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210 policies · 10 sections · last reviewed 13 October 2026
CuraFlow's Care Inspectorate care at home and housing support policies are written for providers in Scotland that hold both registrations, a support service providing care at home and a housing support service, and run them as one combined service. Every policy covers scheduled visits to people in their own homes and support in tenancies and shared or supported accommodation, and says which registration a task belongs to. They work to the Health and Social Care Standards, the Adult Support and Protection (Scotland) Act 2007, the Adults with Incapacity (Scotland) Act 2000, PVG scheme membership, SSSC registration and Scottish tenancy law. Each policy downloads as Word or PDF with your organisation's name, registered manager and address filled in. The library is not written for care homes, or for services in England or Wales.
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Every policy in the Care Inspectorate care at home and housing support (Scotland) library in Word and PDF, yours to keep, with 90 days' free portal access for staff sign-off.
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How The Organisation writes, approves, reviews and keeps true the two statements of aims and objectives required by its combined registration: one for the care at home service and one for the housing support service, each following the structure the Care Inspectorate prescribes, each accurate for its own delivery model, and each properly cross-referenced to the other so that neither reads as if it were the whole of what The Organisation does.
How The Organisation holds and maintains its two registrations, care at home and housing support, how it decides what must be told to the Care Inspectorate and by when for either registration, who submits a notification when the subject is the Registered Manager or the provider, and how an event is analysed to decide which registration it engages, given that most private and third sector care at home services in Scotland are combined with a housing support service in exactly the way The Organisation is.
How The Organisation is governed and held to account across both halves of its combined registration: who the provider is in law, what the board decides and what it delegates, how the board knows what is actually happening on the domiciliary round and in any supported accommodation it operates, and how one board holds two, and sometimes three, regulatory relationships where The Organisation is also a registered social landlord answerable to the Scottish Housing Regulator as well as to the Care Inspectorate.
The operational scheme of delegation for The Organisation: who may take which decision, to what limit, how the authority is granted in writing and checked for competence, and how delegation works on a domiciliary round, across dispersed housing support accommodation, overnight, and in buildings where one worker is the only person present. Covers what is never delegated, how a delegated healthcare intervention differs from an organisational delegation, and the prohibition on one person holding both the housing decision and the support decision for the same individual.
How The Organisation keeps supporting people when something goes wrong, whether that is a disruption to a domiciliary round, which can be reprioritised and stood down for a day, or a disruption to accommodation The Organisation supports people in, which cannot, because people are asleep in it. Covers priority banding for both delivery models, severe weather, staffing collapse, evacuation, loss of a building, decant, utility failure, telecare and systems failure, and an outbreak, with a single worked example showing both models disrupted on the same night.
How The Organisation manages its money honestly and competently across both registrations: the institutional revenue streams a combined provider carries, including commissioned support income, grant funding, Housing Benefit for specified accommodation, service charges and, where The Organisation is the landlord, rent; the personal money a domiciliary care worker or a housing support worker may handle on a person's behalf; the conflict where The Organisation is also the landlord and money moves between functions; financial viability; and the probity arrangements that keep the organisation and the people it supports out of harm.
What The Organisation may say about itself in public, across both halves of a combined registration: accuracy about what care at home actually delivers on a scheduled visit and what the accommodation actually is on the housing support side, the absolute prohibition on implying that somebody's right to occupy depends on taking our support, how photographs and film of people's homes are handled, the conditions under which a testimonial from somebody who depends on us may be used, and what we do when something we have published turns out to be wrong.
How The Organisation works with the Health and Social Care Partnership, social work, health colleagues, other providers, and, on the housing support half of a combined registration, the landlord, the factor and the Scottish Housing Regulator. Covers accepting and declining work on either half, hospital discharge, unmet need, the tripartite problem of commissioner, landlord and provider, and a duty map that says who actually holds what.
How The Organisation enters, manages, varies and leaves the agreements it holds on either half of a combined registration: support contracts and private client agreements for care at home, and, for housing support, service level agreements, landlord protocols, grant agreements and the schedules that say who holds which duty. Includes the tripartite problem expressed as a contracting problem, what we will not sign, and the terms most likely to make a contract unviable.
How The Organisation meets the organisational duty of candour under Part 2 of the Health (Tobacco, Nicotine etc. and Care) (Scotland) Act 2016 and the Duty of Candour Procedure (Scotland) Regulations 2018: how we decide whether the duty is engaged, how we obtain the registered health professional opinion the statute requires, how the procedure runs step by step, how candour sits alongside but separate from notification to the Care Inspectorate, and how the setting, a domiciliary visit or a shared supported accommodation building, changes who else needs to be told even though the statutory procedure itself does not change.
How a worker raises a concern about wrongdoing or risk, on either half of a combined registration, including a concern about a housing support landlord, a factor or a building, what protection they have, and what The Organisation must do in response.
How The Organisation guards against exploitation of its own workforce and supply chain, and what staff do when they suspect a person we support, or a colleague, is being exploited, on either half of a combined registration: exploitation carried out through a tenancy, which is the pattern most often seen in Scottish supported accommodation, and exploitation discovered inside a household a domiciliary worker visits.
How The Organisation prevents bribery and manages conflicts of interest across both a domiciliary care at home round and a housing support tenancy-based service, including the conflict created wherever The Organisation, or a connected person, is also the landlord of somebody it supports.
How The Organisation satisfies itself, continuously, that the provider, its directors and its Registered Manager remain fit to run a domiciliary care at home round and a tenancy-based housing support service, what happens when fitness comes into question on either side, and how fitness is assessed separately, and together, across the combined registration.
How policies are written, approved, issued, read, reviewed and withdrawn for a provider holding both a care at home and a housing support registration, so that the policy set describes what actually happens on both halves of the service, and how a policy borrowed from only one half of the registration, or from England, is adapted rather than adopted wholesale.
How The Organisation uses the Health and Social Care Standards across a combined registration: what the five principles mean both in a scheduled domiciliary visit and in a person's own tenancy, what each headline standard requires in each delivery model, and why headline standard 5 is fully live on the housing support side and essentially dormant on the care at home side of the same registration, and how the statement of aims and objectives has to say so accurately for each.
How The Organisation meets the duty in section 7 of the Health and Care (Staffing) (Scotland) Act 2019 to have suitably qualified and competent people working in the service at all times in appropriate numbers, for both a domiciliary care at home round and a staffed housing support building, how each staffing decision is reasoned from the aims and objectives as section 7(2)(c) requires, how a round is built and tested before it is published, how overnight cover in supported accommodation is decided as a staffing question rather than a rota question, and what happens when the staffing available on either strand falls below the level assessed as appropriate.
How The Organisation covers the hours when the office is shut, across both halves of a combined registration: the on-call manager and what they can and cannot authorise at three in the morning, escalation, staff on site overnight in supported accommodation, what happens between calls on a domiciliary round, concierge arrangements, lone working through the night in a building and on a round, and the handover into and out of the night.
How The Organisation recruits into both halves of a combined registration so that only people fit to work with adults at risk are employed: how we decide whether a post is a regulated role whether it is a domiciliary round or a building, the fourteen checks, how night, sleepover, live-in and concierge posts are treated, what happens when a reference cannot be obtained, and what is issued before anyone starts.
How The Organisation decides which posts on either half of a combined registration are regulated roles, obtains and maintains PVG scheme membership through Disclosure Scotland, handles disclosure information lawfully, refers harmful behaviour, and carries out right to work checks that give a statutory excuse, whether the post is a domiciliary round or a supported accommodation scheme.
What every worker in this service must be trained in, by role and by which half of the registration they actually work in, before when, and how often afterwards. It carries one matrix for a combined workforce, built so that a domiciliary support worker's needs and a building-based support worker's needs are both first-class entries rather than one being bolted onto the other, and it separates what the law requires from what the Care Inspectorate expects and from what The Organisation has decided for itself. It sets out the gates that stop an untrained worker doing a task, and the entitlement to time off work towards a qualification that section 8(1)(b) of the Health and Care (Staffing) (Scotland) Act 2019 puts on the face of the statute.
The idea the whole service is built on, whichever half of the registration a person is supported under: that somebody who needs support to live in their own home, whether that is a tenancy they hold or a house they have always lived in and now receives scheduled visits to, has the same right as anybody else to decide how they live in it. This policy sets out what independent living means, where the idea came from, what is enforceable in Scots law and what is not, how choice and control operate in a domiciliary visit and in a tenancy, and the difference between a service that does things for people and one that makes a life possible.
What happens between somebody first being mentioned to The Organisation, on the domiciliary side or the housing support side, and the day support starts: how an enquiry is logged, the routes a referral for either service actually arrives by and the questions we put to each referrer before anything else happens, the scope and capacity check against whichever registration is engaged, how the prospective assessment is carried out and in whose home, the groups of things we must know before we can say yes, why a housing support decision and an accommodation allocation decision are never one decision, how a refusal is delivered to the person and not only to the referrer, what happens between yes and the first visit, and how an emergency or urgent start is authorised and then caught up with. J10 holds the housing support eligibility criteria, response times, refusal audit and waiting list in full and is not repeated here.
How The Organisation recognises, records, reports and responds to harm to an adult at risk under the Adult Support and Protection (Scotland) Act 2007: the three-point test, the council's duties to inquire and investigate, the protection orders, the undue pressure exception, and the particular problems of harm on a domiciliary visit, harm in shared or grouped housing support accommodation, and harm caused by another person we support under either half of a combined registration.
How Prevent works in Scotland, what a worker delivering domiciliary care at home or housing support is expected to notice in the person's household or in the building around it, and how a concern that somebody is being drawn into terrorism is reported to Police Scotland and taken to the multi-agency panel that considers it.
