D268. Lone Worker and Lone Working in Domiciliary Care

Aim and Scope of Policy

The aim of the policy is to ensure that {{org_field_name}} has adequate systems in place to ensure the health, safety and welfare of lone workers as far as is reasonably practicable, including staff working alone in the location premises and in people’s homes, particularly when visiting their homes outside normal working hours and at night, when providing night care, and when escorting service users outside of their homes.

This policy applies to all employees, permanent or temporary, including any agency, bank staff or visiting professionals employed to provide services on behalf of {{org_field_name}}. {{org_field_name}} will not normally deploy young workers under the age of 18 in lone working roles and would not regard them as “safe to leave”; that is, to work without direct supervision without first gaining substantial experience.

{{org_field_name}} policy is written in a health and safety framework and applies specifically to ensure employee safety. It does not extend to the risks posed by lone workers through possible misconduct or negligence to people receiving care, which are covered by its safeguarding policies.

Policy Statement

{{org_field_name}} works on the principle that the safety and wellbeing of any lone workers it deploys should not be placed at risk because of their lone working conditions. It understands lone workers to be those who work without close or direct supervision or support for substantial periods of time. This includes most domiciliary care staff who visit and care for people in their own homes.

This policy describes the arrangements and procedures {{org_field_name}} puts in place covering the occasions when care service staff are expected to work on their own or are placed in a position, whereby they find themselves working alone for lengthy periods. It applies to all care service staff whenever being in the position of lone workers or lone working.

{{org_field_name}} recognises that staff working alone in potentially isolated conditions have no immediate backup or support and so are at a greater risk of injury through aggression or violence directed towards them from people receiving care, relatives, carers or the general public.

{{org_field_name}} recognises the following.

Staff working alone need to rely on their own judgment and initiative and may be at a greater risk of making mistakes or errors. It also recognises that the risks to lone workers include injury through accidents or illnesses or as a result of exposure to aggression or violence, sexual assaults and other anti-social and possibly serious criminal acts.
Younger or less experienced staff are often at a greater risk when working alone than more experienced staff. Lone workers also need to rely on their own judgment and initiative and may be at a greater risk of making mistakes or errors which could have adverse consequences for people receiving care, colleagues and {{org_field_name}} in general.
It has legal duties as an employer, which are to assess any risks to lone workers and take steps to avoid or control those risks where necessary. {{org_field_name}} will therefore ensure that any of its employees who work on their own with people receiving care or in other capacities, must be able to do so safely with the risks to their and others’ safety always well assessed and controlled.
Training is particularly important for lone workers and research shows that adequate training is the single most critical factor in avoiding panic reactions in unusual situations. In particular, lone workers need to be deemed competent to work alone, to be sufficiently experienced and to understand the risks and precautions needed fully.
Its duty as an employer is to ensure employees are competent to deal not only with the day-to-day aspects of their work but with circumstances which are new, unusual or beyond the scope of their training, for example, if threatened with aggression and violence.

Lone Working: Underpinning Issues

A lone working policy is driven by health and safety considerations for those who have to work on their own, usually for long periods, and as a result are exposed to increased risks to their personal safety.

Lone, peripatetic working is the norm for much of domiciliary care work and therefore requires focused attention.

Some lone working can be considered as low risk, while others are at greater risk, including domiciliary care workers visiting isolated homes or homes at night or lone working night care staff in a care home.

To formulate and apply a lone working policy it requires {{org_field_name}} to take the following steps to be taken in line with Health and Safety Executive guidance.

An analysis of the roles that meet a definition of lone working, which the Health and Safety Executive describes in its guidance as “those who work by themselves without close or direct supervision”, usually for long periods, eg over a whole shift.
Assessment of the risks to the health and safety of lone working and individual lone workers, including in relation to the infection prevention and control of Covid-19 and other infections, and the application of proportionate risk control measures.
The monitoring and regular reviewing of both the risks and the risk controls that have been put in place.
Where required, changes and improvements made to reduce any risks, which could include modifying the working environment and facilities and behavioural changes.

Legislation and Guidance

{{org_field_name}} recognises its responsibility under the Health and Safety at Work Act 1974 to ensure the health, safety and welfare of its employees, and its responsibility under the Management of Health and Safety at Work Regulations 1999 (MHSWR) to identify significant risks within {{org_field_name}} and implement suitable measures to reduce those risks as far as is reasonably practicable.

It recognises that this responsibility applies to lone workers and accepts that it is the employer’s duty to assess any risks to lone workers and take steps to avoid or control risks where necessary.

