-being, MSF will conduct a thorough investigation, taking into account factors such as the extent of harm to residents and whether the SRH and relevant personnel took reasonable steps to comply with the requirements. MSF will prioritise addressing lapses and preventing recurrence, with regulatory or criminal action taken as necessary based on the extent and severity of the breach.

5. MSF’s authority to step in as a last resort: Most respondents agreed that MSF should have the authority to step in to maintain continuity of care, either by taking over operations, or transferring residents to another SRH. However, they were concerned about the scope of these powers and their potential impact on SRH operations and residents. The public emphasised the need for a proper process to assess and decide on the need for stepping in while SRH operators, staff and Board members highlighted the importance of regular assessments and feedback to prevent escalation. They also stressed the need for a clear decision-making framework and careful management to minimise disruptions.

6. MSF acknowledges these concerns and will exercise step-in powers judiciously, particularly when an SRH operator’s imminent operational failure poses a threat to residents’ care. In such situations, MSF may work with other licensees to support or take over operations. Step-in orders may also be considered if there is an imminent risk to residents’ safety and well-being, and regulatory actions have failed because a SRH operator remains non-compliant despite repeated interventions.

7. Independent Board of Visitors: Respondents supported empowering MSF to appoint an independent Board of Visitors (BOV) to assess SRHs’ living conditions, care standards and supervision of residents. They emphasised the importance of trained BOV members with a clear understanding of SRH operations and a balanced perspective that considers both SRH residents and staff. They also highlighted the need for unannounced audits to ensure transparency.

8. MSF acknowledges these concerns and will select BOV members based on relevant expertise, providing them with sector-specific insights – including knowledge of the residential care contexts and the challenges faces by SRHs. MSF will continue to facilitate constructive dialogue between BOV members and SRHs to review findings, drive improvements, and uphold residents’ safety and well-being.

9. Use of restraints: Most respondents emphasised the need to clearly define the circumstances under which restraints may be used, such as in cases of self-harm or potential harm to others. They highlighted the importance of clear guidelines to protect both SRH residents and staff, including de-escalation techniques, non-restrictive intervention options, and proper staff training.

10. MSF acknowledges this feedback and will ensure the Bill specifies the permitted circumstances for the use of restraints. Only staff who have received the necessary MSF-approved training will be authorised to apply restraints.

More Comprehensive Enforcement Framework

11. Penalties for egregious offences: Most respondents agreed on the need for penalties to deter serious breaches and safeguard the safety and well-being residents. Respondents emphasised the need for clear guidelines on what constitutes serious offences and a rigorous investigation process which considers systemic factors beyond individual or institutional negligence to assure the affected operators and staff of a fair proceeding.

12. MSF recognises these concerns. The investigations would be done thoroughly with all aspects of each case duly considered and assessed. To support SRHs in meeting requirements, MSF will also offer upstream support, including staff training to assist SRHs in meeting regulatory requirements.

13. MSF’s power to investigate potential offences: There was broad support to empower MSF to investigate potential SRHB contraventions. A handful of respondents suggested appointing an independent party or providing more information on the investigation process to provide assurance to affected SRHs and staff.

14. MSF’s investigation officers are trained and have extensive experience and specialised expertise in conducting fair and effective investigations for potential offences in the SRHB. Offences that warrant the investigation or intervention by other Law Enforcement Agencies such as the Police will be referred to them when assessed necessary.

Appeal Mechanism for SRH Operators

15. Appeal mechanism for SRH operators: Most respondents supported putting in place a mechanism for SRH operators to appeal against MSF’s decisions under the SRHB.

Supporting SRHs in Transitioning to the SRHB Framework

16. Respondents provided additional feedback on the operational challenges faced by SRHs, such as high staff turnover – which affects continuity of care and requires additional resources – and concerns about the administrative burden from compliance requirements. Respondents also emphasised the need for staff training on handling challenging situations, de-escalation techniques, and regulatory understanding. Respondents suggested that MSF should look into adequate provision of such approved training programmes and ways to improve staff retention.

