Hand Book V2 18

Rule 5 Use the group professionally

Postings to the group must always remain professional, do not use the group for gossip or
social chat. All messages should be work related, transparent, and should not contain
acronyms, or hidden meanings. Ensure messages are clear and concise.
In the event of a safeguarding incident we may be asked to disclose WhatsApp messages
relating to the Service as evidence of our actions to the authorities.
With this in mind, it is easy to understand why comments should be factual, accurate and
not contain personal opinions. Comments such as the one below would not reflect
favourably on the actions of a professional carer, or be helpful to the next carer:

“Mr Smith was pain in the backside tonight”
On the other hand, a comment such as the following one is more constructive, caring and
invokes an action in an attempt to discover if Mr Smith has an underlying problem:
“Mr Smith wasn’t his normal self tonight, please ask him if everything is OK and report back

if you identify a problem”
Please keep WhatsApp messages professional and relevant, remember they could be
disclosed and used against you or the company. One the other hand when used correctly
information can be used as evidence to support your actions, and more importantly can be
used to promote the health and wellbeing of your service users.

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Electronic Telephone Call Monitoring

The company operates a telephone monitoring system, the purpose of the system is to:
to ensure the safety of staff who work alone in the community.

• By logging in and out of service user the company knows where you are is able to
make contact.

• To provide evidence to the Local authority that we have attended each visit on time
and for the correct duration of the visit.

• To provide staff with up to date accurate rotas

The following pages explain how to download the app, how to log in and out of service user
visits, using your rota and leaving messages.

Download App to phone

1. You will need to download the Tagtronics
Homecare Application. The App is available on all
android and I phone platforms via the Play Store
or App store. Once you have you have entered
the Play/App store simply search for Tagtronics
Homecare.

2. Tap Get and app will down load to your phone.

Open the App your

1. Locate the Tagtronics App on
mobile device.
2. Tap the Tagtronics app on
screen to open

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Logging in to your App

1. Open the app on phone and tap the settings tab on
the right of bottom of the screen:

2. Now tap Login and enter the following details:
Company = allaboutyou no spaces or capital letters.
Username = This will be your first name and second
name without any spaces or capital letters (e.g.
simonlee)
Password = password (this has been temporarily set
as a default for everyone & can be changed once you
have your app working)
3. When all this information is entered tap Log in which
is located in the blue box below.

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Home Screen & selecting your rota

When you have successfully logged in you will then be
directed to the homepage.
Within the company details box, you will have displayed
the company telephone number, if you need to call head
office at any time simply tap this number and it will
automatically dial the company.
To select your rota, tap rota at the bottom second icon
from the left.

You can view individual days or navigate on a weekly
basis by using the arrows to the left or right of the
screen. In the example below then you can see that
there are 2 visits on Thursday 10th January

Note: To manually refresh the screen drag your finger
down on the text and let go. This will update recent
changes to your rota.
Once you select a visit you will see more details about
that individual visit including any specific client or
visit notes, messages and if any other employees are to
be with you on that call.

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First time logging in instructions

the first time you log in there are just to
changes you will need to make to you
phone, the first is to set the interval at which
your phone receives updates to your rota.

1. Set refresh Interval
Go to settings and change the refresh
option at the top of the screen, if it says
manual change this to the lowest time
option available, usually between 15
minutes and 1 hour depending on what type
of phone you have. All you need to do is tap
down arrow then tap on time option.
2. Allow software to use camera
the first time you attempt to scan a QR code
to log into a service user’s home a pop up a
message asking for permission to allow the
software to use camera; click on allow you
will now be able to use the scan feature.

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Logging Arrivals and Departures

When you arrive at your visits
you will need to locate the QR
Scan Code located in the front
of the care plan relating to the
service user.
Open up your app:
If you are not already logged in then log into your
app, when logged in:
a) Tap your rota icon at bottom of the home
screen
b) Tap the service user you are visiting and the
screen to the left will appear

To Log in
Press to select the
Scan In button, and
then hover over the
image of the QR Scan
Code with your camera
lens. This will log your
arrival at the visit, your
phone will bleep and
confirmation pop up will appear.

Logging out
Once the visit is completed you will then need to log out.
The button will have changed to Scan Out repeat the
above step to log your departure, once again you will
get a confirmation bleep and pop up.

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Confirmation Pop up’s Following Scanning

On some occasions you may get a different pop up, these are the exceptions:
Mobile App Scans
When scanning your arrival/departure you will now see the potential responses
below:

In tolerance
This response indicates you have scanned within the 15-
minute tolerance window, correct allocated time.

Outside Tolerance
This response indicates you have scanned outside the
correct allocated time. Even if you are late or are asked to
leave early you must still log in and out

No data Signal
This response indicates you have scanned but you are in a
poor signal area, or you have no data allowance
left. The scan will be stored and sent through to the
software once in a good signal area or connected to WIFI.
Multiple scans within 1 minute
This response indicates you have scanned multiple times
after the initial arrival or departure.

Cancelled Visits

When a visit is cancelled in the office the Mobile App will be updated accordingly,
you will be notified by telephone call, and you will that the visit was cancelled on your
app.

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Feedback for next 48 Hours

You can leave a message that will be shared with just the cares who are scheduled
to visit a service user in the next 48 hours. This feature is useful if there is something
happening outside of the normal routine.
For example:

• Can the next carer please empty the washing machine.
• Please check Mrs P’s pads as she has a U.T.I.
• Mrs R is going out after tomorrows lunch visit, please make sure she has her

coat on and ready to leave by 1:00pm
•

To read a message in the feedback section: when you
are logging in you will see a Feedback button on the
same screen. just press to read the message. Please
not this does not replace the Daily Report Sheet.
Always check to see if here is feedback when you log
in.

To enter feedback for
the carers who will be
visiting in the next 48
hours: The screen on
the right will appear
when you have logged
out. press Feedback
and enter your
message and select
SAVE.

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Miscellaneous Guidance and Instructions

Make someone happy, give a little of any
of the above, they are free, infectious and

go a long way

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Confidentiality

The nature of domiciliary care is such that, merely through contact and discussion with
Service Users and their relatives or agents, personnel become aware of detailed personal
information. In addition, it may be necessary for personnel to be advised quite intimate
personal information regarding specific Service Users. All About You Care Services
acknowledges that it is essential for all its personnel to respect the privacy and dignity of its
Service Users. Whilst it may be necessary for personnel to discuss Service User details,
confidential information will not be misused in any way or divulged to a third party unless
that person has a legal right to the information.

Service Users personal written files shall remain confidential and be kept secure. Access to
such files shall comply with the Access to Personal Information Act 1989 and be restricted
to Service Users, their advocates and specific company personal. Similarly, any information
stored on computer records shall have the same limited access and comply with the Data
Protection Act 1984.

Involvement with Service User’s financial and private affairs

Wherever possible Service Users financial and private affairs should be managed by
themselves, relative, or an advocate. Under no circumstances will any member of staff be
involved with a Service User’s financial and private affairs, this specifically includes wills,
legal documents, recommend other services etc. If a member of staff has any concerns
what so ever, regarding a Service User’s financial or legal affairs, this must be reported to a
service manager. Such concerns may include suspicious third-party dealings, substantial
amounts of cash, dubious invoices, etc.

It may be necessary, however, under certain circumstances for members of staff to handle
Service Users monies. On these occasions, it is of the utmost importance that the Service
User is made fully aware of all transactions. If purchases are made on behalf of a Service
User, e.g. shopping, receipts must be obtained and explained to the Service User; also any
change must be counted out when returned. If monies are withdrawn on behalf of a Service
User, e.g. pension, building society etc. the relevant documentation must be explained to
the Service User and the amount collected counted out. Pension books, bank books, etc.
must always be returned to the official holder after each transaction, such items must never
be retained by members of staff. If monies have to be collected from a Service User for a
third party; e.g. County Council contribution, a written receipt must be given to the Service
User. Wherever possible records will be kept of all transactions and will be available for
inspection at any reasonable time. Members of staff will not, under any circumstances,
borrow money from or loan money to a Service User. Other forms of involvement with
Service User's financial affairs are not always obvious, for the benefit of any doubt, these
may include obtaining points on loyalty cards, involvement with gambling or lottery
syndicates or obtaining free goods through in store promotions such as buy one get one
free. Any benefits gained through the use of Service Users finances concerning any of the
afore mentioned, or similar, activities belong to the Service User and should be given to the
Service User and a signature obtained.

