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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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DBS Checks Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} operates lawful, proportionate and robust criminal-record and barring-check arrangements as part of its safer recruitment, appointment and ongoing workforce-monitoring procedures.

{{org_field_name}} will obtain the level of Disclosure and Barring Service check for which each particular role is legally eligible. The organisation will not request a Standard, Enhanced or Barred List check solely because an individual works in health or social care, holds a particular job title, works at a supported living service or may have incidental contact with people receiving support. Eligibility will be determined by the duties actually undertaken by the individual and the relevant statutory eligibility criteria.

This policy supports compliance with Regulation 19 and Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, the Safeguarding Vulnerable Groups Act 2006, the Protection of Freedoms Act 2012, the Police Act 1997, the Rehabilitation of Offenders Act 1974 and its Exceptions Order, the Data Protection Act 2018, UK GDPR and the Disclosure and Barring Service Code of Practice.

DBS checks form one part of the organisation’s wider safer recruitment and workforce-assurance arrangements. They do not replace identity checks, references, employment-history checks, right-to-work checks, professional-registration checks, qualification checks, health-related checks where lawful and necessary, interviews, induction, supervision, competency assessment or ongoing monitoring of conduct and suitability.

{{org_field_name}} will ensure that people employed or engaged for the purposes of carrying on a regulated activity are of good character, have the qualifications, competence, skills and experience necessary for their role, and are able, after any reasonable adjustments, to perform the work concerned.

2. Scope

This policy applies to all individuals employed, appointed, supplied, contracted, seconded or otherwise engaged for the purposes of carrying on a regulated activity by {{org_field_name}}. This includes:

• employees;
• workers and casual workers;
• bank staff;
• agency workers;
• volunteers;
• apprentices and students on placement;
• contractors and self-employed persons;
• consultants;
• shared staff supplied by another organisation;
• registered managers and other managers;
• persons engaged through an employment business or personnel supplier; and
• any other person whose work brings them within the scope of Regulation 19.

The policy covers:

• assessment of DBS eligibility for each role;
• the correct level and workforce of DBS check;
• Adults’ and Children’s Barred List eligibility;
• pre-employment checks;
• checks for agency staff, contractors and volunteers;
• overseas criminal-record information;
• use of the DBS Update Service;
• handling of certificate information;
• recruitment decisions following disclosure of criminal-record information;
• risk assessment;
• ongoing declarations and monitoring;
• action where a person’s fitness or suitability changes;
• legal referrals to the DBS and professional regulators; and
• record-keeping, audit and governance.

3. Related Policies

• Safeguarding Adults from Abuse and Improper Treatment Policy (SL13)
• Recruitment and Selection Policy (SL30)
• Whistleblowing (Speaking Up) Policy (SL29)
• Confidentiality and Data Protection (GDPR) Policy (SL34)
• Good Governance Policy (SL04)

• Equality, Diversity and Human Rights Policy.
• Agency Workers and Contractors Policy.
• Disciplinary Policy.
• Professional Boundaries Policy.
• Staff Conduct Policy.
• Record Retention and Disposal Policy.
• Information Security Policy.
• Right to Work Policy.
• References and Employment Verification Procedure.
• Allegations Against Staff Policy.
• DBS Referral and Professional-Regulator Referral Procedure.

4. Policy Statement

{{org_field_name}} is committed to protecting people receiving support while treating applicants and workers fairly, lawfully, consistently and without discrimination.

The organisation will:

• determine DBS eligibility from the actual duties and circumstances of each role;
• request only the level of check and Barred List information that it is legally entitled to request;
• ensure that recruitment decisions are not based on irrelevant or unlawfully requested criminal-record information;
• consider disclosed information fairly, individually and proportionately;
• comply with DBS filtering rules and will not require an applicant or worker to disclose a protected conviction or protected caution;
• prevent a person who is barred from adults’ regulated activity from undertaking regulated activity with adults;
• maintain evidence that the checks required under Regulation 19 and Schedule 3 have been completed;
• take prompt and proportionate action if information arises that calls a worker’s fitness, good character or suitability into question;
• make referrals to the DBS or a professional regulator where the legal or regulatory referral criteria are met; and
• process criminal-offence data in accordance with UK GDPR, the Data Protection Act 2018 and the organisation’s data-protection policies.

