support staff handbook - Cartrefi Cymru [PDF]

SUPPORT STAFF HANDBOOK

Issued May 2012

Contents

Section 1 – About this Handbook 1.1 1.2 1.3

About this Handbook The services we provide Further information on policy and guidance

Section 2 – Useful Contact Details

Section 3 – Supporting Service Users 3.1 3.2

Individual Support Plans Risk 3.2.1 Risk assessment 3.3 Consultation and participation 3.4 Finances 3.4.1 Service users’ finances 3.4.2 Acceptance of gifts and legacies 3.5 Management of behaviours that may challenge 3.6 Administering medication 3.7 Abuse of vulnerable adults: identification and notification 3.7.1 If you suspect abuse or if service users tell you they are being abused 3.8 Complaints and concerns 3.9 If a service user is detained by the police 3.10 Equal opportunities and culturally sensitive support

Section 4 – Employees’ Roles and Responsibilities 4.1

Standards of conduct and practice 4.1.1 Dress code 4.2 The range of Support Worker tasks 4.3 Employee identification 4.4 Dealing with emergencies 4.4.1 Calling the emergency services 4.4.2 If you are unable to gain access to a service user’s home 4.5 Training 4.6 Record keeping 4.6.1 Safekeeping of records 4.7 Confidentiality 4.8 The security and privacy of a service user’s home 4.8.1 Rights to privacy 4.8.2 When you enter a service user’s home 4.8.3 When you leave a service user’s home 4.8.4 Key holding 4.8.5 Working in a service user’s home in his/her absence 4.9 Relationships and standards 4.10 Disclosure of bad practice

Section 5 – Employees’ and Service Users’ Safety 5.1 5.2 5.3

Health and safety in a service user’s home Employee’s responsibility Safe systems at work 5.3.1 Lone working 5.3.2 Moving and handling 5.3.3 Control of infection 5.3.4 Hepatitis B and Tetanus immunisation 5.3.5 Protective clothing 5.3.6 Electrical safety 5.3.7 Gas Safety 5.3.8 Fire safety

5.4 5.5 5.6 5.7 5.8

Control of Substances Hazardous to Health (COSHH) Food safety and hygiene Reporting accidents and incidents Using your car in the course of your work Driving a company or Motability car

Section 6 – Code of Practice for Social Care Workers 6.1

Code of Practice for Social Care Workers

The layout and some of the content of this handbook are taken, with permission, from “Employees’ Operational handbook: Supported living and domiciliary services”, MENCAP Cymru. The modified version has not been approved or endorsed by MENCAP Cymru

Section 1 – About This Handbook 1.1

About this Handbook This Handbook is a practical guide for Cartrefi Cymru employees working in supported living and domiciliary services.

Section 1 – About This Handbook

1.2

The services we provide Cartrefi Cymru supports a range of people who need care and support. These include:      

People with learning disabilities People with mental health issues People with physical disabilities Older persons People who are elderly and mentally infirm People recovering from substance misuse

We also provide a range of services, including: 

Supported living This service is for small groups of people living in the same house and receiving 24-hour daily support. The service users are often tenants who pay the rent, and are therefore entitled to make all the decisions and choices in their home, with the appropriate level of support. Some service users may be home-owners.

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Sessional or floating support This type of service is for people living in their own home, either renting it as a tenant or owning it but receiving less than 24-hour support. In some cases, people live with their families, partners, friends or co-service users. These people have the same rights of choice and decision-making as people receiving a supported living service

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Care Homes This is where people live in care homes registered with the Care and Social Services Inspectorate Wales (CSSIW). Legally, they do not have the same rights as tenants, although it is Cartrefi Cymru’s approach to encourage choice in the same way.

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Short-stay respite care homes This is where people come to stay for short periods, typically a week, few days or a weekend to have a break from their main carers. This can be to give their carers a break or as a planned transition to more independent living. These care homes are also registered with the Care and Social Services Inspectorate Wales (CSSIW)

Section 1 – About This Handbook

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1.3

Home Care support This is a service which gives people in need extra support to manage at home. The service will typically enable people to stay independent for longer and will provide support to help people with their personal care needs, organising meals, shopping and collecting pension money.

Further information on policy and guidance This handbook is based on the more comprehensive policy, procedure, and guidance documents which are kept in the local Cartrefi Cymru offices, as well as in all care homes and supported living services. These documents include the:      

Company Policy File Human Resources Policy File Finance and ICT Policy File Health and Safety Handbook Employee Handbook, a copy of which is issued to all employees Supported Living Quality Manual

Whilst this handbook is intended to give quick, practical help, it will be necessary in many cases for you to consult the more comprehensive policies, procedures and guidance for the detail of company expectations.

Section 1 – About This Handbook

Section 2 – Useful Contact Details Head Office (Cartrefi Cymru)

5 Coopers Yard Curran Road Cardiff CF10 5NB

T:029 20 642250 F:029 20 642264

30 Dean Street Bangor Gwynedd LL57 1UR

T: 01248 360004 F: 01248 363155

Mid and East

Unit 27 Ddole Enterprise Park Ddole Road Llandrindod Wells Powys LD1 6DF

T: 01597 825566 F: 01597 825098

South and West

2 Waterton Cross Business Park South Road Bridgend Ind. Estate Bridgend CF31 3UL

Regional Offices: North and West

Local Office (please enter the details) On-Call number Front-line (please enter the details)

Section 2 – Useful Contact Details

T: 01656 655606 F: 01656 662583

Section 3 – Supporting Service Users 3.1

Individual Support Plans The support we provide to service users should be based on an Individual Support Plan. The Individual Support Plan may contain a number of elements such as a needs assessment, a Care Management Plan, a Person Centred Plan and risk assessments. The Individual Support Plan takes a ‘person-centred approach’ that identifies:  

What is important to the individual What we need to do to support her/him to achieve it.

