Safe Care and Treatment

Assessing risks to the people we support is an essential part of the regulation.

To meet the regulation, risk assessments must be carried out by people with the necessary skills, competence and experience. Normally, this is the registered person or Designated Health and Safety Lead, although can be delegated to anyone else that is suitably skilled.

Once risks have been assessed, plans must be developed for managing those risks.

Risk assessments should be reviewed regularly, and whenever there has been a change in someone’s needs or wishes about how risk is being managed.

See: Assessing and Monitoring Health and Safety Risk

See: Risk Assessment (person-centred)

All staff must have the qualifications, skills, competence and experience to keep people safe. The registered person must make sure training and supervision is provided before allocating related tasks to staff.

Nobody must carry out tasks they have not been trained to do.

If anyone has concerns about their ability to carry out the tasks they have been asked to do safely, those concerns must be raised swiftly to a manager or the registered person. The manager or registered person must take those concerns seriously and arrange any appropriate training or supervision to develop competence.

Whilst developing skills and competence, staff must receive appropriate levels of supervision or support from colleagues or a relevant professional. That person must be able to assess when the staff member is able to complete the task independently.

The service must have systems and processes in place to ensure that premises and equipment are safe. These processes must reflect any requirements around specific types of equipment e.g., lifting equipment.

The overall responsibility for ensuring premises and equipment are safe is the responsibility of the registered person. This cannot be delegated, even when an external contractor carries out maintenance works or repairs.

Nobody must use equipment until they have been appropriately trained and supervised. Induction plans should set out training requirements.

Staff must never use equipment that appears to be faulty. Systems must be in place to report such concerns and rectify the problem. If problems cannot be rectified, a contingency plan must be in place.

All staff must know how to report accidents, injuries and incidents relating to premises or equipment.

See: Accidents, Injuries and Incidents

The financial plans of the service must factor in costs for maintaining premises and equipment.

Nobody must use equipment until they have been appropriately trained and supervised. Induction plans should set out training requirements.

Staff must never use equipment that appears to be faulty. Systems must be in place to report such concerns and rectify the problem. If problems cannot be rectified, a contingency plan must be in place.

All staff must know how to report accidents, injuries and incidents relating to premises or equipment.

See: Accidents, Injuries and Incidents

Nobody must administer medication until they have received the appropriate training and are skilled to do so. This may mean specialist training for some medication types e.g., medication administered non-orally. The registered person must take steps to ensure that medication training is refreshed and does not expire.

Policies and procedures around medication must reflect current national guidance and include the following areas:

• Supply and ordering;
• Storage, dispensing and preparation;
• Administration;
• Disposal;
• Recording.

All staff must follow policies and procedures about managing medication.

For further guidance see: Medication Support

Medicines that are prescribed should not be allowed to run out.

The amount of prescribed medication available should be enough to cover any emergency periods. For example, if a pharmacy delivery is late or weather has prevented the pharmacy from getting a delivery.

Medical devices and equipment must be available when the person needs them and in good working order.

For further guidance see: Medication Support

The policies, procedures and processes to prevent and control infection should follow the Health and Social Care Act 2008 Code of Practice:

Health and Social Care Act 2008: Code of Practice for health and adult social care on the prevention and control of infections and related guidance.

However, if the registered manager wishes to implement equivalent or better measures than those in the Code, they can do so if the safe care and treatment regulation continues to be met.

When assessing risks from infection, the link between infection, cleanliness, medication management and antimicrobial stewardship (the use of antibiotics and similar medicines) should be clear.

For further guidance see: Infection Prevention and Control

If the person being supported is also using another service, we must make sure that we work with that service to ensure that care and treatment is safe across all provision. 

This includes sharing relevant information about risk, planning joint contingencies, making sure equipment and medication is available and any other action to ensure care and treatment is safe.

This also applies if a person is transitioning from one service to another, goes into hospital, is arrested, is sectioned under the Mental Health Act etc.

Note:  The legal responsibility for making sure care and treatment is safe across all provision lies with the principal provider - the one that provides the most support to the person.

Note: Information sharing must take place in line with legal requirements.

See: Confidentiality and Information Sharing

All incidents of unsafe care or treatment must be properly recorded and reported in line with the process for reporting accidents, injuries and incidents.

See: Accidents, Injuries and Incidents

If the incident of unsafe care or treatment is or may be abuse or neglect, a safeguarding concern should also be raised to the local authority.

See: Recognising Abuse and Neglect

See: Disclosure and Raising a Concern

There may be a legal requirement to report incidents of unsafe care or treatment to the Health and Safety Executive, CQC or commissioning body.

See: Accidents, Injuries and Incidents

If serious physical or psychological harm has occurred, the duty of candour may also apply.

See: Duty of Candour