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The registration and inspection of residential care services for vulnerable adults rests with local government but in 2002 responsibility passes to the new Commission for Care Standards. This paper looks at how inspection units understand and respond to adult protection issues, considers how they contribute to multi‐agency adult protection and speculates on how the planned changes will impact on policy and practice.

Indicates that it is 14 years since the Beavis Consultative Committee recommended that the matter of hotel registration and its effectiveness be reviewed within three to five years. Presents definitions of registration, classification and grading together with a recent historical perspective of the developments of statutory registration in the United Kingdom. Examines the reasons for statutory registration and describes existing UK compulsory schemes outside the mainland. Contrasts the lack of progress in the UK, and the degree to which price and tariff controls are in operation, with schemes in the European Community. A brief literature review presents the support for statutory registration and classification. Re‐examines the eight conclusions of the Beavis Consultative Committee. Concludes that it may be pertinent to review the position of statutory hotel registration, classification and grading.

Describes how the 1984 Registered Homes Act has been implemented at the DHA and operational levels, concentrating on the monitoring of care in private nursing homes. It can be seen that, perhaps due to the unspecific nature of the Act, there are significant differences between the DHAs, in terms of the degree of importance attached to quality of care. However, at the operational level, this issue was considered to be more salient, although still reliant on the discretion of each individual inspection officer. Puts forward a three‐point plan for strengthening inspection practices.

