CHW43-Transportation and Accompanying Service Users Policy

Registration Number: {{org_field_registration_no}}

Transportation and Accompanying Service Users Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} plans, provides, records and reviews the transportation and accompanying of service users in a safe, lawful, person-centred and outcome-focused way. Transport and escort arrangements must support each service user’s well-being, dignity, independence, privacy, rights, safety, Welsh language and communication needs, and personal outcomes. This policy must be applied in accordance with the Regulation and Inspection of Social Care (Wales) Act 2016, The Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended, the Welsh Government statutory guidance for care home services, CIW notification and reporting requirements, the Social Services and Well-being (Wales) Act 2014, the Mental Capacity Act 2005, Deprivation of Liberty Safeguards where applicable, the Equality Act 2010, safeguarding duties and relevant road traffic, health and safety and vehicle safety requirements.

2. Scope

This policy applies to all staff members involved in the transportation of service users, including care workers, drivers, escorts, and management. It covers:

Transport for medical appointments
Social outings and recreational trips
Emergency transportation
Accompanying service users on foot or via public transport
Third-party transport arrangements
Transport or escorting arranged as part of the service user’s personal plan, care and support plan, health plan, risk assessment or best-interest decision.
Journeys for hospital attendance, GP, dental, optometry, podiatry, community health, social, cultural, religious, spiritual, recreational, educational or family-contact purposes.
Journeys involving wheelchair-accessible vehicles, mobility aids, specialist seating, oxygen, medicines, continence supplies, communication aids or other equipment.
Situations where a service user may become distressed, disorientated, unwell, anxious, at risk of falls, at risk of leaving staff supervision, or unable to consent to the proposed transport arrangements.
Transport arranged or provided by family members, representatives, volunteers, taxis, community transport, ambulance services, public transport or any other third-party provider, where staff are involved in planning, accompanying, risk assessment or handover.

3. Principles of Safe and Dignified Transportation

Transportation of service users must adhere to the following core principles:

Person-centred approach: Ensuring individual preferences, needs, and risk assessments are considered.
Safety and compliance: Adhering to Road Traffic Act 1988, MOT regulations, and relevant CIW guidance.
Respect and dignity: Ensuring service users feel comfortable, secure, and respected during transit.
Clear communication: Informing service users and their families about transport arrangements.
Equality and accessibility: Providing transport options that are accessible to all, including those with mobility impairments.
Personal plan compliance: Transport and escort arrangements must be consistent with the service user’s personal plan, provider assessment, care and support plan, mobility plan, moving and handling plan, communication plan and any relevant health or behavioural support plan.
Positive risk-taking: Staff must support service users to access the community and take ordinary life opportunities unless a specific assessed risk means this would be unsafe or inconsistent with the person’s well-being. Restrictions must be lawful, proportionate, recorded and kept under review.
Consent and choice: Service users must be involved in decisions about transport wherever possible, including the purpose of the journey, who accompanies them, what support is needed, and any reasonable adjustments required.
Least restrictive practice: Transport arrangements must not unnecessarily restrict a service user’s liberty, movement, independence or contact with others. Any restriction must be necessary, proportionate, time-limited, documented and lawful.
Welsh language and communication: Staff must take reasonable steps to meet the service user’s language and communication needs, including Welsh language needs, accessible information, hearing or visual aids, communication passports, advocacy support and other aids where required.

4. Planning and Risk Assessment

Before transport or escorting is arranged, staff must check the service user’s personal plan, provider assessment, care and support plan, risk assessments and any relevant health, mobility, moving and handling, communication, behavioural support, falls, choking, continence, medication or end-of-life plan. Transport must not proceed unless the planned arrangements are suitable to meet the person’s needs and support their personal outcomes.

The transport risk assessment must consider, as a minimum:

The purpose, destination, timing, expected duration and route of the journey.
The service user’s physical health, mobility, cognition, emotional well-being, sensory needs, communication needs, continence needs and any known triggers for distress, anxiety or disorientation.
Whether the service user can consent to the journey and any support needed to make or communicate a decision.
Where the service user lacks mental capacity for a specific transport decision, the best-interest decision-making process under the Mental Capacity Act 2005, including consultation with relevant representatives and professionals where required.
Whether the journey involves any restriction, restraint, locked doors, close supervision, harness, lap belt, specialist seating or other arrangement that may amount to control, restraint or a deprivation of liberty.
The safest and least restrictive mode of transport, including walking, public transport, care home vehicle, wheelchair-accessible vehicle, taxi, community transport, non-emergency patient transport or ambulance.
The number and competence of staff required, including whether one-to-one or two-to-one support is needed.
Moving and handling arrangements, including transfers, hoists, ramps, steps, wheelchair tie-downs, passenger restraints and safe positioning.
Medicines, oxygen, rescue medication, food, drinks, continence supplies, mobility aids, communication aids, emergency contact details and any other equipment required during the journey.
Weather, road conditions, traffic, parking, accessibility of the destination, availability of toilets, rest breaks and contingency arrangements.
Emergency arrangements, including what staff must do if the service user becomes unwell, distressed, refuses to continue, goes missing, the vehicle breaks down, the appointment is delayed, or the transport provider does not arrive.

