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Missing Service User Response and Safeguarding Policy

1. Purpose

The purpose of this policy is to establish clear procedures for responding to incidents where a service user is reported as missing, ensuring a swift and coordinated approach to locating the individual, mitigating risk, and safeguarding their well-being. This policy ensures compliance with the Regulation and Inspection of Social Care (Wales) Act 2016, the Social Services and Well-being (Wales) Act 2014, and aligns with CIW safeguarding protocols and multi-agency safeguarding arrangements.

This policy must be read and applied in line 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 Welsh Government statutory guidance for service providers and responsible individuals, the Social Services and Well-being (Wales) Act 2014, the Wales Safeguarding Procedures, the Mental Capacity Act 2005, UK GDPR and the Data Protection Act 2018. The service will notify Care Inspectorate Wales (CIW), the local authority safeguarding team, the police, commissioners and other relevant agencies where required, without delay and in the format required by the relevant body.

Our home care service recognises that missing persons incidents can cause significant distress and risk to service users, their families, and staff. Our aim is to respond efficiently, proportionately, and in collaboration with emergency services and safeguarding partners to ensure that all service users are located safely and protected from harm.

The organisation will act openly and transparently with the individual, their representative and relevant professionals when things go wrong, in line with the duty of candour.

1.1 Legal and Regulatory Framework

This policy is governed by, and must be implemented in accordance with, the following:

• Regulation and Inspection of Social Care (Wales) Act 2016.
• The Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended.
• Welsh Government statutory guidance for service providers and responsible individuals on meeting the service standard regulations for domiciliary support services.
• Social Services and Well-being (Wales) Act 2014, including duties relating to adults at risk and children at risk.
• Wales Safeguarding Procedures.
• Mental Capacity Act 2005 and Deprivation of Liberty Safeguards, where applicable.
• Human Rights Act 1998.
• Equality Act 2010.
• UK GDPR and Data Protection Act 2018.
• CIW notification requirements, including Regulation 60 and Schedule 3 notifications by the service provider.
• Social Care Wales Code of Professional Practice and relevant safeguarding training, learning and development standards.

The service will ensure that this policy is kept up to date, is consistent with the Statement of Purpose, and is accessible to staff, individuals, representatives, commissioners and relevant professionals where appropriate.

2. Scope

This policy applies to:

• all staff, managers, the Registered Manager, the Responsible Individual, volunteers, agency workers, contractors and any person working on behalf of {{org_field_name}};
• all individuals receiving domiciliary support from {{org_field_name}}, including adults, children where applicable, people who may lack mental capacity, people living with dementia, people with learning disabilities, autistic people, people with mental health needs and people with physical or sensory impairment;
• family members, representatives, advocates, attorneys, deputies and emergency contacts, where appropriate and lawful;
• local authorities, commissioners, safeguarding teams, health professionals, police and emergency services involved in the prevention, response, reporting or review of a missing-person incident;
• out-of-hours arrangements and lone-working situations where a missing-person concern may first be identified.

It covers:

• Definition of a missing service user and risk factors.
• Roles and responsibilities of staff in missing persons incidents.
• Immediate actions and escalation process when a service user is reported missing.
• Safeguarding considerations and risk management.
• Collaboration with emergency services and multi-agency working.
• Post-incident procedures, including reporting and learning reviews.

This policy applies whether the concern is identified during a planned visit, missed visit, welfare check, telephone contact, communication from a family member or representative, or information received from another professional or agency.

3. Definition of a Missing Service User and Risk Factors

A missing service user is any individual receiving care and support from {{org_field_name}} whose whereabouts, safety or welfare cannot be confirmed and where there is concern that they may be at risk of harm. This includes where the individual:

• is not at home or at the expected location when staff arrive for a planned visit and their whereabouts are unknown;
• fails to return home or to an agreed location as expected;
• leaves their home, community setting, appointment or supervised arrangement unexpectedly and cannot be located;
• is uncontactable and this is unusual, unexplained or inconsistent with their known routine;
• has missed essential care, medication, nutrition, hydration, clinical support or welfare checks and this creates risk;
• is reported missing or at risk by family, friends, neighbours, professionals, emergency services or another agency;
• is a child, adult at risk, or person whose mental capacity, cognition, communication, mental health, physical health or circumstances increase the level of concern.