A DBS certificate is a point-in-time record and is not, by itself, proof that a person is suitable for employment. Suitability will be assessed through the organisation’s complete safer recruitment and continuing workforce-assurance process.

5. Types of DBS Checks

The level of DBS check available is determined by statutory eligibility and the duties of the role. Working in a supported living service does not automatically make every role eligible for a Standard or Enhanced DBS check. Before advertising or appointing to a role, the recruiting manager must complete and retain a documented DBS eligibility assessment.

5.1 Basic DBS Check

A Basic DBS check may be requested for any role, subject to a lawful basis and the organisation’s data-protection requirements. It shows unspent convictions and conditional cautions that are eligible for disclosure under the applicable rehabilitation legislation.

A Basic DBS check may be considered for roles that are not eligible for a Standard or Enhanced check, where the organisation has identified a genuine and proportionate need for criminal-record information. Examples may include certain administrative, finance, maintenance or support functions, but the decision must be based on the role-specific risk assessment and not on job title alone.

A Basic DBS check does not include an Adults’ or Children’s Barred List check.

5.2 Standard DBS Check

A Standard DBS check contains details of relevant spent and unspent convictions and cautions held on central police records, subject to the statutory filtering rules.

A Standard DBS check may only be requested where the specific position is included within the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 and the Police Act 1997 eligibility framework.

Managerial, supervisory or administrative status does not, by itself, make a role eligible for a Standard DBS check. The recruiting manager must obtain confirmation of eligibility from the organisation’s DBS lead or approved Registered Body before a Standard check is requested.

A Standard DBS check does not include local police information or an Adults’ or Children’s Barred List check.

5.3 Enhanced DBS Check

An Enhanced DBS check contains the information included in a Standard DBS check and may also contain relevant information disclosed by a chief police officer in accordance with the Police Act 1997.

An Enhanced DBS check may only be requested where the duties and circumstances of the role meet the statutory eligibility criteria.

Employees, workers or volunteers who provide personal care to adults because of age, illness or disability will normally be engaging in regulated activity with adults. Where the role involves regulated activity with adults, {{org_field_name}} will request an Enhanced DBS check with an Adults’ Barred List check.

A role that is eligible for an Enhanced DBS check is not automatically eligible for an Adults’ Barred List check. Barred List information will only be requested where the role falls within the statutory definition of regulated activity.

Where a service supports both adults and children, or the role includes regulated activity with both groups, the organisation will assess eligibility for both the Adults’ and Children’s Barred Lists.

It is a criminal offence for a barred person to seek, offer to undertake or undertake regulated activity from which they are barred. It is also an offence for an organisation knowingly to permit a barred person to undertake that regulated activity.

5.4 Regulated Activity with Adults

For the purposes of deciding whether an Adults’ Barred List check may be requested, regulated activity with adults is determined by the activity undertaken and not by whether the person receiving support is described as “vulnerable”.

Regulated activity with adults includes, where the statutory conditions are met:

• providing health care by, or under the direction or supervision of, a regulated health care professional;
• providing personal care, including physical assistance with eating, drinking, toileting, washing, bathing, dressing, oral care or care of skin, hair or nails, where the adult needs the assistance because of age, illness or disability;
• prompting and then supervising an adult in relation to personal care where the adult is unable to decide to perform the activity without prompting because of age, illness or disability;
• training, instructing or advising an adult in relation to personal care where the adult needs that support because of age, illness or disability;
• providing social work by a regulated social worker;
• assisting an adult with their cash, bills or shopping because of age, illness or disability;
• assisting in the conduct of an adult’s affairs under specified statutory arrangements; and
• conveying an adult to, from or between places where the conveyance is provided because of age, illness or disability for the purpose of receiving health care, personal care or social work, subject to the statutory exclusions.