{{org_field_name}} accepts that lone workers should not be at more risk than other employees. In line with the Health and Safety Executive’s guidance, Working Alone, it recognises that this may require extra risk control measures to be put into place, including training, supervision and, where applicable, protective equipment, better means of communication, better security measures and means of raising the alarm in case of emergencies.

{{org_field_name}} also follows the guidance produced by Skills for Care, which is produced for domiciliary care lone workers. This guidance states employers’ responsibilities for lone working to be:

carrying out risk assessments
having systems in place to ensure staff who work alone are safe
recording all assessment and safety measures identified to alleviate risk
regularly evaluating the systems
ensuring that if a risk cannot be made safe, lone working is discontinued
ensuring staff training takes place
knowing where lone workers are during their working hours
ensuring lone workers are supervised regularly
ensuring that the company is insured to cover lone working.

Implementation — Step 1: Analysis of Lone Working

{{org_field_name}} could deploy single person cover in some routine visits at different hours of the day and in the evenings up to 10.00pm, at weekends and at bank holidays. People with more complex needs will often require paired working, but these could arrive and depart from their work situation separately and will be treated as lone workers on those occasions.

{{org_field_name}} location could also be subject to lone working on occasions, for example, with out of hours cleaning.

Implementation — Step 2: Assessing and Controlling Risks

Risk assessments

{{org_field_name}} will assess the risks to any of its employees who have to work on their own and who, in doing so, fall within the definition and scope of this policy. The risk assessments will include any environmental risks which come mainly from working in people’s own homes.
Where a lone working risk is identified, as a responsible employer, {{org_field_name}} will work with the member(s) of staff concerned to assess any risks to the personal safety and to identify any risk control measures that might be needed.
Where a risk is identified, in line with HSE guidance, extra risk control measures may be required to be put into place. The exact measures will vary in line with the roles to be carried out but, again in line with HSE guidance, could include:

Risk control measures

Using the above recommendations as a guide, we have the following safe lone working arrangements in place for the following groups of staff/external people in line with their respective roles and responsibilities. The arrangements are summarised in the following table. [Details will be added in where applicable.]

Staff roles	Descriptions of lone working hours	Assessments of risk of any lone working (which might range from very low to high)	General arrangements to reduce or minimise risks/safety measures used	Contingencies: applicable emergency numbers/contact information for lone working
Duty managers	N/A
Care and support staff (daytime)	9AM-6PM	Very Low	Care and support staff have access to the office phone number where they can get advice on any issue they may face.	They can ring the office phone number for support on: {{org_field_phone_no}}
Care and support staff (evening/night care)/sleeping-in duties	6PM-9AM	Moderate	As the office is closed during these times there will be less senior staff that will be able to offer guidance during out of hours. The Care and support staff will rely on the person on-call.	The person on call can be reached via the office phone number as the calls will be redirected to the person on call. The number staff can use during evening/sleep-in calls is: {{org_field_phone_no}}
Administrative and ancillary staff	N/A
Others	N/A

Maintaining contact

{{org_field_name}} will ensure that duty and on call managers and supervisors are responsible for knowing the whereabouts and maintaining contact with staff working alone and taking appropriate action to contact or locate staff who fail to make contact or return at the expected time.

As well as having contact details, they will use a logging in and logging out system, with the information recorded in the daily diary/on separate forms so that they can take action if there are any unexpected delays in making agreed contact or return in line with the concerns about the delay or absence.

The duty manager will usually discuss in advance possible contingency plans for contacting a care worker who might experience a delay or who could fail to check in as expected.

Implementation — Step 3: Monitoring and Reviewing

{{org_field_name}} will ensure that all lone working risk assessments are regularly reviewed and that they are still adequate and that all risks are appropriately covered.

Managers will review incident forms and reports of safety incidents on a regular basis and look for patterns, trends and repeats.

Implementation — Step 4: Making Improvements

All information collected will be used by management to tighten the safety of lone workers and people receiving care further, and make any necessary adjustments to lone working patterns.

Employees’ Responsibilities

In line with Skills for Care guidance, care staff who work alone are expected to:

take reasonable care of their own and other people’s safety
be aware of their surroundings and the possible threats to their personal safety
be involved in assessing risk and identifying safety measures
leave the working environment if there is an imminent danger to their safety
carry out and follow training provided to ensure their safety
ensure they take regular breaks to avoid working excessively long hours
follow {{org_field_name}}’s policies and procedures set up to protect their safety
use equipment in line with the training given and not misuse it
report to their manager when safety measures are not adequate
report to their manager when they have encountered a near miss or have identified additional risks to their safety that were previously unidentified
report any actual accidents or incidents that occur using agreed organisational procedures.

