AR42-Access To People's Homes Policy and Procedure

AR42 - Access to People's Homes Policy and Procedure
Administration - Registration & Compliance
Tailored Care Services Ltd

Office S11, Flexspace, Monckton Road , Wakefield, West Yorkshire, WF2 7AS
Review Sheet
Last Reviewed Last Amended Next Planned Review in 12 months, or

22 Oct '20 22 Oct '20 sooner as required.
Changes are important, but urgent implementation is not

Business impact
required, incorporate into your existing workflow.
MEDIUM IMPACT
Reason for this review Scheduled review
Were changes made? Yes
The name of this policy has changed from 'No Reply Policy and Procedure' to 'Access to
People's Homes Policy and Procedure'. This policy details the steps that must be taken
Summary:
when a member of staff is unable to gain access to a person's home for an
agreed/scheduled visit. The policy title has been updated to reflect CQC language.
• The Care Quality Commission (Registration) and (Additional Functions) and Health and
Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2012
• The Care Act 2014
Relevant legislation:
• Human Rights Act 1998
• Mental Capacity Act 2005
• Mental Capacity Act Code of Practice
• Author: Care Quality Commission, (2017), Key lines of enquiry, prompts and ratings
characteristics for adult social care services. [Online] Available from:
http://www.cqc.org.uk/sites/default/files/20171020-adult-social-care-kloes-prompts-and-
Underpinning characteristics-final.pdf [Accessed: 22/10/2020]
knowledge - What have • Author: UKHCA (United Kingdom Homecare Association), (2019), No Reply Policy
we used to ensure that Guidance: Responding to situations where service users do not appear to be at home.
the policy is current: [Online] Available from: https://www.ukhca.co.uk/downloads.aspx?ID=267 [Accessed:
22/10/2020]
• Author: The Metropolitan Police, (2020), Herbert Protocol. [Online] Available from:
https://www.met.police.uk/herbertprotocol [Accessed: 22/10/2020]
• Encourage sharing the policy through the use of the QCS App
Suggested action: • Share ‘Key Facts’ with all staff
• Ensure relevant staff are aware of the content of the whole policy
QCS have undertaken an equality analysis during the review of this policy. This statement is
Equality Impact a written record that demonstrates that we have shown due regard to the need to eliminate
Assessment: unlawful discrimination, advance equality of opportunity and foster good relations with
respect to the characteristics protected by equality law.
This policy is Copyright © Quality Compliance Systems Ltd. 2017 (Last updated 2020) and is only licensed for use with a current
Licence Certificate. If you have a current Licence Certificate, it can be accessed in your online account. Page 1/8
Use without a current Licence Certificate is strictly prohibited.

1. Purpose
1.1 To ensure that Tailored Care Services Ltd knows how to respond to a 'No Reply' and recognise that
this is an emergency situation and takes priority over any other day-to-day business. This is sometimes
referred to as 'unable to gain access' or 'access to people's homes'.
1.2 To safeguard the wellbeing of vulnerable Service Users.
1.3 To support Tailored Care Services Ltd in meeting the following Key Lines of Enquiry:
Key Question Key Lines of Enquiry
S1: How do systems, processes and practices keep people safe and
SAFE
safeguarded from abuse?
S2: How are risks to people assessed and their safety monitored and
SAFE managed so they are supported to stay safe and their freedom is
respected?
WELL-LED W5: How does the service work in partnership with other agencies?
1.4 To meet the legal requirements of the regulated activities that Tailored Care Services Ltd is registered
to provide:
The Care Quality Commission (Registration) and (Additional Functions) and Health and Social Care
Act 2008 (Regulated Activities) (Amendment) Regulations 2012

The Care Act 2014
Human Rights Act 1998
Mental Capacity Act 2005
Mental Capacity Act Code of Practice
2. Scope
2.1 The following roles may be affected by this policy:

Registered Manager
Other management
Care staff
Care Co-ordinator
2.2 The following Service Users may be affected by this policy:
A Service User whose visit is scheduled and when staff would reasonably expect the Service User to be
at home
2.3 The following stakeholders may be affected by this policy:
Family
Representatives
Commissioners
Local Authority
NHS

3. Objectives
3.1 To ensure that all staff recognise their responsibility for the safety and security of all Service
Users. Failing to establish the exact situation can lead to tragic consequences for Service Users, their
families, and the staff of Tailored Care Services Ltd, including:
Death or serious harm to the Service User
Distress for relatives and others
Police or safeguarding investigation
Adverse publicity in local or national print or broadcast media
3.2 To ensure that there are clear escalation procedures in place when staff are unable to access to a
Service User's home and that effective communication mechanisms are in place to prevent staff from being
unable to gain access to carry out scheduled care and support.
4. Policy
4.1 Tailored Care Services Ltd recognises the urgency in all situations where access cannot be made to a
Service User's home at the time of a scheduled visit and the Service User does not respond to requests for
entry. Care Workers will consider there to be a possible emergency situation, requiring immediate action to
establish the wellbeing and safety of the Service User, or to alert the emergency services where
appropriate.
It is the policy of Tailored Care Services Ltd that under no circumstances will the attempt to establish the
Service User's safety be discontinued, until the exact circumstances are known, or the matter has been
placed in the hands of the emergency services. Where appropriate to do so, the Service User’s family or
representative will be informed of the situation.
Tailored Care Services Ltd recognises its responsibility to the health, safety and welfare of staff, and at no
point during or after the incident will the safety of staff or others be put at risk.
4.2 Where a Service User's care is commissioned by Wakefield Council, the Access to People's
Home Policy and Procedure at Tailored Care Services Ltd will dovetail with Wakefield Council policies and
procedures to ensure a consistent response.
4.3 All managers, care co-ordinators and Care Workers working for or on behalf of Tailored Care Services
Ltd must be familiar with this policy and procedure where Service Users do not appear to be at home, or do
not respond to requests for entry.
In the event that Tailored Care Services Ltd uses agency staff or sub-contracts their care visits, Tailored
Care Services Ltd will ensure the Access to People's Home Policy and Procedure is understood and
followed by the worker when the worker is allocated any visits.

5. Procedure
5.1 Action Required by the Care Worker

At all times, the Care Worker will consider their own safety, and will not attempt any of the following actions
if they have any reason to be concerned.
The Care Worker will repeat the usual method for gaining access at least three times, allowing
sufficient time for the Service User to respond if they would normally be expected to do so, e.g. knock
at the door and wait for a reply
If the Service User's telephone number is known, the Care Worker will contact them by telephone, if
they are able to do so
The Care Worker must look for signs which may indicate that the house is empty or that the Service
User's condition has changed. This may include letters or newspapers lying uncollected at the door,
unopened bottles of milk which have not been collected, curtains closed when they would normally be
open
The Care Worker will attempt to establish whether the Service User is at home (including the possibility
that they may be lying on the floor) by looking through the letterbox or any windows at the property
which can be accessed safely, and in any gardens adjoining the home
Where appropriate, the Care Worker will attempt to attract the Service User's attention by calling them
through the letterbox or through an open window
The Care Worker will look for possible signs of break-ins, such as broken windows or doors which have
been forced open. If there is any possibility that the Service User's home has been broken into, or that
someone may be in the home without the Service User's consent, the Care Worker will not attempt to
enter the home, but contact the Police by calling 999. If the Care Worker does not have a mobile
telephone, they must use a payphone if there is one nearby, or consider attracting assistance from
neighbours or passers-by if it is safe to do so
If the Care Worker can see the Service User, but they are not responding or appear to be distressed,
they must contact the emergency services by dialling 999 and ask for the Police or ambulance services
(as appropriate)
If it is safe to do so, the Care Worker will consider talking to neighbours to establish the Service User's
whereabouts, or whether they have concerns about the Service User's wellbeing
If speaking to neighbours, the Care Worker must apologise for disturbing them, identify themselves by
showing their ID badge or card, and state that they are concerned about the Service User's wellbeing
Where necessary, Care Workers must be prepared to provide neighbours with the telephone number
of Tailored Care Services Ltd if they wish to speak to their employer. The Care Worker will make
contact with Tailored Care Services Ltd by telephone immediately and ask to speak to their line
manager or the manager in charge at the time. Out of hours, the Care Worker must call the On-Call
Team and follow the same process
The Care Worker must not just leave a message for the manager to call, but must explain their
concerns to a manager who can act on them. The Care Worker will follow any instructions given by
Tailored Care Services Ltd, including waiting at the Service User's home, if it is safe to do so. The Care
Worker must not leave the Service User's home until instructed to by Tailored Care Services Ltd (or the
On-Call Team if the incident occurs out of hours)
5.2 Actions of All Staff Involved in Concerns about a Service User's Location or Wellbeing
Any member of staff receiving a call about inability to access the Service User's home must ensure that the
call is dealt with by a manager capable of responding to the issue and that the manager has accepted
responsibility for managing the issue.
It is generally unacceptable to leave voicemail messages or notes which could go missing, or not be acted
upon without delay. Any details of calls must be logged in the Service User records. This includes dates
and times, and who was involved.
5.3 Actions to be Taken by Tailored Care Services Ltd Staff
Managers (this includes co-ordinators, schedulers, Tailored Care Services Ltd managers and on-call staff)
must be aware that concerns raised by inability to enter a Service User's home could be a potential