How The Organisation meets its duties under the Health and Safety at Work etc. Act 1974 and the Management of Health and Safety at Work Regulations 1999 across both halves of a combined registration: the duty to our employees under section 2, which carries most of the weight on a domiciliary round through a series of homes we do not control, and the duty to everyone else under sections 3 and 4, which carries most of the weight in a building we run because the people most exposed to our decisions are the people who live there and are not on our payroll. Sets out who holds which duty in each of the two delivery models, the regulation 3 risk assessment, competent advice, the four separate reporting duties, and the Scottish position on enforcement, fatal accident inquiries and prosecution.
How The Organisation meets the UK GDPR and the Data Protection Act 2018 across both halves of a combined registration: the lawful bases and Article 9 conditions that apply to a domiciliary care record and to a tenancy-based support record, the two controller functions created wherever The Organisation is also the landlord, suppliers and processors from a rostering system to a telecare monitoring centre, worker and disclosure data, data protection by design in a car boot and in a shared building alike, individual rights, and what happens in the first seventy two hours of a breach on either half of the service.
The duty of confidence The Organisation owes every person it supports on either half of a combined registration, worked through for the two settings where it is actually tested: a small community where a neighbour asks a domiciliary worker a friendly question at the door, and a shared building where a resident asks a housing support worker about the person along the corridor. What a worker may and may not say, why confirming a guess is still a disclosure, where the duty ends, and what happens when it is broken.
How incidents and near misses are reported, fact-found and learned from across both halves of a combined registration, in one log with each entry attributed to care at home, housing support or both: the domiciliary incidents a building log misses (the missed visit that caused harm, the no reply visit, the fall found on arrival after hours alone, the key safe, the road between calls) and the housing support incidents a domiciliary log misses (the landlord who does not repair, the communal stair, the overnight cover that failed, the dispute between residents). Cross-checks every entry against Care Inspectorate notification for the correct service number, the duty of candour and RIDDOR, keeps fact-finding separate from the wellbeing response, and closes an action only when somebody has verified it worked.
The framework policy for Section I. How The Organisation accepts healthcare interventions delegated by a registered health professional to a named worker, under either half of a combined care at home and housing support registration: which half delivers the task, what a valid delegation record contains, our right to decline, what happens when a worker leaves or competence lapses, family carers, visit times and visit lengths, who responds between visits, the overnight question, emergency access to a house or a supported building, storage, power failure, consent to fixings, and what other people may be told.
How The Organisation supports people fed through a gastrostomy or jejunostomy tube, as a healthcare intervention delegated by a registered health professional to a named worker and delivered under the care at home half of the registration, whether the person is visited at home or lives in a tenancy or supported accommodation: the devices, the feed regimen, the procedure step by step, what can go wrong, when to stop and escalate, feeds that run between visits or overnight, visit times and visit lengths, family carers, storage, deliveries, power failure, waste, the shared or family fridge, and what other households and household members may be told.
What each half of The Organisation's combined registration covers: the housing support service defined at schedule 12, paragraph 19 of the Public Services Reform (Scotland) Act 2010 and described by the twenty-one prescribed housing support services, and the care at home support service that delivers personal care by scheduled visit. Sets out where the housing support registration ends and the care at home registration begins, how one person can receive both with every element of their plan tagged to the half that delivers it, how a worker tells which half they are working under on a given visit or shift, how work is moved between the halves rather than absorbed, and what neither half is: not a landlord, a letting agent, a benefits agency, a care home or a nursing service.
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What a new worker completes before working unsupervised on either half of a combined registration, whether that means being sent out alone on a domiciliary round or holding a supported accommodation building overnight, and how The Organisation supports registration with the Scottish Social Services Council within the required timescale.
How The Organisation uses a probationary period to confirm that a new appointment was the right one on either half of a combined registration: what probation actually tests on a domiciliary round and in supported accommodation, how it runs alongside the induction gates and the night gate, how reviews, support plans and extensions work, and what happens, for the worker and for the people affected, when an appointment does not work out.
How The Organisation writes job descriptions and person specifications for a combined registration, including why the job description is the document that decides whether a post is a regulated role on either half, and model duties for the roles that are genuinely distinct: domiciliary support worker and live-in carer on the care at home half, housing support worker, night support worker and concierge on the housing support half.
How The Organisation supervises and appraises its workforce on either half of a combined registration so that practice stays safe, reflective and accountable: frequency and format, what every session covers, and how supervision is actually delivered to a worker who is rarely in the same room as their manager, whether because they work a dispersed domiciliary round, a night, a sleepover, or a live-in placement.
The conduct expected of everyone who works for The Organisation on either half of a combined registration, where the boundary risk runs in two directions at once: the domiciliary drift of small unrecorded kindnesses that slowly replaces a professional relationship with a private one, and the over-familiarity of a long shift in somebody's home that produces a friend, a de facto family member, or a favourite in a shared house. Sets out what is never acceptable, what needs a conversation, and what a worker does when a boundary has already slipped.
How The Organisation deals fairly with conduct and performance problems on either half of a combined registration: telling misconduct from capability, investigating properly, the right to be accompanied, the sanctions available, and the gross misconduct examples specific to a domiciliary round and to supported accommodation alike, including a falsified visit record, an abandoned call, a falsified night record and unauthorised entry to a person's home.
How a worker raises a concern about how they have been treated, and how The Organisation deals with it fairly: the right to be accompanied under the Employment Relations Act 1999, the five working day postponement right, and the grievances specific to each half of a combined registration, including a domiciliary round that cannot be delivered in the time allowed, a sleepover pattern nobody has explained, and the tripartite landlord problem that exists only on the housing support side.
How The Organisation treats its own workforce fairly under the Equality Act 2010 across both halves of a combined registration: recruitment, pay, progression, reasonable adjustments to a round or a shift pattern, religious observance, and what happens when a domiciliary client or a housing support tenant, or their family, objects to a worker on discriminatory grounds.
How The Organisation prevents and responds to bullying and harassment at work, between colleagues and, distinctively for this sector, from people we support, their families and visitors on both a domiciliary round and in supported accommodation. Covers the enhanced duty under the Worker Protection (Amendment of Equality Act 2010) Act 2023 to take reasonable steps to prevent sexual harassment including by third parties, why the risk is structurally different in a building a worker cannot leave from one they can, and how the response protects the worker without punishing a person we support for behaviour connected to their own needs.
How The Organisation keeps a lone worker safe on either half of a combined registration: the domiciliary worker travelling to an unfamiliar house, sometimes in a remote or poor-signal area, and the housing support worker holding a building alone overnight. Covers risk assessment before the first visit or shift, check-in arrangements that actually work, what a lone worker may and may not do, the escalation clock when contact is missed, and the dilemmas specific to each model: leaving a building that still has people relying on the worker, and entering a home nobody is answering the door to.
How The Organisation protects the mental and physical health of a workforce doing two genuinely different kinds of demanding work: a domiciliary round of short, pressured contacts with long relationships that end in loss, and a housing support building held overnight, alone, for years at a time. Covers the legal duty to assess and reduce stress, night work and shift pattern health effects, moral distress and moral injury in both their forms, bereavement whichever way it arrives, debrief, the statutory staffing duty under section 7(1)(c), and wellbeing for the managers who hold the on-call phone or the rota together.
How The Organisation handles a statutory flexible working request and the full range of statutory leave, from the day one right introduced in 2024 to carer's leave, parental leave and time off for dependants, and how a request or a period of leave is actually accommodated against two different kinds of rota: a domiciliary round built from many short, timed visits, and a housing support building or night rota where one worker may be the entire overnight staffing for a scheme. Includes annual leave accrual for bank and irregular hours workers and absence reporting in operational detail.
Two related but genuinely different standards, held in one policy. For domiciliary visits, a fixed, universal workwear and infection control standard: no uniform is issued, bare below the elbow for all personal care, exactly when gloves and aprons are put on and changed, and how workwear is laundered at home. For housing support buildings, a genuinely negotiable question decided with the people who live there: whether staff wear a uniform at all, given that a branded uniform seen for a twelve hour shift by every neighbour on the street can mark somebody's home as an institution. Task-specific personal protective equipment is never subject to negotiation on either half.
How The Organisation manages a worker leaving, on either half of a combined registration or both: key safe codes, building fobs and door entry codes all changed the same day, the referral duty that survives resignation kept separate from the PVG interested party notification, references given accurately and never restricted by a settlement agreement, and the people a leaving worker supported, whether visited on a domiciliary round or living alongside her in a housing support building, told properly with continuity planned rather than left to be discovered.
How The Organisation uses agency, bank and subcontracted staff safely on either half of a combined registration or both: named individual evidence held and verified by us rather than asserted by an agency, the framework agreement that makes an agency's own PVG offences as a personnel supplier real rather than assumed, why an unfamiliar agency worker never holds a lone night shift in a building or attends a person flagged as needing continuity on a domiciliary round, the registration boundary between staffing supply and genuine subcontracting, and how compliance is audited rather than taken on trust.
How The Organisation manages the risk of workers driving for work on either half of a combined registration: the checks before anyone drives, the insurance position for a worker's own vehicle including the gap most people never discover, travel time planning for a domiciliary round and for a fixed external appointment, what changes when a worker carries a person we support as a passenger or drives that person's own car, and what happens after a collision.
How The Organisation obtains, verifies and maintains SSSC registration for every worker on either half of a combined registration who needs it, under the register restructured to four parts with a single housing support and care at home practitioner level, how the employer duty to refer a worker to the SSSC is decided, recorded and carried out without being confused with the separate duty to refer to Disclosure Scotland, and how a fitness to practise concern reaches us whether it arises on a domiciliary round or in a staffed building.