17. MSF remains committed to supporting SRHs as they onboard the SRHB regulatory framework. As part of ongoing efforts to strengthen the residential care sector, MSF will pilot job redesign for care workers in selected Adult Disability Homes and Welfare Homes. Additional funding will be made available to help SRHs to send both local and foreign staff for training. By improving working conditions and career pathways, SRHs can provide better quality of care for residents.

18. For first-time licensees, MSF will offer pre-licensing checks to help identify areas for improvement prior to implementation. Through these initiatives and continued collaboration with the sector, MSF aims to build a strong, robust and effective regulatory framework that prioritises resident safety and well-being while supporting the vital work of SRH staff. MSF will continue to work with SRHs to streamline processes, including leveraging online systems to minimise administrative burden.

Conclusion

19. MSF would like to thank all stakeholders and members of the public who provided feedback on the proposed SRHB. The input has been invaluable in refining the legislation to better meet the needs of SRH residents and staff. MSF remains committed to addressing the concerns raised and implementing suggestions where appropriate, ensuring that all SRHB uphold high-quality, consistent standards.

Detailed Description

Aim

1. The Ministry of Social and Family Development (MSF) invites members of the public to provide feedback on the proposed Social Residential Homes Bill (SRHB), which seeks to uphold quality and consistent standards across the Social Residential Homes (SRHs), for the safety and well-being of their vulnerable residents.

Background

1. The SRHB will replace the Homes for the Aged Act (HFAA) that regulates Sheltered Homes. Existing provisions relating to care standards for Homes in the Children and Young Persons Act (CYPA) and Destitute Persons Act (DPA) will be superseded by the licensing regime in the SRHB.

New Legislation for Social Residential Homes

1. Social Residential Homes (“SRHs”) refer to any premises that are used to provide residential accommodation to persons who require care and/or social intervention. Today, MSF oversees a range of SRHs that provide short- to long-term residential care to different resident profiles. 

2. Over the years, MSF has worked closely with operators of SRHs to raise the standards of care provided to residents. It is timely to codify and harmonise these standards under a common framework to enable clients to benefit from a robust regulatory regime. This ensures that existing operators and new entrants to the sector, continue to uphold quality and consistent standards across SRHs, for the safety and well-being of their vulnerable residents. 

3. While the SRHB will enable the regulation of a wider scope of SRHs, MSF will adopt a risk-based regulatory approach to license SRHs in phases. For a start, MSF will license SRHs caring for the most vulnerable residents, who are heavily reliant on the SRH to meet their daily needs, as listed at 5(a)-(f) below. From Apr to Jun 2024, MSF consulted operators of these SRHs through closed-door engagement sessions, and the draft Bill has taken their feedback into consideration. 

   1. Children’s Homes 

   2. Children Disability Homes 

   3. Sheltered Homes 

   4. Welfare Homes 

   5. Adult Disability Homes 

   6. Adult Disability Hostels 

Key Features of the Social Residential Homes Bill 

1. The SRHB is MSF’s commitment to work with the SRHs to professionalise the sector via one regulatory framework and common licensing standards. To raise professionalism within the sector, the SRHB will emphasise the importance of staff training. SRHs will be required to ensure that their staff are adequately equipped with the necessary skills and knowledge to provide quality care to residents. 

2. Under the SRHB, there will be strong deterrents and consequences for errant operators or staff, including financial penalties or imprisonment. MSF will also have stronger investigative powers over operators to more effectively manage suspected non-compliances.

A. Stronger safeguards for residents’ safety and well-being 

1. The SRHB will articulate expected standards to ensure the safety and well-being of residents in the SRHs. These requirements will promote consistent practices across SRHs, fostering a high-quality care environment for all residents. 

2. To further protect vulnerable residents, the SRHB will require SRHs to obtain MSF’s prior approval before deploying any individual who will have direct and prolonged contact with residents in the SRH. This includes, but are not limited to, SRH staff and regular volunteers. 