The individual’s needs and choices are central to this approach. Service users must be helped to identify what activities they want to be involved in and how they would like to be supported. When people’s needs or choices change, we need to review their Individual Support Plan or particular elements of it. We may then have to change some of the support we provide to the person, and also review their risk assessments. A copy of each person’s Individual Support Plan is kept in their personal file in their home. It is important that you keep yourself up to date with the Individual Support Plan for each person you support. If you feel that the Individual Support Plan is not suitable or does not cover all aspects of the individual’s needs you should discuss this with your manager. For more information see the service users’ Individual Policies and Personal File

3.2

Risk

3.2.1 Risk assessment As an employee, you have a duty to manage risk to:    

Yourself The people you support Your colleagues The general public

Section 3 – Supporting Service Users

This is done by identifying any hazards or risks, assessing the seriousness of that risk, and putting precautions in pace to minimise the risk. Each service user’s personal file will include risk assessments that relate to their individual disability, support needs or lifestyle. It is your duty to make sure you are familiar with these before supporting the person, and to follow any instructions or guidance included in the risk assessment. You should not carry out risk assessments that you are not trained, competent or authorised to do. If you feel that a risk assessment is not suitable, does not cover all aspects it should, or there is no risk assessment in place, then please discuss it with your manager. The full risk assessment procedure is detailed in the main Health and Safety Handbook. Make sure you are familiar with this. For more details see individual risk assessments, Supporting Participation, Minimising Harm: The Assessment and Management of Risk and the Health and Safety Handbook.

3.3

Consultation and participation You must consult with the people you support before you make any decisions which may affect their life and the support they receive. This applies to changes to their Individual Support Plan. It also applies to all decisions about their daily life, such as choices of food and drink, how they spend their leisure time, what to watch on the TV and so on. Person Centred Active Support focuses on supporting people to engage in meaningful activities and relationships with an emphasis on helping people to become as independent as possible and play a full role in society. Some people may not be able to independently communicate their views and they may require an independent advocate to help them. For more details see the individual service users personal policies, the Communication with Service Users Policy, and the Company’s Charter for Involvement.

Section 3 – Supporting Service Users

3.4

Finances

3.4.1 Service Users’ Finances The people we support have the right to manage their own finances and decide on how they spend their money. Each service user must have an individualised finance policy that is drawn up after a financial assessment and risk assessment have been undertaken. These assessments will identify the level of support required. You must act in accordance with the finance policy for all individuals that you support in respect of financial matters. You must not use the service user’s money to pay for anything that is yours, the company’s or another service user’s responsibility. You must not borrow money from service users. You must not lend money to service users nor pay for goods or services on their behalf except in exceptional circumstances. You must ensure that you record all transactions involving a service user’s money that you have been involved in. You must do this on the service user’s personal income and expenditure record sheet which is kept in the service. You must ensure that a receipt is obtained for all financial transactions you have been involved in. Receipts should be kept with the service user’s personal money. You must ensure that you record all details relating to bank transactions that you have been involved in on the service user’s personal ‘income and expenditure record sheet’. These include cheque numbers, paying in slip numbers and amounts of deposits, withdrawals, any cheques raised to pay for goods and all relevant amounts. 3.4.2 Acceptance of gifts and legacies You must not accept gifts or hospitality from service users or their relatives except small token presents such as a small box of chocolates or bunch of flowers on an occasional basis such as Christmas or your birthday. You must notify your line manager if you accept gifts or hospitality from service users or their families. You must not be involved in drawing up the Wills of service users or their families, and you must not accept or receive gifts or legacies from their wills.

Section 3 – Supporting Service Users

For more details see the individual service user’s Finance Policy, Service Users’ Finance Policy and Procedural Guidance and Service Users’ Wills Policy.

3.5

Management of behaviours that may challenge Behaviours that may challenge the skills and commitment of a service have been defined as follows: “Culturally abnormal behaviours of such intensity, frequency, or duration that the physical safety of the person or others is likely to be placed in serious jeopardy, or behaviour which is likely to seriously limit use of, or result in the person being denied, ordinary access to ordinary community services” Examples of such behaviours can include excessive shouting, banging, rocking, saying the same thing repetitively, inappropriate sexual behaviour, refusing to move, hitting oneself or others. This list is not exhaustive. It is very likely that you will be required at some stage to support someone who presents a behaviour that may challenge your service’s skills. Cartrefi Cymru is committed to ensuring that you and your team have all the training and support needed in order to understand the causes of such behaviours and to support the person confidently, respectfully and safely. A lot of “challenging behaviour” is caused by poor support practice. For example, someone with autism may react badly to unexplained changes in their routine. Someone else may have a tooth ache that hasn’t been identified. Someone else may respond aggressively to a staff member who teases or goads them. It is therefore very important that you read and follow the up-to-date guidelines for each individual that you support and also attend any relevant training. The need to use physical restraint is very rare, and is never a substitute for good support practice. You must never participate in physical restraint under any circumstances unless you have been trained to do so. If you have any concerns about a service user’s challenging behaviour or the safety risks to yourself, the person or others, report them to your manager without delay. For more details see individual service user’s Behaviour Policies and Risk Assessments and the Policy on the Management of Challenging Behaviour for Staff.

Section 3 – Supporting Service Users

3.6

Administering medication The people we support must take as much responsibility as possible for looking after and administering their own medication. You must not give someone their medication unless it is clearly stated in their Individual Support Plan and Medication Policy that staff are required to do this. Whether or not it is required may depend on the nature of the support that Cartrefi Cymru has been contracted to provide. For example, we may be providing purely housing support, purely personal care or a mixture of the two. If you are unsure, ask your manager for details of the type of support you are expected to provide. Where you are required to administer medication, you must follow these procedures: 

All medicines should be prescribed by a qualified clinician and administered strictly according to their instructions.  The medication must be in packs or bottles prepared by a pharmacist. Over the counter medication maybe administered if identified in the service user’s medication policy  Before administering medication, you must have received appropriate training and be considered competent to do this by your manager. You must follow these steps whenever you are administering medicines: 1. Where more than one support worker is on duty, identify who is the lead person on the shift for administering medicines. 2. Make sure you know the uses of the medicine to be administered, its normal dosage, side effects, precautions and whether the medication may react with other substances, such as alcohol. 3. Make sure you are aware of the service user’s Individual Support Plan and risk assessments relating to medication or medical treatment. 4. Review the medication record to make sure the medication has not already been given, and to check whether there are any changes to how the medication is administered. This form will be in the service user’s personal file that is kept at their home. 5. Check that the instructions on the label of a medicine are clear and that you understand them. 6. Check that the person is not allergic to the medication before you give it.