5.5 Role Eligibility Assessment

Before a DBS application is made, the recruiting manager must complete a role-specific DBS eligibility assessment recording:

• the role title;
• the actual duties;
• the people with whom the role has contact;
• whether the person provides health care, personal care, social work, assistance with finances, assistance with affairs or relevant transport;
• whether the role is carried out under day-to-day supervision;
• whether the role involves regulated activity with adults, children or both;
• the statutory basis for requesting a Standard or Enhanced check;
• whether an Adults’ or Children’s Barred List check is permitted;
• the workforce stated on the application;
• the level of check approved; and
• the name and date of the person authorising the check.

The completed assessment will be retained with the recruitment record and made available for internal audit or CQC inspection.

6. DBS Check Procedures

6.1 Pre-Employment DBS Checks

The level of DBS check required for each appointment will be established by the role eligibility assessment described in section 5.5.

No Standard, Enhanced or Barred List check will be requested unless {{org_field_name}} is legally entitled to request it.

Before an appointment is confirmed, the organisation will:

• verify the applicant’s identity using the current DBS identity-checking requirements;
• verify the applicant’s right to work in the United Kingdom;
• obtain a full employment history, together with a satisfactory written explanation of any gaps;
• obtain satisfactory evidence of conduct in previous employment concerned with the provision of services relating to health or social care, children or vulnerable adults, where applicable;
• obtain appropriate references;
• verify relevant qualifications, professional registration and employment history;
• complete the appropriate DBS check;
• confirm Barred List status where the role is regulated activity;
• consider whether overseas criminal-record checks or certificates of good conduct are required;
• assess any disclosed information fairly and proportionately; and
• retain evidence that all Schedule 3 information has been obtained.

Offers of employment will normally be conditional upon satisfactory completion of all required pre-employment checks.

The applicant must be informed of the level and type of DBS check being requested, why the role is eligible for that check, how their information will be used, and how they may challenge inaccurate certificate information.

The organisation will see the applicant’s original DBS certificate before making a final decision. Where an Update Service status check is used, the original certificate must also be examined and the identity of the person presenting it must be confirmed.

6.2 Exceptional Commencement Before Receipt of a DBS Certificate

The normal expectation is that no person will begin unsupervised work with people receiving support until the appropriate DBS and Barred List checks have been satisfactorily completed.

In exceptional circumstances, a person may commence restricted duties before receipt of the DBS certificate only where:

• the organisation has confirmed that the DBS application has been correctly submitted;
• identity, right-to-work, employment-history, reference, qualification and professional-registration checks have been satisfactorily completed;
• any legally available separate Barred List check has been completed where required;
• a written risk assessment has been completed;
• the Registered Manager or other authorised senior manager has approved the arrangement in writing;
• the person does not work alone with people receiving support;
• the person does not provide unsupervised personal care;
• the person does not administer medication, handle money, hold keys, access confidential records without supervision, transport people alone or undertake sleep-in or lone-working duties;
• continuous or appropriately close supervision is provided by a suitably checked and competent member of staff;
• the restrictions are recorded on the rota and communicated to relevant managers;
• the arrangement is reviewed at least weekly; and
• the arrangement ends immediately if concerning information is received.

The risk assessment must record the reasons for allowing commencement, the specific restrictions, the supervisory arrangements, the review date and the person authorising the decision.

Commencement before completion of the relevant checks must never become routine or be used to address ordinary staffing shortages.

6.3 Ongoing Monitoring and Rechecking

DBS certificates do not have a statutory expiry date. {{org_field_name}} will not describe a fixed recheck period as a legal requirement or a universal CQC requirement.

The organisation will manage ongoing suitability through:

• contractual duties requiring workers to disclose relevant criminal investigations, charges, cautions, convictions, restraining orders, barring decisions or other information that may affect their suitability;
• supervision and appraisal;
• safeguarding and disciplinary procedures;
• professional-registration checks;
• review of concerns, complaints and incidents;
• DBS Update Service status checks where lawful and authorised; and
• new DBS applications where there is a lawful, proportionate and role-related reason.

