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Management of Accidents, Incidents, and Near Misses Policy

1. Introduction

Our Home Care business is committed to ensuring the safety, well-being, and protection of all individuals receiving care and support, our staff, and others affected by our service. We will identify, report, investigate and learn from accidents, incidents and near misses to prevent recurrence and to maintain safe, high quality care. This policy is written with regard to the Regulation and Inspection of Social Care (Wales) Act 2016 and the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017 (as amended), including the requirements to record incidents and make notifications to CIW (Regulation 60 and Schedule 3, and where applicable Regulation 84 and Schedule 4). It also supports compliance with safeguarding duties under the Social Services and Well-being (Wales) Act 2014 and Wales safeguarding procedures, and workplace reporting duties including RIDDOR 2013 and the Health and Safety at Work etc. Act 1974.

This policy applies to all employees, including Care Assistants, Senior Carers, Coordinators, Managers, and Directors, and provides clear procedures for recording, reporting, and learning from accidents, incidents, and near misses. It also serves as a compliance guide for CIW inspectors assessing our management systems.

2. Key Principles of Accident, Incident, and Near Miss Management

• Prevention First: Risks are assessed, and preventive measures are implemented to minimise the likelihood of accidents or incidents occurring.
• Clear Reporting Procedures: All accidents, incidents, and near misses must be recorded and reported promptly using the Incident Reporting System (IRS).
• Thorough Investigation and Root Cause Analysis: Each event is investigated to determine causes and prevent recurrence.
• Duty of Candour: Full transparency is maintained when incidents occur, and affected individuals are informed appropriately.
• Staff Training and Competency: Employees are trained in accident and incident management procedures, ensuring compliance with CIW standards.
• Continuous Learning and Improvement: Lessons learned from incidents are used to improve care quality and safety practices.

3. How We Manage Accidents, Incidents, and Near Misses Efficiently

A. Definitions and Examples

To ensure clarity, the following terms are defined:

• Accident: Any unexpected event that results in injury, illness, or harm to a service user, staff member, or visitor. (e.g., a fall resulting in a fracture)
• Incident: Any event that disrupts care delivery or has the potential to cause harm but may not have resulted in injury. (e.g., a medication administration error)
• Near Miss: A situation where an accident or incident was narrowly avoided. (e.g., a trip hazard identified but no fall occurred)

For Staff: Understand the difference between accidents, incidents, and near misses, ensuring that each type is reported appropriately.

For CIW Inspectors: Incident logs and audits demonstrate that all events are categorised correctly and reported in accordance with regulations.

B. Reporting and Recording Procedures

All accidents, incidents, and near misses must be recorded and reported immediately using the Incident Reporting System (IRS) to ensure prompt action.

For Staff:

• Step 1: Ensure the immediate safety of the service user or staff involved.
• Step 2: Provide first aid or medical assistance if required.
• Step 3: Complete an Incident Report Form (IRF) via the IRS system, detailing the event, individuals involved, and any immediate actions taken.
• Step 4: Report serious incidents to the Registered Manager or Duty Supervisor.
• Step 5: Record the incident in the service user’s Care Management System (CMS) if it involves a service user.

For CIW Inspectors: IRS records confirm that all accidents, incidents, and near misses are logged, investigated, and followed up appropriately.

C. Record quality, confidentiality, and retention

All incident records (including investigation notes and action plans) must be complete, accurate, dated, and stored securely. Where records are stored electronically, access will be controlled via individual user accounts and permissions so that an audit trail shows who created or amended entries and when. Records will be managed in line with confidentiality and data protection requirements and retained in accordance with our organisational retention schedule and any regulatory/contractual requirements.

D. Investigating Accidents and Incidents

All reported incidents undergo a thorough investigation to identify causes and implement corrective actions.

For Staff:

• Managers conduct a Root Cause Analysis (RCA) to determine contributing factors.
• Interview any witnesses and review CCTV footage (if applicable).
• Document all findings in an Investigation Report (IR).
• Implement corrective actions such as training, process changes, or additional safety measures.

For CIW Inspectors: Investigation reports demonstrate that robust investigations take place, corrective actions are implemented, and lessons are learned.

E. Notifiable Incidents and External Reporting

We will make notifications to CIW and other relevant bodies without delay and in writing, and in the manner and form required by CIW (normally via CIW Online). Where CIW requires a prompt notification, we will do this as soon as practicable (normally within 24 hours) and then provide follow-up information as it becomes available.