emergency and that the policy and procedure must be followed until the location and safety of the Service
User is established. Being unable to gain access takes priority over all routine activity of Tailored Care
Services Ltd, unless failure to do other work will result in immediate harm to another Service User.
On being alerted to a situation where access to the Service User's home has not been possible the
manager responsible must:
Advise the Care Worker to remain at the Service User's home
Check whether there is any prior information about the Service User's absence from home at Tailored
Care Services Ltd
Confirm if the initial actions to be taken by the Care Worker (as outlined above) have been completed
Consider whether there is sufficient concern to summon emergency services immediately
Assess the Care Worker's safety for any future actions requested
Instruct the Care Worker to complete any necessary actions not already undertaken
Follow any contractual unable to gain access procedures
A manager must attempt contact by telephone with the following people to establish any known reason for
non-response, and/or the Service User's location and safety:
The Service User's home telephone, and any mobile phone, if known
The Service User's emergency contact
The Service User's main representative
Members of the Service User's family or friends, where known
Any other responsible person or organisation that may know the Service User's whereabouts and
safety
The Service User's social worker or named nurse (where the care is commissioned by a local authority
or health authority)
If the manager is reassured that the Service User's location and safety are known following a
conversation with any of the above, this must be documented in the Service User's records and the
procedure halted
If necessary, and safe to do so, the manager may request that the Care Worker attempts to gain
access to the Service User home. Please refer to section 5.4 for the procedure to follow
If the care is commissioned by the Local Authority and there is no named social worker, the social
services duty team must be contacted and advised of the situation. Advice will be taken on the next
steps. Tailored Care Services Ltd must document the name of the duty social worker and the date and
time contacted
If Tailored Care Services Ltd is unable to satisfy itself that the Service User is safe, the manager must
contact the Police and co-operate with all reasonable requests for information and assistance. The
Care Worker must be informed and remain at the premises unless instructed to leave by Tailored Care
Services Ltd or the Police
The actions taken by the manager, or information that the Police or emergency services have been
summoned, will be recorded in the Service User's notes and the Service User's main contact, family
members or social worker will be advised accordingly
The manager must check if the Care Worker involved is due to visit any other Service User/s and if the
emergency response will make the Care Worker late. If this is the case, those Service Users must be
contacted immediately and where possible, and where calls are time-critical, a replacement member of
staff known to the Service User will be sent
5.4 Attempting to Gain Access to a Service User's Home
Caution must be taken by Care Workers in the event of any of the following actions, until they have
contacted their manager to discuss the situation and agree that it is safe to do so.
Together with their manager, the Care Worker must assess whether they are able to enter the Service
User's home and whether it is safe to do so. Think about whether there may be anyone else in the house,
or whether there are pets which might injure the Care Worker.
If Tailored Care Services Ltd has the Service User's prior permission to do so and if a key to the Service
User's home is available; if a key can be obtained from a safe place (e.g. through a key safe); or the

