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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Working with External Providers and Agencies Policy

1. Purpose

The purpose of this policy is to set out how {{org_field_name}} will select, engage, work with, monitor and, where necessary, take action in relation to external providers, agencies, contractors and professionals involved in the provision of services to individuals living at the care home.

{{org_field_name}}, as the registered service provider, remains responsible for ensuring that the regulated service is provided safely, effectively, with sufficient care, competence and skill, and in accordance with its Statement of Purpose, irrespective of whether an element of care, support or another service is delivered by an external organisation or worker.

This policy supports compliance with:

• the Regulation and Inspection of Social Care (Wales) Act 2016, as amended;
• the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended;
• statutory guidance issued under section 29 of the Regulation and Inspection of Social Care (Wales) Act 2016;
• the Social Services and Well-being (Wales) Act 2014;
• the Mental Capacity Act 2005, where applicable;
• the Data Protection Act 2018 and UK General Data Protection Regulation;
• the Safeguarding Vulnerable Groups Act 2006;
• applicable requirements and guidance issued by Care Inspectorate Wales and Social Care Wales; and
• other health and safety, safeguarding and professional regulatory requirements applicable to the work being undertaken.

The policy is intended to ensure clear accountability, safe multi-agency working, effective communication, appropriate information sharing and continuity of care, while protecting the rights, dignity, safety and well-being of individuals receiving care and support.

2. Scope

This policy applies to all staff employed by {{org_field_name}} and all external professionals or providers who interact with or support residents within the care home. This includes:

• Agency care workers and nurses
• Allied health professionals (e.g. physiotherapists, speech and language therapists)
• GPs, district nurses, and NHS teams
• Social workers and local authority staff
• Contractors and suppliers
• Third-party service providers (e.g. podiatry, hairdressers, opticians)
• Transport and escort services
• Advocacy or legal representatives

3. Related Policies

This policy should be read in conjunction with:

• CHW07 – Person-Centred Care Policy
• CHW11 – Safe Care and Treatment Policy
• CHW21 – Medication Management and Administration Policy
• CHW34 – Confidentiality and Data Protection (GDPR) Policy
• CHW13 – Safeguarding Adults from Abuse and Improper Treatment Policy
• CHW24 – Management of Accidents, Incidents, and Near Misses Policy
• CHW27 – Staff Supervision, Training and Development Policy
• CHW29 – Whistleblowing (Speaking Up) Policy

4. Policy Implementation and Operational Guidance

4.1 Commissioning, Due Diligence and Role Clarity

Before an external provider, agency or contractor is engaged, {{org_field_name}} will undertake due diligence proportionate to the nature of the service and the level of contact the organisation or individual will have with people receiving care and support.

Where an external worker will provide care or support, or will otherwise work in a position covered by the fitness requirements of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended, {{org_field_name}} must obtain sufficient evidence to satisfy itself that the individual is fit to undertake the role.

This includes, as applicable:

• confirmation of identity;
• satisfactory evidence of qualifications, skills, knowledge, competence and experience relevant to the work to be undertaken;
• required employment history and satisfactory references;
• confirmation of the person’s fitness to undertake the intrinsic requirements of the role, subject to reasonable adjustments;
• an appropriate Disclosure and Barring Service check or evidence of an appropriate DBS status check where the person is subscribed to the DBS Update Service and the role is eligible for such a check;
• confirmation that any legally required registration with Social Care Wales is current, or that the person is within the applicable statutory period for obtaining registration;
• confirmation of current registration with the Nursing and Midwifery Council, Health and Care Professions Council, General Medical Council or another relevant professional regulator where registration is required for the role;
• confirmation of appropriate insurance and indemnity arrangements where applicable; and
• confirmation of training and competence relevant to the duties the person will perform.

Where agency workers are deployed, {{org_field_name}} will ensure that they have been subject to the same applicable fitness and vetting checks as permanently employed staff. The care home must retain evidence that these checks have been undertaken. Reliance on information supplied by an agency will only be accepted where {{org_field_name}} has satisfied itself that the agency’s checking and assurance processes are reliable and robust.