How The Organisation verifies and maintains registration with professional bodies outwith the SSSC, principally the Nursing and Midwifery Council and the Health and Care Professions Council, including revalidation, annual verification on the public register, what happens on the day a registration lapses, and how a worker's professional registration interfaces with the restructured SSSC register and with the registration boundary that governs which half of a combined registration authorises a delegated healthcare intervention.
How The Organisation looks after the health of its workers on both a domiciliary round and in a building and night based housing support service: what may and may not be asked about health before a job offer under section 60 of the Equality Act 2010, occupational health referral, hepatitis B immunisation for exposure prone or sharps-involved tasks, seasonal influenza and COVID-19 vaccination offered and encouraged but never a condition of employment in Scotland, the 48 hour exclusion rule counted without anti-diarrhoeal or anti-emetic medication, skin health surveillance for occupational dermatitis, and how a sick worker is covered whether the affected work is a scheduled visit or a sleepover.
The training every worker in this service holds before working alone, whether their caseload is domiciliary visits, a shift in supported accommodation, or both, because a high proportion of the people we support on either half of a combined registration are autistic, have a learning disability, or are otherwise neurodivergent. It covers what those words mean and what they do not, communication, the sensory environment on a visit and in a building, distress and what makes it worse, reasonable adjustments under the Equality Act 2010, and the things that arise only on a domiciliary caseload or only in shared accommodation. It states the Scottish position accurately, including that there is no Scottish equivalent of the English mandatory programme and that the Bill announced by the Scottish Government was abandoned and is not law.
How a worker in this service, on either half of a combined registration, gets the qualification their SSSC registration requires, and what The Organisation is obliged to do to help them. It sets out the qualification families and the routes through them for a domiciliary care at home worker, a supported accommodation worker, a night support worker, a concierge, a supervisor and a manager, how an SVQ actually works, what paid release and study time we provide under section 8(1)(b) of the Health and Care (Staffing) (Scotland) Act 2019 against a domiciliary round and against a night or sleepover rota, what happens when somebody falls behind, and where the housing content the SVQ does not contain comes from instead. Because the SSSC register is mid-restructure, every period and part name in this policy is a field to be verified at source rather than a number.
How The Organisation establishes that a named worker can safely perform a named task, on whichever half of a combined registration that task falls, as distinct from having attended training in it. It sets out what is assessed and against what written standard, how observed practice is carried out in a person's own home and in supported accommodation, who may assess and who may not, and what a sign-off means and what triggers a reassessment. It gives full, separate treatment to the two cases that matter most and differ most sharply between delivery models: competence to work alone on a domiciliary visit as against competence to work a night alone in a building, and competence to handle money at occasional as against daily exposure. It carries the absolute exclusion of delegated healthcare interventions, which are assessed by the delegating health professional and never by us, whichever delivery model the person receiving them is supported on.
How workers keep learning after induction and mandatory training, on either half of a combined registration: post registration training and learning under the restructured SSSC register, reflective practice adapted to a domiciliary visit and to shared accommodation, the link to supervision, the time and money The Organisation provides against a domiciliary round and against a night or sleepover rota, career pathways across both delivery models, and the personal learning record each worker owns and takes with them. It names, and answers separately, the two different ways release actually gets lost on each delivery model.
The housing and welfare rights knowledge a worker on the housing support half of this combined registration must actually have: how to read a tenancy agreement, the stages of an eviction and what happens at each, the Scottish benefits system including the payments that have replaced reserved benefits, the homelessness routes, the property standards and who is responsible for them, and the point at which a worker stops and hands over to a specialist adviser. Has no care-at-home counterpart and applies only to a worker who holds, or will hold, a housing support caseload. Includes a competence framework and an assessment tool.
How The Organisation assesses need once support has been agreed, under either half of a combined registration or both at once: the person's own account first and verbatim, strengths recorded before needs, the universal domains completed for everybody, the personal care and health domains completed in full wherever care at home or a delegated healthcare task is involved, the tenancy sustainment domain completed in full wherever housing support is involved, the trigger table that turns a finding into a same-day or five-day action, capacity, consent and communication, carers and family and the duties that belong to the local authority under the Carers (Scotland) Act 2016, the interface with the council's own assessment under section 12A of the Social Work (Scotland) Act 1968, and how the assessment becomes the personal plan required within 28 days.
How The Organisation writes, agrees, holds and reviews the personal plan required by regulation 5 of SSI 2011/210: prepared after consultation within 28 days of the service starting, made available to the person, reviewed on request, on significant change, and at least once in every six month period, revised after review and notified. There is one plan per person, whichever half or halves of a combined registration support them: the domiciliary content in full wherever care at home is involved, the housing outcomes carried inside the same plan, not in an annexe, wherever housing support is involved, and both together for a person who receives both. It also sets out the tracker, the audit tool and the hard rule against back-dating that keep the two most frequently breached duties in this sector, the 28 days and the six months, from ever being breached quietly.
How The Organisation assesses and manages risk in a person's own home, whichever half of the registration brings us through the door: a house the person has always lived in and now receives scheduled visits to, or a tenancy they hold with our housing support. It separates four different risks with four different owners: risk to the person, risk to our workers, risk to other residents where accommodation is shared, and risk to the property. It sets out risk enablement, the recorded decision to accept a risk the person has chosen to live with, the sign-off ladder by consequence, and the small number of things we will not accept whatever anybody decides.
How The Organisation obtains, records, revisits and acts on consent, whichever half of a combined registration is involved: what makes consent valid; why touching a person without it is, at common law, an assault, and how implied consent works in ordinary personal care and where it stops; why a tenancy, a support agreement and a house agreement are separate things that nobody here signs on somebody else's behalf; why support is voluntary and no house rule, scheme condition or commissioner's specification can make it compulsory; how a person who agrees to some support and declines the rest is recorded and supported; who can, and cannot, consent on somebody else's behalf; and what happens the moment somebody withdraws consent, mid-task or altogether.
How The Organisation applies the Adults with Incapacity (Scotland) Act 2000 across a combined registration: the presumption of capacity, capacity as decision-specific and time-specific, supported decision making, the five principles at section 1 with benefit as the statutory test, the six Parts of the Act and which of them reach a person supported domiciliarily or in their own tenancy, the covert medication authority under Part 5, working with attorneys, guardians and persons authorised under intervention orders, and what to do when a decision has to be made and nobody holds the authority to make it, on either side of the registration.
There is no Scottish authorisation scheme for depriving an adult of their liberty. The English safeguards regime is not law in Scotland and no Scottish equivalent has been enacted. What exists is Article 5 of the European Convention on Human Rights, the Adults with Incapacity (Scotland) Act 2000 with its benefit principle and its Part 6 intervention and guardianship orders, and the Mental Health (Care and Treatment) (Scotland) Act 2003. This policy sets out what a deprivation of liberty looks like on a domiciliary round and in a person's own tenancy, states honestly that guardianship is an imperfect fit for either, and sets out what The Organisation actually does: identify it, take legal advice, involve the Mental Welfare Commission for Scotland, make sure a guardian with the relevant welfare powers is in place, reduce the restriction meanwhile, and review it, whichever half of the registration is engaged.
How The Organisation makes independent advocacy real for the people it supports, on both a domiciliary caseload and a housing support tenancy caseload: what advocacy is and why a provider can never be somebody's advocate, the right of access under section 259 of the Mental Health (Care and Treatment) (Scotland) Act 2003 and the duty it places on councils and Health Boards rather than on us, individual and collective advocacy, when we must offer it and how an offer is made so that it can actually be accepted, how to find local provision and what to do when there is none, how we work with an advocate who tells us something we do not want to hear, and why a request for advocacy is never treated as a complaint.
How The Organisation finds out how each person communicates, records it so it travels between workers and between a domiciliary round and a housing support tenancy, and provides information in a form they can actually use. It covers British Sign Language under the British Sign Language (Scotland) Act 2015, interpreting and translation, easy read, the housing and benefits documents that are almost never made accessible, communication in a shared building, what happens in an emergency when somebody cannot hear an alarm, and what we do when communication breaks down.
How The Organisation behaves inside a home that belongs to somebody else, whether a worker calls for thirty minutes on a domiciliary round or is present for a whole shift in a supported tenancy. It covers entering and leaving, the person's right to ask us out of the room, where a worker sits, eats and makes a telephone call during continuous presence, the staff base and the sleepover room, noise by day and by night, how we talk about people in their own hearing, dignity in intimate care and the registration boundary that has to be answered before it, the person's belongings and post, and what happens when privacy collides with risk, with another resident, with the landlord or with a worker's safety.
How The Organisation makes sure the people it supports actually decide things, whether they receive scheduled domiciliary visits, are supported in their own tenancy, or both: not only the large decisions but the ordinary daily ones a service quietly takes over. It covers the right to make a decision other people think is wrong, the difference between a real choice and one with a penalty attached, blanket rules in shared housing support accommodation, supported decision making, the limits of an attorney's or a guardian's powers, and what we do when the commissioner, the rota or the building is the thing standing in the way.
How The Organisation meets its duties under the Equality Act 2010 and the Human Rights Act 1998 across both halves of a combined registration: the protected characteristics and the forms of discrimination, the anticipatory reasonable adjustment duty owed to everybody we support by scheduled visit, the separate premises duty at Part 4 of the Equality Act that is engaged wherever The Organisation lets, manages or holds accommodation, a human rights based approach built on the PANEL principles worked through for a domiciliary visit and for a tenancy alike, which public duties bind us and which do not, the Convention rights that arise in each delivery model with Article 8 given explicit treatment in the accommodation context, discriminatory requests and abuse in either setting, and what we do when rights collide.
How The Organisation finds out what matters to each person culturally, religiously and spiritually, and supports it in practice, across a scheduled domiciliary visit and a supported tenancy alike. It covers food and, where accommodation is shared, the shared kitchen; prayer and the space and time it needs; washing, dress, articles of faith and religious objects; festivals and the personal calendar; culture that is not religion, including Deaf culture and Gypsy and Traveller communities; death and what happens in the first hours; the substance of competing needs between residents in shared accommodation; and what happens when a worker's own belief is engaged.