{{org_field_name}} will carry out a new DBS check or Update Service status check when:

• a person moves to a role requiring a different level or type of DBS check;
• a person moves into regulated activity requiring a Barred List check not covered by the existing certificate;
• the existing certificate relates to a different workforce or does not cover the current role;
• an Update Service check shows that the certificate is no longer current;
• the person has not maintained their Update Service subscription;
• the original certificate cannot be produced;
• information or conduct gives rise to a reasonable concern about suitability;
• there has been a substantial break in service and the risk assessment indicates that a new check is necessary;
• required by a commissioner under a lawful and proportionate contractual requirement; or
• otherwise required by law or current regulatory guidance.

As an organisational safeguard, {{org_field_name}} may adopt a periodic rechecking cycle. Where it does so, the cycle will be risk-based, documented and applied consistently. It will not be represented as a statutory DBS expiry date or as an automatic CQC requirement.

6.4 Staff Duty to Report Relevant Changes

All workers must notify their line manager or the Registered Manager without delay if, during their employment or engagement, they:

• are arrested, interviewed under caution or charged in connection with an offence relevant to their work or suitability;
• receive a police caution or criminal conviction that they are legally required to disclose;
• become subject to a restraining order, sexual harm prevention order, civil order or other restriction relevant to the role;
• become the subject of a safeguarding investigation;
• are referred to or barred by the DBS;
• become subject to investigation, conditions, suspension or removal by a professional regulator;
• are dismissed, suspended or restricted from other work because of safeguarding or conduct concerns; or
• become aware of any other matter that may reasonably affect their fitness or suitability.

Workers are not required to disclose protected convictions or protected cautions that are filtered under current legislation.

A failure to disclose information that the worker is lawfully required to disclose may be addressed under the organisation’s disciplinary procedure.

6.5 DBS Update Service and Acceptance of Existing Certificates

{{org_field_name}} will not treat a DBS certificate as automatically transferable between roles or organisations.

An existing Standard or Enhanced DBS certificate may be considered through the DBS Update Service only where:

• the applicant is subscribed to the Update Service;
• the applicant gives informed consent for the organisation to carry out a status check;
• the organisation sees the original certificate;
• the identity details on the certificate match the applicant;
• the certificate is at the correct level;
• the certificate covers the correct workforce;
• the certificate contains the required Barred List information;
• the role remains legally eligible for that level and type of check;
• the certificate does not contain information that requires further assessment; and
• the Update Service response confirms that no new information has been identified.

The organisation will record:

• the certificate number;
• the certificate issue date;
• the level and workforce;
• the Barred List information included;
• the date of the status check;
• the result of the status check;
• the name of the person who saw the original certificate; and
• the recruitment or risk-assessment decision.

If the Update Service indicates that the certificate is no longer current, a new DBS application must be made.

Where the original certificate does not match the level, workforce or Barred List requirements of the new role, a new application must be made regardless of the Update Service result.

6.6 Agency Staff, Contractors and Temporary Workers

Agency staff, contractors, temporary workers and persons supplied by another organisation must not be presumed suitable solely because the supplying organisation states that checks have been completed.

Before deployment, {{org_field_name}} must obtain written confirmation of:

• the person’s verified identity;
• right to work;
• full employment history and explanation of gaps, where applicable;
• references and evidence of previous conduct;
• qualifications and professional registration;
• the level, workforce and date of the DBS certificate;
• whether the relevant Adults’ or Children’s Barred List check was included;
• whether the person is subscribed to the Update Service and, where appropriate, the result of a current status check;
• completion of relevant safeguarding and role-specific training;
• any restrictions, conditions or concerns affecting deployment; and
• the supplying organisation’s confirmation that the person remains fit and suitable for the role.

{{org_field_name}} retains responsibility for ensuring that any person deployed in its service is appropriately checked and suitable. The provider will carry out proportionate sample audits of agency and contractor records and will not deploy a worker where the evidence is incomplete, inconsistent or unsatisfactory.

6.7 Overseas Criminal-Record Checks

A DBS check may not contain criminal-record information from countries in which an applicant has lived or worked.

