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CHW171-Using Alcohol and Drugs (People Receiving Care) Policy

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Registration Number: {{org_field_registration_no}}

Using Alcohol and Drugs (People Receiving Care) Policy

1. Purpose

This policy outlines how {{org_field_name}} manages, supports, and responds to the use of alcohol and drugs by individuals receiving care, in accordance with the Regulation and Inspection of Social Care (Wales) Act 2016, the Social Services and Well-being (Wales) Act 2014, and Care Inspectorate Wales (CIW) regulatory expectations. The purpose is to protect the rights, dignity, and well-being of individuals while ensuring safety for all within the care setting. The policy supports a person-centred approach that balances individual choice and lifestyle with safeguarding, health risks, medication interactions, and legal responsibilities. It provides clear, consistent guidance to staff and ensures CIW inspectors understand how the care home manages this area in a safe, respectful, and lawful manner.

2. Scope

This policy applies to all individuals receiving care and support within {{org_field_name}}, and all staff involved in their care. It includes alcohol, recreational drugs, prescribed controlled drugs, over-the-counter substances, and non-medically approved substances that may affect physical, mental, or emotional well-being. It also covers substances brought in by visitors or third parties for consumption or use by individuals in our care.

3. Related Policies

This policy should be read alongside:
CHW07 – Person-Centred Care Policy
CHW11 – Safe Care and Treatment Policy
CHW13 – Safeguarding Adults from Abuse and Improper Treatment Policy
CHW17 – Infection Prevention and Control Policy
CHW18 – Risk Management and Assessment Policy
CHW21 – Medication Management and Administration Policy
CHW39 – Mental Capacity and Deprivation of Liberty Safeguards Policy

4. Policy Details

4.1 Person-Centred, Rights-Based and Positive Risk-Taking Approach

{{org_field_name}} will support individuals to exercise choice, control and independence in relation to their lifestyle, including lawful decisions about alcohol and other substances. Individuals will be treated with dignity and respect and will be involved in decisions about their care and support.

An adult aged 16 or over will be presumed to have capacity to make a particular decision unless it is established, in accordance with the Mental Capacity Act 2005, that they lack capacity to make that specific decision at the relevant time. An individual must not be treated as lacking capacity merely because they make, or wish to make, a decision that staff, relatives or professionals consider unwise.

Where alcohol or substance use is known or reasonably suspected, the service will assess the individual circumstances and any identifiable risks. Assessment and care planning will consider, where relevant:

Identified risks, agreed risk-management measures and the support to be provided must be recorded in the individual’s personal plan and relevant risk assessments and reviewed when circumstances change and as part of the required review of the personal plan.

Any restriction imposed by the service must have a lawful basis, be necessary and proportionate to the identified risk and be the least restrictive available option. Where an individual lacks capacity to make the relevant decision, any action or decision taken on their behalf must comply with the Mental Capacity Act 2005 and be in their best interests.

Care and support must continue to be provided in a manner which protects, promotes and maintains the individual’s safety and well-being while respecting their dignity, privacy, autonomy and independence.

4.2 Alcohol Consumption

Individuals who have capacity to make the relevant decision may choose whether to consume alcohol, subject to the law and to any lawful, necessary and proportionate measures required to protect them or other people from identified risks.

The service will not impose a blanket prohibition, quantity limit or requirement for alcohol to be consumed in a particular area solely because a person receives care and support. Any restriction must arise from an individual assessment of risk or another lawful requirement and must be the least restrictive available measure.

Where an individual chooses to consume alcohol, staff will consider whether an individual risk assessment and personal plan are required. Relevant factors may include:

Where there is a potential clinically significant interaction between alcohol and prescribed medicines or treatment, appropriate advice must be obtained from the individual’s pharmacist, prescriber, GP or other relevant healthcare professional and recorded.

Where harmful drinking, alcohol dependency or withdrawal is known or suspected, staff must promptly seek appropriate clinical advice. Abrupt withdrawal from alcohol must not be imposed by the service where this may present a clinical risk. Where appropriate and with the individual’s involvement, referral or access to specialist alcohol or substance misuse services will be facilitated.

Any agreed support or risk-management arrangements must be clearly recorded in the individual’s personal plan and relevant risk assessment and communicated to staff who need the information to provide safe care.

Where the individual lacks capacity to make the particular decision concerning alcohol, staff must follow Section 4.6 of this policy and the Mental Capacity Act 2005.

4.3 Prescribed Controlled Drugs and Other Prescribed Medicines

Prescribed controlled drugs and all other prescribed medicines must be managed in accordance with CHW21 – Medication Management and Administration Policy and the service’s medicines procedures.

The service must maintain arrangements which ensure the safe ordering, receipt, storage, administration, recording, reconciliation and disposal of medicines, including controlled drugs, and must undertake appropriate medicines audits in accordance with Regulation 58 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended.