The Registered Manager must ensure that professional or Social Care Wales registration is checked where required and that appropriate action is taken if registration has expired, been suspended, is subject to restrictions or is otherwise not valid for the work being undertaken.

Written contracts, service level agreements or other documented arrangements must clearly identify:

• the service to be provided;
• the respective responsibilities and accountability of {{org_field_name}} and the external organisation;
• the scope and limitations of the work to be undertaken;
• staffing, competence and regulatory requirements;
• safeguarding responsibilities and escalation arrangements;
• incident, accident and complaint reporting arrangements;
• information-sharing, confidentiality and data protection requirements;
• requirements for record keeping and access to records;
• monitoring and quality assurance arrangements;
• insurance and indemnity requirements where applicable;
• arrangements for raising concerns about performance or conduct;
• termination or suspension arrangements where safety or quality requirements are not met; and
• the named points of contact for both organisations.

{{org_field_name}} will not enter into arrangements which transfer or obscure its regulatory responsibility for the care home service.

Where {{org_field_name}} proposes to subcontract the delivery, management, direction or control of any element that may itself constitute provision of the regulated care home service to another legal entity, the Registered Manager and Responsible Individual must consider the CIW registration implications before the arrangement begins. Advice must be obtained from CIW where there is uncertainty about which legal entity or entities are directing, controlling or ultimately responsible for the regulated service.

No legal entity may provide a regulated service without the registration required under the Regulation and Inspection of Social Care (Wales) Act 2016.

The Registered Manager {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}} is responsible for ensuring that external providers understand the requirements applying to their work within the care home and that their work does not compromise the home’s Statement of Purpose, regulatory compliance or the safety, rights and well-being of individuals.

4.2 Conflicts of Interest

{{org_field_name}} must identify, record and appropriately manage any actual, potential or perceived conflict of interest involving an external provider, contractor, agency, professional or person involved in commissioning or delivering services.

Before an external provider is appointed, and whenever circumstances change, relevant conflicts of interest must be declared and considered.

This includes, where applicable:

• financial interests;
• ownership or shareholding interests;
• personal or family relationships;
• gifts, hospitality or other benefits;
• referral arrangements;
• financial incentives connected with recommending a particular service or provider; and
• any other relationship or circumstance which could, or could reasonably appear to, influence professional or commissioning decisions.

Conflicts of interest must be recorded, together with the action taken to remove or appropriately manage the conflict.

A person must not participate in a commissioning, procurement or care decision where an unmanaged conflict of interest could compromise the individual’s interests, the integrity of the decision or the service provider’s regulatory responsibilities.

In accordance with Regulation 63 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended, a medical practitioner who has a financial interest in the ownership of the care home service must not act as the medical practitioner for an individual receiving that service.

4.3 Induction and Site Orientation

All external workers must receive an induction or orientation proportionate to their role before undertaking work within the care home.

For agency care workers, agency nurses and other external workers directly involved in the provision of care and support, the induction must include, as applicable:

• the care home’s Statement of Purpose;
• the person’s role, responsibilities and limits of authority;
• relevant personal plans, risk assessments and communication requirements for the individuals they will support;
• safeguarding procedures and how to report a concern immediately;
• whistleblowing arrangements;
• infection prevention and control requirements;
• fire safety and emergency procedures;
• accident, incident and near-miss reporting procedures;
• medicines procedures where the person’s duties involve medicines;
• moving and handling arrangements where applicable;
• confidentiality, information governance and record-keeping requirements;
• equality, dignity, human rights, Welsh language and communication requirements;
• procedures for obtaining assistance and escalating concerns;
• management, supervision and accountability arrangements; and
• any additional information or training required because of the assessed needs of individuals receiving care and support.

Before an agency worker is permitted to work, the manager or delegated competent person must verify that the required pre-employment and fitness assurances have been received and recorded in accordance with section 4.1 of this policy.

Agency workers must not undertake duties for which their competence has not been established. This includes medicines administration, clinical procedures, delegated healthcare tasks, moving and handling activities and the use of specialist equipment.