Where an applicant has lived, worked or undertaken prolonged residence outside the United Kingdom, {{org_field_name}} will consider whether additional overseas criminal-record information is reasonably available and proportionate to the role.

Depending on the country and circumstances, the organisation may request:

• an overseas police certificate;
• a certificate of good conduct;
• a criminal-record certificate from the relevant authority;
• an embassy or consular check;
• additional references from overseas employers;
• verification of overseas professional registration; or
• other reliable evidence of conduct and suitability.

Where reliable overseas information cannot be obtained, the recruiting manager must complete a written risk assessment and consider additional safeguards, references, supervision, probationary monitoring or whether the appointment can safely proceed.

An overseas check does not replace an appropriate DBS check for work undertaken in England.

7. Handling Disclosure Information

7.1 Confidentiality, Storage, Retention and Disposal

Criminal-record information is highly confidential personal data and will be processed only by authorised persons who require access for recruitment, safeguarding, workforce-management, legal or regulatory purposes.

DBS certificates and certificate information will:

• be handled in accordance with the DBS Code of Practice;
• be processed in accordance with UK GDPR, the Data Protection Act 2018 and the organisation’s appropriate policy document for criminal-offence data;
• be stored securely and separately from general personnel records while a recruitment or suitability decision is being made;
• not be copied, scanned, photographed, emailed or retained in full unless there is a documented lawful and necessary reason;
• not be disclosed to an unauthorised person;
• not be used for a purpose unrelated to the purpose for which it was obtained; and
• be securely destroyed when no longer required.

The organisation will normally retain the certificate or a copy of the certificate for no longer than six months after the recruitment or suitability decision. A longer period may be authorised only where it is necessary to resolve a dispute, respond to a complaint, complete legal proceedings or satisfy a specific regulatory or safeguarding requirement. The reason and retention period must be documented.

Once the certificate is destroyed, the organisation may retain an audit record containing:

• the applicant’s name;
• the date of issue of the certificate;
• the type and level of check;
• the workforce;
• whether a relevant Barred List check was included;
• the certificate reference number;
• the date the original certificate was seen;
• the date of any Update Service check;
• the outcome of the recruitment or suitability decision; and
• the name of the person who made the decision.

Paper certificates will be destroyed by secure shredding or confidential waste disposal. Electronic copies, where exceptionally retained, will be permanently and securely deleted. Certificates will not be placed in ordinary waste or unsecured recycling.

The organisation will co-operate with DBS assurance or compliance activity and will make relevant records available where lawfully required.

7.2 Certificates Containing Information and Applicant Disclosures

Where a DBS certificate contains criminal-record or relevant police information, or an applicant lawfully discloses relevant information, the organisation will not automatically reject the applicant.

The applicant will be given an opportunity to:

• explain the circumstances;
• provide relevant evidence;
• identify any factual error;
• confirm whether they intend to use the DBS dispute procedure; and
• explain evidence of rehabilitation, changed circumstances or risk reduction.

The organisation will not require an applicant to disclose, and will not take into account, a protected conviction or protected caution that is subject to DBS filtering.

The decision-maker will consider:

• whether the information is legally relevant to the role;
• the nature and seriousness of the conduct;
• the circumstances in which it occurred;
• the person’s age at the time;
• the time elapsed;
• whether there is a pattern of behaviour;
• the relevance to the duties, people supported and working environment;
• the level of responsibility, access, trust and unsupervised contact involved;
• any evidence of harm or risk of harm;
• the person’s explanation and insight;
• evidence of rehabilitation;
• references and subsequent employment history;
• whether reasonable safeguards could manage any identified risk;
• the impact on people receiving support, colleagues and the service; and
• the organisation’s safeguarding and regulatory responsibilities.

Any decision to withdraw an offer, restrict duties or end an engagement must be based on a documented, individual and proportionate assessment. The decision must not be based merely on the existence of a conviction or caution.

Where the certificate shows that the person is barred from the regulated activity required by the role, the person must not be appointed or deployed in that regulated activity.