How The Organisation supports the right of the people it works with to relationships, intimacy and sexual expression, across a scheduled domiciliary visit and a person's own tenancy alike. It covers overnight guests and relationships between residents, where The Organisation has close to no authority to prohibit either; consent and capacity under the Sexual Offences (Scotland) Act 2009; the limits of a guardian's or an attorney's powers; contraception and sexual health; LGBT+ people, including confidentiality and never outing anybody; pregnancy and parenthood, including the accommodation question; dementia and learning disability; staff boundaries and the criminal provisions behind them; behaviour directed at workers; and the point at which what looks like a relationship is in fact exploitation.
How The Organisation supports people with their own medicines in their own homes across a combined registration: the registration question asked first for every medicine and every person, so that reminding sits with the housing support half and assisting or administering sits with the care at home half; where medicines are kept in a self-contained home and in a shared flat several people live behind one front door; a resident's right to self-administer and to have that right actively restored rather than only protected; MAR charts, the six checks, PRN protocols, over the counter medicines, covert administration under a section 47 certificate, controlled drugs, errors and competence.
How The Organisation handles medicines that are delegated healthcare interventions rather than ordinary medication support, across a combined registration: the registration question that comes before the clinical one, so that a delegated task is always attributed to the care at home half of the service whether the person is a purely domiciliary client or a housing support tenant; the two separate authorities a delegated medicine needs; what each route requires before a first dose; what changes because a home is shared with other people; and what a worker never does whatever the hour and whoever is asking.
How The Organisation supports people to shop, cook and eat well across a combined registration: enabling somebody to run their own kitchen rather than doing it for them, what changes in a kitchen several people share, food poverty and the cost of cooking, screening with the Malnutrition Universal Screening Tool, named referral routes and a six-level escalation ladder for nutritional and hydration concerns, dysphagia and the IDDSI framework, and the registration question that decides whether a task is housing support life-skills work or care at home personal care.
How The Organisation promotes continence rather than simply containing incontinence, for a person supported on a scheduled domiciliary visit and for a person supported in their own tenancy: assessment before any product, the bladder diary and the referral chase, correct use of containment products, constipation and impaction, the delegated healthcare boundary for catheters and bowel procedures, and the practical questions unique to a shared bathroom, a small flat and a communal bin store, treated with the same seriousness as the clinical questions.
How The Organisation supports people to look after their mouths and to get dental care, on a scheduled domiciliary visit and in a person's own tenancy: getting and keeping a dentist, daily mouth care and dentures, the registration line between reminding, assisting and brushing somebody's teeth for them, dry mouth, refusal and dementia, and the practical questions of a toothbrush in a bathroom four people use, methadone and a homelessness history, treated with the same seriousness as anything a dentist would recognise.
How The Organisation protects the skin of the people it supports using the SSKIN approach, on a scheduled domiciliary visit and in a person's own tenancy: who is at risk, skin inspection at every personal care contact including the blanch test and what damage looks like on darker skin, repositioning, pressure relieving equipment and its checks, the registration line between reminding and personal care, what changes because equipment is going into a rented home, moisture damage distinguished from pressure damage, and the duty of candour and notification decisions required whenever a pressure ulcer develops in our care.
How The Organisation reduces falls risk and responds when a fall happens, on a scheduled domiciliary visit and in a person's own tenancy: screening, the home and building hazard check, medicines and footwear, a strict post-fall protocol that starts with not moving the person and covers the full 999 criteria, the anticoagulant head injury rule and the long lie as an injury in itself, the registration line between reminding and personal care, and the building as part of the risk, including the stair, the close and the bin store a landlord is responsible for.
How The Organisation moves and positions people safely in their own homes, on a scheduled domiciliary visit and in a person's own tenancy: person-specific handling plans detailed enough for a worker who has never been to the house before, prohibited techniques including the drag lift and manual lifting from the floor, hoists, slings and their six monthly thorough examination under LOLER, the registration line between reminding, assisting and clinical handling, equipment consent in a rented property, moving equipment through a shared close, and a worker's unqualified right to decline an unsafe task.
How The Organisation handles moving and positioning that has become a clinical matter rather than everyday assistance, on a scheduled domiciliary visit and in a person's own tenancy: the registration question that comes before the technique, who prescribes and assesses a specialist handling plan, sling inspection before every single use, spinal precautions and autonomic dysreflexia, the absolute rule that the airway takes priority over the manoeuvre for a person with a tracheostomy or on a ventilator, complex postural management, bariatric handling, handling around clinical equipment, positioning at the end of life, what changes because a hoist, a track and a profiling bed are going into somebody else's rented home, and what a worker never does whatever the hour and whoever is asking.
How The Organisation supports people to wash, bathe, shave and groom themselves, on either half of a combined registration: consent asked and continuously checked, water tested before every wash whether the bathroom is a person's own home or a shared tenancy bathroom, the registration line between reminding and physically assisting where personal care has not yet been commissioned, dignity in a shared bathroom, landlord consent for fixed equipment, the absolute rule on toenails, and refusal explored rather than simply recorded.
How The Organisation supports people living with dementia on either half of a combined registration, using the Promoting Excellence framework and the Standards of Care for Dementia in Scotland: knowing the person, communication, the environment of a person's own home or a supported building, stress and distress understood as unmet need, delirium recognised the same day, continuity of worker treated as part of the care, the benefit principle, the deprivation of liberty question where a person lives in a tenancy or a scheme designed around door entry, and a Herbert Protocol record completed in advance for anybody who may go missing.
How The Organisation supports adults living with mental ill health on either half of a combined registration: the Mental Health (Care and Treatment) (Scotland) Act 2003 and what a community-based compulsory treatment order actually requires of us, named persons, advance statements, the section 259 right to independent advocacy, recovery-focused planning, exactly what a lone worker does when somebody is in distress or discloses suicidal thoughts, and what happens to a tenancy, a rent account and a flat during a hospital admission.
How The Organisation supports people who are Deaf, hard of hearing, blind, partially sighted or deafblind, on either half of a combined registration: finding a sensory impairment that has usually gone unreported, communication passports, hearing aids and glasses in the unglamorous detail, sighted guide and deafblind communication technique, fire and door alerting equipment, the particular problems of a shared or communal building, the British Sign Language (Scotland) Act 2015, and the boundary between ordinary support and a delegated ear or eye care task.
How The Organisation supports disabled adults and people regaining function after illness, injury or hospital admission, on either half of a combined registration: the social model, doing with rather than doing for, how reablement is commissioned in Scotland and why it pays a provider to reduce its own hours, working with occupational therapy and physiotherapy, equipment, adaptations to an owned home or a rented tenancy, and the specific things that matter in stroke, Parkinson's, multiple sclerosis, spinal cord injury and chronic pain.
How The Organisation supports a person living with an eating disorder, on either half of a combined registration: recognising and escalating physical risk promptly, supporting rather than policing food and mealtimes in a person's own kitchen whether that is their own house or their tenancy, working with the clinical treating team and family, the particular problems of a shared or communal kitchen, and the firm boundary between ordinary support and clinical treatment.
How The Organisation supports a person to die well, whether they are visited on a scheduled domiciliary round or supported in a housing support tenancy: anticipatory conversations, the Scottish DNACPR and Key Information Summary framework, Just In Case boxes, the registration boundary for delegated clinical tasks, what a worker does on finding a death, the Scottish after-death arrangements, what happens to a tenancy and to belongings, and bereavement support for the family, other residents and staff.
How The Organisation understands and responds to distressed behaviour, whether a person is visited on a scheduled domiciliary round or supported in a housing support tenancy: a human rights based approach, functional assessment, positive behaviour support planning, trauma-informed practice, de-escalation for a lone worker and in shared accommodation, psychological and chemical restraint, physical intervention, post-incident support for everybody affected including other residents, and the point at which something stops being a support matter and becomes somebody else's decision.
Every form of restriction found in a domiciliary home or a housing support tenancy, named and tested: physical, mechanical, chemical, environmental, psychological and surveillance. The seven possible lawful routes, which differ by delivery model, the four questions every restriction must answer, the difference between genuine consent and compliance, and one authorisation, register and reduction framework covering both settings.
How The Organisation treats loneliness and isolation as a health matter and builds a genuine place in the community for the person, whether they are visited on a domiciliary round or supported in a housing support tenancy: the barriers that actually keep people in, employment, volunteering and education, day opportunities without segregation, digital inclusion, self-directed support, and the honest limits of what either delivery model can do alone.
How The Organisation supports a person through significant transitions, from children's to adult services, between levels of support, and through a hospital admission and discharge, whether that means a domiciliary package that must not be allowed to quietly lapse, or a tenancy that must be kept secure, funded and safe while its tenant is in a ward.
What The Organisation does when scheduled support does not happen as planned, whether that support is a short domiciliary visit on a round or housing support hours delivered as a scheduled call, on-site presence, or on-call cover for a building. The door and welfare-check procedure when nobody answers, the escalation ladder, missed, late and aborted or shortened support, telling people, Care Inspectorate notification, charging, and the scheduling causes that produce these failures in the first place.
How The Organisation works within the Social Care (Self-directed Support) (Scotland) Act 2013 across both halves of a combined registration. Covers the section 1 principles, the four options the local authority must offer, what changes when the person buying support is our customer rather than the partnership, direct payments and individual service funds for a domiciliary care package and for a housing support arrangement side by side, the registration boundary a self-directed budget cannot widen, contracts and consumer rights, invoicing detailed enough for the person to account to the partnership, flexibility in how a budget is used, working alongside personal assistants, and the absolute rule that we never steer anybody towards the option that suits us commercially. Includes the case, common on a combined registration, of one person self-directing both halves of what we deliver at once.