Only staff who have received appropriate training and have been assessed as competent may administer medicines or provide medicines support within the responsibilities of their role.

Individuals will be supported to manage and, where appropriate, self-administer their own medicines as independently as possible. Where an individual self-administers medication, the arrangements must be based upon an individual assessment of their needs and risks and recorded in their personal plan. Any support, storage or access arrangements must be proportionate to the identified risks and must not unnecessarily restrict the individual’s independence.

Any suspected medication error, unexplained discrepancy, unauthorised use, diversion, theft or misuse of a controlled drug must be reported immediately to the Registered Manager or person in charge and managed in accordance with the Medication Management and Administration Policy. Appropriate healthcare, safeguarding, police, pharmacy, commissioning and regulatory referrals or notifications must be made where the circumstances meet the relevant legal or regulatory threshold.

A clear record must be maintained of medicines held by the service and of their administration as required by Regulation 59 and Schedule 2 of the Regulations.

The statutory guidance requires records of all medicines kept for each individual and the date and time of administration.

4.4 Suspected or Actual Use, Possession or Supply of Illicit Drugs

{{org_field_name}} will not knowingly permit unlawful possession, production or supply of controlled drugs or any other unlawful drug-related activity within the care home.

Where staff become aware of, or reasonably suspect, illicit drug use, possession, production or supply, they must not place themselves or other people at unnecessary risk. Staff must:

Staff must not conduct an intrusive search of an individual, their clothing, possessions or private accommodation without lawful authority. Any action involving an individual’s possessions must respect their rights, privacy and dignity and must be undertaken only where there is an appropriate lawful basis.

The service must not knowingly facilitate unlawful production or supply of controlled drugs on the premises. Managers must take appropriate action where they know or reasonably suspect that such activity is occurring.

Where the police are contacted and an incident is reported to them, the Registered Manager must ensure that the requirement to notify Care Inspectorate Wales under Regulation 60 and Schedule 3 is considered and, where applicable, completed without delay through CIW Online.

The response to the individual must remain person-centred and non-judgemental. Where appropriate, the individual will be supported to access healthcare, harm-reduction advice and specialist drug or alcohol services.

4.5 Over-the-Counter Medicines, Herbal Remedies, Supplements and Other Non-Prescribed Products

Where an individual wishes to use an over-the-counter medicine, herbal remedy, supplement or other non-prescribed health product, staff must establish what support, if any, the service is being asked to provide and consider whether the product may interact with prescribed medicines or treatment or otherwise create a significant health risk.

Where the service is responsible for administering, storing or supporting the use of an over-the-counter medicine or other medicinal product, it must be managed and recorded in accordance with CHW21 – Medication Management and Administration Policy and the requirements of Regulation 58.

Where a potential interaction, contraindication or other significant clinical risk is identified or reasonably suspected, advice must be sought from a pharmacist, GP, prescriber or other appropriate healthcare professional and the advice and resulting actions must be recorded.

An individual who has capacity to make the relevant decision must be provided with appropriate information and support but must not be prevented from making an informed decision solely because staff consider that decision unwise. Any restriction imposed by the service must have a lawful basis, be necessary and proportionate and be the least restrictive available option.

Where the individual lacks capacity to make the relevant decision, Section 4.6 of this policy must be followed.

4.6 Mental Capacity, Best Interests and Restrictive Measures

The Mental Capacity Act 2005 applies to individuals aged 16 and over in relation to decisions where there is reason to question their capacity.

Staff must begin from the presumption that the individual has capacity to make the decision unless it is established otherwise. Capacity must not be questioned solely because of the individual’s age, diagnosis, disability, appearance, behaviour, substance use or because the individual makes a decision that staff or others consider unwise.

Before concluding that an individual lacks capacity, all practicable steps must be taken to support them to make the decision themselves. This may include providing information in an accessible form, using the individual’s preferred communication method, providing additional time, choosing an appropriate environment and considering whether the decision can safely wait until intoxication, withdrawal, illness or another temporary factor no longer affects decision-making.

Where there is a reasonable basis to doubt capacity, an assessment must relate to the specific decision that needs to be made and the time at which it needs to be made. The assessment and its outcome must be recorded in accordance with CHW39 – Mental Capacity and Deprivation of Liberty Safeguards Policy.

A person is unable to make the particular decision only where, because of an impairment of or disturbance in the functioning of the mind or brain, they are unable to:

Where an individual lacks capacity to make the relevant decision, any decision made or action taken on their behalf must be in their best interests and in accordance with the Mental Capacity Act 2005. The decision-maker must consider all relevant circumstances, including the individual’s past and present wishes and feelings, beliefs and values, and must involve the individual as fully as reasonably possible.

