CH201. Missing Persons in Care homes
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Missing Persons in Care homes (England) Policy
Policy Statement
This policy sets out the values, principles and policies underpinning {{org_field_name}}’s approach to the discovery that a person living in the home is missing.
Through its policy and procedures the home also seeks to comply with the requirements to report serious instances through the CQC’s notification procedures and the local Adults Safeguarding Board’s procedures and take the appropriate actions in the event of accidents or in the event of person living in the home going missing.
It is common for at least some of the people living in the home to be limited in their mobility. Some may also be confused or easily disoriented and therefore become easily lost. For these reasons a person going “missing” would be an obvious cause for concern.
However, it is accepted that there will be many active people living in the home who value their mobility and independence and spend time out in the local community without raising concern. Thus, a person’s need for close supervision must always be balanced against their rights to make their own decisions regarding their movements and whereabouts.
Note:
The policy details should be adapted to conform to local agreements and arrangements.
Preventing Missing Persons Incidents
Staff must remain vigilant at all times and try to be aware of exactly where vulnerable people living in the home are at any given time. people living in the home who are prone to wandering, or who may be at risk of getting lost by reason of their mental state, will have this identified during risk assessment and a suitable entry made in their care plan. Such people are kept under observation as appropriate to the level of risk identified.
Action taken to avoid false alarms includes the simple precaution of encouraging people living in the home, and their relatives and visitors, to inform a member of staff when they are leaving the home on an outing or a walk and to give both a time they expect to return and a contact name and telephone number.
All such arrangements are entered in the home’s log book or record keeping system.
Raising the Alarm
Staff should raise the alarm immediately if they suspect that a person living in the home might be missing by informing their duty manager. Staff should note that it is often difficult to ascertain whether or not an individual has gone missing until certain key points in the home’s daily timetable, such as mealtimes, when all people living in the home would normally be expected to make an appearance.
Situations where a missing persons’ report should be made include the following:
- where a person living in the home has not returned from an arranged outing, activity or walk
- where a person cannot be found in the home or grounds and no arrangements have been made for an outing, activity or walk.
Procedure in the Event of a Person Being Reported as Missing in a Care Home
When it becomes clear that a person living in the home is missing it is vital that all the members of staff work as a team and follow a clearly defined procedure. Upon receiving a missing persons report the duty manager should carry out the following procedure.
• Check in the day book that the person is not on a prearranged outing, activity or walk. If they are, and are overdue, then the manager should make efforts to contact the person or the people/place they are visiting. Where contact cannot be made and the judgment of the duty manager is that they may be at risk, then the police should be contacted and a suitable entry made in the person’s care notes.
• Where a person living in the home is not on a prearranged outing, activity or walk then the following procedure should be followed. The duty manager should carry out the following.
a) Alert all staff to the possibility of the person being missing and ask for information/sightings.
b) Check who last saw the person and question them about their known plans and movements.
c) Where necessary, tactfully question relevant people living in the home about the missing person’s plans and movements.
d) Carry out a thorough search of the home and grounds, checking that the person has not become lost or trapped. Knowledge of the person and their usual movements and habits should be employed (ie staff should search their favourite places and, if they are used to visiting relatives nearby, then relatives should be contacted) and staff may be dispatched to tour the vicinity.
e) It is important here that the duty manager has a structured plan to their search and does not just send staff off in a haphazard way. At the end of the search the duty manager must be confident that the home and its grounds have been systematically searched, including the person’s own rooms, toilet and favourite spots.
f) For searches in the dark a supply of torches are kept in the main office along with a first aid kit and space blanket for treating hypothermia. On no account should other person’s own rooms be allowed to involve themselves in any search of the grounds and sufficient staff should always remain in the home to ensure its proper running and their safety.
• If no sign of the person can be found, or if information is provided from either staff or other people living in the home that raises concern that the person could be at risk, then the local police should be alerted and their advice and assistance sought.
• Where the police are involved then the home’s responsible person should be informed, as should members of the missing person’s family if they have not already been contacted.
• The duty manager should, at the earliest opportunity, fill out an incident form and make a suitable note of events in the missing person’s care notes. Times of actions and decisions should be noted as accurately as possible.
• Families should be requested to telephone the home if the missing person contacts them and relatives should be kept informed at each stage of the search.
• Once the person has been found, it is essential that all the parties who were advised of the emergency are contacted again and informed that the search has been concluded.
If at any stage the duty manager is unsure of what to do then the responsible person should be contacted immediately for advice.
Procedure to Follow after a Missing Persons Incident
Care staff must record any significant incident on the person’s care plan and the service’s accident/incident records (which should be available for CQC inspection if required). The recording should include the times the person went missing and was returned and the actions taken for the person to be returned. All incidents should be reviewed to learn the lessons from them and to prevent reoccurrence.
If the person was injured or harmed or was seriously at risk of being harmed because of going missing, the management will notify the CQC and the relevant Local Authority Safeguarding Board (or MASH), which might wish to investigate further depending on the circumstances. If {{org_field_name}} has acted in error or negligently it should exercise its Duty of Candour in its dealings with the person’s relatives.
If going missing results in a person’s tragic death, there will be a range of procedures to be followed, which could include a police investigation, Coroner’s Inquest and a Serios Case Review.
If a complaint is made against a care staff member as a result of a person living in the home going missing, the matter will be investigated through the complaints procedure. The investigation will include any possible misconduct by the care staff responsible as a result of the person going missing through its established disciplinary procedures.
All staff are made aware of the possible consequences of a person whom they are supervising going missing.
Training
All staff are trained in the missing persons procedure and to know their role in the event of a search.
Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
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