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CHW154-New Service User Onboarding Policy

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Registration Number: {{org_field_registration_no}}

New Service User Onboarding Policy

1. Purpose

The purpose of this policy is to ensure that the process of admitting new service users into {{org_field_name}} is undertaken in a manner that is person-centred, safe, legally compliant, and supportive of the individual’s dignity, preferences, and well-being. The onboarding process is designed to ensure a smooth transition into our care home, promote positive outcomes from the outset, and meet all regulatory obligations under the Regulation and Inspection of Social Care (Wales) Act 2016 and associated statutory guidance.

This policy outlines how we assess suitability, develop personal plans, inform individuals of their rights and what to expect, and promote their inclusion and independence from day one.

2. Scope

This policy applies to all new residents entering our care home, whether for long-term, short-term, respite, or palliative care. It applies to all staff involved in assessment, admission, care planning, and early-stage support, including management, care staff, and administrative personnel. The principles also apply to transitions from hospital, the community, or other care settings.

3. Related Policies

This policy should be read in conjunction with the following:

4. Policy Statement and Implementation

4.1 Initial Enquiry and Information Sharing

When a prospective individual or their representative contacts {{org_field_name}}, clear and accessible information will be provided about the services offered, the Statement of Purpose, fees and charges, the rights of individuals using the service, and what they can expect from the care home.

Information will be provided in a language, style, presentation and format appropriate to the individual’s communication needs and level of understanding. Appropriate support will be provided where necessary to enable the individual to understand the information provided.

Where appropriate, information will also be provided about independent advocacy services and how these may be accessed.

All initial enquiries will be recorded and followed up by an appropriately senior member of staff or the Registered Manager. Relevant questions will be addressed before any decision is made about whether the service is suitable for the individual.

4.2 Pre-Admission Assessment and Suitability Information

Before agreeing to provide care and support, {{org_field_name}} will obtain and consider sufficient information to determine whether the service is suitable to meet the individual’s care and support needs and support them to achieve their personal outcomes.

The information considered will include, where applicable:

Where the individual does not have an existing care and support plan, {{org_field_name}} will, before agreeing to provide the service, carry out an assessment of the individual’s care and support needs and identify their personal outcomes in accordance with Regulation 14 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended.

Any assessment undertaken by {{org_field_name}} for this purpose will be completed by a person who has the skills, knowledge and competence necessary to carry out the assessment and who has received appropriate training in carrying out assessments.

The individual will be involved in the assessment and suitability decision. The placing authority, where applicable, and any representative will also be involved. A representative will not be involved where the individual is an adult, or a child aged 16 or over, who does not wish the representative to be involved, or where involving the representative would not be consistent with the individual’s well-being.

Where relevant, information will also be sought from appropriate professionals involved in the individual’s care, such as hospital discharge teams, community nurses, GPs, therapists or other health and social care professionals.

For an emergency admission, every reasonable effort will be made to obtain relevant assessments, care and support plans and other essential information before the placement starts and to establish that the service can safely meet the individual’s immediate needs.

4.3 Determining Whether the Service Can Meet the Individual’s Needs

Following consideration of the information obtained under section 4.2, {{org_field_name}} will make and record a formal determination as to whether the service is suitable to meet the individual’s care and support needs and support them to achieve their personal outcomes.

The determination will take account of:

The determination will be made by a person with sufficient competence, responsibility and authority to decide whether the service can meet the individual’s needs.

Care and support will not commence unless {{org_field_name}} has determined that the service can meet the individual’s assessed care and support needs and support them to achieve their personal outcomes.

Where reasonable adjustments would enable the individual’s needs to be met, these will be identified and considered before a decision is made not to provide the service.

For an adult, the outcome of the suitability decision will be confirmed in writing. Where {{org_field_name}} determines that it cannot meet the individual’s care and support needs, this will also be confirmed in writing.

The assessment and suitability decision, including the information considered and the reasons for the decision, will be appropriately recorded.

4.4 Consent, Decision-Making and Service Agreement

Before care and support is provided, {{org_field_name}} will establish and record the individual’s ability to make the relevant decisions about their care and support and will obtain valid consent wherever consent is required.

Adults will be presumed to have capacity to make their own decisions unless it is established otherwise in accordance with the Mental Capacity Act 2005. An individual will not be treated as unable to make a decision merely because they make a decision that others consider unwise.