Section 3 – Supporting Service Users

7. Give the medication; making sure you give:  The right dosage  At the right time  To the right person  In the right way 8. Complete the Medication Record to confirm that the medication has been given. Never give one service user’s medication to another service user, even if the medication is identical. If a service user needs advice or information on their medicines, or needs them packing in a certain way, ask the pharmacist supplying medicines to the service user for help. Make sure the service user understands how to store their medicines safely. If they carry their medicines with them during the day, make sure they also understand how to be responsible for the safety and security of their medication. Never offer medication unless it is prescribed by the service user’s GP. People have the right to refuse any medication. If this happens then you should look at the person’s risk assessment on medication, which should describe what action you should take. Contact your manager or on call manager without delay for advice about the service user’s refusal and make sure you record this is on the Medication recording sheet. For more details see the individual service users Medication Policy and the Code of Practice for Staff Involved in the Ordering, Storing and Administration of Medication.

3.7

Abuse of vulnerable adults: identification and notification We have a duty of care to protect our service users’ emotional and physical wellbeing and to support their rights. Abuse is not always obvious – you may just get a feeling that things are not right. If this is the case, it is important that you talk to your manager about this immediately, or discuss it with the on-call manager. Abuse may include: 

Physical abuse – such as hitting, misuse of medication, inappropriate restraint. Section 3 – Supporting Service Users

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Sexual abuse – such as rape, assault, inappropriate touching. Psychological abuse – such as threats, a service user being deprived of contact, for example, with family members or friends, humiliation, verbal or racial abuse, isolation. Financial or material abuse – such as theft, fraud, exploitation, misuse of a service user’s property, possessions or benefits. Neglect and acts of omission – such as ignoring a service user’s medical and physical support needs, withholding access to health, social care and education, withholding the necessities of life such as medication, food, drink or warmth.

You should look out for signs including:           

Bruises or black eyes Lack of food or drink Slap marks A stench or urine or faeces Dirty or unkempt appearance Drowsiness Blood staining of underwear without any apparent reason Denial of a person’s rights, such as choice, respect and privacy Weight loss Having no money Large rent arrears

You should also consider whether the service user has:     

Become withdrawn Become unhappy Had an unusual amount of visits to the Accident and Emergency department Become depressed or confused Been unusually demanding or seeking attention

Abuse may be committed by staff, friends, family, professionals, or the general public. If you suspect there may be abuse from any source you must report any concerns immediately to your manager– if you suspect that your manager may be abusing a service user, then you should make your report directly to their line manager or any other senior manager without delay. The three key principles to remember are:  Always treat service users with respect and dignity  Own up when you make mistakes in supporting people Section 3 – Supporting Service Users

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Always report things you see or hear and are not comfortable with

Any issues you report will be treated in a supportive and sensitive way. You also need to remember that if you do not report any concerns that you may have, you are allowing potential abuse to continue. You have a legal responsibility to report issues of abuse. 3.7.1 If you suspect abuse or if a service user tells you they are being abused You must:     

Report it without delay to your manager Listen to what the service user is telling you Observe the service user and what is happening to them Remember the service user has rights – of choice, opinions and privacy Respect the service user’s confidentiality and discuss your service user only with your manager

But don’t:      

Panic Accuse anyone of committing the abuse Tell anyone you are “reporting” them Document your suspicions in the communication book, diary etc Be judgemental Keep things to yourself – tell your manager

For more details see The Safeguarding Adults from Abuse – POVA Policy.

3.8

Complaints The people we support and other external people, such as family members, advocates, carers and external agencies, have the right to make a suggestion, voice a concern or complain about their service. Think of this positively, as a way of improving our services and meeting service users’ needs. You should help service users to understand their right to complain, to Cartrefi Cymru and to other agencies such as the CSSIW, the local authority, the police and their landlord. Every service user should have a copy of Cartrefi Cymru’s complaints leaflet, which explains the different routes available to them. If they do not have a copy, you should inform your manager at the earliest opportunity.

Section 3 – Supporting Service Users

Service users may bring day to day concerns to your attention. You should deal with these immediately, wherever possible, so that the person is satisfied. If they are satisfied with the response, enter all relevant details in the Complaints and Concerns book. You must report all complaints and concerns received to your manager. The manager will ensure that a record is made of each complaint, how each complaint was dealt with and what the outcome was. For more details see the Policy, Guidelines and Procedures for making Complaints or Expressing Concerns.

3.9

If a Service User is detained by the Police If a service user is detained by the police, you must notify your manager or the on-call manager without delay. If a person with a learning disability is detained, they must be assisted by an “appropriate adult”. An appropriate adult can be a relative, guardian or other person responsible for the person’s welfare. It can also be someone who has experience of dealing with vulnerable people, such as a social worker, but it cannot be a police officer or someone employed by the police. The police usually have access to appropriate adults, or to local organisations that train and support them. You should not act as the appropriate adult unless this is unavoidable and you are competent to do so. Your manager or the on-call manager must agree to this before you act as the appropriate adult. In particular circumstances you may be called as a witness when the detainee’s case comes to court, therefore the appropriate adult will not usually be a staff member from Cartrefi Cymru. For more details see the On Call Policy and individual personalised policies

3.10 Equal opportunities and culturally sensitive support Cartrefi Cymru operates a policy of equal opportunity in the employment of our staff. We also provide a non-discriminatory service to service users, regardless of colour, culture, political beliefs, racial origin, religion, class, gender, age, physical or mental ability, marital status, pregnancy, or sexual orientation or identity.

Section 3 – Supporting Service Users

We must ensure that our support to service users takes into account their specific attributes and is acceptable and appropriate to each person. This means we need to understand what is important to a person’s quality of life. For example, we need to consider:     

Food and drink Worship and celebration of particular festivals Dress Language How people choose to spend their leisure time

Staff will support service users in the most appropriate way to uphold their beliefs and chosen lifestyle, regardless of the staff member’s personal beliefs or preferences.