Risk factors that increase vulnerability include:

• Dementia, cognitive impairment, or learning disabilities leading to confusion or disorientation.
• Mental health conditions, including depression, anxiety, suicidal ideation, or psychosis.
• Physical health conditions or mobility issues, increasing the likelihood of falls or medical complications.
• A history of self-neglect, exploitation, or domestic abuse.
• Sudden behavioural changes, distress, or agitation before going missing.

• The individual lacks, or may lack, mental capacity to make decisions about their safety, location, care or support at the relevant time.
• The individual has a known history of going missing, walking with purpose, self-neglect, refusing care where this creates serious risk, or becoming disorientated.
• The individual requires time-critical medication, nutrition, hydration, oxygen, clinical equipment, moving and handling support, continence care or other essential support.
• The individual is at risk of exploitation, coercion, domestic abuse, cuckooing, financial abuse, sexual exploitation, criminal exploitation or modern slavery.
• The individual has expressed suicidal thoughts, intent to self-harm, hopelessness, acute distress or unusual behaviour.
• The individual may be exposed to environmental risks, including severe weather, traffic, water, isolated areas, unsafe premises or night-time risks.
• The individual has communication needs, sensory impairment, limited mobility or difficulty seeking help.
• There is concern that the individual may have been prevented from receiving care, removed from the home, or placed at risk by another person.

3.1 Risk Classification

All missing-person concerns must be treated as urgent until risk has been assessed. Staff must not assume that the individual is safe because they have previously been absent, declined care or gone out alone.

The Registered Manager or senior person on duty must classify the concern as low, medium or high risk, based on the information available. Where there is any doubt, staff must escalate to the higher level of risk.

High risk applies where there is immediate concern for life, health, safety or welfare. This includes, but is not limited to, where the individual:

• lacks or may lack mental capacity in relation to their safety or whereabouts;
• has dementia, cognitive impairment, learning disability, autism, mental health crisis or significant communication difficulties;
• requires urgent medication, treatment, nutrition, hydration, equipment or personal care;
• is at risk of self-harm, suicide, exploitation, abuse, neglect or domestic abuse;
• is a child or adult at risk and their whereabouts are unknown;
• is missing in severe weather, darkness, traffic, near water, in an unfamiliar area or in other unsafe circumstances;
• has been missing for an unexplained period and contact attempts have failed.

Where the concern is high risk, staff must call 999 immediately and request police assistance. Staff must also inform the Registered Manager or on-call manager, the Safeguarding Lead, the local authority safeguarding team and the commissioner where appropriate.

Medium risk applies where there is concern for the individual’s welfare but no immediate evidence of life-threatening risk. Staff must continue urgent contact and search actions, escalate to the manager, and seek police or safeguarding advice without delay if the person is not located quickly.

Low risk applies only where there is a clear and reasonable explanation for the person’s whereabouts, the individual’s welfare has been confirmed, and there are no safeguarding, health, mental capacity or environmental concerns. The rationale for classifying the matter as low risk must be recorded.

4. Immediate Actions When a Service User is Reported Missing

4.1 Initial Assessment and Risk Evaluation

When a service user is reported missing, cannot be located, is not present for a planned visit, or their welfare cannot be confirmed, staff must treat the situation as urgent and immediately gather the following information:

• the individual’s full name, preferred name, date of birth, address and contact details;
• the time and location where the individual was last seen or last contacted;
• the purpose and scheduled time of the visit or contact;
• the individual’s known routine, likely destinations and places they may attend;
• the individual’s physical description, clothing, mobility, communication needs and any aids used;
• the individual’s medical conditions, mental health needs, cognitive impairment, sensory impairment, medication needs, allergies and time-critical care requirements;
• whether the individual has, or may have, mental capacity to understand risks to their safety and whereabouts at that time;
• whether there are known risks of self-harm, suicide, exploitation, abuse, neglect, domestic abuse, coercion, alcohol or substance use, or criminal activity;
• whether essential care has been missed, including medication, nutrition, hydration, continence care, moving and handling support or clinical interventions;
• whether weather, traffic, water, isolation, darkness, unsafe premises or other environmental risks increase the risk;
• any previous missing incidents, patterns, triggers or known preventative actions recorded in the personal plan or risk assessment.

