DS117. Live-in, Night Care, and 24-hour Care in Domiciliary Care
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Live-in, Night Care, and 24-hour Care in Domiciliary Care (Scotland) Policy
Policy Statement
This policy is written to show how {{org_field_name}} organises its living-in/sleeping-in/24-hour care services where it is responsible for its delivery in line with its registration requirements with the Care Inspectorate and the national health and care standards My Support, My Life.
It describes the arrangements made to ensure that {{org_field_name}} is providing safe and effective care for people using the service and is meeting its responsibilities for the health and safety of the care workers involved, particularly where one-to-one care is being provided.
The policy applies to situations whereby {{org_field_name}} has agreed to:
- appoint one or more of its care staff to provide continuous day and/or night 24-hour cover either through a formal “living-in” arrangement or in shifts
- provide night care through a “waking” and/or sleeping-in service
- provide support to people who need continuous care and supervision.
The policy should be used with reference to other relevant care and staffing policies, particularly those concerning the protection of people using the service and care service staff and where continuous supervision is required because of mental incapacity.
{{org_field_name}}’s Lone Working in Domiciliary Care Policy is particularly relevant for care workers engaged in living-in or sleeping-in duties on their own.
These services for the most part are provided to people living in their own homes or in housing with support facilities. More exceptionally {{org_field_name}} could be asked to provide a service to someone in a care home, where, for example, the home cannot provide all the resources needed to meet their care and support needs.
{{org_field_name}} is mindful of the fact that any living-in or sleeping-in arrangement will be intrusive to the way of life of the person receiving care and potentially stressful to the care workers involved. It always needs to be carefully planned and introduced. Because it involves a person receiving care and possibly other family members having strangers to live-in and share their home and a care worker being a stranger in another person’s home, adjustments will always be needed and there will inevitable compromises to be made in order to achieve the best possible outcomes for the person receiving care.
The agreed service could be provided as a private arrangement between person receiving care (or their representatives) and {{org_field_name}} or as a commissioned care programme planned and organised by health and/or local authority social care services.
{{org_field_name}} will ensure that suitable insurance arrangements are in place.
Care-related Issues
{{org_field_name}} works on the basis that any living-in or sleeping-in arrangement will be an integral part of a person’s agreed care plan, decided from their needs and risk assessments. The care workers’ roles and tasks will be detailed in the person’s care plans and the contracts or service agreements that are entered into.
The care plan will include the personal care tasks to be carried out as “regulated activity” in line with {{org_field_name}}’s registration status and/or local contracting requirements.
Where the care and support is being shared between more than one provider (including where the service is being provided to someone in supported living or a care home), the service will ensure that the care plan clearly distinguishes the respective tasks of the different providers and the agency’s care workers involved are clear about their roles and responsibilities.
Any additional tasks to be carried out by care workers that lie outside the definition of regulated activity, but are part of general “living-in”, will be specified in the service agreement/contract. These could include: general housework, shopping, cooking, laundry and cleaning, emotional and social support, companionship and escorting in relation to social activities and outings, and help with pet care.
{{org_field_name}} will always ensure that it will provide staff who are both competent and committed to carrying out the proposed range of tasks, particularly those that are not formally defined as personal care.
The provision of {{org_field_name}}’s services to people in supported living arrangements, particularly where they have complex needs, will often be carried out by more than one worker as part of a shift pattern. In these instances, it ensures that there is good communication and continuity of the care and support provided.
In the event of providing its services to a resident of a care home or assisted living facility, {{org_field_name}} recognises the importance of its staff developing good working relationships with the home’s staff with clear lines of responsibility and accountability built into the service agreement.
Making the Arrangements
{{org_field_name}} uses the term “live-in” care to apply to arrangements whereby one or more of its care staff will be available to the person receiving care over an agreed period of time as continuous day and/or night care that could extend to being on a 24-hour basis.
The exact arrangements, including duration, the length of staffing shifts and times off, are worked out on a situation-by-situation basis. This reflects {{org_field_name}}’s commitment to providing flexible, responsive services tailored to individual needs and circumstances.
A “live-in” service will usually include some form of night care or “sleeping-in” duties, though night care or “sleeping-in” can be part of a separate care arrangement. Where 24-hour care is being provided, {{org_field_name}} will make sure that the sleeping arrangements and other facilities available for its care workers are adequate and acceptable to them and can ensure an appropriate and acceptable degree of privacy that does not, at the same time, compromise the privacy and dignity of the service user.
{{org_field_name}} distinguishes between its provision of a “night care” service which involves having a carer being active and/or wakeful (with agreed periods of respite) throughout or for most of the night and “sleeping-in”, which requires the care worker to be only available to provide night care as needed, but otherwise being able to sleep.
{{org_field_name}} always ensures that the arrangements made will always reflect the individual’s care needs and will adjust its care workers’ terms and conditions of employment, including payments, to the work demands of the individual situation.
{{org_field_name}} is mindful of its duties of care to both the people receiving care and its employees in making the arrangements and will put in place any safeguards needed to provide mutual protection.
Staff Support and Training
Staff who agree to be employed under a “living-in” or “sleeping-in” arrangement will be appropriately trained and well briefed and have support available at all times. care provider’s policy is to use only experienced, competent and committed staff for these purposes.
This applies particularly to the care of people living with dementia and only staff who have had dementia care training will be employed in these circumstances.
When on duty as lone workers, all risks to their health and safety will be assessed and risk management plans put in place as required in line with the service’s policy on lone working.
Review
This policy will be reviewed on an annual basis to ensure it is being effectively implemented or as new circumstances involving these arrangements arise.
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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