Section 3 – Supporting Service Users

Section 4 – Employees’ Roles and Responsibilities 4.1

Standards of conduct and practice Cartrefi Cymru’s work is driven by three commitments that people will be: o Respected o Safeguarded o Enabled These commitments clearly apply to the people we support and Cartrefi Cymru expects the highest standards of professional practice from our employees. Support Workers are first and foremost enablers rather than carers, even when you are providing service users with significant personal support. You must:            

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Only enter a service user’s home with the service user’s permission. Keep all matters relating to Cartrefi Cymru and its service users confidential. Respect the service user’s individual rights and choices. Promote the service user’s independence. Carry out tasks as identified in the service user’s Individual Support Plan, ensuring the service user’s dignity and privacy. Be punctual and support the service user for the full time allocated to them. Report any change in the service user’s condition or circumstances – particularly in relation to their physical and mental health to your manager without delay. Promote a healthy diet and general good health practice for service users. Comply with all Cartrefi Cymru policies and procedures. Treat the service user’s home and belongings with respect and report any breakages or damage immediately to your manager. Ensure your own safety by keeping the working environment safe. Report any changes in the work area which may pose a risk to yourself or the service user. Ensure the service user’s safety when you leave their property (if Cartrefi Cymru are key holders); check that all the doors are secure, the lights are turned off where appropriate, the windows are secure and all appliances are switched off as necessary. Act in a professional manner at all times and deliver the high standard and quality of care that is expected of you.

Section 4 – Employees’ Roles and Responsibilities

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Promote professional standards at all times and conform to the Code of Practice for Social Care Workers as set out by the Care Council for Wales, which can be found in Section 6 of this handbook.

You must not:             

Smoke in a service user’s home. Drink alcohol shortly before or during a period of work. Be under the influence of or suffering the after effects of alcohol or illegal substances while you are at work. Speak to service users disrespectfully or use offensive or patronising language. Use the service user’s things, such as the television, radio or telephone, or read the service user’s newspaper or letters unless the service user gives you permission. Use the service user’s toilet without the service user’s permission (although this can be assumed when working a long shift or a ‘sleep in’). Consume any food and drinks belonging to a service user unless there are approved arrangements for this. Ask your manager for confirmation. ‘Take over’ any part of the service user’s home – for example, you must leave items such as coats, shoes and bags in the service user’s home, including any designated sleeping-in room. Bring your family, friends or pets to the service user’s home, unless this has been agreed with the service user and your manager, in line with company policy. Hold meetings which do not include the service user in the service user’s home. Be in the service user’s home when the service user is not there – unless this is specifically required as part of the service user’s Individual Support Plan. Attempt any high risk procedure for which you have not been trained. Become involved in the service user’s financial affairs beyond the level of the support the person needs as identified in their financial risk assessment and Individual Support Plan. You must never be involved in any financial dealings with the service user such as loans, gambling, lottery syndicates, catalogue clubs or purchases from or to service users.

For more details see the Care Council for Wales Code of Practice for Social Care Workers and Employers of Social Care Workers (You should have received a personal copy of the Code – if not, please refer to your line-manager).

Section 4 – Employees’ Roles and Responsibilities

4.1.1 Dress code Support staff should dress appropriately for the activities for which they are supporting the service users. Care should be taken to: a) Avoid unintentional injury to service users (e.g. from wristwatches or jewellery worn by staff involved in personal care or manual handling) b) Reduce likelihood of injury to staff (e.g. by wearing neck chains) c) Avoid offence to people (e.g. unduly “skimpy” clothing) Please contact your line manager for confirmation of dress code during working hours. The company’s dress code is contained in Policy & Guidance on Standards of Dress for Staff which details dress codes for relevant situations and activities. The Policy aims to cultivate a positive and professional image of the company and its staff.

4.2

The range of support worker tasks You may be required to provide service users with different types of support, depending on the service user’s individual needs and on the type of service that Cartrefi Cymru has been contracted to provide. These may include: 

Housing support – This includes helping service users to understand tenancy agreements, pay their rent, report repairs, establish good neighbour relationships, carry out minor household maintenance, service and repair equipment, maintain accommodation security, etc.

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Practical support – This includes providing help with house cleaning, making beds, washing clothes, shopping, preparing food, disposing of rubbish, collecting benefits, using transport, budgeting and managing personal finances, arranging holidays and trips, etc.

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Support for rights and responsibilities – This includes helping service users to develop and maintain valued roles and relationships, maintain their religious and ethnic identity, secure equal treatment, understand what is lawful and culturally appropriate behaviour, maintain personal safety and others’ safety, vote, participate in leisure and educational interests. etc

Section 4 – Employees’ Roles and Responsibilities

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4.3

Personal support – This includes providing help with personal hygiene, going to the toilet, eating and drinking, dressing and undressing, taking medication, lifting, ensuring a service user receives basic health care, maintaining a healthy lifestyle, and so on. The service user’s Individual Support Plan should set out which types of support they require and how you should give that support. The aim in all circumstances is for you to enable and actively support people to do things for themselves as independently as possible even if, to begin with, a service user is dependent on you to do it for them.

Employee identification As an employee of Cartrefi Cymru you will have been given an ID card. You must show this card to all new service users and use it as a form of identification when required, such as supporting someone at the bank or hospital.

4.4

Dealing with emergencies Emergencies may arise through property damage, a breakdown in services or by events such as an accident, ill health or dangerous behaviour. Wherever possible you should avoid or minimise emergencies by careful planning, preparation and helping the service user to understand danger and dangerous practices For example, avoid dangers from fire by advising service users on how to use cookers safely, how to dispose of cigarettes safely and the safety benefits of smoke detectors. You should also advise service users what to do in the event of a fire, such as how to evacuate the premises and call the emergency services on 999. It is your responsibility to:     

Be aware of and follow Cartrefi Cymru’s operational and health and safety policies. Follow management advice to ensure your working practices are safe. Minimise risks to yourself and others. Report dangers, and any changes to the service user or their environment that increase the risk of harm. Report any injury or personal incapacity that may affect your ability to work safely to your manager.

Section 4 – Employees’ Roles and Responsibilities

When dealing with emergencies you should:     

Stay calm Assess the situation and choose a course of action that does not unnecessarily put you or others at risk Reassure service users Call the appropriate emergency services if necessary Contact your manager

A manager is contactable on the telephone during office hours. An on-call manager is also available to respond to emergencies outside office hours. You should write their contact number in Section 2 of this handbook. There is a Senior Manager on call 24 hours per day. 4.4.1 Calling the emergency services In the event of an emergency, call the appropriate emergency service by telephoning 999. Call your manager or the on-call manager if necessary and ask for advice. In cases of death, serious injury, or where the news media could become involved, ring the Senior Manager On-Call (or ask the local on-call manager to do so). 4.4.2 If you are unable to gain access to a service user’s home Telephone your manager or the On-Call manager, who will telephone the service user. If there is no reply, you should follow this procedure:     

If the property is on the ground floor, check through windows and letterbox. Check with neighbours. Leave a calling card or note. Your manager will telephone the service user’s representative. Check with local ambulance control that no emergency admission has been taken from the service user’s address.

