When a person is asked for their consent, information about the proposed care and treatment must be provided in a way that they can understand. This should include information about the risks, complications, and any alternatives. A person with the necessary knowledge and understanding of the care and treatment should provide this information so that they can answer any questions about it to help the person consent to it.
Discussions about consent must be held in a way that meets people's communication needs. This may include the use of different formats or languages and may involve others such as a speech-language therapist or independent advocate. Consent may be implied and include non-verbal communication such as sign language or by someone rolling up their sleeve to have their blood pressure taken or offering their hand when asked if they would like help to move.
Consent must be treated as a process that continues throughout the duration of care and treatment, recognising that it may be withheld and/or withdrawn at any time.
When a person using a service or a person acting lawfully on their behalf refuses to give consent or withdraws it, all people providing care and treatment must respect this.
Where a person lacks mental capacity to make an informed decision, or give consent, staff must act in accordance with the requirements of the Mental Capacity Act 2005 and associated code of practice.
Consent procedures must make sure that people are not pressured into giving consent and, where possible, plans must be made well in advance to allow time to respond to people's questions and provide adequate information.
Policies and procedures for obtaining consent to care and treatment must reflect current legislation and guidance, and staff must follow them at all times.
If the service user is 16 or over and is unable to give such consent because they lack the capacity to do so, the registered person must act in accordance with the 2005 Act.
We are sensitive to equality diversity, and human rights which includes working in a person-centred way to meet the needs of people from all equality groups, for example lesbian, gay, bisexual, and transgender people
We meet the accessible information standard, which looks at how we identify, record, flag, share information about, and meet the information and communication needs of people relating to disability, impairment, or sensory loss.
We promote equality, diversity, and human rights in their service, including for their staff.
We give different groups equal access to care pathways and all parts of the service.
Our management structure comprises of Managing Director who will also be the Registered Manager, administrator, IT personnel, and care staff.
The managing director or registered manager oversees the overall operations of the business. The administrator does all the administrative work assisted by the managing director. The IT personnel is also the web designer and is concerned with all IT issues. The care staff can report to the administrator, to the IT department, or to the registered manager depending on the situation. The registered manager, administrator, and IT personnel can sometimes work from home as the situations may require. The care staff will be dispatched or allocated to different clients depending on their abilities, skills, and availability.
We continually question ourselves about the purpose of the organisation, our roles, and our behaviors. We look at the quality of our services and risk management in the organisation. We make changes accordingly in order to continue providing the best care services possible. We also look at what our competitors do from their websites and we decide whether to adopt their methods to improve the way we provide our care services. We continually monitor and improve the quality and safety of the services you provide through feedback from staff, clients, and other stakeholders.
We will have questionnaires for our service users to rate our services so that we can maintain or change the quality, and safety standards.
Record Keeping
Personal data is information that relates to an identified or identifiable individual.
We process data in such a way that individuals cannot be identifiable. This is by using numbers or codes. We make sure that other people cannot easily identify people from the way we process people's information.
When processing information we take into account the content, the purpose, and the impact or effect it will have on an individual.
We are registered with ICO - The Information Commissioner’s Office which is the UK’s independent body that upholds information rights in the public interest. It promotes openness by public bodies and data privacy for individuals.
We keep information for both staff and service users according to GDPR principles which include, fairness, transparency, purpose limitation, accuracy, minimization, storage, accountability, and security.
We will securely maintain and keep accurate records for service users and staff by using protected documents saved on secure discs. Passwords will be changed regularly to make sure they are not compromised.
Good infection prevention and control are needed to minimise and stop the spread of infections to both service users and staff.
We will have an Infection prevention and control lead who will be accountable for infection prevention and control directly and implement the policies involved.
The lead will make sure that there is sufficient infrastructure, equipment, and resources to deliver the program.
All staff are required to read and practice these guidelines and procedures to make sure that effective infection prevention and control is maintained. They will have proper training on infection prevention and control and have adequate resources to implement, monitor and take corrective action to comply with this policy; and a risk assessment will be undertaken and approved through local governance procedures. Risk assessment will take into consideration staff who are pregnant and others at high risk.