Where a worker is unfamiliar with the service, individuals or specialist procedures, appropriate familiarisation, supervision or shadowing must be provided before the worker undertakes those duties independently. The level and duration of this support will be determined by the person’s competence, experience, familiarity with the service and the assessed needs and risks of the individuals concerned.

Contractors and other non-care workers must be given relevant site safety and safeguarding information and must be appropriately supervised where the nature of their work, their access to the premises or the assessed risks require this.

A Disclosure and Barring Service certificate does not, by itself, remove the need for appropriate supervision or risk assessment. DBS checks will only be requested or relied upon where the role and activities are eligible for the relevant level of check.

4.4 Collaboration with Health and Social Care Professionals

{{org_field_name}} works in partnership with NHS, local authority and other relevant professionals to support safe, timely and co-ordinated care and support.

This includes arrangements to:

• contribute to assessment and care planning;
• support continuity of care and treatment;
• share relevant information lawfully and proportionately;
• contribute to multi-disciplinary meetings, reviews and discharge planning;
• implement and monitor agreed professional recommendations;
• identify where further specialist assessment, treatment or advice is required; and
• clarify professional roles and responsibilities where more than one organisation is involved in an individual’s care.

Where multiple professionals or organisations are involved in an individual’s care and support, responsibilities for referrals, decision-making, treatment, monitoring and follow-up must be clear and appropriately recorded.

Relevant advice and recommendations from external professionals must be incorporated into the individual’s personal plan, risk assessment or other care records where necessary.

Where advice or recommendations cannot be implemented, are unclear, conflict with other professional advice or may create a risk to the individual, clarification must be sought promptly from the relevant professional.

{{org_field_name}} will work in accordance with the principles of the Social Services and Well-being (Wales) Act 2014, including promoting well-being, voice, choice and control and effective co-operation between relevant organisations.

4.5 Communication, Confidentiality and Information Sharing

Information shared with or received from external providers must be handled in accordance with CHW34 – Confidentiality and Data Protection (GDPR) Policy, the UK General Data Protection Regulation, the Data Protection Act 2018, the common law duty of confidentiality and other applicable legal requirements.

Only information that is necessary, relevant and proportionate for the intended purpose will be shared.

Before personal or special category information is disclosed, staff must ensure that:

• there is an appropriate lawful basis for the processing and disclosure;
• any additional condition required for processing special category information is satisfied;
• confidentiality requirements have been considered;
• information is shared only with an appropriate recipient;
• secure methods of communication are used; and
• the disclosure and its purpose are recorded where required.

Consent will be obtained where consent is the appropriate legal basis or where it is required to satisfy the duty of confidentiality. Consent must not be treated as the only possible lawful basis for sharing information.

Where an adult may lack capacity to make a particular decision about the use or disclosure of their information, capacity must be considered in accordance with the Mental Capacity Act 2005. A person must not be treated as lacking capacity merely because of their diagnosis, condition, age or because they make a decision that others consider unwise.

Where the person lacks capacity in relation to the specific decision and a decision must be made on their behalf, staff must act in accordance with the Mental Capacity Act 2005, including its statutory principles and best-interests requirements, and must involve any person with relevant lawful authority where applicable.

Information may be shared without consent where there is a lawful and necessary basis for doing so, including where required by law or where disclosure is necessary and proportionate to safeguard an individual or another person. Any such disclosure must be limited to the information necessary for the purpose and appropriately documented.

External providers must provide appropriate records of visits, assessments, treatment, interventions, recommendations and actions relevant to an individual’s care and support. Relevant information must be incorporated into or retained with the individual’s care records and communicated promptly to staff responsible for implementing or reviewing the person’s personal plan.

4.6 Monitoring and Quality Assurance

Services delivered by external providers and agency workers must be monitored proportionately to the nature of the service, the risks involved and the impact on individuals receiving care and support.

Monitoring arrangements may include:

• review of agency worker performance;
• review of the quality and timeliness of services provided;
• feedback from individuals and their representatives;
• staff feedback;
• review of incidents, accidents, complaints and safeguarding concerns;
• verification of continued professional or workforce registration where required;
• review of qualifications, training, competence or insurance where applicable;
• contract or service level agreement reviews; and
• audits or spot checks where these are appropriate to the nature of the service.