How The Organisation supports people to manage and spend their own money on both halves of a combined registration: the occasional handling of a scheduled domiciliary visit and the frequent, sometimes daily, handling that comes with hours spent in a person's tenancy or a shared supported building. Covers what a worker may and may not do with money, the controls that apply every time a worker touches a penny that is not theirs, receipts, cards, cash machines, online shopping, floats and household kitties, transport and fares, the landlord conflict where it arises, and how the service detects the thing it is least willing to look for, which is a trusted colleague taking money over a long period.
The legal routes by which somebody else may lawfully manage a supported person's money in Scotland, which route to reach for and in what order, what none of them authorise, and how The Organisation governs the arrangement that causes most difficulty, which is acting as appointee for a person who is also its own housing support tenant. This policy governs the housing support half of a combined registration only: it has no application where a person receives care at home alone, and D36 governs day to day money handling on both halves once any authority described here is in place.
What happens between the surgery, the pharmacy and the person's own front door, on either half of a combined registration. Covers what is actually being collected in law, who is competent to collect it, ordering repeats without over-ordering, electronic and app-based ordering, emergency supply when something runs out unexpectedly, the order of preference that puts pharmacy delivery ahead of a worker in a car, what is checked at the counter before anything is signed for, the rule that medicines are never left in an unattended vehicle, cold chain items, controlled drugs and their witnessed destruction, handing over into a domiciliary home and into a tenancy or shared supported building, and the absolute prohibition on this service disposing of anybody's medicines itself. The procedure is identical whichever half of the registration a person is supported under, and this policy says so explicitly rather than writing for one setting and assuming the other.
Assistive technology used well increases a person's independence, on a domiciliary visit and in a housing support tenancy alike. Used to save staffing cost, the same equipment becomes a restrictive practice and a privacy question dressed up as a technology question. This policy covers what each kind of device actually does and does not do, the decision to introduce any assistive technology, telecare or remote monitoring, consent and capacity, the specific and serious question of replacing overnight human presence with monitoring technology (which in practice arises on the housing support half of a combined registration, where it means replacing a waking night, though the same least restrictive option test governs any equivalent proposal on the care at home half), data protection, equipment failure, the digital telephone switchover affecting both a rural domiciliary alarm and a supported building's system, and review.
The operational detail of resuscitation decisions in a person's own home, whether that home is a domiciliary care client's own house or a housing support tenancy, and the registration boundary that sits underneath it. Covers the Scottish integrated adult DNACPR arrangements and how they differ from England, Anticipatory Care Planning as the Scottish term, the Key Information Summary shared from the general practice record to NHS 24, the out of hours service and the Scottish Ambulance Service, why a DNACPR decision is clinical and is never made or interpreted by a worker on either half of a combined registration, the absolute rule that it never means withholding any other support, exactly what a worker does when somebody collapses and when a worker finds somebody who has died, what happens in the hours afterwards, the small number of things that genuinely differ between a domiciliary visit and a housing support tenancy, and where this policy stops and D33 or J12 takes over the practical aftermath on each half. Read with D07, D29, I00 and I24.
How The Organisation supports people who drink, who use drugs, or who live with somebody who does, whether the person is visited on the domiciliary round or supported in their own tenancy. Starts from the same principle on both halves of the registration: an adult in their own home decides what they consume, and neither a care package nor a tenancy is made conditional on abstinence. Covers Housing First non-conditionality and the unlawfulness of a blanket no-alcohol or no-drugs house rule applied to a tenancy, what goes in the personal plan on either half, whether and when we buy alcohol for somebody, the interaction between substances and prescribed medicines, alcohol-related brain damage, recognising withdrawal as a medical emergency, overdose and naloxone, illegal drugs and paraphernalia in the home, needles and sharps, worker safety in an intoxicated household or property, working with alcohol and drug services, and the point at which substance use becomes an adult protection matter under the correct statutory test.
The person-specific fire risk that sits underneath F11's building level framework, on both halves of a combined registration: a person may smoke, vape and use prescribed oxygen in their own home, whichever half of the registration governs their package, and a provider cannot simply ban it. Covers the legal position that a home is not no-smoking premises, what we do instead of forbidding, the fire risk created by emollient creams soaking into clothing and bedding, oxygen in the home, the Scottish interlinked alarm standard in force from February 2022 and who is responsible for it on each half, home fire safety visits from the Scottish Fire and Rescue Service, vaping and battery charging, clutter and hoarding, designated smoking areas and communal kitchens in shared housing-support schemes, and exactly what a worker does when something is burning. Read with F11, F20 and F02.
How The Organisation teaches the skills a person needs to run their own home and their own life on the housing-support half of a combined registration, rather than running it for them, what meaningful activity means when it is not a timetable of outings, and how the service resists the standing incentive an hourly-paid support contract creates to do things for people. Applies to the housing-support half only: there is no care-at-home counterpart, because a scheduled domiciliary visit does not carry the same statutory expectation of building daily living skills over time.
How The Organisation gets into the homes of the people it supports on the care-at-home half of a combined registration, and on whose authority. Covers the access options and the order we prefer them in, consent and who owns the code, choosing and siting a key safe, the code register, the events that force a code change including a worker leaving, what a worker may never do with a code, entry by digital lock and app, the rules of lone entry, what happens when access fails, and the honest position that a key safe is a security risk as well as a convenience. Applies to the domiciliary round only. J18 governs keys and access on the housing-support half.
Staff conduct and confidentiality on the care-at-home half of a combined registration when a scheduled domiciliary visit is attended by family, friends, other professionals or a private carer, and what a worker does when a visitor's presence raises a safeguarding concern. Covers the starting position that we are guests and not gatekeepers in a person's own home, working alongside visiting professionals, checking who is at the door, doorstep crime, homes taken over for criminal use, children in the house, infection control without imposing care home rules on a private dwelling, and the strict limits on our power to restrict anybody's contact. Applies to the domiciliary round only. J18 governs visitors on the housing-support half.
The full visit-round procedure for the care-at-home half of a combined registration: what The Organisation does when a scheduled domiciliary visit does not happen as planned. Covers the step by step procedure at the door when nobody answers, the escalation ladder, when the police are called and who forces entry, late visits and time-critical calls, aborted visits, telling the person and the family, the fact that a missed visit may be notifiable to the Care Inspectorate under A02, and the scheduling causes that produce missed visits in the first place. Applies to the domiciliary round only. D34 governs support hours on the housing-support half.
How The Organisation recognises and responds to domestic abuse affecting the people we support and the people who work here, covering the Scottish criminal offence of abusive behaviour towards a partner or ex-partner, the civil and housing remedies available in Scotland, refuge and temporary accommodation, abuse by a co-resident, a neighbour or a family member present during a domiciliary visit, and what either half of a combined registration can actually do when somebody is being abused in their own home.
How The Organisation recognises and responds to human trafficking and exploitation under the Human Trafficking and Exploitation (Scotland) Act 2015, both as it appears inside an ordinary household visited on a domiciliary round and as the pattern most distinctive to Scottish housing support, exploitation delivered through the accommodation itself, where the person who exploits somebody is also the person who houses them.
What The Organisation does when somebody alleges that a worker has harmed, or may have harmed, a person we support: the five separate Scottish routes and the fact that they run in parallel, the first hour, precautionary measures, how an allegation is handled where a worker is alone with somebody in their own home on a domiciliary visit or alone overnight in a supported building, and what happens when a resident or a family member makes an allegation about a worker who supports somebody else.
How The Organisation responds where a person we support is neglecting themselves or has accumulated possessions to a level that affects their safety, their health or their home, on either half of a combined registration. In a tenancy this is four things pulling in different directions at once: an adult protection issue, a fire risk, a tenancy breach and a repairing obligation. In a domiciliary visit it is usually a quieter question of noticing a change over weeks and escalating it, with no landlord and no four-way conflict to hold. Both models are set out in full, because a combined provider runs both at once.
How The Organisation recognises, records, reports and responds to financial harm to the people we support, on either half of a combined registration: the Scottish law of proxies and the Office of the Public Guardian, common to both; the pattern a worker notices on a domiciliary visit; and the two forms that exist only because a person holds a tenancy, rent diversion and benefit appropriation, where the harm attacks the roof over their head as well as their money.
The absolute bars on money, legacies, attorneyships, executries and will witnessing, the narrow threshold for a small non-monetary gift, how a worker declines warmly without wounding the person offering, and the register that lets a provider prove all of it at inspection. Written for a service where a worker is frequently the main relationship a person has, whether that closeness has built up over years of scheduled domiciliary visits or over a shift spent sleeping on the premises of a supported tenancy.
How The Organisation recognises, records and reports concerns about a child, even though it is registered to support adults, because children visit, live with and are cared for by the people we support on either half of a combined registration. A 16 or 17 year old we support directly under the housing support half is a child for this policy at the same time as being a potential adult at risk under E01.
The Scottish statutory offences of ill treatment and wilful neglect under the Adults with Incapacity (Scotland) Act 2000 and the Mental Health (Care and Treatment) (Scotland) Act 2003: what they look like on a scheduled domiciliary round and on a housing support shift or sleepover, the line between a mistake, poor practice and a crime, why this goes to Police Scotland, and how the six referral duties run alongside a criminal investigation on either half of a combined registration.
The Scottish law on female genital mutilation, why the mandatory reporting duty that applies to certain professionals in England and Wales does not apply here and why our route is differently structured rather than weaker, how to recognise that a girl may be at risk, how to support a woman who has undergone it, and the child protection and adult protection routes we use to report. Gives the domiciliary household visited under the care-at-home half of this registration and the tenancy or shared accommodation supported under the housing support half explicit, co-equal treatment throughout, because the law and the recognition material are identical but what a worker actually sees differs by setting.