Your manager will inform the service user’s social worker or the local authority to discuss options, including whether a forcible entry by the police is needed. Never attempt a forcible entry without the police or the service user’s representative present.

Section 4 – Employees’ Roles and Responsibilities

4.5

Training You should not carry out any task that you have not been trained to do or that you do not feel able to carry out. It is your line manager’s responsibility to make sure that you receive the training needed to ensure that you are capable of carrying out your role. You will be expected to successfully complete Cartrefi Cymru’s induction process and probationary period. It is important that you take part in any other training that is needed which includes working towards the QCF qualification relevant to your role. For more details see the Training and Development Policy.

4.6

Record Keeping Service users’ records are an important part of professional practice. We are required by law and by contracts with the organisations buying our services to keep accurate records. Service users’ personal files are kept in the service user’s home if that is where some or all the support is provided. In exceptional circumstances, where the service user does not wish records to be kept in his/her home, arrangements will be made to store them in the local office and there will be a written record of this arrangement. The files must contain all the personal information about the service user that relates to their health and safety, and care and support. For more in-depth information on what personal files should contain, please see the Supported Living Quality Manual (section 1.8.4). Best practice in record-keeping includes:     

The participation of the service users in making and maintaining their own records Signing and dating all records Writing clear, factual, accurate entries using ink and not pencil. (Never using Tippex or its equivalent; mistakes must be neatly crossed out and corrected Avoiding abbreviations, jargon, speculation or statements of opinion Maintaining confidentiality on the “need to know” principle Section 4 – Employees’ Roles and Responsibilities

It is important to remember that the service users have a right of access to their records, and have the right to take legal action if confidentiality is broken, or a record is considered to be inaccurate or offensive. 4.6.1 Safekeeping of records The manager of the service will arrange, with the permission of the service user, for records that are not in active use to be archived appropriately. For more details see the Supported Living Quality Manual.

4.7

Confidentiality We keep records for monitoring and for legal purposes. Service users’ records are subject to legislation concerning who may have access to them. The documents must be kept private. Service users’ records should be read only by those who need to know the details contained in them. Access should be restricted to:     

The service user Employees providing support Internal managers Social services and health employees in line with agreed protocols Those involved in the statutory inspection of the service, or who have a legal right to see the records

Access to service users’ records by outside bodies should only be allowed with the individual’s permission. A service user’s family members may have access to the service user’s records only with the service user’s permission. NOTE: These provisions are subject to Best Interest decisions in the case of someone who does not have “capacity” under the terms of the Mental Capacity Act 2005. In addition, it is important that you do not make any reference to your work, the service location, the people you support, or your colleagues, through text messages, e-mails or on social network sites as this could constitute a serious breach of confidentiality For more details see the Confidentiality Policy.

Section 4 – Employees’ Roles and Responsibilities

4.8

The security and privacy of a service user’s home

4.8.1 Rights to privacy Service users have the right to give you or deny you access or to ask you to leave their home at any time. You are effectively a visitor to the person’s home and must accept any reasonable conditions that they may ask of people entering the place where they live. However, you have a duty of care to protect the safety and well-being of the service user and other people. In situations where a service user puts themselves or others at immediate risk of danger, you may intervene in an appropriate way to prevent people being harmed. 4.8.2 When you enter a service user’s home You must:    

Knock on the door or ring the door bell and wait for the service user to open the door; if the service user is unable to come to the door to let you in, you must announce who you are before you go in. Ask the service user if you can go in. If the service user says “no”, ask why and then get advice from your manager, on-call manager, or other appropriate manager as soon as possible. When you go in, put your belongings including mobile phones in the sleepin room (if there is one) or ask permission to place them somewhere acceptable to the service user. Agree with the service user what you will be doing on this visit.

4.8.3 When you leave a service user’s home You must:    

Check who is present and make sure the service users are safe before you go. Check for any health and safety risks and, with the service user’s permission, make them safe. Check all windows and doors and agree with the service users which, if any, need to be closed or locked. Tell the service user when you are going and close the door behind you.

Section 4 – Employees’ Roles and Responsibilities



If you have been unable to agree with the service user on any matter relating to risk, inform your manager, on-call manager or other appropriate manager as soon as possible.

4.8.4 Key holding You will not usually have the keys to a service user’s home unless a risk assessment and management plan has identified that staff need to enter the premises with a key for safety reasons, or the service user cannot give you access in the normal way. In such cases the service user or representative will confirm in writing that staff may have keys to the property. For security purposes one or more of the following arrangements will be in place:   

A key safe external to the property. Keys for the property will be stored in the Area Office. Keys will be labelled with the service user’s first name but not the address.

If you are required to hold keys for a service user’s home, you must follow these principles and practices:     

If the keys are collected from the Area Office, sign a record to confirm that you have taken the keys. Keep the keys in a safe place. Do not attach any identification to the keys, other than the service user’s first name. If the keys are collected from the Area Office, return them for safekeeping, and record that they have been returned. If the company stops providing support for the service user, it is your manager’s responsibility to collect all keys and return them to the service user or their representative.

For more information, see Entering A Service User’s Home: Policy And Guidance; and Key Holder Policy 4.8.5 Working in a service user’s home in his/her absence If the service user is not at home you should not go there to do any work unless you have the service user’s consent or a written protocol is in place If a service user gives consent for you to visit their home while it is unoccupied you must inform your manager who will then decide whether to permit the arrangement. Section 4 – Employees’ Roles and Responsibilities

4.9

Relationships and standards The Company appreciates that there are many good reasons why a support staff member might develop a social relationship with someone he or she supports or with a member of their family. There are also good reasons why people need protection from a support staff member who might take advantage of a social relationship. Subject to a number of conditions, it is permissible for staff to:     

Form a friendship with someone they support (and their family). Include someone they support within their own social network. Invite someone they support, with whom they have a friendship, to visit their own home or that of a friend or family member. Visit someone they support, with whom they have a friendship, when they are off-duty. Take part in social activities with someone they support, with whom they have a friendship, when they are off-duty.