1. CIW notifications (Service Provider duty – Regulation 60 / Schedule 3)

The Registered Manager (or delegated senior person) is responsible for ensuring CIW is notified of events that are notifiable under Regulation 60 and Schedule 3. This includes (where applicable to our domiciliary support service):

• Any abuse or allegation of abuse relating to an individual involving the provider and/or staff/volunteers;
• Any allegation of misconduct by a member of staff;
• Any serious accident or injury to an individual;
• Outbreak of infectious disease;
• Any incident reported to the police;
• Any events which prevent, or could prevent, the provider from continuing to provide the service safely (e.g., critical staffing shortfalls).

For the purposes of “serious accident or injury”, we will follow the statutory guidance approach that this includes an accident/injury requiring treatment by a health care professional and which has or may have resulted in significant harm (e.g., impairment likely to last more than 28 days, prolonged pain/psychological harm, or death/shortened life expectancy).

2. Responsible Individual (RI) notifications (Regulation 84 / Schedule 4) and delegation

Where a notification duty sits with the RI, the RI will ensure notifications are made as required. The RI may delegate the online submission to a “designated online assistant” but remains accountable for ensuring notifications are made correctly and on time.

3. Safeguarding referrals (Local Authority / partners)

Any allegation, incident or evidence of abuse, neglect or improper treatment will be acted on without delay in line with Wales safeguarding procedures and local safeguarding arrangements, including referral to the local authority safeguarding team/police where required.

4. HSE reporting (RIDDOR)

RIDDOR-reportable incidents affecting staff (e.g., specified injuries, dangerous occurrences, work-related ill health) will be reported to the HSE within statutory timescales, and recorded on our incident system.

5. Commissioners / Local Authority notifications (contractual)

Where our contract or commissioning arrangements require notification (e.g., medication error leading to harm/hospitalisation), we will notify the commissioner/local authority as specified and record when and how this was done.

F. Learning from Incidents and Continuous Improvement

We use incident data to improve service quality and reduce future risks.

For Staff:

• Participate in monthly Incident Review Meetings (IRM) where trends and patterns are analysed.
• Take part in reflective practice sessions following incidents to improve care practices.
• Contribute to the development of new policies and procedures where needed.

For CIW Inspectors: Audit reports and training records show that lessons learned from incidents lead to tangible service improvements.

G. Supporting Service Users, Families, and Staff

Following an accident or incident, it is crucial to support those affected and communicate openly.

For Staff:

• Inform individuals and (where appropriate) their representatives openly and honestly when things go wrong. This includes explaining what is known about what happened, what immediate actions have been taken, what further investigation will take place, and sharing the outcome of the investigation when available. Where appropriate, an apology will be offered, and support will be provided to the individual/representative throughout the process. Staff must be supported to speak up and will not be bullied, victimised or obstructed in exercising candour; any concerns about obstruction or breaches of professional duty of candour will be addressed and, where appropriate, referred to the relevant professional regulator.
• Provide emotional and psychological support to affected individuals.
• Offer debriefing sessions for staff involved in serious incidents.

For CIW Inspectors: Complaints logs and feedback surveys confirm that service users and staff receive appropriate support following incidents.

4. Governance and Continuous Monitoring

We maintain strong governance and oversight to ensure all accident, incident, and near-miss management procedures comply with regulatory standards.

What We Do:

• Conduct Quarterly Safety Audits (QSA) to monitor trends in accidents and incidents.
• Review and update risk assessments every 6 months.
• Hold Annual Health & Safety Reviews (AHSR) to assess compliance with RIDDOR and CIW regulations.
• The Responsible Individual ensures there are effective systems to record incidents and matters requiring notification, and to assure records are legible, accurate and stored securely.
• Incident, near miss, safeguarding and notifiable incident data is aggregated, analysed and reviewed at least every six months as part of the Quality of Care Review process, and improvement actions are tracked to completion.

For CIW Inspectors: Documentation confirms that monitoring, learning, and improvements take place regularly.

We recognise that CIW inspection outcomes and service improvement evidence (including learning from incidents) support our wider regulatory compliance, including the inspection ratings framework introduced in Wales in 2025.

5. Compliance Monitoring and Audit Procedures

• Internal Audits: Conducted quarterly to assess compliance with incident reporting and investigation procedures.
• Annual Reviews: Full compliance check against CIW, RIDDOR, and Health & Safety Executive (HSE) regulations.
• Staff Supervisions & Appraisals: Conducted every six months to ensure all staff understand incident management protocols.

6. Conclusion

We are committed to ensuring that accidents, incidents, and near misses are reported, investigated, and acted upon efficiently in compliance with CIW, RIDDOR, and health & safety standards. This policy ensures that service users, staff, and visitors remain safe, risks are minimised, and lessons are continuously learned to improve the quality of care.

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