Appropriate consultation must take place in accordance with the Mental Capacity Act 2005. This may include people whom the individual has identified as wishing to be consulted, family members or others interested in their welfare, an attorney acting under a valid Lasting Power of Attorney, a Court of Protection deputy or an Independent Mental Capacity Advocate where the statutory requirements for IMCA involvement are met.

Before imposing any restriction, the service must consider whether the objective can be achieved effectively in a way which is less restrictive of the individual’s rights and freedom of action.

Any measure which amounts to control or restraint must comply with Regulation 29 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended. It must be necessary to prevent a risk of harm and a proportionate response to that risk. Where control or restraint is used, the required record must be made within 24 hours.

Where the individual lacks capacity to consent to arrangements which may amount to a deprivation of liberty, the service must ensure that lawful authority is obtained and maintained in accordance with the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards and must follow CHW39.

The service must take account of the current legal definition of deprivation of liberty and applicable national guidance when considering whether an authorisation is required.

4.7 Visitors and Substance Use

Visitors must not bring, supply or facilitate the unlawful possession, production or supply of controlled drugs or other illegal substances within the care home.

Where a visitor brings alcohol for an individual, staff must act in accordance with the individual’s personal plan and any relevant risk assessment. The service must not impose a blanket prohibition on a visitor bringing alcohol solely because the individual receives care and support. Any restriction must have a lawful basis, respond to an identified risk and be necessary and proportionate.

Where staff reasonably believe that a visitor is intoxicated or under the influence of drugs and their behaviour presents a risk to an individual, another person or the safe operation of the service, staff must take proportionate action to maintain safety. This may include asking the visitor to leave, seeking management support or contacting the police where necessary.

Where a visitor is suspected of abusing, exploiting, coercing or unlawfully supplying substances to an individual, staff must take immediate action to protect the individual, report the concern to the Registered Manager or Safeguarding Lead and follow the service’s safeguarding procedures and the Wales Safeguarding Procedures.

Any restriction placed upon visits or contact must be individually justified, proportionate to the identified risk and consistent with the individual’s rights, personal plan, mental capacity and any applicable legal authority.

4.8 Safeguarding, Incident Reporting and Regulatory Notifications

Alcohol or substance use does not automatically constitute a safeguarding concern. Staff must, however, remain alert to circumstances in which substance use is associated with abuse, neglect, improper treatment, self-neglect, coercion, exploitation, criminal exploitation, financial abuse or another risk that meets the relevant safeguarding threshold.

Where there is an allegation, disclosure, evidence or reasonable concern of abuse, neglect or improper treatment, staff must:

The service will co-operate with the local authority, police, healthcare professionals, commissioners and other relevant agencies in the assessment and management of safeguarding risks.

The Registered Manager must also consider whether the incident is a notifiable event under Regulation 60 and Schedule 3 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended.

Care Inspectorate Wales must be notified where a drug- or alcohol-related incident falls within a Schedule 3 notification category, including, where applicable:

Notifications required under Regulation 60 must contain the required details and must be made without delay, in writing and in the manner required by Care Inspectorate Wales. Notifications must be submitted through CIW Online in accordance with current CIW arrangements.

The making of a CIW notification does not replace any separate requirement to make a safeguarding referral, contact the police, obtain emergency medical assistance or notify another statutory or professional body.

Records of safeguarding referrals, incidents, resulting actions and outcomes must be maintained in accordance with Regulation 59 and Schedule 2 and the service’s record-management arrangements. Relevant risk assessments and the individual’s personal plan must be reviewed following an incident or significant change in risk.

4.9 Staff Training and Responsibilities

Staff must receive induction, training, supervision and ongoing development appropriate to their role and to the needs of the individuals receiving care and support.

Staff whose duties may involve responding to alcohol or substance use must understand:

Only staff who have received appropriate medicines training and have been assessed as competent may administer medicines or provide medicines support within their role.

The Registered Manager must ensure that staff have access to this policy, understand the procedures relevant to their role and implement them consistently. Training, competence assessments and supervision relevant to this policy must be recorded in accordance with the service’s staff-development arrangements.

Staff must immediately report significant concerns, incidents, suspected abuse, medication discrepancies and suspected unlawful drug-related activity through the appropriate internal reporting route and must accurately record the actions they have taken.

The Registered Manager is responsible for ensuring that alcohol- and substance-related arrangements are appropriately risk assessed, reflected in relevant personal plans, lawful, proportionate and reviewed following significant changes or incidents.

5. Policy Review

This policy is reviewed annually or sooner if required by legislative changes, updated CIW guidance, or in response to incidents or audit findings. It forms part of {{org_field_name}}’s commitment to safety, transparency, and person-led care.

The Registered Manager must ensure that this policy is reviewed without delay following any material change to legislation, statutory guidance, Care Inspectorate Wales requirements, the Mental Capacity Act 2005 or relevant case law which affects the management of alcohol, substances, restrictive practices or deprivation of liberty.

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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