The conditions which must apply are as follows:  



Your line manager must be made aware if a friendship is developing between you and a service user. If a friendship exists this must be routinely discussed during your supervision meetings so that your manager can judge its appropriateness and its impact on the service user. If a friendship exists your manager will make sure that all appropriate parties are aware of it (this includes meetings with family members, advocate, care manager, person-centred planning group, circle of support etc). An individual agreement must be drawn up setting out clear guidelines in relation to the friendship.

For more details see the policy and guidance: Managing the Boundary Between Professional And Social Contact With The People We Support.

4.10 Disclosure of Bad Practice The company encourages members of staff to use the internal line management structure and other internal mechanisms to report any bad practice or illegal acts or omissions by its employees. The company seeks to ensure that anyone who identifies or suspects bad practice is able to raise concerns without fear of intimidation or harassment, and Section 4 – Employees’ Roles and Responsibilities

be confident that these concerns will be properly investigated and dealt with. What is “bad practice”? It is not possible to list every type of bad practice but the term would certainly include the following:          

Abuse of a service user by a member of staff at any level. Neglect in dealing appropriately with complaints of abuse. A criminal offence which has been committed, is being committed or is likely to be committed. Actual or suspected fraud, financial dishonesty or breach of financial procedures. Damage to property. A failure to comply with a legal obligation. Ignoring or failing to act on a danger to the health and safety of service users or employees. Breaches of company policies and guidelines. Breaches of reasonable directions from management. Attempts to cover up any of the above matters.

Ordinarily, concerns about bad practice in these or any other areas of Company business must be reported to the appropriate manager as quickly as possible. When to use the “whistle blowing” procedure There may be circumstances when matters need to be handled in a different way, and where employees need to be able to raise their concern outside the usual channels, safely and urgently. A range of circumstance may make it necessary to resort to the whistle blowing procedure:    

Personal fear (of recrimination, intimidation, bullying, etc). The complex or extreme nature of the bad practice. The possible of involvement or collusion between colleagues and/or managers. Situations where attempts to use alternative procedures have not been taken seriously or have been sabotaged.

In circumstances where there appears to be no alternative course of action for any of the above reasons, the whistle blowing procedure should be followed. For more details see: Whistle blowing: Policy, Guidance, and Procedures.

Section 4 – Employees’ Roles and Responsibilities

Section 5 – Employees’ and Service Users’ Safety 5.1

Health and safety in a service user’s home For more details on all health and safety matters, see the Health and Safety Handbook. Although you have a duty of care to service users, you have no legal powers to compel people to change their behaviour or the way they live, in order to reduce the risks of harm or injury to them or others. You have a duty to inform and advise service users to minimise the risks to themselves and others. You also have a duty to not put yourself at risk in the course of your work. In supporting service users to reduce risks, you cannot, in the normal course of events, make a service user’s private dwelling safe if this is against the service users wishes, nor can you enforce changes to their lifestyle. However, in certain circumstances the degree and immediacy of the risk may mean that you need to intervene, and this is allowed by law. When you are working in the service user’s own home it is regarded as a ‘workplace’ in respect of the health and safety responsibilities of Cartrefi Cymru and our employees. You are expected to work to the same safety standards in the service user’s private home as you would in any other work environment. However, as discussed in section 4 of this handbook, it is important to respect the privacy of the service user’s home. For example, you should ensure that information such as organisational guidance, manuals and notices are kept and displayed only in the staff sleep-in room (if there is one) or otherwise kept out-of-sight in a agreed place such as a cupboard.

5.2

Employees’ responsibility All employees must co-operate and share responsibility for the full and correct implementation of the Company’s health and safety policy. In particular, it is your responsibility to:  

Be aware of, understand and observe the current Cartrefi Cymru health and safety policies and procedures. Know where to find the HSE poster ‘Health and Safety Law’ and the Health and Safety Manual in your local office. Section 5 – Employees’ and Service Users’ Safety

     



Use appropriate protective clothing where there is a risk of infection. Report any dangerous occurrences or potentially dangerous situations to your manager or the on-call manager. Let you manager know if you have any injuries that could affect your normal ability to move or safely handle either inanimate objects or service users. Follow management advice and ensure you use safe working practices. Work in a manner that will not be detrimental to your own health and safety. Report any changes in the service user’s health, environment or working conditions that might have a bearing on the welfare and safety of the service user or the health and safety of anybody else – including employees. Always make sure you know and understand the details of the service users individual support plans and risk assessments.

It is also your responsibility make sure that you do not carry out any tasks that you are not trained or authorised to do. If you notice significant changes in a service user’s physical or mental health, you should encourage the service user to visit the appropriate health-care professional. You must keep a record of the service user’s health and treatment and report any concerns to your manager.

5.3

Safe Systems at Work

5.3.1 Lone working Employees working alone, particularly in unfamiliar surroundings, are more at risk than staff who are working with colleagues in secure workplaces. Although the additional risk is small, there are precautions you can take to reduce that risk even further. Follow these procedures to ensure safe work systems:    

Don’t make night-time and late evening visits to unknown people in unknown circumstances. Make sure you have up-to-date and accurate information about new service users before you provide support. Before you visit the service location make sure that your manager has carried out a risk assessment for the service user and the service user’s home. Inform your manager immediately if you believe your personal safety may be unduly at risk from anyone or anything in connection with the service being provided.

Section 5 – Employees’ and Service Users’ Safety

 

If your safety or welfare is threatened in any way, leave the situation as soon as possible, making every effort to minimise any risk to service users and others, and make sure that this is reported to your manager or on call. Make sure that the local office has an up-to-date list showing where and when you will be working.