Where there is reason to doubt an adult’s capacity to make a specific decision, an appropriate decision-specific capacity assessment will be undertaken and recorded.

Where an adult lacks capacity to make a particular decision, no family member, friend or other representative will be treated as having authority to consent on the individual’s behalf unless they hold appropriate lawful authority.

Where no person has lawful authority to make the relevant decision, decisions will be made in accordance with the Mental Capacity Act 2005, including its best interests requirements.

Any Lasting Power of Attorney, deputyship, advance decision, advance statement or other relevant lawful authority or decision-making arrangement identified during admission will be verified as appropriate and recorded.

Every individual will be given a signed copy of any agreement relating to their care and support or any other services provided to them. The individual will be given such explanation, communication assistance or other support as is necessary to enable them to understand the agreement.

The service agreement will, where applicable, identify:

Information and agreements will be provided in a language, style, presentation and format appropriate to the individual’s communication needs and level of understanding.

4.5 Admission, Written Guide and Welcome Process

At the commencement of the service, the individual will be welcomed to {{org_field_name}} and supported to become familiar with the home, their bedroom, staff, facilities and arrangements relevant to their care and support.

Each individual will be provided with the service’s written guide.

The written guide will:

The individual will receive such explanation, communication assistance or other support as is necessary to enable them to understand the information contained in the written guide.

The written guide will also provide or signpost the individual to relevant information about the operation of the service, including, as applicable:

On admission, staff will orientate the individual to the premises and explain relevant safety and emergency arrangements in a way the individual can understand.

Particular attention will be given during the initial period to the individual’s physical and emotional well-being, communication needs, orientation, comfort and any indication that the personal plan or risk management arrangements require immediate amendment.

4.6 Personal Plan

Once {{org_field_name}} has determined that it can meet the individual’s care and support needs, an initial personal plan will be prepared and, except in an urgent admission, will be in place before the provision of care and support commences.

Where an individual is in urgent need of care and support and there has been insufficient time to prepare the personal plan before the service commences, the personal plan will be prepared within 24 hours of commencement of the provision of care and support.

The personal plan will be developed with the individual and will set out:

In preparing the personal plan, {{org_field_name}} will take account of:

The individual, the placing authority where applicable, and any representative will be involved in preparing and revising the personal plan.

A representative will not be involved where the individual is an adult, or a child aged 16 or over, who does not wish the representative to be involved, or where involvement would not be consistent with the individual’s well-being.

The personal plan will be reviewed and revised following completion of the provider assessment required under Regulation 18 and whenever the individual’s needs, risks, circumstances or personal outcomes change.

The personal plan will thereafter be kept under review. {{org_field_name}} will review personal plans at least monthly, and sooner where required. Each review will consider the extent to which the individual has been able to achieve their personal outcomes and whether the personal plan requires revision.

A record will be retained of the personal plan, every revised personal plan and the outcome of each review.

A copy of the personal plan and any revised personal plan will be given to the individual and to any representative unless doing so would be inappropriate or inconsistent with the individual’s well-being. Where required by the Regulations, a copy will also be provided to the relevant placing authority.

Copies will be provided in a language and format appropriate to the individual’s needs and level of understanding, and appropriate support will be provided to enable the individual to understand their plan.

All staff involved in providing care and support to the individual will have appropriate access to the current personal plan and will provide care and support in accordance with it.

4.7 Provider Assessment Following Commencement

Within seven days of commencement of the provision of care and support, {{org_field_name}} will complete a provider assessment in accordance with Regulation 18 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended.

The provider assessment is separate from the pre-admission suitability assessment and will build upon the information obtained before admission and the individual’s experience during the first days of receiving the service.

The provider assessment will:

The provider assessment will take account of:

The provider assessment will be undertaken by a person who has the skills, knowledge and competence necessary to carry out the assessment and who has received appropriate training in carrying out assessments.

Where an individual has complex or specialist needs, appropriate specialist advice will be sought.

Where the individual has nursing needs, the assessment of those nursing needs will be undertaken by a registered nurse with the relevant skills and competence.

The individual will be involved in the provider assessment. The placing authority, where applicable, and any representative will also be involved unless the individual is an adult, or a child aged 16 or over, who does not wish the representative to be involved, or where involving the representative would not be consistent with the individual’s well-being.

A record of the completed provider assessment will be retained. A copy will be given to the individual and any representative and, where required by the Regulations, to the relevant placing authority.

