Surveillance and Use of CCTV in Care Homes (England) Policy

This document provides a policy framework on the use of CCTV and similar devices such as webcams for monitoring and surveillance purposes in a care home. The exact contents should depend on the decisions taken by the home on the use or non-use of such methods for monitoring purposes. The focus here is the monitoring of service users’ care and behaviour and the implications for staff and others involved in the running of the home. The use of CCTV solely for external security purposes falls outside the scope of this policy framework.

Policy Statement

This policy is written to describe the use of CCTV and similar electronic monitoring devices, including auditory recording, in {{org_field_name}}, when used for surveillance purposes. Surveillance is defined in Care Quality Commission (CQC) guidance (June 2015) as “the monitoring of a place, person, group, or ongoing activity to gather information”.

The policy is written in line with CQC and Information Commissioner Office guidance and Codes of Practice, and adopts the definitions and scope of the issues that can be found in these documents. The relevant publications are:

Information Commissioner Office: CCTV Code of Practice
Information Commissioner Office: CCTV Guidance for Organisations (see www.ico.org.uk)
Care Quality Commission: Using Surveillance. Information for Providers of Health and Social Care (December 2014 updated June 2015) (see www.cqc.org.uk).

The policy should be used with reference to the home’s policies on Data Protection and Stress at Work.

Data Protection Issues

{{org_field_name}} understands that visual images such as photographs and video recordings are defined as data and are covered in the same way as written records by data protection principles in organisations, where data protection laws apply. The home is covered by data protection laws, including the General Data Protection Regulation, which means that the guidance produced by the Information Commissioner’s Office on the use of CCTV and other forms of surveillance will apply to {{org_field_name}}.

{{org_field_name}} recognises that it is providing a social service, which, in line with its registration responsibilities, has a duty to make sure on the one hand that its service users are kept safe from harm and on the other that its staff are not subject to undue harassment or pressures that could impair the quality of the care and their welfare, which they provide.

{{org_field_name}} is therefore aware that service users, relatives and representatives might seek to use CCTV and similar devices to record the care being given to service users as a protective measure, but this might also have the effect of increasing staff stress and be counterproductive in terms of achieving the standards of care that are expected of them.

{{org_field_name}} might also in some circumstances seek to install surveillance systems itself in residents’ private accommodation or in communal areas such as lounges and corridors.

{{org_field_name}} has therefore devised its own code of practice, which it applies in respect of the use of any surveillance equipment operating in the home. The code is written to reflect the responsibilities of users of surveillance methods in their relationships with other parties who might wittingly or unwittingly be exposed to them as described in the Information Commission Office guidance on the use of CCTV in organisations where data protection principles and CQC guidance on the use of CCTV for surveillance purposes apply.

Scope of a Surveillance Policy

CCTV surveillance equipment can be used in several areas of a care home, including for premises security purposes. Inside a home it might be installed in residents’ rooms or in communal areas such as lounges or corridors. It will not be installed in toilets and bathrooms for the reasons discussed below. A decision to use CCTV must be consistent with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, ensuring that it will comply with the following regulations.

Regulation 9: Person-centred Care, including recognition of residents’ rights to choose their care arrangements.
Regulation 10: Dignity and Respect, particularly where people are receiving intimate personal care.
Regulation 11: The Need for Consent, including the provisions under the Mental Capacity Act 2005 for people unable to give their consent to specific decisions because of lack of mental capacity.
Regulation 12: Safe Care and Treatment, for example, where monitoring methods are used to ensure that people are receiving safe care and treatment.
Regulation 13: Safeguarding Service Users from abuse and improper treatment, which is often the main justification for the use of surveillance. However, surveillance could also be used as a restrictive measure that meets the deprivation of liberty test and, if justifiable, would need to be authorised under the Deprivation of Liberty Safeguards.
Regulation 17: Good Governance, particularly in relation to record keeping and data protection.

The home is aware that if it uses surveillance in any part of the home, the CQC will be checking that it complies with the relevant regulations.

Code of Practice

Pre-Installation

In general, before installing or agreeing to install any equipment that could be used for monitoring and surveillance purposes in residents’ private accommodation and/or in any communal area, the home will carry out a full consultation with all those whose personal data could be captured by the applications.
This includes individual residents and their lawful representatives where the key aim of the consultation will be to assess the impact of any installation on the privacy and dignity of the people whose behaviour and presentation will be recorded. This includes service users, their relevant others and staff. If any equipment is installed in any part of the premises there will be clear signs to indicate that it is there and could be recording people who are in that location.
{{org_field_name}} will always use equipment and devices that are fit for the required purpose and which can be switched on and off, when not required for the purpose or if there are risks that people’s rights, dignity and privacy will be compromised by the capturing of their images.

Purposes

{{org_field_name}} recognises that CCTV and other recording devices have many potential purposes and can be used for other than monitoring and surveillance. It could be used for example to enable a relative to keep in touch with and communicate with a service user at a distance. However, it is also recognises that video recording can be a useful tool to help protect a service user from harm and the risk of harm, to promote learning and development and to improve the quality of care if used appropriately.
{{org_field_name}} will always seek to establish the purpose of the use of the CCTV (which might not always be directed at {{org_field_name}}’s staff, but a means, for example, of checking on the service user herself or himself). It will then set out in writing the purpose and any specific objectives, which are relevant to the individual care and support plan.
{{org_field_name}} could agree to certain aspects of the care provided to be recorded (with consent) for a specific purpose, eg for problem-solving or learning, where there are benefits of recording the procedure for both service user and staff.

