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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Emergency Supply Shortages and Contingency Planning Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} is prepared to respond efficiently and effectively to any disruptions in the supply of critical goods, services, or utilities that may impact the safety, wellbeing, or care of the people we support. It outlines our contingency measures for managing short-term or long-term shortages in supplies such as personal protective equipment (PPE), medicines, food, hygiene products, staffing, utilities, and equipment.

This policy supports compliance with the Health and Social Care Act 2008 and the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, including Regulation 9 (Person-centred care), Regulation 12 (Safe care and treatment), Regulation 14 (Meeting nutritional and hydration needs), Regulation 15 (Premises and equipment), Regulation 17 (Good governance) and Regulation 18 (Staffing). It also supports compliance with the Care Quality Commission (Registration) Regulations 2009, including the requirement to notify CQC of relevant events and incidents that affect the health, safety and welfare of people using the service.

2. Scope

This policy applies to all staff, volunteers, and contractors working for or on behalf of {{org_field_name}}, including those involved in procurement, care delivery, and operational management. This policy applies to all residents, staff, volunteers, visiting professionals, contractors, relatives and representatives insofar as they may be affected by a supply shortage, emergency or disruption to the safe running of the service. It applies to all types of supply chain interruptions whether caused by industrial action, IT or cyber incidents, loss of electronic care planning systems, transport disruption, supplier insolvency, fuel shortages, severe weather, infectious disease outbreaks, utility failure or any other foreseeable or unforeseen incident. This policy ensures that every member of the team understands their role in maintaining services and safeguarding people during supply shortages.

3. Related Policies

This policy should be read in conjunction with the following:

• CH11 – Safe Care and Treatment Policy
• CH15 – Premises and Equipment Policy
• CH17 – Infection Prevention and Control Policy
• CH18 – Risk Management and Assessment Policy
• CH19 – Emergency and Business Continuity Plan
• CH21 – Medication Management and Administration Policy
• CH25 – Notification of Other Incidents Policy

• Safeguarding Adults Policy.
• Duty of Candour Policy.
• Complaints and Concerns Policy.
• Nutrition and Hydration Policy.
• Fire Safety and Evacuation Policy.
• Staffing and Safe Recruitment Policy.
• Mental Capacity and Best Interests Policy.
• Data Protection, Records and Information Governance Policy.
• Information Technology, Cyber Security and System Failure Procedure.
• Business Continuity Plan.
• Heatwave, Cold Weather and Adverse Weather Plans.
• Infection Prevention and Control Outbreak Management Plan.
• Local Authority, ICB and Emergency Services Escalation Contacts.

4. Identification of Critical Supplies

Critical supplies are items essential for the delivery of safe and effective care. These include PPE (gloves, masks, aprons), cleaning and disinfectant products, food and nutrition supplies, medication, medical consumables, continence products, utilities (electricity, water, gas), assistive equipment (hoists, wheelchairs), and communication tools (phones, Wi-Fi, alarms). Each care location must maintain a list of critical items with minimum stock levels. These stock levels are reviewed at least weekly and monitored by the Home Manager, Deputy Manager, maintenance lead, catering lead, medicines lead or other designated supplies lead, depending on the category of supply. Any item falling below the agreed minimum level must be escalated on the same day and recorded on the supply shortage log.

The critical supplies list must include, as a minimum:

• medicines and MAR documentation;
• prescribed nutritional supplements and thickening agents;
• food, specialist diets, texture-modified meals and emergency food supplies;
• drinking water and arrangements for safe water supply;
• PPE and infection prevention and control supplies;
• cleaning, laundry and waste disposal supplies;
• continence products and personal care items;
• moving and handling equipment, slings, hoists and wheelchairs;
• pressure-relieving equipment, beds, mattresses and clinical consumables;
• oxygen or other clinical equipment where used in the service;
• heating, lighting, hot water, refrigeration and temperature control systems;
• call bells, fire alarms, telephones, Wi-Fi, electronic care records and electronic medicines systems;
• transport arrangements for urgent appointments or evacuation;
• staffing resources, including agency and emergency cover arrangements.