Staff who will be exposed to infections will be referred to relevant departments for immediate action and intervention. Staff will have health checks, and mandatory immunisations before employment, and infection prevention and control will be part of their job description. Staff uniforms will be bare below the elbow, and they will report to the manager any concerns in their infection prevention and control training plus any concerns about their own health. Staff will always report incidents of infection outbreaks to the manager who will report to the local Infection prevention teams and to the UK Health Security Agency in a timely manner.
Service users will be assessed prior to being accepted for care services to make sure that proper measures are taken to prevent infections from being transmitted to staff, other healthcare professionals, and the public. Potential service users with diarrhoea, vomiting, fever or respiratory symptoms, those with MRSA history, and those who have been in hospital or abroad will be assessed to prevent cross infection.
Effective regular hand washing is encouraged, and antiseptic hand washing can be introduced in case of an outbreak of infection. Hand hygiene is considered one of the most important ways to reduce the transmission of infectious agents that cause healthcare-associated infections (HCAIs). Hand wash basins will be a must-have with mixer taps and in good condition with wall-mounted liquid soap and paper towels.
Before hand washing staff will make sure they are bare below the elbow with no jewellery, with short, and no fake nails plus cuts and abrasions have to be covered with a waterproof dressing. If hands are visibly dirty or soiled, non-antimicrobial soap and water will be used. This will apply to those with diarrhoea and vomiting, as well as suspected or known gastrointestinal infections. In all other cases, alcohol-based hand rubs will be used.
In case hand hygiene facilities are missing, wet wipes followed by alcohol-based hand rubs will be used and hands washed at the very first opportunity. Hands will be washed before and after preparing or handling food, before touching a patient, before aseptic or clean procedures, after body fluid exposure, and after touching the service user's immediate surroundings. Hand washing will also be done before and after using gloves. Hands will be dried thoroughly after washing, and hand cream applied as appropriate.
Respiratory and cough hygiene will be observed by using paper towels when coughing, sneezing, and blowing nose or using the crook of an arm if no paper towels are available. Used tissues will be disposed of in bins, and vulnerable service users will be provided with tissues and bins as necessary.
Bodily fluids will be cleared immediately and protective equipment will be used such as aprons and gloves.
Samples will only be collected on GP request and staff will use protective disposable gloves, and wash hands after the procedure.
Sharps will be disposed of in proper containers and will not be overfilled. They will then be sealed and collected by authorized waste handlers.
Needlestick injuries will be cleaned properly to allow bleeding before heading to A&E for immediate attention.
Notifiable diseases should be reported to RIDDOR (Reporting of Injuries, Diseases, and Dangerous Occurrences Regulations 2013.
Staff will work in collaboration with local infection control agencies.
Soiled linen and laundry will be washed at high temperatures (60 degrees Celsius) to prevent infections that may affect service users' health and well-being. Appropriate PPE and hand washing will be observed when handling soiled linen.
If a service user is to be admitted to the hospital, the admission unit should be informed so that they can take precautions.
When staff sneeze, they will use disposable tissue and wash their hands afterwards.
Working areas for staff will be kept clean, tidy, and free from offensive odours.
Service users, families, carers, and friends will always be kept informed of infection control measures in a language they can understand.
Staff will be supplied with clean uniforms to wear at all times.
Staff will be provided with enough equipment such as PPE, sanitisers, waste bags, and hand gels as required.
An annual statement will be issued to the Compliance team mentioning any outbreak of infection, audits undertaken, risk assessment taken, training done for staff, and review and update for policies and procedures.
Staff will always inform the manager or supervisor if they have diarrhoea and vomiting, and don’t return to work until they are cleared by a GP.
No false nail polish or jewellery shall be worn while at work.
All new staff will attend basic infection control courses and read the policies on food safety, and preparation on induction. Most of the courses are updated every year but some after three years. Additional courses will be added to food handling staff as necessary.
All staff will be trained in the cleaning of spillages and will always carefully follow the dilution instructions on the disinfectant bottle.
Records of attendance at infection control training will be kept, including the date attended and level of training.
Medications policy involves principles of assisting service users with their medication. The aim of the policy is to make sure that service users manage their medicine as much as possible except in circumstances where it is not possible. Staff will be given a framework within which they can assist service users with their medication. It specifies the documentation involved and the records to be kept.