Service User's home is fitted with a security keypad, use it to open the Service User's door. Do not attempt
to force doors or window frames, or to smash windows to gain access.
Arrangements Where the Care Worker has Access to the Home, but the Service User is Not
There
In some situations, the Care Worker may have access to the Service User's home as part of their normal
duties (e.g. because the person is unable to open the door). If the Service User cannot be found, follow the
steps outlined in the section below.
Arrangements for Checking Individual Rooms in the Service User's Home
The Care Worker must announce their presence before entering the home as well as in each individual
room, in a loud and clear voice.
The Care Worker must establish whether the Service User is present by checking each room on the
premises, if it is safe to do so, and if necessary contacting the Police or ambulance service as appropriate.
The Care Worker must be aware of the possibility of the Service User being behind a locked door or on the
floor, and ready to seek guidance from their office on how to proceed if that is what they find. The Care
Worker must record the time and date that the home was entered in the Service User's care records, and
any actions needed. Once access to the Service User's home is complete, the Care Worker must make
sure that the premises are secure, that the door used to gain entry is locked, and any keys obtained from a
key safe have been returned.
5.5 Process for Service Users Known to 'Walk About' from Home
Every Service User has a right to independence, choice and control. There may be Service Users who do
not inform Tailored Care Services Ltd when they are going out and this may be an issue if a care visit is
due. If the Service User has capacity, a process must be agreed with the Service User (and any
commissioners) of what the Service User wants to happen if a Care Worker fails to gain access.
Tailored Care Services Ltd will ensure that there are detailed records about significant people, places and
contact numbers if the Service User is known to walk about and leave the home. Tailored Care Services
Ltd will work closely with other external partners to ensure a plan is put in place to keep the Service User
independent, but safe.
Tools such as the Herbert Protocol used in care homes may be useful to adapt for use with Service User's
with dementia, mental health conditions or learning disabilities.
5.6 Communication between Other Care Providers
Tailored Care Services Ltd will ensure that there are robust communication procedures in place
when Service Users move between other care providers, particularly following admission or discharge from
hospital, to ensure that 'unable to gain access' incidents do not arise when a Service User is expected to
be at home and is delayed arriving home, to avoid placing unnecessary strain on emergency services.
5.7 Auditing
All 'unable to gain access' incidents will be documented and a root cause analysis undertaken to
understand why they occurred, if procedures were followed correctly, and if there are any lessons that can
be learned from the incident. High numbers of 'unable to gain access' incidents may indicate an issue with
rota scheduling, travel time, access arrangements or communication issues.
5.8 Safeguarding and Regulatory Notification
Where an incident of being unable to gain access occurs, and the Service User is harmed or has been put
at risk of harm because of a failure by a Care Worker, Tailored Care Services Ltd, or another
organisation; a safeguarding notification must be made. Tailored Care Services Ltd also has a statutory
requirement to submit a notification to the Care Quality Commission.
Tailored Care Services Ltd must ensure that all staff are aware that 'unable to gain access' can be
a safeguarding matter, and failure to follow the agreed procedures by any member of staff working for or
on behalf of Tailored Care Services Ltd may result in disciplinary action being taken.