Why the trigger for a genuine missing person concern sits in a different place on the two halves of a combined registration: a scheduled domiciliary visit creates a reasonable expectation the person will be at home, while a housing support tenant is entitled to go out and not say where. Sets out both positions honestly, then gives one response once a concern is triggered: the timed door and entry sequence for each setting, how Police Scotland grade and respond, the Herbert Protocol for people with dementia, the overnight and shared-accommodation version on the housing support half, and the point at which an unexplained absence becomes a cuckooing or adult protection concern rather than a going-missing one. Works alongside D46, which owns the routine domiciliary no-reply procedure, and read with D08, E13, J17 and J18.
How The Organisation recognises and responds when somebody else takes over, uses or exploits a supported person's home, when exploitation arrives disguised as friendship, and what a service can actually do given that the person has a legal right to have whoever they like in their own home and may not want anybody protected from. Applies to the housing support half of this combined registration only: the tenancy, the landlord relationship and the tenant's own exposure as an occupier are what make the mechanisms in this policy possible, and none of them exist on the care-at-home half, where a person is supported in a privately owned or privately rented home to which The Organisation has no landlord or occupancy relationship at all.
How The Organisation assesses the places it works in under a combined registration: a single household visited on a domiciliary round, where nothing beyond the front door is our business, and, where housing support is provided in a building The Organisation runs, the building itself, the stair, the close, the garden, the external lighting and the route from the street. Sets out the ownership question that governs both models, whose risk is this, the difference between a risk inside somebody's own home which is theirs to take and a risk in a communal area which is somebody else's to fix, and what a worker does when the answer to who is responsible turns out to be nobody.
How The Organisation prevents and controls infection across a combined registration: the National Infection Prevention and Control Manual for Scotland as the standard, the ten Standard Infection Control Precautions applied by every worker at every contact, and the two very different routes an organism actually takes in the two delivery models this service runs. On the care at home half, the worker moving between otherwise unconnected households is the route, and breaking it is entirely a matter of individual practice. On the housing support half, where support is delivered in a building The Organisation runs, the building itself, its shared bathroom, kitchen and laundry, is the route, and a person in their own tenancy cannot be compelled to isolate, so the effort goes into making isolation possible rather than enforcing it. Sets out workwear where no uniform is issued, staff illness, the public health reporting route, and what changes and does not change between the two models.
The clinical infection prevention and control standard applied whenever a worker carries out a delegated healthcare intervention under I00, wherever it happens: Aseptic Non-Touch Technique, key parts and key sites, creating a suitable clean or sterile field at a kitchen table rather than a clinical trolley, invasive device care including catheters, feeding tubes, tracheostomies, wounds and stomas, the additional precautions needed for an aerosol generating procedure, safe use of sharps, blood borne viruses, and respecting a device's single use or single patient use status during the procedure itself. The clinical standard is identical whether the person is visited under the care at home registration or supported in a tenancy under the housing support one, and every worked example in this policy is given for both.
How The Organisation applies the National Infection Prevention and Control Manual's standard on hand hygiene across both halves of a combined registration: the moments for hand hygiene adapted for care delivered in a person's own home, including the extra moments on entering a home, before leaving it and on getting back into the car; the technique for handwashing and for alcohol based hand rub and when hand rub does not work; the personal hand hygiene kit every worker carries; bare below the elbows; occupational skin health; what happens when a house has no soap or hot water and when a shared building's communal facilities fail; family carers and residents; and how hand hygiene is audited where there is no ward to walk. The standard and the procedure are identical whether the person is visited on a domiciliary round under the care at home registration or supported in a tenancy or supported accommodation under the housing support registration, and every worked example is given for both.
How The Organisation selects, supplies, stores and disposes of personal protective equipment under the Personal Protective Equipment at Work Regulations 1992 as amended in 2022, on both halves of a combined registration. Gloves, aprons, gowns, fluid-resistant surgical masks, respirators and eye protection are chosen against an assessment of the task rather than worn as a uniform, and only after the higher principles of prevention have been applied. The policy sets out the shared standard once, donning and doffing, fit testing, latex and the legal duty to every worker including bank and agency staff, and then gives co-equal treatment to the two delivery models: PPE carried on a domiciliary round, put on at the point of care, removed and disposed of in the home and never worn travelling; and PPE in a tenancy or a shared supported building, where supply runs through a communal point, nights have to be covered without a restock, environmental tasks such as clearing a neglected flat need their own assessment, and PPE is worn in front of other residents who will draw conclusions from it.
How The Organisation prevents and manages sharps injuries under the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013, on either half of a combined registration: eliminating unnecessary sharps use, safer sharps devices, the ban on recapping, who supplies and who empties a sharps container in a domiciliary household as against a housing support tenancy, and the immediate action and post-exposure route after a needlestick. It sets out in full the problem a single household visit rarely raises and a shared building raises constantly: a sharp discarded somewhere nobody expected one, where the person who used it may not be known to the service at all and the people put at risk include children, other residents, contractors and the public.
How The Organisation classifies, segregates, stores and arranges the collection of clinical and healthcare waste under the duty of care in section 34 of the Environmental Protection Act 1990, the Environmental Protection (Duty of Care) (Scotland) Regulations 2014 and the Special Waste Regulations 1996 as amended in Scotland, regulated by SEPA rather than the Environment Agency. It sets out whose waste it is in a person's own home and when The Organisation is itself the producer, as against the shared bin store, council collection interface and landlord responsibility question a housing support building raises, and it covers offensive and infectious waste streams, colour coding, transfer notes and special waste consignment notes, sharps container disposal in partnership with F06, medicines waste, and why waste does not, as a rule, travel in a worker's own vehicle.
How The Organisation assesses and controls exposure to substances hazardous to health under the Control of Substances Hazardous to Health Regulations 2002: the hierarchy of elimination, substitution, control and personal protective equipment, safety data sheets, the three absolute rules of no decanting, no mixing and nothing unidentified, and the substances this service actually handles, from cleaning products and disinfectants to biological agents and the gases used in delegated healthcare interventions. It gives full and separate attention to the question a domiciliary visit raises, that most of the products a worker uses belong to the person and were never selected by us, and to the different question a shared supported building raises, storing substances safely where several people, some genuinely at risk, share the same rooms.
How The Organisation decides what is reportable under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013, who makes the report, and by when. It sets out the reportable categories, the gateway test of an accident arising out of or in connection with work, and the limb this sector misses most often: injury to somebody who is not at work, taken from the scene to hospital for treatment, which barely arises in a private domiciliary home and arises constantly in a shared supported building. It carries the full decision tree as a working annex, sets out the accident book and the statutory record, and separates the RIDDOR duty from the Care Inspectorate notification under A02 and the duty of candour under A10, which are different duties that one event can trigger at once.
How The Organisation meets its duty under the Health and Safety (First-Aid) Regulations 1981 to provide adequate first aid equipment, facilities and trained personnel for its own employees, based on a first aid needs assessment covering a dispersed domiciliary round and one or more supported buildings; what first aid means for the people we support, who are not employees, and where that boundary sits against the clinical registration framework in I00; what a worker may and may not do; and the two lone working questions this library brings together with equal weight, a domiciliary worker with the nearest colleague twenty minutes away, and a building's overnight worker who may also be the person who needs help.
How The Organisation manages fire risk on both halves of a combined registration: in a person's own home on scheduled domiciliary visits, where nobody holds a fire safety duty for the building and the person is often alone between visits, and in tenancies and supported accommodation, where the building may be relevant premises and The Organisation may be the duty holder. Covers which Scottish fire safety law applies and to which premises, who holds the duty in each setting, The Organisation's own office, the premises fire risk assessment and the person-centred fire safety risk assessment, smoking, emollients, oxygen and air flow mattresses in combination, home fire safety visits by the Scottish Fire and Rescue Service, what a visiting worker does on finding a hazard, the end-of-visit fire check, personal emergency evacuation plans for people who cannot get themselves out, including when no worker is present, stay put and simultaneous evacuation, fire doors and detection, and what staff do in a fire and afterwards.
How The Organisation prevents its workers slipping, tripping and falling on either half of a combined registration: in a person's own home during a domiciliary visit, where we cannot change the floor and must change the way we work, and in the communal areas of a shared building, where the defect belongs to a landlord, a factor or the owners collectively, including who grits the path, who changes the bulb on the stair, and what a worker does when the honest answer to either question is nobody.
How The Organisation meets its duties under the Health and Safety (Display Screen Equipment) Regulations 1992 as amended, on either half of a combined registration: who counts as a user, workstation assessment for an office, a converted scheme office, a dispersed coordinator's own home and a domiciliary worker's occasional desk time, eye and eyesight tests, breaks and changes of activity, and the question the Regulations were never written for, a support worker's near-continuous use of a handheld device to record daily notes, medication and delegated healthcare interventions throughout a domiciliary round or a shift in a building.
How The Organisation identifies and assesses the risk of work-related violence under regulation 3 of the Management of Health and Safety at Work Regulations 1999, on either half of a combined registration: the three genuinely different sources of risk in this sector, the person we support, a third party, or a colleague, and why the response to each differs; individual and household or building level risk assessment; personal safety plans, markers and two-worker decisions; the domiciliary and the housing-support hazard sets side by side; and the immediate response to an incident, including the RIDDOR decision, the police, and the trigger for the debrief whose mechanics B13 already carries in full. Cross-referred to B13 for the Management Standards psychosocial risk framework and the general debrief conversation, and to B12 for the lone working safety mechanics, so that neither is repeated here.