NICE guidelines in managing medicines
The 6 Rights are:
Medication will be handled respecting people's dignity, privacy, religious beliefs, and cultural beliefs. The immediate helpers with service user's medication will be family and friends. Carers will only assist with consent signed by service users, their advocates, or family and friends. In the case of Dementia service users, recommendations for service users with incapacity shall be used. All staff who assist with medication will be assessed by the Manager and recorded in annual monitoring.
Care Workers will only provide help with medicines management only if:
Medicine Storage
The responsibility for storing medicines usually stays with the patient and/or their family members/carers and they should be encouraged to do so. The location where the medicines are stored should be documented in the care plan. If the care worker is responsible for administering the medicines, they should ensure that the medicines are stored in accordance with the manufacturer’s instructions. Where it has been agreed and documented in the care plan that the service is responsible for storing a patient’s medicines they should:
Employees have to be of good character, and have regard to the matters outlined in Schedule 4, Part 2 of the regulations. It is not possible to outline every character trait that a person should have, but we take into account honesty, trust, reliability, and respect.
If we discover information that suggests a person is not of good character after they have been employed, we take appropriate and timely action to meet this regulation.
If we consider that an applicant is suitable, despite them having information about anything set out in Schedule 3, our reasons are recorded for future reference.
Where a qualification is required for a role, either by law or ourselves, we have the means to help us to check that employees hold the appropriate qualification(s).
We have appropriate processes for assessing and checking that people have the competence, skills, and experience required to undertake the role. These processes are followed in all cases and relevant records are kept.
We have systems in place to assess the competence of employees before they work unsupervised in a role. We provide appropriate direct or indirect supervision until the person is assessed as competent to carry out the role. Competence may include the demonstration of a caring and compassionate approach. It is expected that we follow the Care Certificate standards to assess staff competence.
We consider that a person can be engaged in a role based on their qualifications, skills and experience with the expectation that they will become competent within a specified timeframe once in the role. This means that they may work and undergo training at the same time in order to become competent.
All reasonable steps are made to make adjustments to enable people to carry out their role. These are in line with requirements to make reasonable adjustments for employees under the Equality Act 2010. This may include offering alternative roles.
This aspect of the regulation relates to the ability of individuals to carry out their roles. This does not mean that people who have a long-term condition or a disability cannot be appointed.
When appointing an employee, we have processes for considering their physical and mental health in line with the requirements of the role.
We have effective recruitment and selection procedures that comply with the requirements of this regulation and ensure that we make appropriate checks for both employees and directors.
Information about candidates is confirmed before they are employed. A full employment history does not apply to volunteers except where they are service providers, directors or registered managers. This is on the basis that those roles hold a level of responsibility where it is necessary to have full employment history to ensure a person’s suitability and appropriateness of the role.
We request employment history for volunteers where we consider this is necessary to the role.
Other checks deemed appropriate may also be undertaken.
Selection and interview processes assess the accuracy of applications and are designed to demonstrate candidates' suitability for the role while meeting the requirements of the Equality Act 2010 in relation to pre-employment health checks.
Recruitment and/or checks on candidates may be carried out by a party other than the provider. In this case, we assure that all checks are complete and satisfactory.
Persons employed must be registered with the relevant professional body where such registration is required by, or under, any enactment in relation to–
(a) the work that the person is to perform, or
(b) the title that the person takes or uses.
Where a person employed by the registered person no longer meets the criteria in paragraph (1), the registered person must–
(a) take such action as is necessary and proportionate to ensure that the requirement in that paragraph is complied with, and
(b) if the person is a health care professional, social worker or other professional registered with a health care or social care regulator, we inform the regulator in question.
The response taken to concerns about a person's fitness is always fair to the
Safeguarding is about protecting people's rights, safety, security, and well-being of everyone especially those who cannot protect themselves from harm, abuse, and neglect.
What constitutes abuse
Abuse is actions by a person that intentionally injures or harms another.