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Receipt of purchases made on behalf of a Service User

Some packages of care may involve shopping for Service Users, where this is the case all
staff are required to obtain a "Record of Purchases on Behalf of a Service User Form" from
their manager who will explain how to complete the form. Due to the nature of the Service
User group and for your own protection it is of the utmost importance that signatures for
goods and change are obtained. Each record can be used for more than one Service User,
when a sheet is full, please hand this to manager who will keep it on file. Below is an
example of a Record of Purchases on Behalf of a Service User Form

Date Service Cash Description Cost of Change Total of Service
User issued of goods goods given to receipt User
name Service and signature
User change
21/03/07 Mrs £25.00 Groceries £21.50 £3.50 £25.00 J Smith
28/03/07 Smith £5.00 Tesco £3.00
28/03/07 Alan £1.00 Lottery 45p £2.00 £5.00 A Brown
Brown ticket
Pat Stamps 55p £1.00 P Smith
Smith Post Office

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Record of Receipts of Purchases Made on Behalf of a
Service User

Name of Service User………………………………………………………………

Date Service Cash Description of Cost Change Total Service
User Issued goods of given to receipt User
Name goods Service and signature
User change

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Financial Guidelines Supporting Service Users to Attend Paid Venues

There will be certain circumstances when support /care workers will be assigned to
accompanying service users to attend social activities where charges are made for
entrance, participation or both, some examples of this are going to the cinema, Ten Pin
bowling, eating out, bingo etc.
When accompanying a service user on any activity you will normally be charged either for
entrance, participation or both, it is the responsibility of the service user to pay for your
entrance and participation if required. However, in the interest of the service user and to
clearly identify limitations to staff the company sets out the following guidelines.

1. In order to promote inclusion many companies make concessions to certain groups
of people, this assists them to participate in everyday social activities. When your are
supporting a service user to attend a social activity or event you should make it clear
at the point of payment that you are attending in the capacity of a support worker and
ask if there are any concessions available. This will usually result in a discount or
free entrance and a saving to the service user.

2. When travelling by public transport there is usually discounted or free passage
available. It is the responsibility of staff to identify and to encourage service users to
take advantage of these concessions. Bus travel is usually free and discounts are
normally available for rail and other form of transport.

3. When eating out it advisable to look for two for one offers, by doing so do will save
the service user from paying for the cost your meal, if there are no such offers at the
restaurant you are visiting then support workers should not take advantage and
always choose a cheaper option from the menu.

In order to protect the financial interest of service and also to negate any accusation of
financial abuse against ourselves it is important to follow these guidelines. If you are unsure
about any part of these guidelines or have any other questions, please contact your line
manager.

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Use of Service User Debit / Credit and Prepaid Cards

Under no circumstances is it permitted for a member of staff to obtain, or be in the
possession of a PIN (Personal Identification Number) for credit, debit or prepaid cards
belonging to a service user. Staff are also prohibited from making purchases with credit,
debit or cash cards belonging to a service user
If asked by a service user to withdraw cash, or make any other type of card transaction with
their credit, debit or cash card, then you should politely decline and explain it is against
company policy.
Anyone found to be using service user’s cards to withdraw cash or carry out any other type
of transaction will be subject to disciplinary action. For the benefit of any doubt, this also
includes paying utility bills and online shopping.
If a service user requires assistance to manage their financial affairs you should report this
your line manager who will refer the problem to the appropriate authority.

One Simple Rule ……………
Home Care Staff are prohibited
from making cash withdrawals
and purchases on behalf of
service users using Debit, credit
or prepaid cards belonging to
Service Users.

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Professional Practice and Conduct

Attached to your role as a care worker are responsibilities requiring you to conduct yourself
professionally in your role. You are expected to adhere to standards and codes of practice
found in the publications, it is important you read and understand what is expected from
you.

General Social Care Council Codes of Practice for Social
Care workers

https://www.scie.org.uk/workforce/files/CodesofPracticeforSocialCareWorkers.pdf?res=true

Skills for care Code of Conduct for Healthcare Support
Workers and Adult Social Care Workers in England

https://www.skillsforcare.org.uk/Documents/Standards-
legislation/Code-of-Conduct/Code-of-Conduct.pdf

Inappropriate Behaviour

There are also behaviours considered inappropriate, the following list gives examples but is
not exhaustive:

• Aggression and violence (physical, verbal or written).
• Sexual harassment (unwelcome sexual conduct of any kind)
• Stalking (repeated attempts to impose unwanted communication or contact)
• Threat to harm another or damage property
• Bullying (repeated, unreasonable conduct in the workplace)
• Harassment - offensive, belittling or threatening behaviour.
• Engaging in a sexual activity with a service user.

Maintaining Boundaries

You are expected to maintain professional boundaries with service users and their families
by always behaving respectfully towards them. You should respect their privacy, sexuality,
their relationships and intrinsic values.

Do not become overfamiliar or engage in conversations relating to other service users or
your colleagues. If you are asked about your private life and relationships reply with
caution, do not divulge anything you wish to be kept private.

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being too familiar or showing emotional expressions could be misinterpreted and lead to
unwanted suggestions or advances. Care should be taken not to give out the wrong
signals, even the most innocent kiss, touch or compliment may turn into a difficult and
embarrassing situation and possibly lead to accusations of psychological harm prompting a
safeguarding enquiry.

If conversations become inappropriate i.e. sexual, racist, intrusive or the use of offensive
language is used politely inform the service you do not wish to be part of the conversation.

If a service users makes sexual advances or attempts to involve you in any inappropriate
sexual activity firmly state that this is not appropriate and something you cannot do. Report
the incident to you line manager who will advise you what action to take.

Do not cross the line, always maintain your professional boundaries. Report inappropriate
behaviour to your manager as soon as possible and if you find yourself in situation where
someone is behaving inappropriately towards you or you feel threatened by their actions
then walk away and contact your manager.

Recruitment

Our aim is to recruit, retain and develop an effective group of staff who are able to provide a
high standard of care appropriate to resident’s needs. We are aware of the need to
continuously review our practices and improve our own understanding of how staff
development can increase the quality of life for our residents.
Our recruitment policy encompasses all legal requirements and good practice covering;

Equal Opportunities
Recruitment
Selection
Contracts and Conditions
Induction
Development

The suitability of employees to perform their duties as described in their job description is
critical for the success of the company. It is the policy of the Company, therefore, to recruit
all personnel on the basis of their:

Ability with regard to the position to be filled
Relevant qualifications
Relevant experience
References and DBS Checks

It is also the policy of the Company to regularly review recruitment and selection
procedures to ensure that no forms of discrimination, either direct or indirect, should occur.

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Communication

It is our policy to promote effective and regular communication throughout the staff team. It
is
the responsibility of the management team to achieve this through formal and informal
channels. The flow of information will not be restricted to one direction and all members of
staff will be encouraged to contribute to every aspect of the service and Service User well
being.

The directors will
be available and receptive to comments from the staff group at all reasonable times.
The use of written reports is not only essential for effective communication but also plays an
important role in care planning. Reports should relay significant developments and all
observations. They should be clear and concise, providing facts not opinions. Reports
should not contain insignificant information.

Supplier Performance and Stock Control

It is the policy of the company to acquire consumables and equipment that represent best
value; this means the most effective for the job at the best price. It is the responsibility of
the directors to continually assess purchasing strategy and supplier performance. Decisions
regarding supplier selection will take full consideration of all legislative requirements. Once
nominated suppliers have been established relevant personnel with purchasing authority
will be informed. Where practical, stock and reorder forms will be used to ensure
satisfactory levels of supplies.

Gifts and gratuities

The vulnerable nature of many Service Users, in association with the close relationship and
dependence between Service User and carer makes the giving of gifts and gratuities very
sensitive. It is a strict policy of the company, therefore, that all gifts and gratuities will
usually be declined.

There may be occasions, however, when a Service User wishes to make a small token gift
or gratuity to a particular member of staff. This must be reported by the member of staff
to his or her manager. Only after careful consideration and discussion with the Service
User's relative or advocate, if appropriate, will a decision regarding acceptance be made. If
a Service User is insistent on making a substantial gift or gratuity to either the company or a
member of staff, then he or she will be advised to seek independence advice. Likewise, the
company will also seek similar advice and also involve all relevant groups before a decision
is made.

Withdrawal of service

All About You Care Services aims to provide domiciliary care and other related services to
its Service Users for as long as it is required by them. There may be occasions, however,
when the company feels it is either inappropriate or unable to continue providing a service
to a particular Service User, e.g. where there is racial or sexual harassment of staff. If this
situation arises then the following procedure will be followed.

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1. The reason for withdrawal will be clearly identified.
2. The reason will be discussed with the Service User and all other relevant groups.
3. Alternatives to withdrawal will be sought and considered.
4. If no alternatives are deemed to be suitable then written notice will be issued to all

relevant groups.

