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Most businesses working with people who require special care, such as the very young and very old, must be officially registered.

Businesses in Northern Ireland that provide social care or private health care services must register with the . This includes care homes, children's homes and private clinics. 

Care service businesses that must be registered

The following care service businesses must legally be registered with RQIA:

• adult placement agencies
• children's homes
• day care settings
• domiciliary care agencies
• independent clinics
• independent hospitals (including private dental practices)
• nursing agencies
• nursing homes
• residential care homes
• residential family centres
• voluntary adoption agencies

How to register

You can contact the RQIA Helpline on Tel: 028 9536 1111 or .

Certain businesses will need to pay registration fees.

In Northern Ireland, businesses offering childcare services for children up to the age of 12 must register with their .

If you provide care services to the young, the ill or the very old, bear in mind that many hazards can present a greater risk of accident or ill health to people from these groups. Your risk assessments should consider a number of key hazards.

Workplace hazards

Some common hazards to consider include:

• room layout - avoid sharp edges, hidden steps and loose fittings that may cause trips
• flooring - avoid uneven and slippery surfaces
• stairs - consider whether hand rails or stairlifts can be fitted
• door locks - you should prevent people being able to lock themselves in
• water - ensure you have thermostatically controlled mixing valves for controlling hot water temperature and barriers to prevent people falling into pools and ponds
• hot surfaces - ensure that radiators, hot water pipes or other space heating devices do not pose a risk to vulnerable people
• legionella - ensure that water systems are maintained to reduce the risk of legionella bacteria
• play equipment - check it is safely designed, complies with toy safety law and carries the CE mark, and is in good condition
• fires - install early warning devices and put procedures in place to speed the evacuation of vulnerable people
• security - monitor and control who enters and leaves your premises

Often the steps required to remove or reduce health and safety risks are very simple. For example, providing bath rails or anti-slip mats can greatly reduce the chances of accidents in the bath.

Ease of use

As well as minimising risks of accidents and injuries, it's also important to make your premises as user friendly as possible. Simple design changes can be very effective, such as:

• making door handles easy to open
• installing stairlifts for elderly clients
• placing light switches at accessible heights
• using rails near baths and toilets to aid balance

The earlier you think about these issues, the easier it will be to deal with them. You should make ease of use a priority when choosing equipment.

Employees in care service businesses can face a range of specific health and safety hazards. As an employer you must do all you can to reduce the risk of harm from these hazards. Your risk assessments should consider a number of key topics.

Manual handling

Employees looking after the young, the ill and the very old often have to carry out manual handling tasks. These include moving equipment around and lifting or assisting those who are unable to move themselves.

You can minimise the risks these tasks pose by training employees in proper lifting techniques. You should use automation where possible. See safe manual handling at work.

Infection

Businesses providing day or residential care may need to protect employees from infection. General handcare is key in infection control matters. If medical attention is being provided, protective gloves should be provided when open wounds are being treated. Vaccines can be used to prevent against such infections as Hepatitis B. They should only be offered if there is a significant risk of infection, eg if there is the chance of contact with infected needles or infected bodily fluids.

Businesses should advise members of staff who are unwell that they should stay at home to avoid the spread of the illness to others. See diseases, infections and allergies in the workplace.

Challenging behaviour and violence

Any incident in which an employee is verbally abused, threatened or assaulted can be a source of injury and distress. Aggressive or violent acts could be due to medication, age and stress.

Employees must ensure that employees have the appropriate skills to prevent or reduce the risk of injury or distress from aggressive behaviour.

The risks of violence and aggression should be assessed and appropriate steps taken to deal with it. These steps might include providing suitable training and information to staff or making changes to aspects of their roles. If necessary, you could improve the design of the working environment by providing physical security measures.

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Hazardous substances

Care-service businesses are likely to use a wide range of hazardous substances and items - from cleaning products to syringes, latex gloves and medical supplies.  In these instances you will need to comply with the Control of Substances Hazardous to Health Regulations (COSHH). See hygiene and hazardous substances in care service businesses.

Stress, drug and alcohol use

Looking after other people can be very demanding. Put procedures in place to help identify employees who are having difficulty coping with the stress. See how to deal with stress and workplace policies on smoking, drugs and alcohol.