The completed risk assessment must be recorded, dated, reviewed when needs change, and reflected in the service user’s personal plan where transport is a regular or foreseeable part of their care and support.

5. Staff Responsibilities in Transportation

All staff involved in transportation must:

Have the training, competence, confidence and information required for their role, including moving and handling, wheelchair and passenger restraint use where applicable, safeguarding, first aid or emergency response, infection prevention and control, medication support where delegated, Mental Capacity Act and Deprivation of Liberty Safeguards awareness, communication needs, equality and diversity, lone working, and incident reporting.
Ensure vehicles used are roadworthy, insured, and compliant with regulatory requirements.
Secure wheelchairs and mobility aids properly in vehicles.
Ensure that seatbelts and restraints are used appropriately.
Ensure that any wheelchair, wheelchair tie-down and occupant restraint system is suitable for occupied transport and is used in accordance with the manufacturer’s instructions and staff training. Wheelchair lap belts and postural supports must not be treated as vehicle occupant restraints unless they are designed and approved for that purpose.
Record and report any incidents, delays, or concerns that arise during transport.
Escalate immediately to the Registered Manager or person in charge where a delay, missed appointment, incident, accident, injury, safeguarding concern, refusal, distress, medication issue, missing person concern or transport failure may affect the service user’s safety, well-being or access to care.
Maintain confidentiality and dignity of service users at all times.

6. Consent, Capacity and Best-Interest Decisions

Staff must seek the service user’s consent before arranging or providing transport or escorting support, unless there is an emergency or a lawful best-interest decision has been made. Consent must be informed, voluntary and specific to the journey or arrangement wherever possible.

A service user must be presumed to have capacity unless it is established that they lack capacity for the specific decision at the specific time. Where there is reason to believe the service user may lack capacity to decide about a journey, staff must follow the Mental Capacity Act 2005 and the organisation’s Mental Capacity and Deprivation of Liberty policy.

Where a service user lacks capacity for a specific transport decision, any decision made on their behalf must be in their best interests, be the least restrictive option, and be recorded. The record must include the decision, the reason for the decision, who was consulted, the risks and benefits considered, and how the person’s past and present wishes, feelings, beliefs and values were taken into account.

Transport arrangements must not deprive a person of their liberty unless lawful authority is in place. Any concern that transport, supervision or restrictions may amount to a deprivation of liberty must be escalated to the Registered Manager before the arrangement is used, unless urgent action is required to prevent immediate harm.

7. Accompanying Service Users on Foot or Public Transport

When accompanying service users outside the care home, staff must:

Follow individual care plans regarding mobility and supervision needs.
Ensure service users are appropriately dressed for weather conditions.
Maintain awareness of potential hazards (e.g., uneven pavements, traffic crossings).
Offer assistance and reassurance while promoting independence where possible.
Use public transport safely, ensuring priority seating and accessibility considerations.
Staff must carry or have access to essential information required for the journey, including emergency contact details, relevant health information, communication needs, known risks, appointment details, destination details and return arrangements. This information must be kept confidential and secure.
Staff must maintain appropriate supervision in accordance with the person’s personal plan and risk assessment, while avoiding unnecessary restriction or over-supervision.
Where public transport is used, staff must consider accessibility, step-free access, seating, crowding, noise, risk of distress, toilet access, route changes, delays and contingency arrangements.
If a service user becomes distressed, refuses to continue, becomes unwell, is separated from staff, or there is any immediate risk to safety, staff must follow the individual’s risk assessment and emergency procedures and contact the care home immediately.

8. Use of Care Home Vehicles

Where {{org_field_name}} provides its own transport services:

Vehicles must be suitable for the intended use and for the needs of the service users being transported.
Vehicles must be taxed, insured for the correct business and passenger use, MOT-compliant where applicable, serviced and maintained in accordance with manufacturer and legal requirements.
Pre-use vehicle checks must be completed and recorded before use, including fuel or charge level, tyres, lights, mirrors, horn, brakes, seatbelts, wheelchair restraints where applicable, ramp or lift operation, first aid kit, emergency equipment and cleanliness.
Only authorised drivers may drive care home vehicles. The provider must check and record that authorised drivers hold a valid driving licence for the vehicle category, are fit to drive, are insured, and have completed any required driver assessment or familiarisation.
Drivers must notify the Registered Manager immediately of any change that may affect their ability or legal entitlement to drive, including licence endorsements, disqualification, medication, health condition, eyesight issue, fatigue or any incident involving a vehicle used for work.
A journey log must be completed for each journey and must include the service user’s name, date, driver, escort where applicable, vehicle used, destination, purpose of journey, departure time, return time, mileage where required, any incidents, delays or concerns, and any follow-up action.
Wheelchair-accessible vehicles, ramps, lifts, clamps, wheelchair tie-downs and occupant restraint systems must only be used by staff who have been trained and assessed as competent. Manufacturer instructions must be followed.
Vehicles must be kept clean, hygienic, smoke-free and free from avoidable hazards. Infection prevention and control procedures must be followed, including cleaning after contamination with bodily fluids or infectious material.
Emergency procedures for breakdown, collision, adverse weather, medical emergency, missing person concern, safeguarding concern or delay must be available in the vehicle or accessible to staff during the journey.

9. Wheelchairs, Mobility Aids and Specialist Equipment

Where a service user travels in a wheelchair, staff must consider whether the safest option is for the person to transfer to a vehicle seat with the wheelchair safely stored as luggage. Where the person cannot transfer or it is not safe or appropriate to transfer, the risk assessment must confirm that the wheelchair is suitable for occupied transport and that the correct wheelchair tie-down and occupant restraint system is available.

Staff must not transport a service user in a wheelchair unless the wheelchair, vehicle, ramp or lift, tie-down system and occupant restraint system are compatible and safe for the person’s weight, posture, seating position and support needs.

Mobility aids, walking frames, oxygen cylinders, bags, communication aids and other equipment must be secured during transport so that they do not create a risk of injury.

Staff must report any defect, failure, missing part or concern about a vehicle, ramp, lift, wheelchair, tie-down, restraint, seatbelt or mobility aid immediately. Equipment must not be used if it is unsafe.

10. Third-Party Transport Arrangements

Where external transport services (taxis, ambulances, or community transport) are used:

Only reputable and licensed providers must be used.
Where taxis, private hire vehicles, community transport or other external providers are used, staff must take reasonable steps to confirm that the transport is suitable for the service user’s needs, including accessibility, wheelchair access where required, passenger restraints, insurance, safeguarding considerations and the ability to meet the agreed time and destination.
The provider must have appropriate insurance and safeguarding policies.
Service users must not be left alone with a third-party driver unless this has been assessed as safe, agreed with the service user where they have capacity to decide, recorded in the personal plan or risk assessment, and is consistent with safeguarding, mental capacity and best-interest requirements. Where the service user lacks capacity, any decision must be made and recorded in their best interests.
Staff must document and confirm transport arrangements with the service user and their family.
Staff must ensure there is a clear handover arrangement at the destination and return point. Where the service user is attending an appointment without staff remaining present, the risk assessment must identify who is responsible for the person during the appointment, how the person will be supported, and how staff will be contacted if the appointment is delayed or cancelled.

11. Emergency Transport Procedures

In case of a medical emergency requiring urgent transport:

In a life-threatening or serious medical emergency, staff must dial 999 immediately, follow emergency response procedures and provide clear information about the service user’s condition, location, risks, communication needs, mobility needs and any known allergies or relevant health information.
A designated staff member must accompany the service user to hospital or another emergency destination unless emergency services advise otherwise, it would be unsafe to do so, or an alternative arrangement has been agreed by the Registered Manager or person in charge.
Staff must take essential information with the service user where possible, including their current medication information, allergies, relevant health conditions, communication needs, next of kin or representative details, DNACPR or advance decision information where applicable, and any hospital passport or similar document.
The service user’s next of kin, representative or placing authority must be informed as soon as practicable, unless this would be contrary to the person’s wishes, well-being, confidentiality or legal requirements.
The Registered Manager or person in charge must be informed as soon as possible. The incident must be recorded in the service user’s care records, personal plan review notes where relevant, accident or incident record, and any other required record.
Where the incident is notifiable to CIW, the Responsible Individual or delegated authorised person must ensure a notification is submitted through CIW Online without delay and in accordance with CIW requirements.

12. Medicines, Health Information and Appointments

Where a service user requires medicines during a journey or appointment, this must be planned in advance and recorded in accordance with the Medication Policy. Staff must only administer or support medicines where they are trained, competent and authorised to do so.

Time-critical medicines, rescue medicines, inhalers, insulin, pain relief, oxygen or other prescribed treatment must be considered before the journey begins. Staff must check that the correct medicine, dose, records, storage arrangements and administration instructions are available.

Staff accompanying a service user to a health appointment must support the person to participate as fully as possible, communicate their wishes and understand information given. Relevant outcomes, advice, changes to treatment or follow-up actions must be recorded and communicated to the nurse, senior staff member, Registered Manager or relevant staff before the end of the shift.

