Continuity of Care or Support Workers Policy

Policy Statement

This agency aims to be fully compliant with current staffing regulations as set out in Regulation 18: Staffing of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

It is therefore committed to ensuring that staffing levels, in terms of both numbers and skills, are appropriate for the number of service users being cared for and to meet their assessed needs.

The agency recognises that service users often prefer to receive care from a single worker or small group of workers with whom they have built a relationship and it will endeavour to ensure that care is delivered by these workers as much as possible.

It has also followed, as far as practically possible, all government guidance to reduce contacts between service users and staff during the Covid-19 emergency situation by zoning and cohorting its staff deployment.

General Rules for Replacing Workers

A manager or supervisor who has to arrange for a replacement worker should observe the following general rules.

Consult the service user or their representative if possible and if there is time. This is advisable in every case if the change is permanent or likely to last longer than 30 days.
Always, unless the previous worker was found to be unsatisfactory, use a worker who as near as possible replicates the skills, experience and knowledge of the worker being replaced.
If the service user has several workers supplying service, consider whether one of the other existing workers could be available, by extending hours or by shifting from other duties but avoid setting off chains of changes which disrupt several service users.
If the service user has had other workers in the past and was satisfied with them, consider whether they could be available.
Ensure that the newly allocated worker is briefed both by you and, if feasible, by the worker being replaced.
If there is time, ensure that the newly allocated worker receives appropriate specialist training before starting to provide service, or as soon after as possible.
Apologise fully, express sympathy and as far as possible provide support to the service user and their carer or representative throughout the process.
In cases where a service user has communication or comprehension difficulties, take special care to ensure, as far as possible, that they understand what is happening, and that the position has been explained to the service user’s relative or representative if there is one.
In cases where a service user is receiving substantial help from a carer, ensure that the situation is fully explained to the carer as well as to the service user.
Remember that we have obligations to staff as well as to service users. In particular, be careful not to reveal confidential information about a staff member.
In communicating with a service user or their representative, always consider whether it would be best for a care worker who is familiar with the service user to carry out this function on the agency’s behalf.

Specific Reasons for Making a Change

Worker is unavailable at short notice

Most sickness absence is unpredictable, so quick action is likely to be needed to fill the gap created by the non-availability of a worker. An attempt should be made to work out how long the absence is likely to be and to make a plan to cover the whole period rather than proceeding on a day-to-day basis. An absence arising from special or compassionate leave should be similarly handled.

Worker on holiday or training

It should usually be possible to anticipate absences resulting from holidays or training, to make careful replacement plans and to explain the situation fully to the service user in advance.

Worker leaves {{org_field_name}}

It should usually be possible to anticipate absences resulting from a worker’s leaving the agency, to make careful replacement plans and to explain the situation fully to the service user in advance.

Sudden, unpredicted need to change worker permanently

If a worker, for example, leaves the agency without notice or it becomes necessary to change a worker urgently for any reason, quick action is likely to be needed to fill the gap. Consideration should be given as to whether it is possible to make an alternative long-term arrangement immediately or whether a temporary arrangement is necessary until a more satisfactory long-term replacement can be available.

Service requirements change in ways which make it impossible for the worker to continue

If a situation arises in which it becomes apparent that a worker does not have the necessary skills, physical capacity or training to deal with a service user’s changed needs, or cannot be available for additional hours or changed times, it should usually be possible to anticipate the development and make planned arrangements for a replacement. If not, the point above applies.

Service user requests a change of worker

If the service user requests a change of worker, the manager should of course explore the reasons. In most cases, since we always aim to meet service users’ requirements, the request should be met. Even if the request seems unreasonable, it may be wise to make a change as the relationship with the existing worker may deteriorate further.

Only if the request seems flippant or if there are repeated requests, should we hesitate to comply with a service user’s wishes. Before making the change the manager should discuss the request with the worker to obtain as full a picture as possible, to support the worker if appropriate, and if the worker was indeed unsatisfactory to initiate any other necessary action, for example, further training, increased support or supervision, or, in serious cases, discipline.

Subject to some discretion, the manager should confidentially brief the replacement worker on what happened.

A non-professional relationship has developed

If a non-professional relationship has developed between a service user and a worker, it is usually necessary to act swiftly, but the service user should still be consulted as fully as possible about the replacement.

The manager should then assess whether the incident should lead to further training or disciplinary or other action in respect of the worker and, subject to some discretion, should confidentially brief the replacement worker on what happened.

An assignment causes severe stress for a worker

If it is necessary to relieve a worker because of the stress the assignment generates, the situation should usually be anticipated and a carefully planned replacement introduced with full consultation.

The new worker should, of course, be confidentially briefed on what has happened and, if appropriate, be provided with additional support.

Careful consideration should be given to the future workload and support needs of the worker replaced.

Worker suffers abuse or discrimination

If a worker suffers abuse or discrimination to an extent that they need to withdraw from a service user, the manager should thoroughly explore the situation and consider whether {{org_field_name}} can continue to provide a service.

If it is decided to continue, any replacement worker should be thoroughly briefed on the risks in the situation.

The service user or their representative should still be consulted as fully as possible about the replacement but they should be warned that any recurrence of the abuse or discrimination may prejudice the continuance of the service.

Training

The service managers responsible for implementing this policy receive suitable training to enable them to assess and address the situations in which changes of personnel are indicated.

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.

S36. Continuity of Care or Support Workers