Assessment and review

All Service Users of All About You Care Services will be assessed with regard to the
services they receive. Assessments will involve service managers, carers and other
relevant groups. Service Users with complex packages of services will receive far more
searching assessments that those with less complex services. Assessments are designed
to identify Service User needs and preferences within the framework of services provided.
Most Service Users will have already been assessed (to identify specific needs) prior to
service commission, in these cases the company will endeavour to obtain results of this
assessment and add it to the Service User's records.
Once an assessment has been made it is important to ensure that the identified needs and
preferences are met. To achieve this, each Service User will be reviewed soon after
services have been commissioned and thereafter on a regular basis. Wherever possible,
reviews will involve the original assessment team together with the Service User. As with
assessments, reviews will be carried out with regard to the services provided. Service
Users with complex packages of care will be reviewed more frequently than those with less
complex services. In addition to ensuring identified needs and preferences are met, reviews
will monitor Service User progress and any changes in circumstances. If it is felt that a
Service User’s needs and preferences have changed sufficiently enough to necessitate a
review of service provision, then all relevant groups will be notified.
As with all Service User records, assessments and reviews will be treated with the strictest
confidentiality.

Risk taking and restraint

Responsible risk taking is regarded as normal; Service Users will not be discouraged from
taking part in activities on the grounds that there is an element of risk. Service Users who
are able to judge the risk to themselves will be encouraged to make their own decisions so
long as they do not threaten the safety of others. Wherever possible information and advice
will be given by staff that will assist them to make informed decisions. Service Users who
are unable to judge risk will be protected from harming themselves and others, if such
action is considered, by the company or any other relevant group, to constitute restraint in
any form physical, chemical or by regime, all relevant groups, including the Service User's
relative or representative, will be notified and an agreement reached. Any actions will taken
will comply with the companies Safe Guarding Adults procedures and will be in compliance
with the Mental Capacity Act 2005 regulations and its Code of Practice of practice. In all
cases of restraint, the company will maintain proper records and always be in a position to
justify its actions.

Accessibility of management

During normal working hours (Monday to Friday 9.00 am. to 5.00 pm) a member of the
management team will be contactable at the office on the advertised telephone number.
Outside these hours all calls will be diverted to a manned telephone, urgent calls will be

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passed onto a member of the management team who will deal with the matter promptly.
Non urgent calls will be dealt with on the next normal working day.

Staffing Levels

The company believes the quality and consistency of its service is paramount. To this end
the company will retain sufficient numbers of staff to meet contracted hours plus a small
group of bank staff. Keeping the number staff each Service User receives to a minimum
ensures:

• effective monitoring of Service User progress
• consistency for the Service User
• the building of positive Service User/carer relationships
• Service User confidence in the service
• consistent application of planned inputs

Involvement of Service User and Carer in service provision

The company has always encouraged service users and carers to be involved with service
planning and provision. Service Users and carers are encouraged to take part in all
meetings and decisions regarding their own individual care, and on a daily basis how the
service is delivered. In addition to this we seek to take part in group meetings involving
Service Users, carers, social services, primary health etc. These meetings are used to
discuss the broader aspects of the service and how Service Users would like it to develop.

Partnership working with key agencies

The company prides itself on its ability to work openly and closely with others; we have
always made this a priority and welcome input from all interested groups. On a daily basis
company employee at all levels liaise and work closely with many representatives of other
agencies including, social workers, district nurses, community psychiatric nurses,
continence advisors, etc.

Key Holding

There may be occasions when it is necessary for the company or its employees to hold
keys for a Service Users home. Before any such agreement is entered into written
permission will be sought from the Service User or their representative and the service
funder. When not in use these keys will be kept secure at the company’s office. A record of
all keys held by the company will be kept and individual members of staff will sign when
taking and returning keys. The company will endeavour to keep to a minimum the number
of staff who uses client’s keys; this will be regularly monitored and controlled.

Key Safes & Coded Door Locks

In some circumstances entry to service user’s homes can only be gained by opening a
coded key safe and removing the door key, or by entering a code into the lock.

The code for key safes and coded locks are available from your Tagtronics app, you will
only find codes for a service user that you are scheduled to visit, and key codes will only be
visible after you have logged into the app. Codes are visible on your rota below the service

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users name and address. If you remain logged into the app please ensure that your phone
is locked with a PIN (Personal Identity Number). For security reasons codes will change
from time to time.

Once the key safe is open you should remove the key open the door and announce your
arrival to the service user. Do not leave the key in the door, on your departure you should
put the key back in the key safe ensuring it is firmly locked.

Divulging a code of a service users key lock or key safe to a third party will be considered
an act of gross misconduct by the company and may result in dismissal, furthermore, this
act is in contravention to the Data Protection Act 1998 and could lead to prosecution.

Insurance

All members of staff whilst engaged in their specified duties are covered against accident or
injury arising from employer’s negligence. It is the duty of the employee, however, to work
in a sensible manner and accept some responsibility for themselves and others around
them. Employees should be aware that any personal accident suffered in circumstances not
covered by this policy will be at their own risk. A full and detailed copy of the insurance
policy document is available for inspection upon request.

Telephones

The use of a Service Users own telephone by company personnel is forbidden unless;

• It is at the Service User's request
• In an emergency situation
• The care package requires it
• To log in and out of a service users home

The company recognises the benefit of personnel carrying their own private cellular mobile
phone. However, whilst on duty in a Service User's home members of staff should only
make and receive urgent calls directly related to their work. Any other incoming calls should
be terminated immediately. If a Service User requests for the domiciliary care worker's
phone to be switched off, then this will be adhered to.

Security of Company Vehicles and Load

When you leave your vehicle, always lock it up and set any alarms. Always take the keys
with you and never leave them in the cab when it's unattended. Load-carrying compartment
keys should always be on the same ring as the ignition key. This way you keep the ignition
key with you when you leave the cab to open up the load compartment.
In the event that a driver’s vehicle is stolen because they have failed to observe the above
instruction will be deemed as committing an act of gross misconduct and liable to dismissal.
Never pick up any passengers.

Driver Responsibility

When you collect the keys for a vehicle, you become legally responsible for it. If the police
or local transport authorities stop you then you are personally liable for any transgressions
of the law. When driving a company vehicle, you are not only responsible for your own
vehicle. You are responsible for any stock being carried, your life, and other drivers' lives.

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Am I responsible for Roadworthiness?

It is an offence to use an unroadworthy vehicle on the road; both the company and the
driver have a legal responsibility to ensure roadworthiness.
The law requires that:

• A daily walk around check is made by a responsible person (this is the driver) before
the vehicle is used.

• This also applies to hired vehicles
• Defects must be reported promptly to your manager immediately and rectification

work will be made as soon as possible, in cases where the vehicle is not roadworthy,
then it must not be used under any circumstances.
You are responsible for any company vehicle when in position of the keys If it is not road
worthy - do not drive it. Trips are important, but lives are more important.
Below are the checks that should be carried out daily to ensure that they are road worthy,
and safe to complete the trip that you are about to go on.
Vehicle checks fall under four categories:

Vehicle exterior
Engine fluid levels
Vehicle interior
Vehicle systems - checked once vehicle is running: lights, indicators, brake
lights, tyre wear, vehicle brakes.
Not only do these checks ensure that the vehicle is road worthy, but they protect you from
blame and fines if the vehicle is broken or damaged. Any user failing to check their vehicle
or report an accident or damage to their vehicle may face disciplinary action.

Social, Environmental and Ethical Issues

The Directors are aware of the significance of social, environmental and ethical matters to
the success of the company, we welcome opportunities to broaden our awareness and
adopt new protocols. This would include all aspects of service delivery and we feel all our
stake-holders should be encouraged to express their views.

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Green Housekeeping

All About You Care Services is committed to playing its part in the preservation of natural
resources and in the prevention of environmental pollution. In working towards this the
company will comply with both the spirit and the letter of all legislative and regulatory
requirements and wherever possible:

• Reflect best industry practice in comparable situations.
• Use environmentally favourable products, favouring those made from recycled

materials. Support the EC eco-labelling scheme by favouring products bearing
such labels.
• Foster employee awareness on environmental issues through instruction and
training.
• Promote environmental awareness amongst suppliers and contractors.

In order to achieve the above the company will endeavour, wherever possible, to adopt the
following practical measures:

• Assess the likely environmental effects of proposed projects.
• Use paper that contains at least 40% recycled material and is manufactured chlorine

free.
• Ensure premises and equipment are energy efficient
• Routinely service vehicles and use 'clean' fuel to reduce emissions.
• Ensure waste products, materials and substances are managed and disposed of

properly.

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Culturally Appropriate Care

The Company believes inclusivity

and equality must be at the centre of

organisational development,

workforce planning and service

delivery. We seek to encourage

diversity through open, honest and

mutually respectful communication

and attitudes. We are committed to

developing and operating our

business in a way that is designed to

lead to a more diverse and inclusive

culture. By promoting diversity and

equality of opportunity in our

recruitment and development

process' our aim is to build a

balanced representative workforce

that reflects the local population

profile and enables our customers to

receive culturally appropriate care

and equality of access to services.