How The Organisation manages equipment it mostly does not own, on either half of a combined registration: hoists, slings, beds, rails and medical devices in a domiciliary client's own home and in a housing support tenancy, who holds the six-monthly thorough examination duty for anything that lifts a person, what a worker checks before every lift, how MHRA field safety notices reach a frontline worker, the landlord's consent needed before anything is fixed to a rented structure, moving equipment between properties, and what happens when equipment fails, is recalled, or a package or a tenancy ends.
How The Organisation decontaminates reusable equipment between uses and between people, under the National Infection Prevention and Control Manual (Scotland) and the manufacturer's instructions for each item, on both halves of a combined registration. It covers the classification of equipment by infection risk and the four practical categories that decide who does what with an item; what a worker may clean in the home and what goes back to the equipment store, the supplier or the NHS; cleaning before disinfection, contact time and the correct strength of a chlorine-releasing agent; chemicals under COSHH in a domestic kitchen or bathroom; the household decontamination schedule written with the person and any family carer; slings, laundry and spillages; the contamination status declaration for anything leaving a home; equipment moving between people and shared equipment in supported accommodation; the worker's bag, tablet and car; and outbreaks. The governance and procedure are identical whether the person is visited at home on a domiciliary round under the care at home registration or supported in a tenancy or supported accommodation under the housing support registration, and the worked examples cover both.
How The Organisation recognises and manages an outbreak of infection on both halves of a combined registration. On the care at home half there is no building: the link between cases is a worker or a round, the pattern exists only in the office system, and the service cannot close, so this policy sets out how visits are tiered, workers cohorted and rounds sequenced to keep people who have nobody else safe. On the housing support half a shared building is an outbreak setting: shared bathrooms, kitchens and laundries, communal areas that may belong to a landlord, and tenants who cannot be compelled to isolate in their own homes. Common to both: the NHS board Health Protection Team leads, the statutory powers under the Public Health etc. (Scotland) Act 2008 belong to a health board or a sheriff and never to us, workers with vomiting or diarrhoea stay away for 48 hours on full pay, and a pandemic is the same event for longer, everywhere at once.
The environmental impact of a combined care at home and housing support provider, treated as two genuinely different sets of measures rather than one generic statement: the domiciliary round (mileage per visit, protective equipment used only when indicated, medication waste) and the organisational and premises side (the waste duty of care, the single-use plastics ban, an Energy Performance Certificate where The Organisation is a landlord). States plainly what national environmental legislation does and does not require of a provider of this kind, keeps a short list of figures a commissioner can be shown, and states what The Organisation will never trade for either.
How The Organisation prevents scalds and contact burns wherever it supports somebody, on either half of a combined registration: the bathing procedure that applies identically whoever owns the property, the three temperature figures and where each comes from, the legionella tension and how it is resolved, and who is responsible for a thermostatic mixing valve in a rented property, treated separately for a housing support tenant under the three arrangements at J02 and for a domiciliary care at home client whose tenure sits outside that framework altogether. Covers hot surfaces, hot drinks and food, and what happens in the first twenty minutes and the first twenty four hours after somebody is burned.
How The Organisation works with the condition of the buildings that people receiving the housing support half of a combined registration live in: the repairing standard and the tolerable standard, landlord registration and letting agent regulation, HMO licensing, property inspection where we hold a duty, how repairs are reported and chased, and what we do when a landlord will not act. Applies only to a housing support tenancy under one of the three arrangements at J02: a person receiving care at home only has no landlord relationship with The Organisation at all, and F19 section 6 sets out the separate, lighter route that policy uses for that half of the registration.
How The Organisation identifies and controls the risk of legionella and other water safety hazards in the housing support properties it works in: who the duty holder is under each of the three arrangements at J02, risk assessment and the written scheme of control, temperature control, flushing regimes for little used outlets, voids and reletting, thermostatic mixing valves and the tension with scald prevention, and what happens when somebody becomes ill. Applies only to the housing support half of a combined registration; a domiciliary care at home client's ordinary household water system is addressed by F02 and F19 without this policy's supported-accommodation apparatus.
How The Organisation manages the gas, electrical, carbon monoxide and appliance safety of the housing support properties it works in: the landlord's annual gas safety check under the Gas Safety (Installation and Use) Regulations 1998, electrical installation condition reports and appliance testing, carbon monoxide and interlinked fire detection under the tolerable standard, how tenure changes which standard applies, and what we actually do when a tenant will not let anybody in. The certification apparatus applies only to the housing support half of a combined registration. The warning signs, the gas escape and carbon monoxide procedures and the immediate action card apply to every worker in every home, including a domiciliary visit to a person who receives care at home only, for whom D42 and F19 section 6.2 carry the rest.
How The Organisation manages the security and shared parts of buildings in which it supports people under the housing support half of a combined registration: who holds keys, fobs and codes, how door entry systems are run and repaired, who is responsible for cleaning, lighting and gritting communal areas, the limits of our authority over a tenant's visitors and the tenant's right to exclude, the data protection position on CCTV in a building where people live, and access to the building out of hours. Applies only to the housing support half. For a person who receives care at home only, D44 governs keys and access for a scheduled visit and D45 governs visitors during a visit, and the close outside their door is a building in which our worker is a visitor. A person who receives both is covered by this policy for their tenancy and building, and by D44 and D45 for their scheduled visits.
How The Organisation creates, holds, retains, transfers and destroys the records generated on either half of a combined registration: the home file and records in transit for a domiciliary round, records held inside a shared or supported building, the retention schedule and the reasons behind each period, and the rule that governs wherever The Organisation is also the landlord, where a support record and a housing record about the same person or event are held once, for the longer of the two retention periods, with a cross-reference rather than a duplicate.
How The Organisation recognises, logs and answers a request from a person for a copy of what is held about them, on either half of a combined registration: the time limit as the Data (Use and Access) Act 2025 now sets it, who may ask on somebody else's behalf, the search that covers a home file in a person's kitchen, call monitoring data and a support file in a shared building alike, a single response where a request touches both teams or both the support and the housing file, the third party information that runs through every care and support record, the health data rule that a non-clinical provider has to apply before disclosing, and requests made after a person has died.
How The Organisation decides whether to share information about a person it supports, with whom and on what basis, on either half of a combined registration: the eight Caldicott principles and their status in Scotland, the lawful bases including the recognised legitimate interests added in 2026, the landlord as a separate controller with its own lawful basis whether the person is a housing support tenant or a care at home client who rents their home, sharing between our own housing and support functions where we are also the landlord, the constant clinical sharing a domiciliary round depends on, the commissioner and call monitoring data, family carers and key holders, the council's adult protection service, Police Scotland, the absolute adult protection override, and the record kept every time.
The recording standard for both halves of a combined registration: what a care at home visit note and a housing support shift or session note must contain, how observation is kept apart from conclusion, why every entry is written as if the person will read it, what a note about somebody's own home and a note made in a shared building must leave out, how call monitoring, telecare logs and disturbance logs are read alongside the notes, how a record is corrected and never rewritten, and why falsifying one is gross misconduct. G03 owns where records are kept and for how long; this policy owns what goes in them.
How The Organisation secures the systems a combined care at home and housing support service actually depends on: named accounts and multi-factor authentication, encrypted devices carried into a different house every day or left overnight in a staffed building, two separate networks where the service operates inside a shared building, the telecare and call monitoring arrangements that carry part of the safety model on each half of the registration, backups that survive ransomware, supplier due diligence, and what happens in the first hours of an incident that reaches both a domiciliary round and an overnight scheme at once.
What a worker may and may not post, message or photograph on a personal account or a personal phone, on either half of a combined registration: the absolute rules, why a post with no name in it still identifies somebody, telephones during a domiciliary visit and telephones during a housing support shift, the group chat that becomes a handover system, friend requests from a lonely client or tenant, and, distinctly, a housing support tenant's own right to their own phone and their own social media presence in their own home, which this service does not own, monitor or restrict except on the narrow, recorded grounds this policy sets out.
Who may take an image, of what, on which device and for which of four strictly separated purposes: clinical or care-record, incident or property, promotional, or personal, on either half of a combined registration. Written consent specific to the medium and revocable without reason; wound photography as a clinical record and never a marketing asset; the position where a person lacks capacity, which is that their image is not used for promotion at all, whatever a guardian or attorney says; and, distinctly, the third party problem a shared housing support building generates that a domiciliary client's own home almost never does.
How The Organisation handles every camera, microphone and monitoring device it meets on either half of a combined registration. On the care at home half that is mostly the household's own equipment: asking at assessment, the household declaration, telling every worker before their first visit, audio, bathrooms and personal care, the hidden camera found part way through a package, and the camera a relative installs for an adult who cannot decide. On the housing support half it is mostly the building's: the necessity and proportionality test for communal CCTV and door entry, the controller question where a landlord is involved, the device register, and the far harder question of a device proposed in place of staff overnight. It also sets out why we do not use body worn cameras, why we never carry out covert surveillance, signage, retention, and how footage is viewed, preserved, requested and handed to us.
Whether, when and how the Freedom of Information (Scotland) Act 2002 reaches The Organisation on either half of a combined registration. As a private or third sector provider we are not, in general, a Scottish public authority. The Act reaches us in three checkable ways: designation by order, which in practice means the 2019 Order for registered social landlords and their connected bodies; information we hold on behalf of a Scottish public authority or supply to one under contract; and, by far the most common, the material every partnership, council, landlord and regulator already holds about us. This policy sets out how each is tested, how a request that reaches us is handled whether or not we are covered, how we answer when an authority consults us, why we write to commissioners and landlords as though it may be published, and how freedom of information differs from subject access.