5. Risk Assessment and Preparedness

Risk assessments are conducted at least annually and sooner where there is a change in residents’ needs, premises, staffing, suppliers, equipment, medicines arrangements, local risk level, national guidance, weather warnings, infectious disease outbreaks, utility disruption, cyber risk, or following any incident, near miss or activation of this policy. This includes assessing single supplier dependencies, remote location risks, reliance on external contractors, and storage capacity. Each risk is rated and added to the organisation’s risk register. Contingency plans are developed and tested for each risk scenario. Key suppliers are asked to provide continuity plans to demonstrate their ability to maintain service during emergencies. Emergency plans are documented, accessible, and reviewed regularly.

The risk assessment must consider the impact on each resident, including people who are clinically vulnerable, require time-critical medicines, require specialist nutrition or hydration support, use oxygen or pressure-relieving equipment, require moving and handling equipment, are at risk of distress due to routine changes, or may be unable to understand or communicate the impact of the disruption. Where a shortage may affect a resident’s care, the resident’s care plan and risk assessment must be updated promptly.

Preparedness arrangements must include documented escalation contacts for suppliers, the local authority, Integrated Care Board, community pharmacy, GP practice, district nursing team, utility providers, emergency services, maintenance contractors and CQC. Contact details must be checked at least quarterly.

5.1 Business Continuity Activation Levels

The Registered Manager, or the most senior person on duty in their absence, will decide the activation level using the following framework:

• Level 1 – Minor disruption: A shortage or disruption is identified but safe care can continue using normal stock, staffing or supplier arrangements. The issue must be logged and monitored.
• Level 2 – Moderate disruption: Normal arrangements are affected and alternative suppliers, staffing changes or amended routines are required. The Registered Manager must be informed, a risk assessment completed and affected residents, staff and relatives informed where appropriate.
• Level 3 – Major disruption: The disruption may affect safe care, staffing levels, medicines, food, hydration, infection control, equipment, utilities or the safe running of the home. The provider’s business continuity plan must be activated, senior management informed and external escalation considered, including the local authority, ICB, emergency services, utility providers and CQC where notification criteria are met.
• Level 4 – Critical incident: The service cannot continue safely without urgent external support, evacuation, emergency supplies, emergency staffing or temporary service changes. The emergency plan must be activated immediately and the safety, dignity and wellbeing of residents must be prioritised at all times.

All decisions to activate, escalate or stand down the plan must be recorded, including who made the decision, the time, the risks identified, the actions taken and any follow-up required.

6. Communication and Escalation Procedures

Any anticipated or actual disruption to critical supplies, staffing, utilities, medicines, equipment, food, hydration, IT systems or premises safety must be reported immediately to the Registered Manager or, in their absence, the most senior person on duty. The person receiving the report must assess the immediate and potential impact on residents, staff and the safe running of the home.

The Registered Manager will decide whether the issue can be managed locally or whether it must be escalated to the provider, senior management, alternative suppliers, maintenance contractors, the local authority, Integrated Care Board, community pharmacy, GP practice, emergency services, utility providers or other relevant agencies.

Residents must be kept informed in a way they can understand. Relatives, representatives and advocates must be updated where the disruption is likely to affect care, safety, visiting, routines, nutrition, hydration, medicines, comfort, dignity or wellbeing. Communication must be honest, proportionate and reassuring.

Staff must receive clear instructions about:

• the nature of the disruption;
• immediate actions required;
• changes to routines, duties or risk controls;
• escalation routes;
• documentation requirements;
• how residents’ dignity, choice and rights will be maintained.

The Registered Manager must consider whether a statutory notification to CQC is required. CQC must be notified, without delay, where an incident falls within notification requirements, including events that stop or may stop the service from running safely and properly, serious injury, abuse or allegations of abuse, police involvement, death of a person using the service, or other notifiable events.

All communication and escalation actions must be recorded, including the date and time, the person contacted, advice received, decisions made, actions taken and follow-up required.

