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Registration Number: {{org_field_registration_no}}

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Live-in and Overnight Care Policy

1. Purpose

This policy sets out the standards and procedures for delivering live-in and overnight care at {{org_field_name}}, ensuring that people we support receive high-quality, person-centred, and safe care. It establishes best practices for staff providing round-the-clock support, ensuring compliance with Care Quality Commission (CQC) regulations while balancing the well-being, dignity, and independence of those in our care.

This policy ensures that live-in and overnight care is delivered efficiently, with appropriate risk management, safeguarding measures, and staff welfare considerations.

2. Scope

This policy applies to:

• People we support who require live-in or overnight care.
• Live-in care staff, including full-time, part-time, agency, and relief workers.
• Overnight care staff, including waking night staff and sleep-in carers.
• Managers and senior staff responsible for scheduling, monitoring, and ensuring compliance.

3. Legal and Regulatory Compliance

This policy aligns with:

• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014:
  • Regulation 9 – Person-Centred Care (Tailoring care to individual needs)
  • Regulation 10 – Dignity and Respect (Ensuring people’s privacy and choice in overnight support)
  • Regulation 12 – Safe Care and Treatment (Ensuring appropriate risk management and emergency planning)
  • Regulation 13 – Safeguarding from Abuse (Preventing harm, abuse, or inappropriate care practices)
  • Regulation 17 – Good Governance (Ensuring clear documentation and accountability in live-in care arrangements)
  • Regulation 18 – Staffing (Ensuring sufficient and well-trained staff for live-in and overnight care)
• Working Time Regulations 1998 – Ensuring compliance with rest breaks, working hours, and staff welfare.
• Equality Act 2010 – Ensuring non-discriminatory practices in care provision.
• Mental Capacity Act 2005 – Protecting individuals’ rights in decision-making about overnight care.
• Fire Safety Order 2005 – Ensuring emergency procedures for overnight staff.

4. Types of Live-in and Overnight Care

4.1 Live-in Care

Live-in care means a staff member resides in the home of the person we support and provides 24-hour care and support. This arrangement is suited to individuals who:

• Require continuous support for medical or personal care needs.
• Need assistance with daily living, including medication management, mobility support, and household tasks.
• Benefit from companionship and reassurance throughout the day and night.

4.2 Overnight Care

Overnight care can be provided in two main formats:

4.2.1 Waking Night Support

• The staff member remains awake and alert throughout the night to respond to care needs, emergencies, or safety concerns.
• This is required when:
  • A person has night-time medical needs (e.g., epilepsy, complex care needs).
  • There is a risk of falls or wandering.
  • Regular positioning or continence care is needed overnight.

4.2.2 Sleep-In Support

• The staff member is present at night but is permitted to sleep in a designated staff sleeping area.
• They may be woken if assistance is needed, but frequent interruptions should be minimised.
• This arrangement is suitable when:
  • Occasional support may be needed overnight.
  • The presence of a staff member provides reassurance.

5. Person-Centred Planning for Live-in and Overnight Care

All live-in and overnight care arrangements must be tailored to the individual’s needs and documented in their care plan, including:

• Daily routines and preferences, ensuring a comfortable and familiar environment.
• Communication needs, including non-verbal cues, assistive technology, or night-time monitoring devices.
• Privacy and dignity considerations, ensuring the person’s personal space and choices are respected.
• Risk assessments, detailing any night-time health risks or environmental hazards.
• Emergency procedures, ensuring staff and individuals know what to do in case of fire, falls, or medical emergencies.

6. Safe and Dignified Delivery of Live-in and Overnight Care

6.1 Privacy and Boundaries

• Staff must respect the personal space of individuals and use designated staff areas when off duty.
• Personal belongings of the individual must never be used by staff.
• Staff must always knock before entering bedrooms or private areas.

6.2 Medication and Health Monitoring

• Any night-time medications must be administered in line with Medication Administration Policies.
• If the individual requires turning, repositioning, or continence care, this must be documented and provided sensitively.
• Monitoring for health conditions (e.g., epilepsy, diabetes) must be carried out as per care plan instructions.

6.3 Sleep-In Care Expectations

• Sleep-in staff must be provided with a quiet and safe sleeping area.
• Any disturbances to sleep must be recorded and reviewed to assess workload and staffing needs.
• If a person requires frequent night-time support, a waking night arrangement may be considered instead.

6.4 Night-Time Risk Management

• Regular environmental safety checks must be completed, including ensuring that:
  • Emergency exits are accessible.
  • There are no trip hazards or fire risks.
  • Security measures are in place to prevent unauthorised access.
• Staff must have immediate access to emergency contacts and medical protocols.

7. Staff Support and Well-Being

7.1 Workload and Rest Breaks

• Live-in carers must have scheduled breaks during the day to prevent burnout.
• Sleep-in staff must receive uninterrupted sleep, except in emergencies.
• Waking night staff must have appropriate rest breaks in line with Working Time Regulations.

7.2 Lone Working Considerations

• If a lone worker is providing overnight care, additional risk assessments must be in place.
• Staff must have emergency contact systems, such as on-call managers or alarmed monitoring devices.
• Staff must never work excessive hours that could lead to fatigue or unsafe care practices.

8. Documentation and Record-Keeping

• All care activities provided during live-in and overnight care must be recorded in the individual’s care notes.
• Any incidents, concerns, or emergency interventions must be reported immediately.
• Staff must document any interruptions to sleep for review by management.

9. Safeguarding and Reporting Concerns

• Any suspected abuse, neglect, or breaches of professional boundaries must be reported under the Safeguarding Policy.
• If a person receiving care expresses concerns about their overnight care, this must be addressed promptly and appropriately.
• Staff must receive regular training on safeguarding and whistleblowing procedures.

10. Training and Competency of Staff

All staff providing live-in and overnight care must receive:

• Mandatory induction training covering personal care, dignity, safeguarding, and health & safety.
• Ongoing specialist training based on individual care needs, including dementia, epilepsy, and continence care.
• Annual refresher training to maintain competency.
• Regular supervisions and appraisals to discuss challenges and identify support needs.

11. Related Policies

• SL09 – Confidentiality and Data Protection Policy
• SL13 – Safeguarding Adults from Abuse Policy
• SL16 – Health and Safety at Work Policy
• SL18 – Risk Management and Assessment Policy
• SL20 – Fire Safety and Evacuation Procedures

12. Policy Review

This policy will be reviewed annually, or sooner if:

• Legislation or CQC guidance changes.
• A serious incident occurs requiring policy amendments.
• Feedback from staff or people we support suggests improvements.

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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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