Providing Culturally Appropriate Care
is not about making an assumption
about personal preferences or by
pandering to the media-driven myth
of political correctness, which makes
people nervous about asking ‘culture’
questions in case they offend. It
involves asking questions about
personal preferences from individuals
rather than making assumptions and
once established responding and
respecting those intrinsic values and
beliefs.

Training

The employees of the company represent it greatest asset. By providing opportunities,
facilities and funding for training the Company aims to ensure all members of staff are in
possession of the Knowledge, skills and experience necessary for them to perform their job
to an acceptable standard.
As a result of an annual appraisal, training need will be identified and an outline budgeted
plan will be agreed for the start of each financial year.

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Human Rights Act 1998

Policy Statement

To gain a better understanding of the Human Rights law and how the law impacts on our
services, the following information has been taken from the Equality and Human Rights
resources for older people, the information explains what people receiving our services
should expect from us in relation to their Human Rights. It is the policy of the company to
ensure the following articles are observed by all staff during delivery of the service.

Human Rights and Homecare

The following human rights protections are most relevant to homecare; these rights are set
out in the European Convention on Human Rights Act 1998.

Article 1 of the first Protocol: Right to protection of property

Everyone has the right to keep their belongings from their home such as money and
possessions, if a care worker steals from a Service User whilst on duty, this would be a
breach of this right. It is also a criminal offence and regarded by the company as gross
misconduct.

Article 2: Right to Life

Public authorities must not place your life in danger. If someone dies as a result of
consistent poor treatment by care workers, this may be a breach of their right to life under
article 2. It may also be a criminal offence. As a provider of homecare services on behalf of
the authority we have contractual duty to ensure these rights are observed.

Public authorities must also act to ensure care packages offer enough support for assessed
needs and services are safe. It should check that care workers do not a criminal record and
are trained to work with older people. If a care worker does not raise concerns about a
serious deterioration in someone’s health and this contributes to that person’s death, this
could also be a breach of the person’s right to life.

If someone dies under suspicious circumstances, the state has a duty to investigate the
death. If that investigation is inadequate, this could also be seen as a breach of Article 3.

Article 3: No one shall be subject to inhuman or degrading treatment

homecare should not cause serious physical or mental harm, or humiliate or degrade
anyone. Depending on the circumstances, examples are of inhuman or degrading treatment
by care workers could include:

repeatedly failing to change soiled clothes or bed sheets if someone is incontinent.

not providing a service user with enough food or water.

failing to wash some over a prolonged period of time who cannot wash themselves

Not turning some who is in bed for a prolonged period of time resulting in severe bed
sores.

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Using excessive force to restrain someone.

Only the most serious cases of poor treatment will be considered a breach of this right.
However, other cases may still count as a breach of a person’s right to a private and family
life, home and correspondence. (see article 8)

Article 5: Right to Liberty and Security

Everyone has the right not to have their liberty taken away from them, people should be
free to leave and return home at will. People should not be prevented from leaving or
returning to their home by other people. Care workers cannot lock people inside their home.
They should not stop service users going out because they might fall or get confused. To
do so could be a breach of the right to liberty and security.

There are exceptional circumstances where this right does not apply. For example,
someone can be kept in hospital if they are detained (sectioned) under the Mental Health
Act 1983. This deprivation of liberty would only be applied to someone who was a risk to
themselves and others.

Article 8: Right to a Private and Family Life, home and Correspondence

People should be able to live their lives as they choose. These rights can be in some can
be circumstances, for example to protect the rights of other people because of public safety
or national security. In terms of home care, this might give the right to:

Privacy

Keep post, personal documents and phone calls private.

Service users have the right to request care workers to leave their post unopened and ask
you to leave in order to take a phone call. Even if care workers are trying to be helpful, they
do not have the right share service user information.

See your family

If a person cannot live with their family, they should be allowed to have regular contact
them. For example, if a spouse is moving to a care home because it is unsafe for him or her
to live at home, then the council s should not place their spouse in a care home far away,
where they could not visit them. In offering the spouse a care home placement they must
also consider the right to a family life of the spouse and their partner.

Have adequate care and support

This is essential if a right to a home life is to be protected. Care workers turning up late, not
carrying out all of the tasks listed in their care plan or simply not carrying out tasks properly
could amount to a breach of someone’s private life.

Not to be handled abusively or roughly by care workers.

Care workers must listen and act on the wishes of service users, if they ask them to be
more careful, carers should carry out tasks more carefully and precisely, they should take
account of an individual’s health conditions or difficulties they may have. If carers are asked

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to be more careful, use disability equipment correctly, and not cause discomfort or pain and
they do not respond to the service users request then they could be breaching human
rights. If care worker’s subjects someone to serious ill treatment, this could be inhuman or
degrading treatment (Article 3)
Accept or refuse home care services
Everyone has the right to accept of refuse home care services, some may prefer to make
alternative arrangements such as having meals delivered, a laundry service, using door to
door transport to do their own shopping instead of using the support of a care worker. This
is often because find having people in their houses intrusive.
Having Choice about care
People should be offered choice about their care for example: what day centre to attend,
what agency they wish to receive their care from and who providers their meals, along with
a choice of food they like.
People should be allowed wear what they wish, care workers must not make people wear
items of clothing they don’t like or would not normally wear. Care workers cannot make you
wear slippers on a shopping trip just because it’s easier for them to put then on instead of
outdoor shoes. If a carer stopped someone wearing items of jewellery related to their
religion this would be a breach of someone’s religious freedom (Article 9)

Live your life according to your wishes
Visiting at inappropriate times to give support and assistance could undermine a person’s
right to be in control of their daily lives. For example; being put to bed or being helped to eat
too early or too late could be a breach of their right to a private life. If carers are visiting at
irregular hours, it may stop people from going out to visit friends and family infringing on
their right to have a family life.

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Article 9 Freedom of Thought

You can think what you want and hold any religious or non-religious beliefs that you want.
You are free to observe and practice your religion, either alone or with others, in public or in
private. This right may be restricted in some circumstances, for example to protect the
rights of others or to maintain public order.

Carers should ensure they are aware of any needs relating to a person’s religion of belief.
This should be included in care plans. Carers should be assist people with religious
observance and practice, if someone wears a hijab or a cross and chain related to their
religion then care workers should still assist them to dress. Likewise, if someone has a
particular diet because of their religion, for example halal, vegetarian or kosher diet then
carers should assist people to obtain this and eat this food.

Article 14: Right not to be discriminated against un the way your human rights are
protected.

Huma Rights cannot be
breached or enforced differently
because of age, religion.
Gender. Sexual orientation,
ethnicity, political beliefs or
disabilities. This right can be
only be used in connection with
another article set out in the
Human Rights Act. For example,
a Muslim man does not get halal
meals, but a Jewish neighbour
gets kosher meals from the
same home care agency. The
Muslim man is being
discriminated against in his right
to practice his religion (Article 9)

Training

As a result of supervisions,
annual appraisals and
competency observations;
training will be identified and
given to ensure staff understand
human rights and how it affects
their work and those they care
for.

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'Whistle-Blowing

Employees are often the first to become aware of a malpractice or wrongdoing at work.
However, many do nothing about it fearing recrimination if they report their suspicions to
their employer. It is the policy of All About You Care Services to encourage employees to
make any disclosures internally with full confidence that they will not be victimised or
dismissed as a result and that the matter will dealt with in full compliance with the Public
Interest Disclosure Act 1998. An employee should make a disclosure if they hold a
reasonable belief that a failure has or is about to take place with regard to one or more of
the following:

• Criminal Offence • Danger to Health and Safety
• Failure to Comply with a Legal Obligation • Damage to the Environment
• Miscarriage of Justice
• Deliberate Concealment of Information
relating to any of the above

How do I report someone using the Whistle Blowing Policy?

• There are several ways you can report someone under the policy you can:
• use the company complaint procedure
• use the company grievance procedure
• report it verbally to any senior member of staff face to face or by telephone
• put your concerns in writing and send it to your manager
• ask a colleague a friend or advocate to report it for you using any of the above methods

Who do I report my concerns to?

• This will depend on who you are reporting, if you are reporting a colleague you would report
this to your manager

• If you are reporting your manger you would report it to a more senior person in the company.
• If you were reporting about someone not employed by the you would report to the company

care manager
• You can report the Quality Care Commission address and contact details can be found in

your staff hand book
• You can report to the Police if you think a criminal offence has been committed

Do I have to disclose my name and identity?

No if you prefer to remain anonymous the company will still thoroughly investigate you
concerns. However, if you do report something and do not disclose who you are, then
please pass on as much information as is possible and try to establish facts such as dates
and times in your report.

Will there be any recriminations if I use the Whistle Blowing Policy to report someone?

Wherever possible your identity will not be disclosed to the person you are reporting,
furthermore, the company will ensure all concerned will be deal with in a professional and
appropriate manner. Please remember Don’t feel you are being a “grass”. If you don’t act
who will?