The different types of abuse
The different types of abuse laid out by The Social Institute for Excellence (SCIE) are physical, sexual, psychological or emotional, financial or material abuse, domestic violence or domestic abuse, organisational or institutional abuse, modern slavery, self-neglect, discriminatory abuse, and neglect or acts of omission.
Physical abuse can involve beating, biting, spitting, pulling, pushing, being denied food and water, being denied using the bathroom, misuse of their medicines, and other such actions that can hurt someone.
Sexual can involve rape, sexual language, inappropriate touching, pornography, indecent exposure, and other such actions that can hurt someone or their feelings.
Psychological or emotional abuse can involve abusive words or body language, cyberbullying, threats to hurt or abandon, and other actions that can affect people emotionally. Social media, theft, and other such actions affect people`s emotions.
Financial or material abuse involves theft of possessions or money, fraud or scams, misuse of powers of attorney, refusing help with accessing benefits, or help with money management, and other financial matters. It also involves unnecessary or expensive repairs, and poor or no repairs at all to property, staying in someone’s house rent-free or without permission, false representation with bank cards, taking loans from service users, giving substandard care than expected, and not allowing people to access their own property and other belongings.
Domestic violence or Domestic abuse can be physical, psychological, financial, emotional, and sexual.
Modern slavery involves human trafficking, domestic servitude, sexual exploitation, prostitution, pornography, escort work, and forced debt recovery.
Self-neglect includes lack of self-care, neglecting personal hygiene, being unable to manage personal affairs, not looking for help to access healthcare services, and not being able to avoid self-harm.
Discriminatory abuse involves verbal abuse and other defamatory language related to protected characteristics such as age, gender, disability, marriage, and civil partnership. Refusing people healthcare services, communication aids, harassment and exclusion from services or offering substandard services because of protected characteristics, plus unequal treatment due to protected characteristics such as age, gender, marriage, sexual orientation, religious beliefs, disability, civil partnership, pregnancy, maternity, and race.
Neglect or acts of omission include failure to provide basics such as food, clothing, shelter, and heating. Failure to provide privacy and dignity, administer prescribed medication, and person-centred care. Not allowing visitors, refusing people to make their own decisions, not providing hearing aids or glasses, and ignoring or isolating people.
Organisational and institutional abuse involves a lack of staff, poor management, and supervision, poor attitude, overcrowding, and lack of respect, dignity, and privacy. Not managing abuse from other residents, not responding to complaints, interfering with service users' private communication, and not responding to people's cultural, religious, and ethnic needs. Refusing visitors, improper manual handling methods, small amounts of food, and lack of assistance with feeding.
Preventative measure
We prevent abuse by informing the service users of what abuse is, how to recognise it, and how to seek help in case of abuse. All staff are trained in safeguarding, and whistle-blowing is encouraged. All staff are DBS checked and codes of conduct are put up for all workforce. A safeguarding lead is also maintained to oversee all cases involving abuse. In case of a safeguarding incident, the staff involved should record it and then escalate to the safeguarding lead who will take it up by asking the service user open questions.
The information recorded can range from what the service user was wearing, their moods, what the ate that day, and how they react to the presence of certain staff members. The lead will then notify the Local authority Designated Officer and the Commission of incidents of safeguarding, and if necessary, escalate to the Disclosure and Barring Service. Charity commissions and Care Quality Commission would also be informed.
We share information with authorised local authorities (The Local authority Designated Officer) handling safeguarding issues.
Overview of the safeguarding procedures with reference to current legislature
Safeguarding Vulnerable Groups Act 2006 underpinned by
Care Act 2014
The major principle here is to help improve people's well-being and independence by preventing harm and neglect
Mental Capacity Act 2005
We assume that everyone has capacity, to involve them in decision-making even if they make unwise decisions sometimes, act in their best interests, and take the least restrictive options.
Health and Social Care Act 2012 is underpinned by empowerment, prevention, diagnosis, and treatment of physical and mental illness.
Safeguarding lead of the organisation
The registered manager will be the safeguarding lead and will handle all the allegations of abuse.
Staff will raise issues by reporting to the safeguarding lead. The local authority safeguarding contact details in Crawley are:
West Sussex Safeguarding Adults Board (WSSAB)- 0330228400
Crawley Borough Council - 01293438000
The police- 999