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Death of a Service User Policy

1. Purpose and Scope

This policy outlines the procedures and responsibilities for managing the death of a service user in our care home. It ensures that we handle the situation with dignity, respect, and compliance with the latest Care Quality Commission (CQC) Single Assessment Framework, relevant regulations, and best practice guidelines.

This policy applies to all staff within our care home and covers all scenarios, including expected and unexpected deaths.

2. Regulatory and Legal Compliance

• Regulations Covered:
  • Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
  • CQC Key Lines of Enquiry (KLOEs), including “Safe (S1, S2, S6)”, “Caring (C1, C3)”, and “Well-Led (W3, W5)”
  • Notification of Death Regulations (Regulation 16)
  • Mental Capacity Act 2005 (when considering DoLS-related deaths)
  • Coroner’s and Justice Act 2009 (reporting requirements)
  • Data Protection Act 2018 (confidentiality of deceased persons’ records)

3. Procedures for Managing a Death in the Care Home

3.1 Expected Deaths

If a resident is on an end-of-life care plan, the following steps must be followed:

1. Verification of Death
   • Only a qualified healthcare professional (GP, nurse, or paramedic) can verify the death. Staff should not assume death without verification.
2. Notifying Next of Kin
   • The Registered Manager (or Senior on Duty) must immediately notify the next of kin in a sensitive and professional manner.
   • If a person lacks capacity and has a legal representative (e.g., a Court Appointed Deputy), they must be informed.
3. Informing the GP
   • Contact the resident’s GP or on-call doctor to certify the death and issue a Medical Certificate of Cause of Death (MCCD).
4. Notifying Authorities
   • If applicable, notify the local coroner if the cause of death is unknown or under specific circumstances (e.g., fall, neglect allegations, restraint use).
   • If the resident was under a Deprivation of Liberty Safeguards (DoLS) order, notify the CQC and local coroner immediately as required by law.
5. Death Notification to CQC
   • CQC must be notified via the Provider Portal within 24 hours, using the correct form as per Regulation 16.
6. Recording and Documentation
   • Staff must document the time, date, and circumstances of death in the resident’s care plan.
   • Ensure all medicines, belongings, and financial accounts are secured and documented.
7. Dignified Handling of the Deceased
   • Ensure the body is treated with dignity and respect.
   • Relatives should be given time and privacy to say their goodbyes.
   • Arrange for a funeral director as per the resident’s or next of kin’s wishes.

3.2 Unexpected Deaths

If the death is sudden or unexplained, the following procedures must be followed:

1. Call Emergency Services (999)
   • Do not move the body unless directed by paramedics or police.
   • Staff should preserve the scene if foul play or neglect is suspected.
2. Inform the Registered Manager Immediately
   • If unavailable, the Senior on Duty must take charge.
3. Contact GP/Coroner
   • The GP or local emergency team should be contacted immediately to confirm death.
   • If the death is suspicious or unexpected, the coroner and police must be informed immediately.
4. CQC and Safeguarding Reporting
   • Notify CQC within 24 hours via the Provider Portal.
   • If abuse or neglect is suspected, report to Adult Safeguarding and local authority safeguarding team.
   • Complete a Serious Incident Report (SIR) if necessary.
5. Family Communication
   • Inform the family sensitively and promptly, offering support.
   • Provide information on post-mortem and coroner procedures if applicable.
6. Handling of the Deceased and Belongings
   • If the death is unexplained, personal belongings should not be removed until the police or coroner confirm it is appropriate.
   • Arrange for the deceased’s cultural and religious wishes to be observed.

4. Supporting Staff and Residents

• Staff debriefing and emotional support: Staff involved in handling a resident’s death should be given access to support services and an opportunity to discuss their experiences.
• Resident communication and support: Other residents should be informed with sensitivity, with additional emotional support offered where needed.

5. Reviewing and Learning from Deaths

• Analysis of Deaths (Learning Culture – Quality Statement S1 & W3)
  • All deaths should be reviewed to assess:
    • Whether care met the required standards.
    • If there were any safeguarding concerns.
    • If improvements are needed in end-of-life care.
• Annual Death Audit
  • Conduct an annual review of all deaths within the care home to ensure continuous improvement.
  • Share learning outcomes with the staff team, local safeguarding boards, and CQC inspectors when requested.

6. Roles and Responsibilities

Registered Manager

• Ensures compliance with CQC reporting and regulatory requirements.
• Leads investigations for unexpected deaths.
• Reviews end-of-life care provision regularly.
• Ensures staff are trained in dealing with death, bereavement, and end-of-life care.

Senior on Duty

• Manages the immediate response to a death.
• Liaises with the GP, family, and funeral directors.
• Ensures proper documentation and reporting.

All Care Staff

• Provide dignified and compassionate care during the final moments of life.
• Ensure correct documentation and follow protocol for handling deaths.
• Support other residents during the grieving process.

7. CQC Inspection Compliance & Evidence

During CQC inspections, we provide:
✅ Death records and audits demonstrating compliance with safe and well-led regulations.
✅ Incident reports for unexpected deaths, including follow-up actions.
✅ Training logs for staff covering end-of-life care and bereavement support.
✅ Cultural and religious support policies ensuring dignity in death.
✅ Family feedback and complaints handling records related to deaths.

This policy is reviewed annually or following significant incidents, ensuring alignment with CQC’s latest assessment framework.

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