6. Definitions
6.1 Walking About

Many people with dementia feel the urge to walk about and in some cases, leave their homes. Walking
is not a problem in itself - it can help to relieve stress and boredom and is a good form of exercise.
When a person with dementia often walks about, it can be worrying for those around them and may at
times put the person in danger
It may not be clear why the person is walking about, and this is often referred to as 'wandering'.
However, this term is unhelpful because it suggests aimlessness, whereas the walking often does have
a purpose
Rather than dismissing it, it is important to think about how the person's independence, safety and
dignity can be preserved

6.2 Herbert Protocol
The Herbert Protocol initiative is named after George Herbert, a war veteran of the Normandy landings,
who lived with dementia
It is an initiative adopted by many police forces compiled of useful information, which may be used in
the event of a vulnerable person with dementia going missing. Tailored Care Services Ltd will seek
advice from their local Police force on the initiative in the local area
6.3 Missing
Anyone whose whereabouts cannot be established and where the circumstances are out of character,
or the context suggests the person may be subject of crime, or at risk of harm to themselves or another
6.4 No Reply
People receiving a service who do not answer the door, for example, on a day when the service is
being provided. This is referred to by the CQC as Access to People's Homes
Key Facts - Professionals
Professionals providing this service should be aware of the following:

All Service Users have the right to refuse services. However, a risk assessment will be completed to
ensure that Tailored Care Services Ltd is clear about the risks posed to the person without the
provision of services
This assessment will include any issues relating to mental capacity or functioning, and will be
documented on file
In situations where the Service User is likely to be at high risk without the provision of services, every
effort will be made to provide support. If the Service User continues to refuse services, the risks will be
clearly documented and signed by the person concerned
Key Facts - People affected by the service
People affected by this service should be aware of the following:

If you will not be at home when your Care Worker is scheduled to visit, you must let Tailored Care
Services Ltd know in advance, so that Tailored Care Services Ltd can ensure the Care Worker does
not attend
If you think you will have difficulty answering the door, you must discuss access arrangements with

As part of the risk assessment procedures at Tailored Care Services Ltd, you will be asked who you
would like contacted in an emergency situation

Further Reading
As well as the information in the 'underpinning knowledge' section of the review sheet we recommend that
you add to your understanding in this policy area by considering the following materials:
Age UK - The Herbert Protocol:
https://www.ageuk.org.uk/calderdaleandkirklees/about-us/latest-news/articles/2018/the-herbert-protocol/
Outstanding Practice
To be ‘ outstanding ’ in this policy area you could provide evidence that:

There is evidence that staff have been trained and understand the Access to People's Homes Policy
and Procedure on induction

Any 'unable to gain access' incidents are reviewed and the lessons learnt are applied
Service User risk assessments reflect their right to choice and to refuse services, however, this is
supported by robust mental capacity assessments and evidence of valid consent
There is a clear culture that staff understand the importance of communicating any information about
Service Users being away from home, or of planned visits being cancelled, and this information is
passed on accordingly
The wide understanding of the policy is enabled by proactive use of the QCS App
Forms
Currently there is no form attached to this policy.

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AR42 - Access to People's Homes Policy and Procedure

Administration - Registration & Compliance

Tailored Care Services Ltd

Last Reviewed Last Amended Next Planned Review in 12 months, or

Changes are important, but urgent implementation is not

Reason for this review Scheduled review

Were changes made? Yes

Tailored Care Services Ltd

Act 2008 (Regulated Activities) (Amendment) Regulations 2012

 Human Rights Act 1998

 Mental Capacity Act 2005

 Mental Capacity Act Code of Practice

2.1 The following roles may be affected by this policy:

Tailored Care Services Ltd

Tailored Care Services Ltd

5.1 Action Required by the Care Worker

Tailored Care Services Ltd

Tailored Care Services Ltd

Tailored Care Services Ltd

6.1 Walking About

dignity can be preserved

Key Facts - Professionals

Professionals providing this service should be aware of the following:

Key Facts - People affected by the service

People affected by this service should be aware of the following:

Tailored Care Services Ltd

would like contacted in an emergency situation

Tailored Care Services Ltd

To be ‘ outstanding ’ in this policy area you could provide evidence that:

and Procedure on induction

Currently there is no form attached to this policy.

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Human Rights Act 1998

Mental Capacity Act 2005

Mental Capacity Act Code of Practice