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Whistle Blowing Policy

Standards of Behaviour in Our Work Place
What would you do if you witnessed behaviour that made you feel uneasy or
uncomfortable?
Perhaps it might be:

❑Someone being rough or unreasonable with a Service User or work colleague.
❑Someone using aggressive or foul language to a Service User or work colleague.
❑Someone using aggressive or threatening behaviour to a Service User or work

colleague.
❑Someone bullying or harassing a Service User or work colleague.
It may be an isolated incident, or it could be a persistent.
Don’t feel you are being a “grass”. If you don’t act who will?

.Report what you see when you see it using the company’s “Whistle Blowing’ Policy”

For further information, see your Staff Handbook
179

Bullying, Harassment and Coercion

The wish that All About You Care Services shall be a safe and happy environment in which
to work and live is the foundation upon which this key policy is developed.
The value of the individual is the central theme of the company's 'people strategy'. Work
place harassment and bullying therefore undermine the core values of this strategy which is
based upon an assumption of positive attitudes, commitment and enthusiasm.
All staff have a duty to comply with this policy and to ensure that their colleagues and
Service Users are treated with dignity and respect. Harassment and bullying will not be
tolerated at any level within the company. Employees found bullying or harassing will be
subject to disciplinary action. Any such action will comply with company's disciplinary
procedure and policy on victimisation.

Harassment

Under this policy harassment is defined as conduct which is detrimental based on an others
sex, race, disability or sexuality which creates an intimidating, hostile or humiliating working
environment for the recipient.
Harassment is based upon perceived vulnerability, powerlessness or membership of a
minority group in society. Harassment may be oral, written or transmitted by electronic
means.
Sexual harassment is 'unwanted conduct of a sexual nature or other conduct based on
sex affecting the dignity of men and women at work'.

Racial harassment is 'unwanted conduct of a racial nature or other conduct based on race
affecting the dignity of men and women at work'.

Harassment because of a person’s disability can include derogatory remarks, jokes or
treatment about or at the expense of someone’s disability, physical appearance or the
disabled group to which the person belongs.

Harassment because of a person’s sexuality can include derogatory remarks, jokes, the
use of offensive names and titles, or treatment about or at the expense of someones
sexuality, appearance or the sexuality group to which the person belongs.

Examples of inappropriate behaviour.

Unnecessary or unwelcome physical contact

Lewd, suggestive or over familiar comments.

Insulting remarks.

Persistent requests for sexual favours

Indecent exposure

Display or circulation of pornographic or sexually explicit material in the work place.

Physical assault

Jokes about a person’s racial origins, disability, physical appearance or sexuality.

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Bullying

Bullying can be defined as persistent, offensive, abusive, intimidating, malicious, or insulting
behaviour, abuse of power or unfair penal sanctions, which could make the recipient feel
threatened, humiliated or vulnerable and undermines their self-confidence causing them to
suffer distress.
Bullying involves the persistent and intentional use of offensive behaviour which gradually
undermines the person’s self-esteem and confidence. The bully denigrates the person,
intimidating and belittling them in a systematic way.
Bullying may be related to power and position and may be perpetrated by an individual or
by a group.

Examples of Bullying

Aggressive, inappropriate and threatening language.
Inappropriate tone of voice, persistent criticism, spontaneous rages, public
humiliation, insults and name calling, spreading unfounded malicious rumours.
Actual violence, violent gestures and threatening violence.
Abrupt mannerisms, ignoring and excluding.
Allocating only uninteresting work, undervaluing effort, miss-allocation of blame.
Subjecting subordinates to humiliation and ridicule, unjustified criticism, imposing
impossible deadlines, having no regard for personal commitments, unjustified
removal of responsibilities, blocking training or promotion.
Instilling fear and persecution through threats, teasing or practical jokes.

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Code of Conduct

The company will make aware to all domiciliary care staff that their working environment is
usually within the Service Users own home and the following should be adhered to:

The approved company uniform should be worn and staff should be presentable at
all times whilst on duty.

The approved company identity card must be carried whist on duty and shown to
Service Users and others upon request.

All items of property belonging to a Service User must be treated with care and
respect

Service Users personal domestic appliances and equipment should only be used
with their permission and where it is necessary for the care package.

Smoking is not allowed whilst in a Service Users home or whilst in contact with a
Service User.

The consuming of or being under the influence of alcohol, or illegal substances is
strictly prohibited whilst on duty.

Refreshments, meals and snacks should not be consumed in a Service Users home
unless specifically invited.

Roster sheets should be treated as confidential looked after carefully.

Protective clothing (provided by the company) should be worn when necessary.

No member of the company's staff will enter a Service User's home against their or
their representative's wishes and similarly any member staff will leave a Service
User's home when requested by the Service User or their representative.

Service User's will be asked how they wishes to be addressed, this will notified to all
relevant personnel and adhered to at all times. Staff will also be made aware that the
Service User's wishes may change with time.

Only personnel directly employed by the company will enter a Service User's home.

Policy on Sex and Sexuality

Regardless of age people are entitled to express themselves sexually, therefore it is the
policy of All About You Care Services Ltd. to ensure that each individual is allowed to
express their individual sexual identity and experience a range of relationships of their
choosing.
In order to promote this the company will:

respect the privacy and dignity relating of service users concerning sex and sexuality

enable service users to express themselves sexually in the privacy of their own
rooms

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not discriminate against a service user regardless sexual orientation or preferences

not tolerate abusive, violent or inappropriate sexual behaviour which could offend
others

not attempt to influence or act in any manner that would either discourage or
promote relationships between service users and others

Attendance Management Policy

All About You Care Services Ltd. is committed to dealing sympathetically with all cases of
illness and absence within its workforce. Our procedures are intended to provide managers
with guidance on promoting better working conditions in order to reduce sickness and
absence. Sickness and absence not only increases the workload of colleagues it also limits
the company's ability to deliver the best possible service to our service users and therefore
cannot be ignored.
We aim to combine a caring attitude towards the health and well being of all our people, but
will take a firm approach to those who take time off without good cause or explanation.
Our approach is based on the following principles:

Acceptance that we will achieve the best results where there is a commitment to the
attendance management approach by all staff and line managers.

Commitment to health promotion by the provision of effective health and safety
management that will support both staff and managers in maintaining high levels of
attendance and preventing accidents, illness and injury

Identifying and reducing the causes of stress in the workplace

Provision to managers of regular, accurate and comprehensive advice and
information concerning sickness absence levels, trends and problem areas.

Commitment to supporting managers in adopting a robust approach to dealing with
cases of abuse of the system

Commitment to provide training, which ensures that staff and managers understand
the policies and procedures.

Promoting a better work life balance and adopting more family friendly policies which
recognise that pressure on staff outside the workplace that also impact on our
working lives.

Whilst we are aware that some sickness absence is unavoidable, all staff and
particularly their line managers are required to play their part in maintaining the
lowest possible level of sickness absence.

The company recognises that from time to time, employees may suffer ill health or
may need to attend doctors for appointments etc., provision will be made for staff to
attend these appointments.

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Combating Violence Against Care Staff/Safer Places

The company recognised that violence, threats and abuse are unacceptable. This includes
sexual and racial harassment, and threats to family and property. Violence and abuse are
NOT part of the job. Managing violence, threats and abuse is the responsibility of both the
employer and employee. Organisations, managers, employees and service users working
together provide the best means to safer practice.
As your employer the company will:

produce and issue you with policies (including this one) and that clearly sets out a
code of practice that fits your job and where you work

clearly assess the risks to you from the individuals and groups you work with

give you clear procedures about what to do when there is a risk; what to do after an
incident, and what follow-up there will be

offer you training that fits your job, including what responsibilities you have towards
colleagues and to service users

provide a working environment that maximises your safety

support you in dealing with your concerns about threats, abuse and violence

put in place procedures for making sure precautions are working and can be
reviewed

provide support after an incident fits what you and others who were involved need to
recover from the experience

carry out a self- audit to identify actions that need to be taken by the company or its
employees to minimise any incidents of violence, threats or harassment

It is the responsibility of staff to:

Familiarise yourself with the company procedures, including those for when you are
working away from your base or with colleagues from other organisations or when
visiting Service Users homes

Understand what triggers violence and abuse, so that you are prepared to cope with
violence and abuse that may occur in your job

Use the procedures in place for raising any concerns you have with colleagues and
managers i.e. Your weekly supervision session, the Whistle blowing policy.