Care staff are expected to report to their line manager any situation where lone working risks cannot be controlled. They will be expected to comply with all precautionary and safety measures including guidelines laid down by managers.

Reporting and Recording Incidents Arising from Lone Working

Any incidents arising from lone working that put the lone worker and/or the person receiving care at risk of harm or that have resulted in harm should be reported immediately to the duty manager/supervisor. Incidents to be reported include accidents, errors and near misses.

Upon notification, the duty manager/supervisor will report the incident to their manager, who will decide what actions should be taken. The immediate aim will always be to ensure the safety of those involved and, following, to notify the appropriate authorities if required.

Lone working staff must record all incidents, no matter how minor, in the incident book, and an incident report form should be completed as necessary. Forms should be signed by a witness.

Lone Worker Supervision Policy

By definition lone workers are those who work without constant supervision throughout their working day, therefore procedures must be put in place to monitor lone workers to ensure they remain safe and to provide supervision on a regular basis. This includes supervisors periodically visiting and observing those working alone and regular contact between the lone worker and supervision by telephone.

{{org_field_name}} considers that supervision helps to ensure that employees understand the risks associated with their work and that the necessary safety precautions are carried out. The extent of supervision required depends on the risks involved and the ability of the lone worker to identify and handle health and safety issues.

Lone Worker Security Procedures

When a member of staff visits someone in their own home, they may be at risk through health and safety hazards in and around people’s homes and of physical or verbal assaults and hostility from people receiving care, relatives and the general public. Recent evidence suggests that such incidents may be on the increase, and home visiting protocols should take this into account, particularly in high-risk areas such as high-crime rate areas.

At {{org_field_name}}:

the assessment of all new referrals should include a risk assessment which includes threats from health and safety hazards and from aggression and violence and other threats to lone working
lone workers should carry panic alarms and mobile phones so that they can summon help quickly, all phones should include an emergency number which will be attended at all times that staff are working
lone workers should call in at regular intervals to report that they are safe, including at the end of a shift
office staff should log and keep details of all home visits as well as having access to the names, addresses and telephone numbers of people receiving care
administration staff should contact the duty manager in the event of any emergency situations
in a situation where a lone worker feels under immediate threat of their physical safety they should contact the police directly or inform the duty administrator/manager who should contact the police for them; the administrator should be careful to take all appropriate information from the lone worker, such as location and telephone number, and to pass this on to the police; after the incident the lone worker should fill in an incident form.

{{org_field_name}} strongly advises its staff to carry in their cars the absolute minimum amount of equipment and that they always park their car in a well lit, public place if at all possible. Thefts from cars are a major area of concern and muggings of care staff are a real threat, especially in high crime areas. If on foot then care staff should avoid dark, unlit, isolated routes to work.

In cases where care is to be provided in a high crime area or to someone with a known history of aggression or violence associated with them, the supervisor/manager should carry out a full risk assessment. Where there is significant risk, the care plan should be altered accordingly, either by reviewing the case with the relevant case manager or by arranging for care workers to attend in pairs.

Training

All care staff must read this policy and be trained in personal security procedures. Security training is included in the induction training for all new staff and in-house training sessions on security are conducted at least annually and all relevant staff attend.

As part of the induction process their manager must be satisfied that each member of staff is competent and safe to work alone and that they are clear about how to act in ways that will maximise their own safety and about what to do in an emergency situation.

Lone worker training is given at induction or at any point where the staff member is expected to work on their own and have been assessed as “fit to work alone”; that is, without direct supervision.

Lone worker training follows Skills for Care lone worker safety guidance and covers the following aspects:

who is a lone worker?
what are the possible risks to a lone worker’s safety?
what can be done to counter these risks?
what policies, procedures and protocols are in place to ensure their safety?
how to report accidents, incidents and near misses that occur during lone working?
how to make sure that their whereabouts as a lone worker are traceable?
how to call for help in an emergency?
personal safety
dealing with threatening and aggressive behaviour
awareness strategies
what to do in specific situations
record keeping.

Training will also be provided to other staff with specific responsibilities for supporting and monitoring lone working.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}

Reviewed on: {{last_update_date}}

Next review date: this policy is reviewed annually (every 12 months). When needed, this policy is also updated in response to changes in legislation, regulation, best practices, or organisational changes.

D268. Lone Worker and Lone Working in Domiciliary Care