3. The SRHB will empower MSF to issue directions to SRHs to take measures to rectify any circumstances that compromise the residents’ safety, well-being and continuity of care. 

4. To complement MSF’s regulatory checks on the SRHs, the SRHB will enable MSF to appoint an independent Board of Visitors to inspect SRHs’ living conditions, standards of care and supervision of residents. 

5. The SRHB will prohibit the use of restraints on residents except under exceptional circumstances where residents are at risk of hurting themselves or others. Safety restraints should only be implemented as a last resort, with priority given to de-escalation techniques and other non-restrictive interventions. Only trained and certified staff may apply safety restraints to residents, and only under supervision and with proper documentation. This provision recognises that some SRHs care for residents with psychiatric and/or behavioural conditions, who may occasionally face challenges in regulating their emotions and behaviours due to a range of underlying issues, and that restraints may be necessary in such exceptional circumstances. The use of restraints in any other circumstances will be strictly prohibited. 

6. To ensure continuity of care and protect residents from potential disruptions in service, the SRHB will authorise MSF to issue step-in orders when necessary. These orders will allow MSF to temporarily direct SRH operations, safeguarding residents against abrupt discontinuation of service. These step-in orders will be limited in duration, ceasing once operations are stabilised or all affected residents are safely transferred to a new SRH. MSF will exercise these step-in powers judiciously, employing them only as a last resort when all other mitigating measures have been exhausted or are no longer viable. 

B. More comprehensive enforcement framework 

1. To underscore the paramount importance of residents’ safety and well-being, the provisions in the SRHB ensure that necessary and robust measures are in place to address and deter egregious offences. The SRHB will also enhance penalty quanta for offences to align with more recently enacted legislation such as the Healthcare Services Act.

2. To promote accountability and encourage vigilance within the sector, the SRHB will grant MSF the necessary powers to investigate offences thoroughly. To foster a culture of transparency and responsible reporting, the SRHB will extend protection to any person who, in good faith, reports a potential offence under the SRHB to MSF. This will also enable early detection and swift resolution of issues that may affect the quality of care provided to residents.

C. Appeals 

1. To ensure fairness, transparency and due process in the implementation of the licensing framework, the SRHB will establish an appeal mechanism for SRH operators. This provision aims to offer a structured recourse for operators who wish to seek a review of MSF’s decisions related to the implementation of this licensing framework. SRH operators may present their case, seek clarification, and request reconsideration of decisions that significantly impact their operations. By incorporating this appeal process, the SRHB seeks to foster a collaborative environment where concerns can be addressed constructively, ultimately contributing to the continuous improvement of care standards across the sector.

Transition to the new Social Residential Homes Bill

1. MSF has been actively engaging SRHs on the SRHB since Apr 2024 and will continue to support and prepare them ahead of its implementation. MSF will support 61 SRHs that will be licensed under the SRHB to meet the new requirements.

2. Additionally, MSF will support all SRHs licensed under the SRHB with a one-off transition support package. For SRHs seeking to be licensed for the first time, MSF will also offer pre-licensing checks to identify areas for improvement, prior to implementation.

3. MSF intends to enact the SRHB by the first half of 2025, with implementation commencing one year later, i.e., from the first half of 2026.

Invitation to Provide Feedback on the Social Residential Homes Bill

1. MSF is seeking views from (i) caregivers, clients and the general public, and (ii) providers that operate residential homes and/or shelters that currently meet or may meet the definition of SRH. For residential homes and/or shelters that will not be licensed for now, we will study and consider the need for licensing under SRHB, in subsequent phases. Your feedback on the draft Bill is important to us and will better inform the development and implementation of SRHB in future.

2. Please provide your feedback by 2 January 2025 via the “Share Your Feedback” button below. Your responses will be kept confidential and used only for the purpose of formulating the SRHB. MSF will consolidate and publish a summary of key feedback received, along with our responses, after this public consultation exercise ends. Thank you.