When you think there is a risk, to discuss your concerns with colleagues and
managers

To gather as much information as possible about threatening service users and
share it with colleagues and managers

To take part in any training that promotes safer practice

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Use the company's risk assessment procedures and keep re-assessing the risk of
violence

Know how might the service user/s interpret what you are doing, e.g. is the service
user frightened, or under the influence of drugs or alcohol

If you are you limiting the choice of the service user/s, or removing or restricting their
freedom as this may lead to violence or aggression

If are you saying 'no' to something they want to do or have that they think will make a
big difference to them

Share information about service users and carers with colleagues that will help keep
them safe

Record thoroughly what the assessment is and the plan for managing the risks

Review and regularly re-assess the risks with your manager

As a result of risk assessment and implementation of other safety procedures the
following should be considered in any plan of action:

Take part in discussions with your managers and colleagues, including those outside
your organisation where they are, or may become, involved

Include, whenever possible, service users and carers in the planning

Have a strategy for coping with an incident where there is a known risk, covering for
example:

Your organisations contact arrangements
A safe place to meet

Who to involve

Ways of responding to violence, particularly the response to physical contact and
what you think is a safe distance

Any equipment you may need (mobile phone/attack alarm)

An exit strategy for you and others who may be at risk

Be prepared for the rare, unpredictable and unexpected incident
Ways to reduce risk include:

managers who take responsibility at all times to provide easy access to adequate
technology (alarms, panic buttons etc), coupled with the necessary procedures to
adopt if the alarm is sounded.

workers who are skilled in their work and have a confident, calm, professional
approach that demonstrates understanding and respect

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service users and carers who are:

well informed and given information that is jargon-free

respected for their experience, expertise, history and culture

involved in planning safe practice, environments and training

good, detailed records and ensuring that colleagues (within and outside your
organisation) are kept aware of incidents and risks -think about colleagues who will
follow on from you

knowing signs that indicate a service user may become violent, such as shouting,
agitation, confusion; signs of alcohol or drug abuse, and knowing ways that tonight
reduce their anxiety, distress or anger

workers who know the procedures and how to use them when a situation gets out of
control, including finding a way to leave

reviewing incidents, re-planning for the future

systems to check that learning from incidents is used

Do not put themselves or service users in places that that may place you in danger,
e.g. In unfamiliar surroundings, dark alleyways or places known for having a high
level of crime or violence.

Conclusion
This policy takes a common sense approach dealing with ways of providing you with safer
place to work, however the policy should not be read in isolation but read with other
company policies.
Suggested reading:

❖ Risk Taking and Restraint
❖ Dealing with violent Incidents
❖ Whistle Blowing
❖ Abuse Procedure
❖ Policy on Physical Intervention
❖ Bullying Harassment and Coercion
❖ No Secrets In Lancashire
❖ Policy on Abuse of Vulnerable Adults
❖ Accident and Incident Reporting
❖ Investigation of Accidents
❖ Risk Assessment
❖ Inappropriate and Challenging Behaviour

This list is not exhaustive and many of the issues mentioned are contained in other
company policies and in this handbook.

186

Valuing People / Personalisation Policy,

(A company plan to implement valuing people)

All About You Care Services is committed to working towards the vision as set out in the
government white paper “Valuing People: A new strategy for Learning Disability for the 21st
Century”
Whilst the company believes it is already achieving many of the desired outcomes as
outlined in the white paper we will continue to deliver change by working with our local
partnership board and other professionals. The company will provide appropriate training
that will raise the awareness of the Valuing People key principles and objectives. It is
intended that the outcomes of this training will be used to equip both service users and staff
with the knowledge to promote inclusion, legal and civil rights within the mainstream of
society.

The Four Key Principles

In order to achieve the desired outcomes, it is important that all Managers, staff and most
importantly service users understand the four key principles.

1. Legal and Civil Rights:

The company is committed to enforceable civil rights for disabled people in order to
eradicate discrimination in society. People with learning disabilities have the right to a
decent education, to grow up to vote, to marry and have a Family, and to express their
opinions, with help and support to do so where necessary.

All public services should treat people with learning disabilities as individuals with respect
for their dignity, and challenge discrimination on all grounds including disability. People with
learning disabilities will receive the full protection of the law when necessary.

2. Independence:

Promoting independence is a key aim for the Government’s modernisation agenda.
Nowhere is it of greater importance than for people with learning disabilities. While people’s
individual needs will differ, the starting presumption should be one of independence, rather
than dependence, with public services providing the support needed to maximise this.
Independence in this context does not mean doing everything unaided.

3. Choice:

Like other people, people with learning disabilities want a real say in where they live, what
work they should do and who looks after them. But for too many people with learning
disabilities, these are currently unattainable goals. We believe that everyone should be able
to make choices. This includes people with severe and profound disabilities who, with the
right help and support, can make important choices and express preferences about their
day to day lives.

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4. Inclusion:

Being part of the mainstream is something most of us take for granted. We go to work, look
after our families, visit our GP, use transport, and go to the swimming pool or cinema.
Inclusion means enabling people with learning disabilities to do those ordinary things, make
use of mainstream services and be fully included in the local community.

The Eleven Objectives

The government set out eleven objectives in the white paper, although, objectives number
one and two do not apply to the company due to the age of our service users it is felt
important that they are understood and will be included as part of staff training. The
company will systematically work towards achieving all of these objectives by:

Looking at where we are now
Identifying what we need to do to meet the objectives
Continually review this process
Work with our local partnership board
Provide the resources necessary to meet the objectives

Objective 1: Maximising Opportunities for Disabled Children

To ensure that disabled children gain maximum life chance benefits from educational
opportunities, health care and social care, while living with their families or in other
appropriate settings in the community where their assessed needs are adequately met and
reviewed.

Objective 2: Transition into Adult Life

As young people with learning disabilities move into adulthood, to ensure continuity of care
and support for the young person and their family and to provide equality of opportunity in
order to enable as many disabled young people as possible to participate in education,
training or employment.

Objective 3: Enabling People To Have More Control Over Their Own Lives

To enable people with learning disabilities to have as much choice and control as possible
over their lives through advocacy and a person-centred approach to planning the services
they need

Objective 4: Supporting Carers

To increase the help and support carers receive from all local agencies in order to fulfil their
family and caring roles effectively.

Objective 5: Good Health

To enable people with learning disabilities to access a health service designed around their
individual needs, with fast and convenient care delivered to a consistently high standard
and with additional support where necessary.

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Objective 6: Housing
To enable people with learning disabilities and their families to have greater choice and
control over where and how they live.
Objective 7: Fulfilling Lives
To enable people with learning disabilities to lead full and purposeful lives in their
communities and to develop a range of friendships, activities and relationships.
Objective 8: Moving into Employment
To enable more people with learning disabilities to participate in all forms of employment,
wherever possible in paid work and to make a valued contribution to the world of work.

Objective 9: Quality
To ensure that all agencies commission and provide high quality, evidence based and
continuously improving services which promote both good outcomes and best value.
Objective 10. Workforce Training and Planning
To ensure that social and health care staff working with people with learning disabilities are
appropriately skilled, trained and qualified, and to promote a better understanding of the
needs of people with learning disabilities amongst the wider workforce.

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Objective 11: Partnership Working
To promote holistic services for people with learning disabilities through effective
partnership working between all relevant local agencies in the commissioning and delivery
of services.
Personal Centred Planning
At the centre of delivering change the will be Person Centred Planning, Person Centred
Planning is finding ways of listening to people to find out what is most important to them
and what they want from their lives. Following this as a company we will, wherever
possible, help people to get those things and too achieve their ambitions.
Valuing People said that services should put use person centred approaches to planning for
everyone who needs services.

Conclusion
In order to achieve the
desired outcomes of this
policy will necessitate the
involvement of
management, staff, service
users and partnership
working. The lead person
appointed is the L.D
Manager who will have
responsibility for
implementation. The
company directors will
provide the necessary
resources required to
support her and the team.

190

Policy & Procedure Service User Requiring Medical Attention.

If you find a service user in need of medical attention the action you take will vary
depending on type of medical assistance being requested by the service and your own
assessment of the medical attention required, this could be:

a) Calling 999 if the service user is suffering a life threatening condition.
b) Calling 111 To Seek Guidance for advice from a Health Advisor.
c) Obtaining assistance for a service user who has had a fall.
d) Calling GP for advice or to book an appointment for service user.

Someone’s life may depend on the action you take. The following guidance is given to
assist you to make the right decision, situations vary from critical life threatening conditions
to minor injuries. If you are unsure of the appropriate action you must call your line
manager who will make the decision for you.

a) Calling 999 For Urgent Medical Assistance

If your service user has a life threatening condition you must always call 999 for an
ambulance. Examples are, although not exhaustive are:

Emergency Symptoms
Condition

Collapse / Cardiac arrest Unconscious - not breathing - no pulse – unresponsive Call
999

Heart attack Chest pain - pains through arm - shortness of breath - clammy. Call
Convulsions / fitting 999
If it’s their first seizure - it lasts more than 5 mins - they don’t
regain full consciousness. Call
999

Stroke Face starts to droop - unable to fully lift their arms - difficulties Call
with speech, becomes slurred. 999

Traumatic / serious injury Major blood loss - Bone fracture Call
999
Severe burns / scalds Red or peeling skin- Blisters- Swelling
Call
Choking Airway blocked, either fully or partly - Unable to breathe 999

Severe allergic reactions Swelling - difficulty swallowing or speaking or difficulty Call
breathing 999

Call
999

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When your 999 call is answered

• Give clear and concise answers to any question asked by the person responding to
your 999 call.