You must report any concerns about your safety to your manager immediately. You must tell him or her in advance if you are not able to provide a planned session of support to a service user for safety reasons. For more details see the Lone Worker Policy. 5.3.2 Moving and handling Never carry out a moving and handling procedure for which you have not been trained or which you do not feel able to perform. If you ever feel unsure about how to move or handle an object or service user, telephone your manager and ask for further instruction or training before you attempt the move. Your manager, along with the service user’s representative or a specialist adviser, will assess the service user who needs lifting, to determine the most appropriate method of moving and handling. Your manager will then make sure this detail is in the Individual Support Plan and risk assessment. You must follow the Individual Support Plan and risk assessment and inform the manager of any changes that could be detrimental to good moving and handling practices. These could be changes affecting the service user, the environment or your own health conditions. You should be aware of current legislation relating to the correct techniques for moving and handling people, and you will be trained on these techniques as a part of the company induction process. The Individual Support Plan should state when moving and handling activities should be reassessed, and this should be agreed by your manager. You should attend a moving and handling course. This should be shortly after you start work with Cartrefi Cymru and certainly before you attempt to move a person in the course of your work. If you are not able to move a service user or have difficulty in doing this as set out in the Individual Support Plan and risk assessment, then do not move the service user. Make the service user safe and comfortable, and call your manager or on-call for assistance. Do not try to move the service user in any other manner apart from the one detailed in the Individual Support Plan, as this will put the service user and yourself at risk. Section 5 – Employees’ and Service Users’ Safety

If you are unable to move any object, or have difficulty doing so, ask a colleague for assistance or leave the object until help is available. Do not attempt to move the object using bad manual handling practices; your first responsibility in this situation is to your own health and safety. If the Individual Support Plan and risk assessment state that a hoist must be used then under no circumstances must you move a service user in any other way. You must be trained by a competent person in the use of a particular hoist before you attempt to use it. If a service user refuses to be moved by hoist when a hoist has been assessed as the correct method of moving them, you must not attempt to move the service user in any other way but call your manager for advice. 5.3.3 Control of infection You will not normally work in situations where the risk of serious infection is any different from those in most domestic environments. However, at all times you must follow good infection control practice in order to protect service users, yourself and other employees. Good practice in providing personal support seeks to eliminate the risk of cross infection or disease, even if a service user or employee is not thought to have any illness or infection. It is your responsibility to:      

Inform your manager without delay if you or any member of your family develops an infectious disease. Report to your manager if you are suffering from diarrhoea and/or vomiting. Always cover any broken skin with a waterproof dressing. Always wash your hands thoroughly before and after you deliver any personal care. Ensure that you use the protective clothing provided appropriately and that you dispose of the contaminated clothing carefully and in accordance with the local arrangements for this. Monitor supplies of protective clothing and ask for new supplies before stocks run out, allowing time for postage.

Always use gloves and aprons when you are:  

Delivering personal care to a service user. Dealing with an injury to a service user. Cleaning a commode or toilet. Section 5 – Employees’ and Service Users’ Safety

 

Sluicing soiled bed linen. Do not sit on the service user’s bed or the area which has been soiled. Disposing of, or cleaning up, any body fluids or waste, including disposing of soiled pads.

5.3.4 Hepatitis B and tetanus immunisation If you support an individual who is known to have Hepatitis B or similar, your line manager will ensure that appropriate risk assessments and training is provided to ensure that risks to yourself are minimised., Cartrefi Cymru strongly recommends that in such circumstances employees are immunised and will reimburse any associated costs, provided a doctor’s receipt is provided. You must work in a way that minimises the risk of an infectious disease being transmitted to yourself or others 5.3.5 Protective clothing Cartrefi Cymru provides protective clothing needed for delivering personal care to service users. 5.3.6 Electrical safety When working in a sessional support (i.e. not 24 hour) service you must connect any electrical equipment you use to a Residual Current Device (RCD) or circuit breaker to minimise any risk to yourself from potentially faulty appliances. Use only one appliance at a time when you are using an RCD. In 24 hour supported living houses, all electrical appliances are tested annually for safety so an RCD is not necessary. You must be aware of safety at all times when you are using electrical equipment in a service user’s home. Always visually inspect appliances before you use them and follow the manufacturer’s instructions when they are available. If you or another employee have identified or suspect a hazard in relation to any appliance, do not use that item of equipment. You must advise the service user to not use that appliance until it is repaired or replaced. Make sure you make a note of the hazard and the advice given in the service user’s personal file. You should continue to monitor the situation and support the service user to find either a qualified electrician to repair the appliance or a store where they can buy a replacement.

Section 5 – Employees’ and Service Users’ Safety

5.3.7 Gas safety As part of their risk assessment, we always advise service users to have gas appliances serviced regularly. Some people are eligible for free safety checks on their gas appliances and installations. In rented property, the landlord or their agent is usually responsible for organising regular servicing and maintenance of fixed gas appliances such as boilers. If the service user owns any gas appliances you should advise them to have those appliances regularly serviced. What to do if you smell gas:   

Open all the doors and windows, to get rid of the gas and let the air in. Check whether the gas has been left on or whether the pilot light has gone out. Do not relight the gas pilot light until the gas has dispersed fully.

If there has not been a pilot light error, or an appliance that was not lit, then there is the possibility of a gas leak         

Turn off the whole gas supply at the meter. Call the gas emergency services on 0800 111 999. Do not touch any electrical switches, including light switches and door bells. Do not use matches or any naked flames. Do not smoke. Escort service users away from the area, near an open door or even out of the building. If you need to contact the emergency services, dial 999. Contact your manager or the On-Call manager as soon as it is safe to do so. Service users’ and employees’ safety must come first. Only return to the area or the building once the gas has dispersed. It may be necessary to ask a neighbour for help, to give you and/or the service user temporary accommodation until the leak is fixed.

For further information see individual Fire Evacuation Policies and Service Grab File or Emergency File 5.3.8 Fire safety You have an important role in helping service users to prevent fires in the home and also helping them to deal with any fires safely if they do occur.

Section 5 – Employees’ and Service Users’ Safety

You should advise service users:        

Not to smoke in bed Not to leave appliances plugged in overnight Not to leave pans unattended on cookers To dispose of rubbish appropriately and regularly To ensure that flammable liquids are stored safely To have smoke detectors fitted If there are any dangerous appliances in their homes What to do if they discover a fire

You should also:  

Be aware of the exits from homes and check that doors and windows open easily Check the location of any smoke detectors and fire extinguishers

In the event of a fire:      

Telephone 999 immediately for the fire service Remain calm and if possible escort the service users out of the home Get out Do not stop to collect possessions Stay out Do not re-enter the building until the fire officer has told you it is safe to do so

For further information see individual Fire Evacuation Policies and Service Grab File or Emergency File

5.4

Control of Substances Hazardous to Health (COSHH) The Health and Safety at Work Act regulations require employers to carry out an assessment of risks to employees from substances employees may be in contact with in the workplace. In domiciliary and supported living services, your workplaces may be the service user’s private home. Cartrefi Cymru and its employees do not have the final say over any substances present in a service user’s home. However, it is a requirement that you do not put yourself at risk and advise service users on how to use and store those substances safely. Before we provide support, the manager visits the service user’s home and formally assesses any risk to Section 5 – Employees’ and Service Users’ Safety

employees from substances found there. You should find a copy of the COSHH risk assessment in the service user’s personal file at their home. Read this risk assessment to make you aware of any risk that has been identified.