7.3 Disputing Certificate Information

Where an applicant disputes the accuracy or relevance of information on a DBS certificate, the organisation will explain the DBS dispute process.

Where it is safe and appropriate to do so, the recruitment decision may be paused for a reasonable period while the dispute is considered. The organisation is not required to leave a post open indefinitely and may take an interim decision where delay would create unacceptable operational or safeguarding risk.

The applicant must not undertake regulated activity where the available information indicates that they may be barred or otherwise presents an unmanaged safeguarding risk.

8. Risk Assessment and Decision-Making

8.1 Criminal-Record and Suitability Risk Assessment

A written risk assessment will be completed where:

• a DBS certificate contains information;
• an applicant or worker discloses relevant information;
• required checks remain incomplete and exceptional commencement is being considered;
• overseas criminal-record information is unavailable;
• there is a break in service;
• information arises during employment that may affect fitness or good character;
• an Update Service check indicates a change;
• an agency or contractor cannot provide complete evidence; or
• any other suitability concern is identified.

The assessment will be completed by the Registered Manager and HR Lead, or by other appropriately authorised senior persons. Where possible, at least two people will be involved in a decision to reject an applicant, withdraw an offer, restrict duties, suspend a worker or terminate an engagement.

The risk assessment must record:

• the information considered;
• how the information was verified;
• the applicant’s or worker’s explanation;
• the relevance of the information to the role;
• the people who could be affected;
• the nature and likelihood of potential harm;
• existing controls;
• any additional safeguards;
• whether the risk can be safely managed;
• the decision and reasons;
• the person authorising the decision;
• any review date; and
• whether safeguarding, DBS, CQC, commissioner, police or professional-regulator notification or referral is required.

Decisions will be lawful, evidence-based, proportionate, non-discriminatory and consistent with the organisation’s safeguarding responsibilities.

8.2 Review of Recruitment or Suitability Decisions

An applicant or worker may request a review of a decision based materially on DBS or criminal-record information.

A request should normally:

• be made in writing within 10 working days of the decision;
• identify the decision being challenged;
• explain why the person believes the decision was unreasonable, based on inaccurate information or procedurally unfair; and
• include any relevant supporting evidence.

The review will be conducted by a senior manager who was not the original decision-maker wherever reasonably practicable.

The reviewer may:

• uphold the original decision;
• require further information;
• amend the risk assessment;
• impose or remove safeguards;
• refer the matter back for reconsideration; or
• overturn the decision.

The outcome and reasons will be communicated in writing.

This internal review does not replace the DBS certificate-dispute process, the organisation’s grievance or disciplinary procedure, or any statutory right available to the individual.

8.3 Action Where a Worker May No Longer Be Fit and Proper

Where information arises suggesting that a worker may no longer meet the requirements of Regulation 19, {{org_field_name}} will take prompt, necessary and proportionate action.

Action may include:

• immediate risk assessment;
• increased supervision;
• temporary restriction or alteration of duties;
• removal from regulated activity;
• suspension in accordance with the disciplinary procedure;
• a new DBS or Update Service check where legally available;
• safeguarding referral;
• disciplinary investigation;
• notification to the placing authority or commissioner;
• referral to a professional regulator;
• referral to the DBS; or
• termination of employment or engagement.

The primary consideration will be the safety, rights and welfare of people receiving support, while maintaining a fair process for the worker.

Where the worker is a registered health care professional, social worker or other regulated professional and no longer meets the required fitness criteria, the organisation will consider and make any required referral to the relevant professional regulator.

9. DBS Barring Referrals

{{org_field_name}} recognises that, as a regulated activity provider, it may have a legal duty to refer information to the Disclosure and Barring Service.

A referral must be considered where:

• the organisation has withdrawn permission for a person to engage in regulated activity, or would have done so had the person not resigned, retired, been made redundant, been transferred or otherwise ceased the activity; and
• the person has harmed, or poses a risk of harm to, an adult or child; has satisfied the statutory harm test; or has received a caution or conviction for a relevant offence.