• Make sure you have the service users address and postcode and date of birth at
hand to give the person taking your call.

• Answer any questions asked by the emergency services to the best of your ability.
• You may be asked to stay on the line to and given further instruction, if so, follow the

instructions given.

Keep the company on call service informed of the situation after you have called 999,
keep calm, do not panic.

b) Calling 111 To Seek Guidance for Advice from a Health Advisor

If a service user tells you they are feeling unwell and you are unsure of what action to take
you should call NHS 111 for advice. Have the Service User’s care plan to hand, the first
person you will speak to will be a call handler who will ask:

• who you are.
• about your Service User i.e. their name, address, postcode, and date of birth.

To provide the best help and advice they will need to know as much as possible about the
Service User’s current condition and medical history (refer to the care plan for information).
They may also ask you what medication they are taking. The information you give will help
them to assess the situation and if needed to refer you to another NHS service.
At this point you may be told they are calling an emergency ambulance or you may be
transferred to a suitable healthcare professional such as a clinician, nurse, pharmacist, or
dental nurse, who will:

• talk to you about the service user’s symptoms.
• tell you what care they think the Service User needs.

They might suggest that:
• you advise the service user to treat themselves at home.
• they see a doctor or another health professional.

In times of high demand you may be put on a clinical queue, managed by a senior clinician,
to be called back by a relevant advisor depending on the type of help you need. If you are
informed someone will call you back, ask them if you should stay with the Service User until
they call back. If not an emergency, you will usually be able to leave. If asked to remain
inform the on-call service who will cover your next call/s
If an ambulance is called and no one else is immediately available, you must wait for the
ambulance to arrive. Inform the on call service you are waiting for an ambulance and they
will find a replacement carer to attend if you cannot stay. Do not leave the service user until
either your replacement or paramedic arrives. Failing to stay with your service user could
inferred as an act of abuse.

c) Finding a service user has fallen and found on the floor.

It is important for you know what to do if you find a service user has fallen on the floor and
you deal with the situation professionally, do not to panic stay calm. Your actions will
determine what happens next and can either reduce further harm or, if not managed

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properly, could cause further injuries than the fall itself. It is the policy of the company not to
lift anyone who has suffered a fall.
If the person is injured:

• First, check for any existing hazards or dangers and if safe to do so remove the
hazard.

• If the person is responsive talk to them and try and ascertain how the accident
happened and if there could be any medical cause such as a fit or stroke – do not
stress them if they are confused.

• Try and work out where it hurts most and look at them closely to see if there is any
obvious bleeding, bruising or contorted limbs indicating a particular injury.

• If they are conscious and you think they may have fallen from a height or could have
injured their neck or spine – Do not move them. Try and keep them as still as
possible and discourage them from twisting.

• Phone 999 and keep reassuring them until paramedics arrive.
• If you are aware of any bleeding apply firm pressure with a clean pad.

If there is no obvious injury or medical cause for the fall

• Check if they are responsive, i.e. conscious, although they may in shock.
• If they are responsive, provide reassurance and comfort the person.
• Ask the person to stay still before checking, e.g. for pain, loss of sensation

(feeling), loss of movement in arms and/or legs, swellings, visible injury and
deformity, which might indicate a fracture. Also, check for sickness, confusion,
drowsiness, delirium and agitation.
• If there is no evidence of injury and no signs of a change in health, in line with the
person’s wishes allow them to get up independently if they are able.
• For example, ask them to first roll over, then get on their hands and knees before
using a safe means of support, e.g. nearby chairs, to stand up and/or give direct
help in line with the care service’s moving and transferring procedures.

If the service user is unable to get up by themselves

• Carefully place a pillow under their head.
• if the service user is shivering or cold cover them with a blanket.
• call lifeline for assistance who will send a falls team. Stay with your service user

until a replacement carer or the falls team arrives.
• If the service user does not have a lifeline then call 999 for assistance and wait

for the ambulance to arrive.
• Inform the on call service you are waiting for an ambulance who will either

instruct you to wait with the service user until either paramedics or a replacement
carer to arrive.

Once help is on the way contact your line manager or company out of hours service who
will advise of anything you are unsure of, cover your outstanding visits or provide a
replacement carer to attend and contact service users next of kin. Do not leave the service
user until your replacement arrives. Depending on circumstances and in terms of guidance
failing to stay with your service user could be an act of abuse.
Please ensue you record the fall and your actions on your feedback notes.

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d) Calling GP for advice or to book an appointment for service user.

On occasions you may be asked by a service user to speak to their GP, they may be
concerned about their health or they may wish to book an appointment. To do this you
should have their consent, you must record any recommended actions and advise your
Service User accordingly e.g.

• book an appointment on their behalf.
• advise them their medication will be changed.
• advised them to monitor their condition and contact their surgery if condition

deteriorates.
If you are concerned and do not have consent then contact your line manager who,
depending on the problem, will speak to the GP’s practice or social worker.

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Policy Care of the Dying

It is the policy of the company to ensure consistent, high quality care for people in the last
days and hours of life. The company will adopt and implement the following five Priorities for
care of the Dying Person at the end of life. We will ensure that all care given to people in the
last days and hours of life in care is compassionate, is based on and tailored to their needs,
wishes and preferences of the dying person, their family, and those identified as important to
them

Priorities for Care of the Dying Person.

The Priorities for Care are when it is thought that a person may die within the next few days
or hours. This possibility is recognised and communicated clearly, decisions made and
actions taken in accordance with the person’s needs and wishes, and these are regularly
reviewed and decisions revised accordingly.
Sensitive communication takes place between staff and the dying person, and those
identified as important to them.
The dying person, and those identified as important to them, are involved in decisions about
treatment and care to the extent that the dying person wants.
The needs of families and others identified as important to the dying person are actively
explored, respected and met as far as possible.
An individual plan of care, which includes food and drink, symptom control and
psychological, social and spiritual support, is agreed, co-ordinated and delivered with
compassion.

Priority 1

This possibility [that a person may die within the next few days or hours] is recognised and
communicated clearly, decisions made and actions taken in accordance with the person’s
needs and wishes, and these are regularly reviewed and decisions revised accordingly.

If a person in our care deteriorates unexpectedly, and it is thought they may die soon, i.e.
within a few hours or very few days, and a doctor subsequently informs us the condition is
potentially reversible we will immediately implement any changes necessary to the persons
plan as advised by the GP. This may involve changes to medication or dietary requirements
providing it is in accordance with the person’s wishes or in their best interests. If it is
established they lack capacity to make the decision about treatment at that time then their
family or advocate will seek the views of others caring for them and make a best interest
decision on their behalf.

If the doctor judges that the person is likely to be dying, it is the doctor’s responsibility to
clearly and sensitively explain to the person in a way that is appropriate to their
circumstances.

If requested our managers and staff will seek the views of their family and others identified
as important to them in order to establish the person’s views and preferences which will be
taken into account, we will endeavour to involve others in decisions to enable us to act in
accordance with the person’s wishes. It is the responsibility of the manager or delegated
senior person to work with the Doctor and clinical staff to develop a documented a plan of

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care, and make regular reviews of the person to check that the plan of care remains
appropriate and to respond to changes in the person’s condition, needs and preferences.

The point at which a person becomes a ‘dying person’, when treatment might end and care
becomes palliative staff should continue to focus on assessing the person’s condition,
needs and wishes and respond appropriately.

It is the responsibility of health professionals to make clear to the dying person and those
who are important to them when it is thought that the person is likely to be dying and they
should explain to them why they think this, what it is likely to entail and the uncertainties
round this.

Even if it has been determined that someone may be dying, health care staff must continue
to offer them food and drink, provided eating and drinking would not harm the person. If the
person wants this and needs help to eat and drink, care staff must provide that help.

Clinically unstable Service users who may not recover and those important to them will be
involved as much as possible in any decisions being made about their care, rather than
focusing on a ‘diagnosis of dying’, as occurred with the Liverpool Care Pathway, we will
focus on changes in the condition of the person who is dying and how we best care,
comfort and support as their condition changes, rather than focussing on the diagnosisof
dying only.

Priority 2

Sensitive communication takes place between staff and the dying person, and those
identified as important to them.

Staff must ensure they have open and honest communication between themselves and the
person who is dying, and with those identified as important to them. Communication
between the person who is dying and those important to them must be clear,
understandable and in plain language. If the dying person needs additional support to
understand information to communicate their wishes or make decisions then managers and
staff will be pro-active, and will actively seek alternative ways to communicate, not simply
wait for the person or those important to them to ask questions. All communication will be
two-way, i.e. staff will listen to the views of the person and those important to them, not
simply provide information.