5.5

Food safety and hygiene Unless your manager tells you otherwise, you are expected to monitor how service users store, handle and prepare food according to good food hygiene practices. Training on this subject is available; please speak to your line manager for further details. You are also expected to give advice and guidance to the service users on those matters to reduce the risks of ill health associated with poor food hygiene. In some cases you may be directly involved in preparing food in a service user’s home. Whether you are monitoring or directly involved, you should observe the following principles, to reduce the risk of any germs growing and spreading, which could cause illness: 







Maintain good standards of personal hygiene: o Wash your hands before and after handling food (particularly meat) o Wash your hands after going to the toilet o Use plasters to cover cuts and sores. Cook and heat foods thoroughly: o Proper cooking kills bacteria. It is important to cook foods right through to the middle, particularly meat o Follow the instructions when you are cooking ready prepared meals and make sure they are ‘piping hot’ all the way through o Do not re-heat foods more than once. Store food properly and at the right temperature o Keep foods in the recommended compartments of the fridge and freezer o Do not use foods after their ‘use by’ date o Keep raw and ready-to-eat foods separate o Use different chopping boards for raw food and ready-to-eat food o Clean all knives and other utensils thoroughly after use. Keep the kitchen clean: o Keep animals out of the kitchen o Mop up all spills immediately o Make sure that all surfaces are kept free of dirt and food particles o Regularly clean all surfaces and kitchen equipment.

Section 5 – Employees’ and Service Users’ Safety

5.6

Reporting accidents and incidents If any accident happens that results in injury to you or your work colleagues, you must report it immediately to your manager or the on-call manager. You must also report serious injuries to service users that occur while they are being supported by Cartrefi Cymru staff, or to members of the public while visiting a Short Stay or Registered house. If the accident is serious, you should call the emergency services first: telephone 999 and then call the Cartrefi Cymru office or the on-call manager. If you are involved in or you witness an accident or incident, you must complete an Accident and Incident (A&I) form and return it to your manager. More serious accidents and incidents may need to be reported to the Health and Safety Executive. You must record and report these in the same way, using the A&I forms, and they will be properly reported by a member of the Health and Safety section. These forms are available from your manager. You must also make an entry in the accident book at the service. It is your responsibility to ensure that you follow all Cartrefi Cymru policies and procedures in order to minimise the risk of any accidents.

5.7

Using your car in the course of your work A service user’s Individual Support Plan may specify that a person should be taken on social trips out, go shopping or be taken to meetings and so on. You should use public transport for these trips, but in some circumstances your manager may ask you if you wish to use your car. Unless it is a requirement of your job, you can choose whether or not to use your own car to undertake a work-related task while you are on duty, which might involve the transport of a service user. If you do agree to use your private transport for work you must do as follows:  

Never agree to take a service user in your car unless it is already detailed in the support plan and your manager knows and gives their permission. Your insurance policy must include occasional business use otherwise you will not be insured to drive while in work time. This applies to taking service users in your car, travelling between services or attending training courses if you are claiming mileage expenses.

Section 5 – Employees’ and Service Users’ Safety

 

Give your manager a copy of your driving licence, MOT and insurance certificate, which they will keep on file. You will need to do this every 12 months. For more details see Travel and Subsistence Policy. When you have a service user in your car you must not have anyone other than staff members or other service users in the car at the same time. In other words, you must not give anyone outside the Company a lift when using your car to take service users out.

You can claim any reasonable travel expenses incurred in the support of a service user from Cartrefi Cymru. These will be at the current agreed rates. You must have prior approval from your manager. You must not take money directly from a service user for transport (or any other reason) to cover the cost of your personal expenses. This is not acceptable and will be considered a serious breach of policy. You must make claims for workrelated expenses directly to Cartrefi Cymru who will reimburse you for legitimate expenses incurred in the course of your work. We may ask service users to make a reasonable contribution to the travel cost of the service they receive but this is collected as a payment to Cartrefi Cymru, not the employee, and will be arranged by the manager.

5.8

Driving a company or Motability car As part of your job you may be required to drive a company car or a car privately hired by the service user you are supporting through the Motability scheme. To drive these cars you must provide your manager with copies of both parts of your driving licence, i.e. the paper part and the card. This will show any motoring convictions you have; if you have a lot of motoring convictions or have been banned in the last 5 years it may affect your ability to drive company or Motability cars. You do not need additional insurance to drive these cars as they are covered by either the Company or Motability. If you are required to drive a Motability car in a sessional (i.e. not 24 hour support) service, ask to see the insurance policy to ensure you are covered to drive. This is especially relevant if the service user lives at home with their family, as the family members may be the only named drivers. It is your responsibility to check the insurance on any cars you drive. Remember that driving without insurance is a criminal offence. If you are convicted of any motoring offence at any time you must report this to your line manager immediately to ensure you are still covered to drive by the insurance policies in place. Section 5 – Employees’ and Service Users’ Safety

If you are found by the police to be under the influence of drink or drugs while driving, you must inform your manager immediately and not wait for the conviction to be processed through the courts.

Section 5 – Employees’ and Service Users’ Safety

Section 6 – Code of Practice for Social Care Workers 6.1

Code of Practice for Social Care Workers: Care Council for Wales The code, set out by the Care Council for Wales, describes the standards of conduct and practice within which social care staff should work. In summary, these are: Social Care workers must: 1. Protect the rights and promote the interests of service users and carers: 2. Strive to establish and maintain the trust and confidence of service users and carers; 3. Promote the independence of service users while protecting them as far as possible from danger or harm; 4. Respect the rights of service users whilst seeking to ensure that their behaviour does not harm themselves or other people; 5. Uphold public trust and confidence in social care services; and 6. Be accountable for the quality of their work and take responsibility for maintaining and improving their knowledge and skills. You should have received a copy of the Code when you commenced employment. If you have not, please ask your manager for a copy as soon as possible.

Section 6 – Code of Practice for Social Care Workers