Confidential health information must only be shared on a need-to-know basis and in the service user’s best interests or with their consent, unless there is another lawful basis for sharing.

13. Safeguarding During Transport and Community Access

Staff must remain alert to safeguarding risks during transport, appointments and community activities, including abuse, neglect, exploitation, financial abuse, discriminatory treatment, unsafe restraint, inappropriate conduct by others, unexplained injury, distress, intimidation, coercion or a service user going missing.

Any safeguarding concern arising before, during or after a journey must be reported immediately in accordance with the Safeguarding Policy and Wales Safeguarding Procedures. Staff must take immediate action to protect the service user and any other person at risk.

Where the concern involves a third-party transport provider, driver, volunteer, staff member, visitor, professional or member of the public, the Registered Manager must consider whether referrals are required to the local authority safeguarding team, police, CIW, commissioning body, DBS, professional regulator or other relevant body.

A clear record must be kept of the concern, action taken, referrals made, advice received and outcomes.

14. Missing Person, Late Return or Unplanned Absence During Transport

If a service user is missing, separated from staff, fails to arrive, fails to return as expected, leaves an appointment or vehicle unexpectedly, or cannot be contacted following a planned journey, staff must take immediate action in accordance with the Missing Person/Unauthorised Absence procedure and the individual risk assessment.

Staff must contact the care home immediately, remain calm, search the immediate area where safe to do so, contact the destination or transport provider where relevant, and escalate to the police where there is any risk to the person’s safety or well-being.

The Registered Manager or person in charge must inform the service user’s representative, placing authority or commissioner where appropriate, and must consider whether the incident is notifiable to CIW.

The incident must be fully recorded and the service user’s risk assessment and personal plan must be reviewed before further similar journeys take place.

15. Infection Prevention and Control During Transport

Staff must follow the Infection Prevention and Control Policy during transport and accompanying duties. This includes hand hygiene, use of PPE where required, safe management of bodily fluids, safe disposal of waste, cleaning of vehicles or equipment after contamination, and consideration of infection risks before shared transport is used.

Where a service user has symptoms of an infectious illness, the risk assessment must consider whether the journey is essential, whether clinical advice is needed, what precautions are required, and whether transport providers or receiving services need to be informed on a need-to-know basis.

Vehicles, mobility aids, wheelchairs, restraints, handles and frequently touched surfaces must be cleaned in accordance with the organisation’s cleaning schedule and infection control requirements.

16. Records and Documentation

The following records must be completed where relevant:

Transport risk assessment.
Journey log.
Vehicle pre-use check.
Driver authorisation and licence check record.
Vehicle insurance, MOT, servicing, repair and maintenance records.
Wheelchair-accessible vehicle, ramp, lift, tie-down and restraint maintenance records.
Record of staff training and competency for driving, escorting, moving and handling, wheelchair restraint use, emergency procedures and medication support where applicable.
Appointment outcome record, including advice received and follow-up actions.
Accident, incident, safeguarding, missing person, medication or complaint records where applicable.
CIW notification record where applicable.

Records must be accurate, dated, signed or attributable to the person making the record, stored securely, and reviewed as part of quality assurance.

17. Compliance and Monitoring

The Registered Manager is responsible for ensuring that transport and accompanying arrangements are implemented safely, consistently and in accordance with this policy, the statement of purpose, personal plans, risk assessments and CIW requirements.

The Registered Manager must ensure that:

Transport risk assessments are completed, person-centred, proportionate and reviewed when needs or circumstances change.
Regular transport arrangements are reflected in the service user’s personal plan.
Staff are trained, competent and supervised for the transport and escorting duties they undertake.
Vehicles, equipment, wheelchair restraints, ramps and lifts are checked, maintained and removed from use if unsafe.
Incidents, accidents, delays, complaints, safeguarding concerns, missed appointments and near misses are recorded, investigated and used for learning.
CIW notifications are made where required and without delay.
Service user, family, representative, staff and professional feedback is considered as part of service improvement.
Audits are completed at least annually, or sooner where risks, incidents or changes indicate this is necessary.

The Responsible Individual must maintain oversight of transport-related risks, incidents, complaints, safeguarding concerns, CIW notifications and improvement actions through the service’s governance and quality assurance arrangements.

18. Related Policies

This policy should be read in conjunction with:

CHW07 – Person-Centred Care Policy
CHW11 – Safe Care and Treatment Policy
CHW18 – Risk Management and Assessment Policy
CHW42 – Communication and Engagement with Service Users and Families Policy

19. Policy Review

This policy will be reviewed at least annually, or sooner following changes in legislation, Welsh Government guidance, CIW requirements, the statement of purpose, service provision, vehicle arrangements, serious incidents, safeguarding concerns, complaints, audit findings, feedback from service users or representatives, or any identified failure in transport or accompanying arrangements.

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}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.