All communication will be conducted in a way that maximises privacy, be sensitive,
respectful in pace and tone and take account of what the dying person and those important
to them want and feel able to discuss at any particular point in time.

Staff must check the other person understands the information that is being communicated,
and document this.

Staff must listen, respond sensitively to their issues and concerns, provide information in a
way that meets their communication needs and check that explanations and information are
understood. The content and outcome of all discussions This includes conversations about
goals of care must be documented in the persons care plan and accessible to all those
involved in the person’s care, including particular concerns that the person, their family and
those identified as important to them have expressed.

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Priority 3

The dying person, and those identified as important to them, are involved in decisions about
treatment and care to the extent that the dying person wants.

Individuals vary in the extent to which they wish to be involved in decisions about their own
treatment, though most would want to make or influence decisions about the care they
receive, and the way this is delivered. This includes day to day decisions about food, drink
and personal care. Individuals also vary in the extent to which they wish their families and
those important to them to be involved in decision-making.

Sensitive communication is needed to ascertain the wishes of the dying person, how much
they want to be involved, and who else they want to involve in decisions concerning their
care treatment. To achieve this it is essential the dying person and those important to them
must be told who the senior carer in the team is, and who has responsibility for their
providing and maintaining the quality of their personal care.

Where it is established that the dying person lacks capacity to make a particular decision,
then any decision made or action taken on their behalf must be in their best interests, and
they should still be involved as far as possible in that decision.

Involving families and carers in decisions about a dying person’s treatment and care can be
a very difficult and sensitive area. In some cases, relatives and carers incorrectly consider
they are entitled to decide what treatment their relatives receive, and in others clinicians fail
to seek consent or consult the relatives and carers in a ‘best interests’ assessment when
they should. The company and its staff will ensure care and support provided by the
company is as a result of a ‘best interest assessment’ involving the dying person and those
who are important to them.

Decisions to withdraw or not to start potentially life-prolonging treatments are the
responsibility of Doctors, nurses and other healthcare professionals.

Capacity and advance decisions or advocacy for people who lack capacity to consent. The
Mental capacity act 2005 provides that in certain circumstances where the person lacks
capacity to make a decision, arrangements for an independent mental capacity advocate, to
represent and support the person, should be made, the company will contact any know
advocates and draw to the attention of other professionals any know advance decisions
concerning the dying person.

Priority 4

The needs of families and others identified as important to the dying person are actively
explored, respected and met as far as possible.

Families and those important to the dying person, including carers, have their own needs
which they, and others, can overlook at this time of distress. They are often tired, both
physically and emotionally, and may be anxious and fearful, especially if they are the dying
person’s main carer. Even those who may appear to be coping well appreciate an
acknowledgement that the imminent death of somebody they know well is hard and that
they have a role in ensuring that they receive a good standard of care as they near the end
of life. Where staff and those close to the dying person have particular needs for support or

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information, the company will meet these needs where possible, within its scope as an
employer and care provider. Although it is not always possible to meet the needs or wishes
of all family members, we will listen to and acknowledging their concerns. If a person who is
dying lacks capacity to make a decision, the decision-making process will be explained to
those people who are supporting the person and they will be involved as much as possible.

Priority 5

An individual plan of care, which includes food and drink, symptom control and
psychological, social and spiritual support, is agreed, co-ordinated and delivered with
compassion.

A plan for care and treatment will be developed to meet the dying person’s own needs and
wishes in relation to how their care should be managed and any treatment preferences they
may want to express. This plan must include attention to symptom control (e.g. Relief of
pain and other discomforts) and the person’s physical, emotional, psychological, social,
spiritual, cultural and religious needs.

We will support the person to eat and drink as long as they wish to do so, and their comfort
and dignity will be prioritised. We will promptly refer any changes in condition and make
changes to the plan of care as advised by the doctor and specialist palliative care team.
This plan of care will be documented so that consistent information about the person’s
needs and wishes are shared with those involved in the person’s care and available at the
time this information is needed.

It is part of good care for a dying person to plan ahead as much as possible, if they wish
this, we will involve them as much as possible and assist with best interests’ decisions for
people who lack capacity. The care plan will be reviewed as circumstances, including the
dying person’s preferences, change. The care plan or, as a minimum, key elements of it,
will be immediately available to health and care staff who are or might become involved in
caring for the dying person, (including ambulance services, social care services and ‘out-of-
hours’ general practitioners), so that the person’s preferences are known and can be taken
into account across the range of services they receive.

Some people will deteriorate and die unexpectedly and the Priorities for care should be
applied in such circumstances. However, in many cases people will already be receiving
care and the care plan for their last few days and hours of life will be part of a planning
process that started days, weeks, months or even years before. For example, people with
long-term conditions and vulnerable older people should have care plans in place, if they so
wish, well before the last few days and hours of life. The process of planning for dying
should be part of these and other care planning processes, with the pace and timing of
discussions about dying reflecting the person’s and, where appropriate, their families’ and
friends’ readiness to discuss particular aspects.

All service users, including those who are dying, are entitled to food and drink of adequate
quantity and quality and to the help they need to eat and drink. Malnutrition and dehydration
can be both a cause and consequence of ill health, so maintaining a healthy level of
nutrition and hydration can help to prevent or treat illness and symptoms and improve
treatment outcomes for patients. The plan will document dietary requirements to ensure
nutrition and hydration are being provided in a way that meets service user needs, and if
necessary, service users will be being given adequate help to enable them to eat and drink.
The offer of food and drink by mouth is part of basic care (as is the offer of washing and

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pain relief) and must always be offered to service users who are able to swallow without
serious risk of choking or aspirating food or drink. As part of the plan staff will assist other
professionals to monitor nutritional and fluid status.

Policy on Security of the Home

It is the policy of the company to ensure the security and safety of service users and their
homes whilst working in domiciliary situations. The company has clear protocols and
procedures that must be observed by all domiciliary care staff at all times.

Entering a Service Users Home

1. Prior to the commencement of any package of care, the care manager or a senior
member of the team will carry out a risk assessment of the home, during this visit the
protocols for entering the service users home will be established between the
agency and service user. Following this the carers appointed to deliver the care will
be informed of the entry arrangements during their weekly supervision. For example,
this may be: ringing the door bell, knocking on the door or verbally announcing their
arrival, asking a neighbour to let them in etc.

2. On entry, if you are not known or recognised by the service user you should
introduce yourself and validate your identity by showing your Identity Badge. You will
be informed of any alternative arrangements for identification that have been made
for service users with communication difficulties.

3. Your manager will inform you of how the service user prefers to be addressed i.e.
Mr, Mrs, first name etc., please respect this at all times as it is the wish of the service
users.

4. It is not the policy of the company to hold keys for any service user's property, it is
strictly forbidden for any member of staff to hold service user’s keys.

5. In cases where a service user is immobilised or is unable to open the door for any
other reason, then the care manager will arrange with the local authority to have
either a door key safe or a coded security lock fitted. These codes are strictly
confidential and will be kept on the company database. It is most important that care
workers do not divulge this information to anyone else.

Leaving a Service Users Home

When leaving a service user home, it is the responsibility of care staff to ensure the home is
secured safely, when you leave you should ensure:

1. Any appliances not in use are turned off; this includes cookers, hobs, irons etc.

2. Clothes are not left to dry m front of fires

3. Taps are not left running

4. Keys are placed back m key safes and locked

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5. Doors and windows are locked when required

Action to be taken if entry cannot be gained

In the event that entry cannot be gained then the carer will:
▪ Look for obvious signs that may indicate if the service user is at home i.e. Is there
milk on doorstep, is there mail building up, are the curtains shut, are there lights on
m daylight hours.
▪ Look through the window to establish if the service user has fallen or m distress. If it
is evident that the service user is in distress or has fallen then immediately contact
your care manager who will inform you of what action to take
▪ Attempt to make your presence known by knocking on the window, or shouting
through the letterbox.
▪ Check to see if any doors are open, if so announce your presence verbally
▪ If at this stage, you cannot get a reply then check with neighbours who may have
further information about their whereabouts

After following the above steps, you are unable to establish whether or not the service user
is at home then immediately call the office and speak to the care manager who will advise
you what to do.

It is the responsibility of the care manager to take the following action:
• Attempt to contact the service user by telephone
• Attempt to contact the service users next of kin or key holder
• Check the company records to establish if the visit has been cancelled
• If at this stage the whereabouts of the service user is not established, then the care
manger will contact the Social Services emergency duty officer who will advise us of
what action the authority will take.The care manager and carer will keep in regular
contact by telephone m order to keep each other informed of any progress.

The company has a
range of key safes for
sale, if a service user
needs a key safe we

can usually fit in 24
hours.

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