Permissions

{{org_field_name}} works on the basis that care practices must only be recorded on CCTV and similar devices with the express permission of {{org_field_name}} and individual carers.
Service users / representatives who seek to make use of CCTV within the service delivery process must make this clear at the beginning of the service or when proposing it at any later stage so that its use and conditions of its use can be written into the service agreement.
Representatives of a service user who seeks to install or use CCTV on behalf of the actual service user must have obtained the latter’s permission or if the person lacks mental capacity to give their consent, {{org_field_name}} will insist that a “best interests” process is carried out before agreeing to its installation and use. The uses to which the equipment will be put must be clearly spelled out and recorded in the accompanying written agreement.
Where any such agreement has been reached, {{org_field_name}} will then make the relevant staff aware of its use and obtain their written consent to their being recorded.
{{org_field_name}} will not agree to the routine recording of any intimate personal care that invades the privacy of the service user and affronts their dignity.
{{org_field_name}} will not seek to make use of any recording for its own internal monitoring purposes without obtaining the permission of all those involved.

Impact and Implications

{{org_field_name}} will discuss with the service user / representatives as part of the agreement on the use of the CCTV how long the images of its staff will be retained, what access other people might have to those images and how they will be disposed of. These are all matters that could affect the rights of {{org_field_name}}’s employees.
{{org_field_name}} will also come to some agreement with the service user / representatives as part of the agreement the rights of access of its staff to any recorded images of them, as they would if the process was following data protection principles.
If or when {{org_field_name}} decides to make use of CCTV or other surveillance equipment or devices, it will make sure that it has all the related policies and procedures in place to make sure that their use is ethical and lawful. These include clear procedures on the positioning and use of the equipment or devices and time-scales for their use, the keeping of appropriate records regarding their use and access to the records and the captured information.

Covert Surveillance

{{org_field_name}} will not in principle agree to the use of covert surveillance of its staff by a service user and/or their representatives, which implies lack of trust and confidence in both individual staff and {{org_field_name}}. If it discovers that covert surveillance methods are being used unilaterally and without adequate reasons it will discuss the implications on the contract that has been made with the service user or representative, which could include ending its services to that user.
Under some circumstances and in line with CQC guidelines, it might accept the results of covert recordings if they provide clear evidence of malpractice or misconduct on the part of the staff member being recorded or to support a complaint.
There might be some circumstances where the home itself might wish to install some form of covert surveillance, where for example it has evidence of malpractice, eg night care staff who sleep on duty or criminal acts, eg to catch suspected thieves. However, it would only do this as a last resort after a full impact assessment and making sure that no service user’s sense of dignity and privacy would be compromised.
In exceptional circumstances where, for example, there is prior evidence of a care home employee harming the service user in any way or putting the person at risk of harm or engaging in any other kind of possible misconduct, it might agree with the service user / representatives to staff behaviour being recorded covertly. The evidence obtained could then be used to trigger {{org_field_name}}’s safeguarding procedures.

Restraints and Deprivation of Liberty

As described in CQC guidance “Using Surveillance”, {{org_field_name}} recognises that devices are available to track individuals’ movements that could be used to restrict their freedom of movement and result in a deprivation of their liberty. The home would only ever use such devices or consent to their use as last resorts and then only after all the necessary measures are taken to make sure that their use is lawful.

Other Considerations

{{org_field_name}} accepts that each situation should be treated differently and the agreements reached will on an individual basis.
The home also recognises that it might need to make its information on and from its use of any CCTV or other surveillance methods available for inspection by the Care Quality Commission.

Documentation

The following aspects will be fully documented and made available to the CQC inspectors as required.

An assessment of the need for surveillance, the reasons behind the idea and why CCTV or similar would seem to be the best option out of the options available.
A statement of the purpose, including specific goals and the outcomes sought from the use of the preferred surveillance method.
The time-scales involved: starting, periods of use (if not continuous).
How the decision to use CCTV in a specific place has been arrived at.
Confirmation that the surveillance methods proposed or used are lawful and the steps taken to establish their legal basis.
The steps taken to obtain consent of all whose personal information is being captured; not least where surveillance methods are being installed in communal areas resulting in the exposure of a wide range of people.
How consent from people who might lack mental capacity has been obtained.
Any deprivation of liberty safeguarding issues that have arisen.
How the service has addressed concerns about possible loss of privacy, dignity and respect and the concerns of staff and others.
The scope, methods and results from the consultation process followed.
A statement of the information that will be/has been captured and the steps to ensure that its capturing is legitimate and complies with data protection requirements.
How the data is or will be kept secure.
How people are informed, eg by signage that they might be subject to surveillance in certain areas of the home.
If covert surveillance is to be used, a statement of the over-riding reason for it and when and how it can be minimised and discontinued at the first opportunity.
The personnel responsible for the operating of the system, including the processing of the information captured, their accountability and the systems for monitoring, reviewing and auditing the surveillance process.

Note:

See Appendix for a checklist for recording purposes and Forms for a full recording framework.

Training

All staff are made aware of the home’s policy (for or against) the use of CCTV and other surveillance methods and the conditions that apply or would apply to its use.

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}}

CH332. Surveillance and Use of CCTV in Care Homes