Removing a person from regulated activity includes:

• dismissal;
• ending an agency or contractual placement;
• permanent transfer to duties that are not regulated activity;
• refusing to allow a volunteer to continue;
• not renewing a contract because of the safeguarding concern; or
• circumstances in which the person resigns or leaves before the disciplinary or safeguarding process is completed and the organisation would otherwise have removed them.

The Registered Manager, Safeguarding Lead and HR Lead must consider the referral duty whenever an allegation or investigation concerns harm, risk of harm or relevant offending by a person who is, has been or may in future be engaged in regulated activity.

A compromise agreement, settlement agreement, resignation or withdrawal of an allegation will not prevent a referral where the statutory conditions are met.

Referrals will be made as soon as sufficient information is available and will not be delayed unnecessarily pending the conclusion of unrelated employment proceedings.

The organisation will retain a record of:

• the facts considered;
• the referral decision;
• the statutory criteria applied;
• the date of referral;
• the information supplied; and
• the reasons where a referral is not made.

Where appropriate, the organisation will also consider referral or notification to:

• the local authority safeguarding team;
• the police;
• CQC;
• the relevant commissioner;
• the relevant professional regulator; and
• any other body with a statutory safeguarding or regulatory function.

10. Responsibilities

10.1 Registered Manager

The Registered Manager is responsible for:

• ensuring that no person is deployed without the checks appropriate to their role;
• ensuring that Barred List eligibility is correctly assessed;
• approving exceptional commencement arrangements;
• reviewing DBS and suitability risk assessments;
• ensuring that agency and contractor assurance is sufficient;
• taking proportionate action where a person’s fitness changes;
• considering safeguarding, DBS and professional-regulator referrals;
• monitoring compliance with Regulation 19 and Schedule 3;
• ensuring that recruitment restrictions are reflected in rotas and deployment arrangements; and
• reporting significant risks or compliance failures through the governance system.

10.2 HR Department or Recruitment Lead

HR or the Recruitment Lead is responsible for:

• maintaining role-specific DBS eligibility assessments;
• ensuring that the correct level, workforce and Barred List check is requested;
• verifying identity and supporting documentation;
• ensuring that applicants receive required DBS and privacy information;
• maintaining Schedule 3 recruitment records;
• monitoring conditional offers and outstanding checks;
• recording Update Service consent and status checks;
• managing certificate information securely;
• ensuring timely destruction of certificates;
• supporting fair risk-assessment decisions;
• monitoring restrictions and recheck actions;
• auditing agency and contractor assurances;
• maintaining the central recruitment-compliance register; and
• escalating any gap, discrepancy or safeguarding concern immediately.

10.3 All Workers

All workers must:

• provide complete and accurate information during recruitment and employment;
• present original identity and DBS documents when required;
• disclose relevant changes in accordance with section 6.4;
• comply with restrictions imposed pending completion of checks;
• not undertake regulated activity if they are barred from that activity;
• co-operate with lawful Update Service checks or new DBS applications required for their role;
• notify the organisation of changes to professional registration or conditions of practice;
• comply with safeguarding, confidentiality and safer-working requirements; and
• raise concerns where they believe an unchecked, barred or unsuitable person is being deployed.

10.4 DBS Lead or Counter-signatory

The DBS Lead or counter-signatory is responsible for:

• maintaining current knowledge of DBS eligibility and filtering rules;
• advising managers on complex role eligibility;
• ensuring compliance with the DBS Code of Practice;
• liaising with the Registered Body or Umbrella Body;
• ensuring that role descriptions accurately reflect the duties used to establish eligibility;
• preventing unlawful or excessive DBS applications;
• overseeing handling, retention and destruction of certificate information;
• supporting DBS assurance audits; and
• reporting suspected misuse of DBS information.