The staff member must immediately contact the Registered Manager or on-call manager and follow the risk classification process in this policy. The manager must decide whether immediate police, safeguarding, commissioner, health or family/representative escalation is required. Where there is immediate concern for the person’s safety, staff must call 999 without waiting for managerial approval.

The assessment, rationale, actions taken, persons contacted and timescales must be recorded clearly and factually.

4.2 Immediate Response and Escalation Process

1. Attempt Contact:
   • Call the service user’s mobile phone or landline.
   • Check if family members or friends have seen or heard from them.
   • Visit the service user’s home to check for signs of recent activity.
2. Search the Immediate Vicinity:
   • Staff should search the home and nearby areas, including local shops, parks, or known locations the service user frequents.
   • If the service user resides in sheltered accommodation or a care setting, check with staff and other residents.
3. Notify Emergency Contacts and Report to the Police:

Staff must call 999 immediately where:

• there is immediate concern for the individual’s life, health, safety or welfare;
• the individual is a child or adult at risk and their whereabouts are unknown;
• the individual lacks, or may lack, mental capacity in relation to their safety or whereabouts;
• the individual has dementia, cognitive impairment, learning disability, autism, mental health crisis or significant communication difficulties;
• there is risk of self-harm, suicide, exploitation, abuse, neglect, domestic abuse, coercion or crime;
• the individual requires urgent medication, healthcare, nutrition, hydration or essential support;
• the individual is missing in unsafe environmental circumstances;
• initial contact and reasonable checks have failed and concern remains.

Staff must provide the police with:

• the individual’s full name, date of birth, address, contact details and preferred language or communication method;
• physical description, clothing and any mobility or communication aids;
• last known location, time last seen and known destinations;
• medical, mental health, medication and cognitive risks;
• known risks of self-harm, suicide, exploitation, abuse, neglect or crime;
• details of family, representatives, advocates or professionals involved;
• actions already taken by staff and any information from the personal plan or risk assessment.

4. Inform the Registered Manager and Safeguarding Lead:
   • The Registered Manager ({{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}) and the Safeguarding Lead ({{org_field_safeguarding_lead_name}}) must be notified immediately.
   • A serious incident log must be initiated.
5. Notify the Local Authority Safeguarding Team and Commissioner:

The Registered Manager or Safeguarding Lead must notify the local authority safeguarding team without delay where the missing-person incident indicates that the individual is an adult at risk or child at risk, may have experienced or be at risk of abuse, neglect, exploitation, improper treatment or self-neglect, or where there are concerns about a failure in care. The service commissioner must also be informed where the incident affects the commissioned care and support, risk management, visit arrangements, personal plan or the person’s safety.

6. Work with Police and Local Safeguarding Teams:
   • Provide police and safeguarding authorities with relevant background information.
   • Cooperate with the Wales Safeguarding Procedures and local authority missing persons protocols.
7. Notify CIW Where Required:

The Registered Manager, Responsible Individual or authorised CIW Online user must notify CIW without delay and in writing through CIW Online where the incident is notifiable. This includes, but is not limited to:

• any incident reported to the police;
• any abuse or allegation of abuse involving the service provider, staff member or volunteer;
• any allegation of misconduct by a member of staff;
• serious accident, serious injury or serious harm to an individual;
• any event which prevents, or could prevent, the provider from continuing to provide the service safely;
• any safeguarding incident or concern that indicates risk to individuals or service failure.

Where there is uncertainty about whether the incident is notifiable, the Registered Manager must seek advice and record the rationale for the decision. The service will err on the side of openness and transparency.