Where concerns are identified about an external provider or worker, the Registered Manager must ensure that appropriate action is taken without delay.

This may include:

• requesting clarification or corrective action;
• providing additional instructions or supervision;
• restricting duties;
• suspending the person’s or organisation’s involvement with the service;
• escalating concerns to the person’s employer or agency;
• reviewing or terminating the contractual arrangement;
• making a safeguarding referral;
• notifying or referring the matter to CIW, Social Care Wales, the Disclosure and Barring Service or another relevant professional regulator where required; and
• reviewing any impact on individuals’ personal plans, risk assessments or continuity of care.

Any action taken must be recorded.

Information arising from monitoring of external providers and agency workers must be considered as part of the service’s wider arrangements for monitoring, reviewing and improving the quality and safety of care and support where relevant.

4.7 Safeguarding and Incident Management

All external providers, agency workers, contractors and professionals working within the service must immediately report any actual, suspected or alleged abuse, neglect, improper treatment, exploitation or other safeguarding concern in accordance with CHW13 – Safeguarding Adults from Abuse and Improper Treatment Policy and the Wales Safeguarding Procedures.

Concerns must be reported immediately to {{org_field_safeguarding_lead_name}}, the Safeguarding Lead, or to the person in charge where the Safeguarding Lead is unavailable.

Nothing in this policy prevents a person from making a direct referral to the local authority, police, Care Inspectorate Wales, Disclosure and Barring Service or another appropriate body where they are entitled or required to do so.

Where there is an allegation or evidence of abuse, neglect or improper treatment, {{org_field_name}} must:

• take immediate action to protect the individual and any other person who may be at risk;
• preserve relevant evidence and records;
• make appropriate safeguarding referrals;
• co-operate with the local authority, police and other agencies as required;
• accurately record the allegation or evidence, actions taken, decisions made and referrals submitted; and
• review and update relevant risk assessments and personal plans where necessary.

Where an incident, concern or allegation involves an external or agency worker, {{org_field_name}} remains responsible for taking the actions required of the registered service provider. Reporting the matter to the person’s agency, employer or professional body does not replace the service provider’s own safeguarding, regulatory or notification responsibilities.

The Registered Manager must ensure that every relevant incident involving an external or agency worker is considered promptly against the notification requirements applying to the service under the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended.

Where a statutory notification to Care Inspectorate Wales is required, it must be made within the required timescale and contain the information required by the Regulations.

This includes, where applicable, notifications concerning:

• abuse or an allegation of abuse involving the service provider, a member of staff or a volunteer;
• an allegation of misconduct by a member of staff;
• a serious accident or injury to an individual;
• an incident reported to the police; and
• any other event for which notification is required under Regulation 60 and Schedule 3 of the Regulations.

The Registered Manager must not delay a required CIW notification solely because an internal investigation, agency investigation, safeguarding enquiry, police investigation or disciplinary process has not yet concluded.

Where necessary, further information or an update will be provided when additional facts or outcomes become available.

The provider must also consider whether the circumstances require notification or referral to:

• the relevant local authority safeguarding team;
• the police;
• the Disclosure and Barring Service;
• Social Care Wales;
• the Nursing and Midwifery Council;
• the Health and Care Professions Council;
• the General Medical Council;
• another relevant professional regulator;
• the commissioning body; or
• another statutory body.

Where concerns indicate that the continued deployment of an external worker or provider may place an individual at risk, their duties or access to the service must be restricted or suspended as necessary while the concern is assessed or investigated.

Any decision to permit the person or organisation to resume work must be based on documented consideration of risk, fitness, competence, safeguarding information and any findings or restrictions imposed by relevant authorities.

4.8 Involving Individuals and Representatives

Individuals must be involved, as appropriate, in decisions concerning external providers who contribute to their care and support.