11. Legal and Regulatory Compliance

This policy supports compliance with the following requirements:

• Health and Social Care Act 2008, section 20: provides the statutory basis for regulations concerning the fitness of persons working in regulated activities, workforce management, training and records.
• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 19: requires persons employed for the purposes of carrying on a regulated activity to be of good character, have the necessary qualifications, competence, skills and experience, and be able, after reasonable adjustments, to perform the work concerned.
• Schedule 3 to the 2014 Regulations: requires the provider to obtain and make available specified information about persons employed or appointed for regulated activities, including appropriate criminal-record information.
• Regulation 13: requires systems to protect people from abuse and improper treatment. Appropriate checking, barring and referral arrangements support this requirement.
• Regulation 17: requires effective systems and processes to assess, monitor and improve quality and safety and to maintain accurate, complete and contemporaneous records.
• Safeguarding Vulnerable Groups Act 2006: establishes the barring framework, offences relating to barred persons and regulated activity, and the legal duty to refer in specified circumstances.
• Protection of Freedoms Act 2012: amended the scope of regulated activity and the barring arrangements.
• Police Act 1997: establishes the legal framework for Standard and Enhanced criminal-record certificates.
• Rehabilitation of Offenders Act 1974 and the Exceptions Order 1975: regulate when spent criminal-record information may lawfully be requested and considered.
• Data Protection Act 2018 and UK GDPR: regulate the lawful, fair, secure and proportionate processing of personal data and criminal-offence data.
• Equality Act 2010: requires fair, non-discriminatory recruitment and reasonable adjustments where applicable.
• DBS Code of Practice: governs the lawful use, handling, storage, retention and disposal of DBS certificate information.

Regulation 19 is the primary CQC regulation for the recruitment and continuing fitness of employees and other persons engaged in carrying on the regulated activity. Regulations 13 and 17 provide connected safeguarding and governance requirements.

12. Schedule 3 Recruitment Record Requirements

{{org_field_name}} will maintain sufficient evidence for every person employed or appointed for the purposes of carrying on a regulated activity to demonstrate that the information required by Schedule 3 has been obtained.

The recruitment file or central compliance record must include, as applicable:

• proof of identity, including a recent photograph where required;
• an appropriate DBS certificate or Update Service evidence;
• satisfactory evidence of conduct in previous employment concerned with health or social care or work with children or adults at risk;
• satisfactory documentary evidence of relevant qualifications;
• a full employment history;
• a satisfactory written explanation of any gaps in employment;
• information about physical or mental health relevant to the person’s ability to perform the role, processed lawfully and with reasonable adjustments considered;
• professional registration details;
• references;
• right-to-work evidence;
• the role-specific DBS eligibility assessment;
• any criminal-record or suitability risk assessment;
• any restrictions or supervision arrangements; and
• the final recruitment authorisation.

These records must be accurate, complete, up to date and readily available for authorised audit and CQC inspection.

13. Audit, Monitoring and Governance

The Registered Manager and HR Lead will monitor compliance through:

• pre-deployment checks;
• a central recruitment-compliance register;
• monthly monitoring of outstanding checks and restrictions;
• regular sample audits of employee files;
• regular audits of agency and contractor assurance;
• review of Update Service status-check arrangements;
• monitoring of certificate-retention and destruction dates;
• review of suitability and criminal-record risk assessments;
• review of DBS and professional-regulator referral decisions;
• analysis of safeguarding concerns linked to recruitment or workforce suitability; and
• reporting of significant findings to the provider’s governance meeting.

Audit findings will identify:

• the compliance failure;
• the person responsible for corrective action;
• the required action;
• the completion deadline;
• any immediate safeguards; and
• evidence of completion.

Any person found to be working without the required eligibility assessment, DBS check, Barred List check or other essential safer recruitment evidence will be removed from unrestricted deployment until the matter has been reviewed and any risk is safely managed.

14. Policy Review

This policy will be reviewed at least annually and sooner where:

• legislation or statutory guidance changes;
• CQC publishes or revises relevant regulatory guidance;
• DBS eligibility, filtering, identity-checking, Update Service or referral guidance changes;
• an internal audit identifies a material gap;
• a safeguarding incident or recruitment failure identifies a need for amendment;
• the organisation changes the services it provides or the groups it supports; or
• a commissioner introduces a relevant lawful contractual requirement.

Managers and staff affected by material changes will be informed and, where required, receive updated guidance or training.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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