5. Safeguarding Considerations and Risk Management

5.1 Preventing Missing Person Incidents

To minimise risk, our organisation takes proactive measures such as:

• Conducting risk assessments for service users prone to wandering or self-neglect.
• Implementing GPS tracking technology or telecare solutions where appropriate.
• Encouraging family involvement in monitoring service user movements.
• Ensuring service users with memory loss or confusion have clear identification and contact details on them.
• Regular welfare checks for service users with mental health vulnerabilities.

• Ensuring the individual’s provider assessment, personal plan and risk assessments identify known missing-person risks, triggers, preventative measures, escalation contacts and agreed actions.
• Recording known routines, preferred places, community contacts, mobility needs, communication needs, language needs and likely destinations.
• Agreeing with the individual and, where appropriate, their representative or commissioner, what action staff should take if the individual is not at home for a planned visit.
• Ensuring missed visits, failed access, no replies and welfare concerns are escalated in line with the missed visit, lone working and safeguarding procedures.
• Using technology-enabled care, GPS, telecare, key safes, door sensors or welfare check systems only where this is lawful, proportionate, consented to where the person has capacity, or agreed as being in the person’s best interests where they lack capacity.
• Reviewing preventative measures after any incident, near miss, change in health, change in capacity, safeguarding concern, hospital admission or change in living circumstances.

Where restrictive or monitoring measures are considered, the least restrictive option must be used. Any restriction, monitoring or technology must be lawful, proportionate, recorded in the personal plan and risk assessment, and reviewed regularly. Where the person lacks capacity, decisions must be made in accordance with the Mental Capacity Act 2005 and must be in the person’s best interests.

5.2 Safeguarding At-Risk Individuals

A missing-person incident may indicate that an individual is experiencing, or is at risk of, abuse, neglect, self-neglect, exploitation or improper treatment. Staff must follow the Wales Safeguarding Procedures and must report concerns without delay to the Safeguarding Lead or Registered Manager.

The Registered Manager or Safeguarding Lead must make a report to the local authority safeguarding team where:

• the individual is an adult at risk or child at risk;
• the individual may have suffered or may be at risk of abuse, neglect, exploitation, self-neglect or improper treatment;
• the incident may have resulted from missed care, poor practice, unsafe staffing, failure to follow the personal plan, medication omission, poor communication or failure to escalate;
• a staff member, volunteer, contractor, family member, representative or other person may have contributed to the risk;
• there is a suspected crime;
• the individual lacks, or may lack, mental capacity in relation to the relevant decision;
• the individual’s wishes not to report are outweighed by risk to their safety, risk to others, legal duty, public interest or suspected organisational abuse.

The service will co-operate fully with safeguarding enquiries, strategy discussions, police investigations, commissioner reviews and CIW enquiries. Records of safeguarding referrals, decisions, outcomes and actions must be maintained and reviewed by the Registered Manager and Responsible Individual.

5.3 Mental Capacity, Consent and Best Interests

Staff must presume that the individual has mental capacity unless there is reason to believe otherwise. Where there is concern that the individual may lack capacity to make a decision about their safety, whereabouts, care or support, staff must escalate this immediately to the Registered Manager or on-call manager.

Where the individual lacks capacity for the relevant decision, any action taken must be in their best interests, must be the least restrictive option available and must be recorded. This may include contacting emergency services, family, representatives, attorneys, deputies, commissioners, health professionals or the local authority safeguarding team where this is necessary to protect the individual from harm.

Where the individual has capacity and chooses to leave or decline contact, staff must respect the person’s rights and autonomy but must still escalate where there is serious risk, safeguarding concern, suspected crime, risk to others, coercion, domestic abuse, exploitation or concern that the decision may not be freely made.

5.4 Welsh Language, Communication and Accessible Information

The service will take reasonable steps to meet the individual’s language and communication needs during prevention, response and post-incident support. This includes identifying whether the individual’s language of need or choice is Welsh, English or another language, and whether the individual uses communication aids, British Sign Language, Makaton, pictures, easy read information, hearing aids, glasses, assistive technology or support from a representative or advocate.

When reporting a missing-person concern to the police, safeguarding team, commissioner or health professional, staff must share relevant communication and language information so that the individual can be located, approached and supported safely.