If you run a care service business, such as a care home or cr猫che, you need to pay particular attention to hygiene practices and procedures.

Elderly and young clients may be more vulnerable to infections and to harm from spillages and other accidents. Businesses providing care to them may face particular issues of workplace hygiene.

Hygiene hazards in care homes

Look at all the tasks being carried out in your business and see which ones involve potential hygiene risks. You need to ensure:

• food preparation areas are clean and uncluttered
• spillages are mopped up straight away
• kitchen waste is properly stored and disposed of
• laundry is properly bagged, with soiled laundry separated
• clinical waste and sharp objects are kept separate from general waste
• hand-wash facilities are plentiful and clean
• bathrooms and toilets are clean

Staff will often also require training and equipment to prevent the spread of infections in businesses such as child day care centres or care homes for the elderly. For instance, a cr猫che or playgroup may need procedures to prevent the spread of head lice.

In care homes, you may need to take steps to prevent the spread of blood-borne diseases. The biggest risk of blood-borne infection comes from needlesticks where sharps are infected. See diseases, infections and allergies in the workplace.

Hazardous substances in care homes

You're required by law to ensure that risks from hazardous substances used by your business are assessed and managed effectively. These substances may include things such as:

• cleaning products
• latex
• medicines
• blood
• asbestos
• solvent-based paint and ink
• solvents
• chemical waste
• pesticides

You must minimise exposure to hazardous substances and train staff in how to handle these substances safely. You should ensure staff know how to deal with accidents and spillages according to the Control of Substances Hazardous to Health Regulations (COSHH). .

You must also comply with laws covering the disposal of hazardous waste. See dealing with hazardous waste.

The health and safety of children, people with special needs or the elderly whom your business looks after depends on having suitable staff.

You should put procedures in place to properly vet new employees. You must make sure that your staff are competent and trained to provide care services of the highest standard.

Disclosure and barring

Disclosure and barring arrangements help protect vulnerable groups and allow care service businesses to ensure that new recruits are suitable. The holds a "barred list" of individuals who are deemed to be a potential risk to children or vulnerable adults.

There are certain with vulnerable groups that disclosure and barring relates to. This includes providing health and personal care services to children and adults.

AccessNI

Certain job applicants, including those applying for care service positions, require a background check. In Northern Ireland,  carry out these checks. There are different levels of checks that provide details about a person's criminal record.

Positions working with children and vulnerable adults require an enhanced AccessNI check. The enhanced check includes:

• details of spent and unspent convictions
• check of local police records
• information held by the Disclosure and Barring Service

Training

Good health and safety staff training is another essential part of reducing the risk of your clients being harmed. Training should be part of every employee's induction. You should provide training on an ongoing basis, particularly when:

• new equipment is introduced
• your procedures or work patterns change
• clients with new needs come into your business' care

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There's a wide range of factors to consider when trying to ensure the health, safety and welfare of clients, employees and the environment in care-service businesses. This includes cr猫ches, playgroups and care homes.

Make sure you:

• check that all potential staff are suitable before employing them  - see vetting, AccessNI and training in care service businesses
• provide health and safety training and information
• carry out a health and safety risk assessment and take actions to reduce risks 
• keep the design and layout of your premises simple and obstacle-free
• make your premises easily accessible, by providing lifts, for example - see disabled access and facilities in business premises
• keep electrical, mechanical and other equipment in good order -  - see safety of workplace machinery, equipment and tools
• keep up repairs to your premises
• install user-friendly fixtures and fittings in your premises
• secure your business premises
• write a health and safety policy for your business and communicate it to staff
• ensure staff are aware of, and help to manage, key risks eg hot water, surfaces, moving and handling, window and balcony safety, bedrail safety, slips and trips and infection control
• provide suitable equipment - from protective gloves to lifting equipment
• keep wash facilities clean and well stocked
• provide sufficient rest rooms and ensure rest breaks are taken
• train staff in managing waste on site
• store wastes properly before disposal
• segregate wastes - especially hazardous wastes
• store liquid wastes away from watercourses and drains
• fit stair and bath rails
• use non-slip flooring where appropriate - see avoid slips and trips in the workplace
• keep hazardous substances such as chemicals and medicines locked away with restricted access - see hygiene and hazardous substances in care service businesses 
• provide adequate lighting