7. Stock Management and Emergency Reserves

Each care home maintains an emergency reserve of essential supplies, such as PPE, infection prevention and control supplies, cleaning products, continence products, hygiene items, bottled water or alternative safe drinking water arrangements, and emergency food supplies that reflect residents’ dietary, cultural, religious, allergy-related and texture-modified requirements. Medicines must not be stockpiled unless this is lawful, clinically appropriate, authorised by the prescriber or pharmacist, and managed in accordance with the Medication Management and Administration Policy.

These reserves are clearly labelled, inventoried, and stored securely in accessible areas. Stock rotation procedures ensure that emergency items do not expire or degrade. Replenishment is the responsibility of the designated procurement officer or supplies lead. Monthly audits of emergency stocks are conducted and reported to the senior management team.

Emergency food and hydration supplies must be sufficient to support residents safely for at least 72 hours and must include arrangements for people who require fortified diets, prescribed supplements, thickened fluids, diabetic diets, pureed or texture-modified meals, allergies or other specialist dietary requirements.

Emergency supplies must be stored safely and securely, protected from contamination, damage, theft, unauthorised access and inappropriate temperatures. Where supplies have expiry dates, these must be checked and rotated as part of the monthly audit.

8. Alternative Suppliers and Mutual Aid

{{org_field_name}} maintains a directory of approved secondary and emergency suppliers for all critical categories. This includes local pharmacies, wholesalers, catering services, utility providers, and agency staffing services. Where possible, service-level agreements (SLAs) are in place to ensure priority supply during emergencies. We also maintain mutual aid arrangements with other care providers and local resilience forums to share critical items or staff during periods of extreme shortage. Participation in local authority contingency planning groups helps ensure collaborative and coordinated responses.

The approved supplier directory must include emergency out-of-hours contact details, delivery arrangements, account numbers where relevant, expected delivery times, substitute product arrangements and any known limitations. The directory must be reviewed at least quarterly and after any failed or delayed supply.

Before using an alternative supplier or accepting mutual aid, the Home Manager must be satisfied that the supplies are safe, suitable, lawful, within date where applicable, stored correctly and appropriate for the needs of residents. Medicines must only be obtained through lawful and clinically appropriate routes, such as the supplying pharmacy, prescriber, NHS service or other authorised route.

Mutual aid arrangements must not compromise the safety of residents in either service. Any items received or provided through mutual aid must be recorded, including the item, quantity, source, date, condition, expiry date where applicable and authorising manager.

9. Medication and Clinical Supply Shortages

In the event of medication shortages, staff must immediately inform the Registered Manager and liaise with the community pharmacist or prescribing clinician to arrange alternatives. No unprescribed substitutions should be made. Risk assessments must be undertaken, and the GP consulted to adjust prescriptions or treatment plans. Medicines must only be obtained, stored, administered, supplied, returned or disposed of in accordance with legal requirements, the prescriber’s instructions, pharmacy advice and the Medication Management and Administration Policy. Staff must not make substitutions, borrow medicines from another resident, use another resident’s medicines, alter doses, omit medicines or change administration times unless this has been authorised by an appropriate prescriber or in accordance with agreed clinical advice. All changes must be recorded in the care plan and MAR chart, and clearly communicated to staff, families, and the individual being supported.

Where a medicine is unavailable, the Registered Manager or medicines lead must:

• check the current stock and MAR chart;
• contact the supplying pharmacy urgently;
• contact the GP, prescriber, specialist nurse or out-of-hours service where clinical advice is required;
• identify whether the medicine is time-critical;
• assess the risk to the resident if the medicine is delayed, omitted or changed;
• document all advice, decisions and actions;
• update the care plan and MAR chart where a lawful change is made;
• inform the resident and, where appropriate, their representative;
• monitor the resident for any adverse effects or deterioration.

Any medicines incident, missed dose, delayed dose, incorrect substitution, unsafe storage issue or clinical deterioration linked to a medicine shortage must be recorded, investigated and escalated in line with the medicines policy, safeguarding procedures, duty of candour requirements and CQC notification requirements where applicable.