Information provided to the individual after the incident must be in a format, language and communication method appropriate to their needs, age, capacity and level of understanding.

6. Post-Incident Procedures and Learning Reviews

6.1 Safe Return and Well-Being Check

Once the individual is found, staff must ensure their immediate safety and must contact emergency services if urgent medical, mental health or safeguarding support is required.

A safe return and well-being check must be completed as soon as practicable by a competent staff member, manager or relevant professional. This must include:

• checking for injury, pain, distress, confusion, dehydration, hypothermia, exhaustion, medication omission, neglect or signs of abuse;
• asking, where appropriate and safe, where the individual has been, what happened, whether anyone harmed, threatened, coerced or exploited them, and whether they feel safe;
• considering whether the individual needs urgent medical assessment, mental health crisis support, police support, advocacy or safeguarding support;
• considering whether family, representatives, attorneys, deputies, commissioners or health professionals need to be informed;
• ensuring the individual receives reassurance in a way they can understand;
• recording the individual’s account, presentation, actions taken and any referrals made.

Staff must not assume the incident is resolved simply because the individual has returned. The Registered Manager must consider whether the incident indicates unmet need, changing risk, safeguarding concerns, mental capacity concerns, service failure or the need for changes to the personal plan.

6.2 Reporting and Documentation

Following any missing-person concern, staff must complete a full incident report before the end of the shift, or sooner where required by the Registered Manager. Records must be factual, timed, dated, signed and stored securely.

The incident record must include:

• the date and time the concern was identified;
• the scheduled visit time or expected contact time;
• who identified the concern and how;
• the individual’s last known location and time last seen or contacted;
• presenting risks, including health, mental health, medication, capacity, safeguarding and environmental risks;
• contact attempts made, including times and outcomes;
• searches or checks completed and by whom;
• police contact, including incident or reference number;
• local authority safeguarding referral details, where applicable;
• commissioner, family, representative, advocate, health professional or emergency contact notifications;
• CIW notification details, where applicable, including date, time, method and person submitting the notification;
• actions taken to protect the individual and others;
• outcome of the incident and safe return check;
• whether duty of candour was triggered and what communication took place;
• immediate actions to reduce further risk;
• whether the personal plan, provider assessment, risk assessment, visit schedule or staff guidance requires review.

The Registered Manager must review the incident report, ensure statutory notifications and safeguarding referrals have been completed, and confirm whether further investigation, staff support, training, disciplinary action, commissioner review or multi-agency review is required.

6.3 CIW Notifications

The Registered Manager, Responsible Individual or authorised CIW Online user must notify CIW without delay, in writing and using CIW Online, where the missing-person incident meets a notifiable threshold.

A CIW notification must be made where the incident includes or results in:

• police involvement or any incident reported to the police;
• serious accident, serious injury or serious harm;
• abuse or allegation of abuse involving the service provider, a staff member or volunteer;
• allegation of misconduct by a staff member;
• safeguarding concern indicating risk to an individual, unsafe care or possible service failure;
• an event which prevents, or could prevent, the provider from continuing to provide the service safely;
• any other circumstance required by CIW or the Regulations.

The notification must include details of the event, immediate action taken, agencies informed, current risk, safeguarding actions, support provided to the individual, and planned follow-up. A copy or record of the notification must be retained with the incident record.

6.4 Duty of Candour

Where a missing-person incident has caused harm, may have caused harm, indicates service failure, or has caused significant distress or risk, {{org_field_name}} will act in an open and transparent way with the individual and, where appropriate, their representative, family, commissioner and relevant professionals.

This will include:

• explaining what is known at the time;
• apologising where appropriate;
• explaining immediate actions taken to protect the individual;
• explaining what further enquiries or investigations will take place;
• providing updates where further information becomes available;
• explaining learning and actions taken to reduce recurrence;
• recording all duty of candour communications.