The outbreak of typhoid fever which had been traced to a “carrier” of the fever germs may be given as a reason for the following note on the regulations relating to the manufacture of ice cream. This brief re‐statement of the regulations will serve to indicate the nature of the control exercised by the health authorities over a widely spread trade. It need hardly be pointed out that cream in the usually accepted sense of that term or its substitute containing a certain proportion of milk powder or skim milk is peculiarly liable to act as an agent in the dissemination of certain types of disease. “New regulations, the “Ice Cream (Heat Treatment) Regulations, 1946,” at present in draft, but operative from May 1st, 1947, deal with the sterilisation of the raw material and the retail sale in the finished and frozen state. Registration of premises, inspection by the local authority, combined with the goodwill of the trade, are obvious safeguards. The term “ice cream” possibly suggests to the average consumer a frozen mixture of cream—as that word is usually understood to mean—flavoured with the fresh juice or fresh‐fruit pulp of the name fruit. Such a mixture, if made from wholesome materials under hygienic conditions, would be a good, palatable luxury, and from the nature of the case seasonal. Most of us at some December midnight have had something called strawberry ice. The name stands, but the composition is rather a matter for speculation by the uninitiated. The term “cream” has been for many years applied to substances which though wholesome in themselves are not cream—vegetable fats, milk powder and the like—but they form the basis, so to speak, either in whole or in part of ice cream. There is in fact no official standard to define what is meant by ice cream, and the definition which we have ventured to offer must obviously be extended to apply to a large number of substances that do not of necessity consist either partly, still less wholly, of cream or of any substance whose origin is to be found in fruit of any kind. Ice cream, in fact, is a substance whose composition it seems may vary within wide and undefined limits. Thus the Ice Cream (Prohibition of the Manufacture and Sales) Order, 1942, says “‘Ice cream’ includes water ices.” The Ice Cream Transport Order (No. 305, March 22nd, 1945), prohibiting the export of ice cream to Great Britain from Northern Ireland, says: “Ice cream includes water ices and any article, whether frozen or chilled, and under whatever description it is sold, which is sufficiently similar to ice cream as to constitute a substitute for ice cream.” The statements just quoted seem to imply that ice cream may be made of almost anything as long as price, temperature and taste suit the requirements of the consumer. However, our concern is less to do with its composition as with regulations that have to do with the hygienic requirements of its manufacture. It may be pointed out that as things stand at present registration relates to premises and not to persons employed therein. Anyone can be employed in an ice cream factory, as he can be employed in any other kind of food factory. The matter of engaging him is left to the heads of the factory. They, as commonsense business people, with the interests of their business at heart, are not likely to engage anyone who is at sight obviously unfitted for the job. On the other hand, habits and health, especially the latter, become of peculiar importance when such a substance as ice cream is the object of manufacture. To make regulations as to the registration and inspection of premises, is one thing. It is not too easy to enforce such regulations. In the case of persons it is more delicate and difficult. If the offence be of habit it can be readily detected and dealt with. If of health, it becomes a matter for the Medical Officer of Health and his professional colleagues. Under Section 14 of the Food and Drugs Act, 1938, which came into force on October 1st, 1939, all premises in which ice cream is sold, manufactured, or stored must be registered with the local authority. The purpose for which registration is sought—sale, storage, or manufacture—must be stated, and also the nature of other business, if any, that may be carried on on the premises. If the premises appear to the local authority to be unsuitable, registration may be refused, or, if previously granted, may be cancelled. Notice of the refusal to register, or to cancel registration, must be served on the applicant or tenant of the premises by the local authority, giving reasons for the act, and the applicant or tenant may then, if he wishes, request the local authority to show cause, for the reasons given by them, why they should refuse to register or wish to cancel registration.” It need hardly be pointed out that the sole reason for registration is to enable the local authority to satisfy themselves that hygienic conditions are complied with, such as cleanliness, light, ventilation, adequate water supply and sanitation in general. Though the conditions may be complied with there is still the more serious danger that may arise from “milk‐borne diseases,” a danger that is admittedly peculiarly acute when such a substance as ice cream is the subject of manufacture or storage. The Medical Officer of Health must therefore be informed by the manufacturer if any milk‐borne disease has occurred among persons living or working in or about the premises. We may hazard the guess that it may not always be easy for the manufacturer to obtain such certain knowledge. “Milk‐borne disease” means enteric fever (including typhoid or paratyphoid), dysentery, diphtheria, scarlet fever, acute inflammation of the throat, gastro‐enteritis, and undulant fever—a formidable list—and any other disease that may be declared milk‐borne by the Minister of Health. With the best will in the world on the part of everybody concerned the enforcement of this Order, and there can be obviously no half measures in doing so, presents difficulties that can only be adequately appreciated and discussed by medical practitioners who are conversant with the nature of the disease in general and with the particular conditions that led to its occurrence. Apart, however, from its purely medical aspect, and if we consider the manufacturer we find that if he has done his duty in this respect he may have his business brought to a standstill, or at least a part or even the whole of his stock destroyed. The Medical Officer of Health is very rightly empowered, in the interests of public health, which override all other considerations, to prohibit the use for human consumption of any substance likely to convey milk‐borne disease and to order either its removal or its destruction. Compensation can be paid to the manufacturer if the Medical Officer of Health, after further enquiry, be satisfied that the suspected substance is not injurious. His notice for destruction or removal must then be withdrawn. On the other hand, compensation will not be paid if the suspected substance was actually injurious, or was made on the premises while the order of the Medical Officer was still in force. If a person feels aggrieved by the decision of the local authority he may appeal to a court of summary jurisdiction. Any change in the occupation of registered premises must be notified to the local authority by the ingoing tenant if he intends to use such premises for the purpose for which they were registered. If at the commencement of the Act of 1938 a local Act was in force dealing with the conditions for registration of premises it may remain in force unless the Minister, at the request of the local authority, declares the 1938 Act, 14 (1), to be in place of it. The use of unregistered premises renders the offender liable to a fine not exceeding £20, and for a second offence a maximum penalty of £100 and for three months imprisonment. Every street seller of ice cream must have his name and address on the barrow or container. It may be added that hotels, clubs and inns are exempt from registration, and theatres, music halls and the like are also exempt unless they manufacture ice cream on the premises. The Order of 1942 prohibited the manufacture of ice cream in catering establishments or in institutions, meaning by these terms premises previously authorised to do so by licence from the Ministry of Food or by a Food Control Committee. Institutions or households were exempt from this Order if the ice cream manufactured was to be consumed on the premises. This Order was rescinded by an Order of November 16th, 1944, and manufacture was resumed from that date. This was certainly not due to any marked increase in the milk supply. The trade demand was and is at least in part met by a permitted substitute.

Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.

Index by subjects, compiled by K.G.B. Bakewell covering the following journals: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.

Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.

Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.

THE INTENTIONS OF THE registration system for registered care homes were honourable, but in practice their application to services has frustrated attempts to give people the chance of an ordinary life. This institutional framework is inconsistently used and needs reform.