10. Staffing Shortages

In the event of sudden staff shortages due to illness, transport disruption, or other emergencies, {{org_field_name}} activates the emergency staffing rota. This includes:

• Reassigning existing staff based on priority need
• Extending hours or authorising overtime with staff consent
• Deploying trained office-based staff for frontline care
• Engaging pre-approved agency workers
• Prioritising resident care interventions based on assessed risk, dependency, clinical need, dignity, hydration, nutrition, medicines, continence, pressure care, mobility, safeguarding and emotional wellbeing.

The Registered Manager ensures that staffing levels remain safe and documented, and that any missed or delayed visits are reported, investigated, and followed up appropriately.

Staffing contingency arrangements must ensure that there are enough suitably qualified, competent and experienced staff deployed to meet residents’ assessed needs. The Registered Manager must review staffing levels, dependency levels, skill mix, agency use, staff competence, leadership cover, fire safety arrangements, medicines cover, moving and handling needs and night staffing arrangements.

Where staffing falls below planned levels, the Registered Manager must complete and record a dynamic risk assessment. The assessment must identify:

• residents most at risk;
• essential care that must not be delayed;
• tasks that may safely be deferred;
• additional support required;
• agency, bank or management cover required;
• communication with staff, residents and relatives;
• whether external escalation is required.

Staff must not be asked to work in a way that is unsafe, outside their competence or likely to compromise residents’ safety, dignity or rights.

10.1 Utilities, Premises and Equipment Failure

Where there is disruption to electricity, gas, water, heating, hot water, refrigeration, lifts, call bells, fire alarms, laundry, waste disposal, telephones, Wi-Fi, electronic care records, electronic medicines systems or essential equipment, the Registered Manager must complete an immediate risk assessment and activate the relevant contingency arrangements.

The assessment must consider:

• resident safety, comfort, dignity and wellbeing;
• room temperatures and safe heating or cooling;
• safe food storage and refrigeration;
• safe drinking water and hygiene;
• medicines storage temperatures;
• fire safety and alarm systems;
• call bell or alternative checking arrangements;
• moving and handling equipment;
• pressure care equipment;
• lighting and trip hazards;
• infection prevention and control;
• whether evacuation, temporary relocation or external support is required.

Where equipment is unavailable or unsafe, staff must not use it until it has been checked, repaired, replaced or risk assessed as safe. Alternative equipment or safe manual handling arrangements must be put in place without delay.

Any failure of premises, utilities or equipment that affects the safe running of the home must be escalated to senior management and relevant external agencies, and CQC notification must be considered.

10.2 IT, Cyber and Records Contingency

Where electronic systems are unavailable, including care planning systems, electronic medicines systems, staff rostering systems, telephones, internet, Wi-Fi, alarms or digital records, the Registered Manager must activate the IT and records contingency procedure.

The service must maintain access to essential information required to keep residents safe, including:

• emergency contact details;
• current care plans and risk summaries;
• medicines information and MAR charts;
• allergies;
• DNACPR or ReSPECT documentation where applicable;
• moving and handling plans;
• nutrition, hydration and choking risk information;
• pressure care needs;
• safeguarding risks;
• GP, pharmacy, district nursing and emergency contact details.

Paper records used during an outage must be accurate, legible, dated, signed and transferred back into the main record system as soon as practicable. Any data breach or cyber incident must be escalated in line with the organisation’s data protection and information governance procedures.

10.3 Infection Prevention and Control Supply Shortages

Shortages of PPE, cleaning products, disinfectants, laundry supplies, waste disposal arrangements or isolation equipment must be escalated immediately to the Registered Manager and infection prevention and control lead.

The service must not reduce infection prevention and control standards because of a supply shortage. Where usual products are unavailable, alternative products must be checked to ensure they are suitable, safe, effective and compatible with current infection prevention and control guidance.