The provider assessment will be kept under review and revised whenever necessary, including where there is a significant change in the individual’s needs or where the personal plan is not supporting the achievement of the individual’s personal outcomes.

Following completion or revision of the provider assessment, the individual’s personal plan will be reviewed immediately and revised where necessary.

4.8 Early Review and Settling-In Evaluation

In addition to the provider assessment required under section 4.7, an early settling-in review may be undertaken during the initial period following admission to consider how the individual is adjusting to the service and whether any additional practical or emotional support is required.

The settling-in review does not replace the provider assessment required under Regulation 18 or any required review or revision of the individual’s personal plan.

The individual will be encouraged to discuss their experience of moving into the service, including their comfort, routines, relationships, communication, meals, activities, sleep, privacy, dignity and any concerns or preferences.

Staff will remain alert to signs of distress, anxiety, confusion or disorientation, particularly where the individual has dementia, cognitive impairment, communication difficulties or complex needs.

Any information obtained that indicates a change in need, risk or personal outcome will be recorded and will prompt an appropriate review and, where necessary, revision of the provider assessment, risk assessments and personal plan.

4.9 Safeguarding and Risk Management

From commencement of the service, {{org_field_name}} will provide care and support in a way that protects the individual from abuse, neglect and improper treatment.

As part of the admission process, the individual and, where appropriate, their representative will be provided with accessible information about:

Information will be explained in a manner appropriate to the individual’s communication needs and level of understanding.

Risk assessments identified during pre-admission assessment will be reviewed and supplemented following admission and as part of the provider assessment.

Risk management arrangements will balance the individual’s safety with their rights, independence, choices and opportunities for positive risk-taking.

Staff will remain alert to any indication of abuse, neglect, improper treatment, unexplained injury, deterioration, unmet need or other safeguarding concern.

Where there is an allegation, evidence or suspicion of abuse, neglect or improper treatment, staff will take immediate action to protect the individual, follow the service’s safeguarding policy and the Wales Safeguarding Procedures, make appropriate referrals and preserve an accurate record of the concern, action taken and referrals made.

Safeguarding concerns and relevant changes in risk will be reflected promptly in the individual’s assessments, personal plan and risk management arrangements where appropriate.

4.10 Involving Representatives, Families and Advocates

{{org_field_name}} recognises the value that representatives, families, carers and advocates may contribute to an individual’s care and support.

Their involvement will, however, respect the individual’s wishes, rights, confidentiality, mental capacity and any applicable lawful decision-making arrangements.

Where the individual has capacity to decide who should be involved in their care and support, their wishes regarding family, friends and representatives will be respected and recorded.

An adult family member or friend will not be treated as having legal authority to make decisions on the individual’s behalf solely because of their relationship with the individual.

Where an individual has a lawfully authorised representative, including an attorney or deputy acting within the scope of their authority, that authority will be recognised and appropriately recorded.

For the purposes of assessments, preparation or review of the personal plan and other processes where the Regulations require involvement of a representative, a representative will not be involved where an adult, or a child aged 16 or over, does not wish them to be involved, or where their involvement would not be consistent with the individual’s well-being.

Subject to the individual’s wishes, lawful authority and confidentiality requirements, appropriate representatives and family members may be involved in assessment, care planning, reviews, communication and decisions concerning the individual’s care and support.

Where advocacy would assist the individual to understand information, express their wishes, exercise their rights, participate in decisions or raise a concern, {{org_field_name}} will provide information about relevant advocacy services and support the individual to access them.

4.11 Quality Monitoring and Improvement

The onboarding and admission process will be monitored as part of {{org_field_name}}’s quality assurance and quality of care review arrangements.

Monitoring will consider, where relevant:

The Registered Manager will undertake appropriate checks and audits to ensure that onboarding arrangements are implemented consistently and in accordance with this policy.

The Responsible Individual and service provider will receive relevant information through the service’s governance and quality assurance arrangements to enable effective oversight of the quality and safety of the service.

Where monitoring identifies gaps, delays, poor outcomes or non-compliance, appropriate action will be taken promptly and learning will be incorporated into service improvement arrangements.

5. Policy Review

This policy will be reviewed annually, or earlier if required by changes in legislation, CIW guidance, or organisational needs. Updates will be approved by the Registered Manager and communicated to all staff during team briefings and training refreshers.

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.

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