This includes:

• providing information about relevant external services in a form the individual can understand;
• obtaining consent where consent is legally required;
• taking account of the individual’s views, wishes, feelings and preferences;
• supporting the individual to express concerns or refuse a particular external provider where they have the right to do so;
• involving representatives where appropriate and lawful;
• providing access to advocacy where required; and
• taking account of feedback about external services as part of quality monitoring.

Where an individual has capacity to make a particular decision, their decision must be respected.

Where an individual lacks capacity to make a particular decision, decisions must be made in accordance with the Mental Capacity Act 2005, including the statutory principles and best-interests requirements, and any person with relevant lawful authority must be appropriately involved.

Where a change in an external provider could materially affect the way an individual’s care and support is delivered, the individual and, where appropriate, their representative must be informed and involved in accordance with their rights, needs and personal plan.

4.9 Staff Responsibilities

All staff at {{org_field_name}} must:

• co-operate appropriately with external professionals and providers in accordance with individuals’ assessed needs, personal plans and the Statement of Purpose;
• provide external professionals with relevant information where there is a lawful basis for doing so;
• ensure that relevant advice, assessments, treatment instructions and recommendations from external professionals are accurately recorded and communicated to the staff responsible for the individual’s care;
• only implement instructions or delegated activities where they are authorised to do so and have the necessary knowledge, training, competence and information;
• seek clarification immediately where an instruction or recommendation is unclear, conflicts with the personal plan, falls outside the person’s competence or appears unsafe;
• report concerns about the conduct, competence, fitness, professional registration or practice of an external or agency worker immediately to the Registered Manager or person in charge;
• report safeguarding concerns, accidents, incidents and near misses in accordance with the relevant policies;
• not assume that an agency or external organisation has made a safeguarding, regulatory or professional referral on behalf of {{org_field_name}};
• contribute to monitoring and review of external providers where requested; and
• maintain confidentiality and comply with information governance requirements when communicating with external organisations.

4.10 Regulatory Compliance, Oversight and Assurance

{{org_field_name}} will maintain sufficient records and governance arrangements to demonstrate that the use of external providers and agency workers does not compromise compliance 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 Statement of Purpose or the safety and well-being of individuals.

Records must be sufficient to demonstrate, where applicable:

• the due diligence undertaken before an external provider or agency is engaged;
• evidence that required fitness, DBS, registration, qualification and competence checks have been completed;
• induction and orientation provided to agency or external workers;
• written contracts, agreements and allocation of responsibilities;
• monitoring of the quality and safety of externally provided services;
• action taken in response to poor performance, incidents, safeguarding concerns or complaints;
• relevant safeguarding and regulatory referrals and notifications;
• management of conflicts of interest;
• involvement of individuals and their representatives, where appropriate;
• review and implementation of advice received from healthcare and other professionals; and
• learning and improvements arising from monitoring, incidents, complaints, safeguarding matters or feedback.

The Registered Manager must ensure that concerns identified through these arrangements are acted upon promptly.

The Responsible Individual’s oversight arrangements must take account of relevant information about agency staffing and external providers where that information affects the quality, safety, effectiveness or regulatory compliance of the service.

Information arising from external provider monitoring must be considered as part of the service’s wider arrangements for monitoring, reviewing and improving the quality of care and support where relevant.

5. Policy Review

This policy will be reviewed at least annually and sooner where necessary.

An earlier review must take place where relevant following:

• a change to applicable legislation, regulations, statutory guidance or CIW requirements;
• a change to Social Care Wales or other relevant professional registration requirements;
• a change to the care home’s Statement of Purpose which affects the operation of this policy;
• a significant change to commissioning, subcontracting or agency staffing arrangements;
• a safeguarding concern, serious incident, complaint or regulatory notification involving an external provider or agency worker where learning indicates that this policy requires amendment;
• an identified failure in external provider due diligence, monitoring or governance arrangements;
• a relevant CIW inspection finding or enforcement action; or
• evidence that the policy is no longer effective or compliant.

Any changes must be communicated to relevant staff and incorporated into practice. Where a change directly affects an external provider or agency, the relevant requirements must also be communicated to that organisation.

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