6.5 Lessons Learned and Policy Improvements

To prevent recurrence and improve practice, the Registered Manager must ensure that every missing-person incident or near miss is reviewed. The review must consider:

• what happened and why;
• whether staff followed this policy and related procedures;
• whether the personal plan, provider assessment and risk assessments were accurate and up to date;
• whether visit times, call monitoring, missed visit procedures, travel arrangements or staffing arrangements contributed to the incident;
• whether communication with the individual, family, representatives, commissioner, safeguarding team, police, health professionals and CIW was timely and effective;
• whether mental capacity, consent, best interests, safeguarding and duty of candour were considered appropriately;
• whether further staff training, supervision, competency checks or disciplinary action are required;
• whether the incident indicates wider service risk, patterns or trends.

The outcome of the review must be recorded. Actions must be allocated to named persons with timescales for completion. The Registered Manager must monitor completion of actions, and the Responsible Individual must have oversight of significant incidents, trends, learning and improvement actions through the service’s governance and quality assurance arrangements.

6.6 Personal Plan and Risk Assessment Review

Following any missing-person incident, near miss, failed access concern or significant welfare concern, the Registered Manager must ensure the individual’s personal plan, provider assessment and risk assessments are reviewed and revised as necessary.

The review must consider:

• whether the individual’s needs, risks or personal outcomes have changed;
• whether additional preventative actions are required;
• whether visit times, frequency, duration or staffing arrangements need to change;
• whether assistive technology, telecare or welfare checks should be considered;
• whether mental capacity assessment or best interests decision-making is required;
• whether health, mental health, social work, advocacy or safeguarding input is needed;
• whether family, representatives or commissioners need to be involved in the review;
• whether staff require updated guidance or training.

Where changes are made, the updated plan must be communicated to relevant staff before they next provide care and support.

6.7 Staff Training and Competence

All staff must receive training appropriate to their role so they understand how to prevent, identify, respond to, record and escalate missing-person concerns. Training must include:

• safeguarding adults and children in Wales;
• Wales Safeguarding Procedures;
• recognising adults at risk and children at risk;
• missing-person response and escalation;
• missed visits and failed access;
• mental capacity, consent and best interests;
• duty of candour;
• record keeping and confidentiality;
• lone working and staff safety;
• communication needs, Welsh language needs and accessible information;
• use of telecare or assistive technology where applicable.

Staff understanding of this policy must be checked through induction, supervision, team meetings, competency checks, incident debriefs and annual refresher training. Any failure to follow this policy may result in supervision, retraining, disciplinary action or referral to relevant external bodies where required.

7. Related Policies

This policy should be read alongside:

• Safeguarding Adults from Abuse and Improper Treatment Policy (DCW13)
• Safeguarding Children Policy, where applicable
• CIW Notifications Policy
• Incident Reporting and Accident Policy
• Duty of Candour Policy
• Mental Capacity and Deprivation of Liberty Safeguards Policy (DCW39)
• Risk Management and Assessment Policy (DCW18)
• Personal Plan / Care Planning Policy
• Missed and Late Visits Policy
• Lone Working Policy
• Staff Code of Conduct Policy
• Whistleblowing (Speaking Up) Policy (DCW29)
• Complaints Policy
• Medication Management and Administration Policy
• Requesting Medical Support: GP, Paramedic and Specialist Services Policy
• Data Protection and Confidentiality Policy
• Assistive Technology / Telecare Policy
• Equality, Diversity and Human Rights Policy
• Welsh Language and Communication Policy, where separate

8. Policy Review

This policy will be reviewed at least annually, or sooner where:

• there is a change in legislation, regulation, statutory guidance, CIW expectations or Wales Safeguarding Procedures;
• a missing-person incident, near miss, safeguarding concern or serious incident identifies learning;
• CIW, the local authority, commissioner, police, safeguarding board or another relevant body recommends a change;
• audit, quality assurance, complaints, concerns, staff feedback or incident trends identify the need for improvement;
• the Statement of Purpose, service model, staffing arrangements or systems change.

The Registered Manager is responsible for ensuring this policy is implemented, audited and kept under review. The Responsible Individual must maintain oversight of significant incidents, notifications, safeguarding referrals, learning and improvement actions.

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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}}
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