During an outbreak or suspected outbreak, the Registered Manager must liaise with relevant health protection, local authority, NHS or infection prevention and control professionals as required. Residents, staff, visitors and relatives must be given clear information about any temporary changes to visiting, isolation, PPE use, cleaning or routines.

10.4 Food, Hydration and Catering Disruption

Where food, catering, kitchen equipment, refrigeration, drinking water or specialist dietary supplies are disrupted, the Registered Manager and catering lead must complete an immediate risk assessment.

The service must ensure that residents continue to receive food and fluids that meet their assessed needs, preferences and safety requirements. This includes consideration of:

• allergies and intolerances;
• religious and cultural dietary needs;
• diabetes and other clinical diets;
• fortified diets;
• prescribed nutritional supplements;
• thickened fluids;
• pureed, minced, moist or texture-modified diets;
• choking risk;
• food hygiene and safe storage;
• hydration risks during hot weather or illness.

Emergency menus must be available and must be suitable for the needs of residents living in the home. Any significant disruption to nutrition or hydration must be recorded, escalated and monitored until resolved.

11. Training and Awareness

All staff receive training on this policy as part of their induction and ongoing development. This includes recognising supply risks, understanding escalation procedures, stock control responsibilities, and how to respond to supply-related emergencies. Annual drills are conducted as part of our CH19 – Emergency and Business Continuity Plan to ensure staff readiness. Learning from actual incidents is shared with staff through team briefings and supervision.

Training and awareness must be role-specific and include:

• how to identify and report supply shortages;
• use of the emergency supplies list;
• medicines shortage escalation;
• food, hydration and specialist diet contingencies;
• utility failure and emergency equipment arrangements;
• IT, cyber and records downtime procedures;
• infection prevention and control supply shortages;
• safe staffing escalation;
• CQC notification triggers;
• communication with residents, relatives and professionals;
• maintaining dignity, choice, equality and human rights during disruption.

Scenario-based testing must include out-of-hours situations, weekends and bank holidays, when senior staff, suppliers or usual contacts may not be immediately available.

12. Governance, Audit and Learning

The Registered Manager is responsible for overseeing supply chain risks, contingency preparedness and business continuity arrangements. The provider must maintain effective governance systems to assess, monitor and improve the quality and safety of the service, including the risks created by supply shortages, staffing shortages, utility failure, equipment failure, medicines disruption, food or hydration disruption, infection prevention and control supply issues and IT or cyber incidents.

The quarterly review must include:

• shortages, near misses and incidents;
• stock audit outcomes;
• medicines supply issues;
• staffing shortage episodes;
• equipment or utility failures;
• infection prevention and control supply issues;
• supplier performance;
• complaints, concerns or feedback linked to disruption;
• safeguarding concerns linked to shortages;
• CQC notifications made or considered;
• actions completed and outstanding;
• learning shared with staff.

Audit findings must be used to update risk assessments, resident care plans, supplier arrangements, emergency stock levels, staff training and business continuity plans.

13. Records and Evidence

The service must keep clear records of all supply shortages, disruptions, decisions and actions. Records must be accurate, complete, contemporaneous and available for audit, investigation, safeguarding enquiries, commissioners and CQC where required.

Records must include:

• the date and time the issue was identified;
• the supply, service, equipment, staffing or system affected;
• residents affected or potentially affected;
• risk assessment completed;
• immediate actions taken;
• people and agencies contacted;
• advice received;
• decisions made and by whom;
• communication with residents, relatives and staff;
• whether CQC notification was required or considered;
• outcome and lessons learned.

The supply shortage log, emergency stock audits, supplier directory, business continuity tests, incident records and action plans must be retained in line with the organisation’s record retention policy.

14. Policy Review

This policy will be reviewed at least annually and sooner where there are significant supply chain changes, changes in legislation, CQC guidance updates, changes in residents’ needs, changes in the service model, supplier failure, serious incident, safeguarding concern, complaint, CQC feedback, business continuity exercise or activation of this policy. The review will be led by the Registered Manager in consultation with the provider, senior management, procurement, health and safety, infection prevention and control, medicines, catering, maintenance and care team leads.

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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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