303.Part II of the Act concerns nursing homes and mental nursing homes, the definitions of which are mutually exclusive. The definition of nursing home is very broad, and encompasses any premises where nursing care is provided, from a traditional nursing home for elderly people through to an acute hospital (Section 21). Provision is also made for the Secretary of State to define what are termed ‘specially controlled techniques’, which at present are class 3b and class 4 lasers. Settings where these techniques are used are also required to register. There are a range of exemptions to this definition, including NHS settings and services provided by local authorities. School sanatoria, first aid rooms, occupational health facilities and facilities to be used solely by a medical or dental practitioner or a chiropodist are also exempt unless specially controlled techniques are in use.
304.Mental nursing homes are separately defined in Section 22, and include any settings where nursing care or treatment is provided for one or more mentally disordered patients. NHS settings and services provided by local authorities are the main exemptions to this definition.
305.The registration procedure is in many respects very similar to that employed under Part I of the Act. Although in this case the Secretary of State formally operates the registration scheme, in practice it is delegated to Health Authorities. Homes may be dually registered under Parts I and II.
306.The key differences between Parts I and II centre on the requirements relating to nursing or medical care in Part II. For example, applicants for mental nursing homes must declare if they wish to take patients detained under the Mental Health Act 1983 (section 23). The person in charge of a nursing or mental nursing home must be a registered medical practitioner, a qualified nurse or a registered midwife in the case of a maternity home, and conditions of registration will include the number of qualified nurses that must be on duty at any time.
307.Procedures relating to variation of registration conditions, cancellation of registration (including an urgent procedure), right to make representations (section 32) and right to appeal (section 34) and inspection powers in nursing homes are very similar to those under Part I. Special provision is made in section 35 for the inspection of mental nursing homes. This enables a medical practitioner to examine a patient in private and to inspect any medical records relating to that patient’s treatment in the home.
ANNEX 1: Existing Legislation The Registered Homes Act 1984 Part II