The complaints procedure regulation 18 requires, for both halves of a combined registration: frontline resolution and investigation on the Scottish Public Services Ombudsman model, read against regulation 18's twenty working day limit; the Care Inspectorate open to anyone at any time under section 79(2); a full Stage 2 investigation method; what happens when the complaint is about the Registered Manager; and routing, so that a person who is unhappy about their care, their housing support, their building and their landlord at once is sent to the right place for each. Covers the complaint made at a domiciliary door, the commissioner, the NHS and the joint equipment service, the social and private landlord routes including the Housing and Property Chamber, owner-occupiers, the Ombudsman only where it genuinely applies, and the rule that complaining never affects anybody's care, support or home.
How The Organisation checks that what its policies say happens is what actually happens, across both halves of a combined registration: a domiciliary round of short scheduled visits that nobody from the office sees, checked through visit-time and call monitoring audits, spot checks and observed practice in people's homes; and a housing support service spread across tenancies and shared houses, much of it overnight, checked through night visits, shared-house checks and tenancy sustainment outcomes. Sets out the audit programme, sampling, how findings are written and graded, and what the board sees.
How The Organisation judges how good it is on each half of a combined registration, using the Care Inspectorate's quality frameworks as the self-evaluation tools they were written to be, and how that judgement turns into a single improvement plan with owners, dates and measures. Covers what improvement looks like on a domiciliary round, where the unit of change is a round, a time band or a small team and the constraint is the visit length a commissioner pays for, and in a housing support service, where the outcomes that matter belong to a tenancy and much of what needs to change sits with a landlord.
How The Organisation finds out what the people it supports actually think, on both halves of a combined registration, and how it involves them in how the service is run rather than only telling them about decisions. Covers the person receiving domiciliary care alone in their own home, who depends on the worker they are being asked about and has no communal space and no residents' meeting; and the tenant in housing support, whose views are often said in passing in a kitchen, who may share a building with other people we support, and whose landlord has tenant participation duties that we usually do not hold.
How the Care Inspectorate inspects The Organisation's combined care at home and housing support registration as one service: which quality framework is applied and why it is the support services framework rather than both, the core assurances, the six point scale, what inspectors look at on each half (visit scheduling, call monitoring and time in people's homes; tenancy sustainment, separation of housing and support and shared living), visiting people at home only with their agreement, requirements, areas for improvement and the action plan, the draft report and the error response form, annual returns, enforcement, and the appeal to the sheriff within 14 days under section 75.
How The Organisation supports people using prescribed oxygen, as a healthcare intervention delegated by a registered health professional to a named worker, whether the person is visited at home on a domiciliary package under the care at home half of the registration or supported in a tenancy or supported accommodation under the housing support half. The governance and the procedure are identical on both halves, and the task is delivered under the care at home half wherever the person lives. Covers oxygen as a medicine, the target saturation range and why higher is not better, the devices and sources, who may delegate, competence and the separate delegation for pulse oximetry, hypercapnia and why turning the flow up can kill, the procedure, escalation and the limits. Then what differs in practice: who holds a fire safety duty in a private dwelling and in a shared building, and what actually carries the load in each; smoking, emollients and the household; the time-critical visit and who responds between visits when nobody from us is there; family carers and the back-up cylinder; the night at home and the night in a staffed building; storage, deliveries and restocking; noise, heat and the running cost; consent to anything fixed or wired; power failure, the Priority Services Register and the telephone that dies with the power; lone working; emergency access by key safe or close door; and what the household, the landlord and the neighbours may and may not be told.
How The Organisation supports people with a tracheostomy or a laryngectomy, as a healthcare intervention delegated by a specialist registered health professional to a named worker, whether the person is visited at home on a domiciliary package under the care at home half of the registration or supported in a tenancy or supported accommodation under the housing support half. The governance and the procedure are identical on both halves, and the task is delivered under the care at home half wherever the person lives. Covers the tube types, the difference between a tracheostomy and a laryngectomy that decides an emergency, humidification, inner tube care, stoma care and tapes, the emergency box and bedhead sign, what to do when a tube blocks or comes out, the narrow exception for emergency tube change, escalation and the limits. Then what differs in practice: a person who cannot shout and how they summon help between visits and overnight, at home or in a staffed building; time-critical tasks and double-up visits on a round; family carers taught by the specialist in their own right; getting an ambulance crew to the bedside through a key safe or a close door in the minutes a blocked tube allows; power failure and the telephone that dies with it; a cold or damp home; the shower and who consents to it; fire; lone working; and what the household, the landlord and the neighbours may and may not be told.
How The Organisation supports people using non-invasive ventilation at home, as a healthcare intervention delegated by a home ventilation, respiratory or sleep service to a named worker. Governance and procedure are identical whether the person is visited under the care at home half of the registration or supported in a tenancy or supported accommodation under the housing support half, and the delegated task itself always sits in the care at home part. Covers the devices and interfaces, why the mask is the whole treatment, how long this person can safely go without the machine, alarms, power failure and the battery comparison, and the question that decides most arrangements: who is with the person when the mask is on. In a building that means somebody in the building is not somebody with the person. On a care at home package it means the hours between the late visit and the morning one, the family carer, telecare and the key safe. Also covers noise through a party wall or in a shared bedroom, a cold bedroom and condensation, storage and restocking, landlord consent and the owner-occupier, and emergency access at three in the morning.
How The Organisation supports a person ventilated through a tracheostomy at home, as a healthcare intervention delegated by a specialist home ventilation service to named workers. Governance and procedure are identical whether the person receives a care at home package in their own house or housing support in a tenancy or supported accommodation, and the delegated task always sits in the care at home part of the registration. Covers the five things that kill people on home ventilation, equipment checks and batteries, the back-up ventilator and the manual resuscitation bag, alarm response, why continuous invasive ventilation is a two person waking night and not a sleepover or a set of scheduled visits, the trained family member as the second pair of hands, how an ambulance crew gets through a controlled close door or a key safe at three in the morning, power failure in a house and across a close, where a month of consumables goes, clinical waste from a house and from a shared bin store, and the limits of a worker's role.
How The Organisation supports a person to use a cough assist machine at home, as a healthcare intervention delegated in writing by a specialist physiotherapist. Governance and procedure are identical whether the person receives scheduled care at home visits or housing support in a tenancy or supported accommodation, and the delegated task always sits in the care at home part of the registration. Covers the prescription that is never changed, the contraindications and the feed interval, the pre-session safety check, watching the person rather than the machine, a visit long enough to contain the routine, the family member who runs the sessions between visits, where in a small or shared home the session happens and what that means for dignity, noise through a party wall or in a family house and why it never shortens a session, infection risk in a building we do not control, what happens when a chest infection pushes the routine into the night, power failure, clinical waste from a house and from a shared bin store, and the limits of a worker's role.
How The Organisation supports a person who needs their airway suctioned, whether they are visited at home under the care at home half of the registration or supported in a tenancy or supported accommodation under the housing support half. The governance and the clinical procedure are identical on both halves: a healthcare intervention delegated in writing by a registered health professional, the four numbers that are the whole of the safety, why deep suction is never delegated, the default position on nasopharyngeal suction, the stop triggers and suctioning at the end of life. What differs is the setting, and the policy deals with both. On a domiciliary package: a call long enough to hold the passes and the recovery, a late call and a person waiting with secretions, who suctions between calls and overnight, people who suction themselves, family carers taught more than our workers may do, telecare for a person who may not be able to speak, and entry by key safe when the worker cannot leave the bedside. In supported accommodation: where the procedure happens and who hears it, where the jar is emptied when the bathroom is shared, why a person who needs suctioning at night is a waking night rather than a sleepover, and how a crew gets in through a controlled door. In both: storage and restocking, portable suction and power failure, waste, and what happens when something goes wrong.
How The Organisation supports a person living with a urinary catheter, whether they are visited at home under the care at home half of the registration or supported in a tenancy or supported accommodation under the housing support half. The governance and the clinical procedure are identical on both halves: a healthcare intervention delegated in writing by a registered health professional, the closed system and why it is opened as rarely as possible, the balloon that is never touched, falling output as a blockage forming, new confusion as a sepsis sign, and autonomic dysreflexia in spinal cord injury. What differs is the setting, and the policy deals with both. On a domiciliary package: leg bag capacity against the gaps between calls, a catheter valve with no worker between calls, the bedtime call that comes too early, the night with no worker, family carers, a relative's telephone call about confusion that has to reach the nurse, telecare, and entry by key safe. In supported accommodation: dignity when the bathroom is shared, where the bag is emptied and the measuring container is kept, locks and doors, what the building is told, a smell in a close and the tenancy, and whether a catheter changes the shape of the night. In both: storage and restocking, getting a crew in, waste, and what happens when something goes wrong.
How The Organisation supports a person's bowel care, whether they are visited at home under the care at home half of the registration or supported in a tenancy or supported accommodation under the housing support half. The governance and the clinical procedure are identical on both halves: ordinary bowel support and why it prevents most of the harm, suppositories and enemas under a prescription and a written delegation, digital rectal examination and digital removal of faeces as specialist interventions only, transanal irrigation where a specialist has written the routine, overflow mistaken for diarrhoea, and autonomic dysreflexia. What differs is the setting, and the policy deals with both. On a domiciliary package: product onset times against the length and timing of the call, the person alone for the result after the worker has gone, family carers and their own doses, time-critical visits on a round, entry by key safe, and storage, restocking and waste in the person's own home. In supported accommodation: an hour of bathroom occupancy where several people share one toilet, smell and thin walls, laundry and the shared drying space, what the building is told, and soiled waste in shared bins.
How The Organisation handles a request to give a subcutaneous injection, whether the person is visited at home under the care at home half of the registration or supported in a tenancy or supported accommodation under the housing support half. The governance and procedure are identical on both halves: why the default answer is no, the narrow exception route and the nine conditions, no drawing up and no calculation, site rotation and lipohypertrophy, the sharps discipline, and anaphylaxis. What differs is the setting, and both are dealt with. On a domiciliary package: the evening injection call on a round and how late is too late, named workers on a round, a family carer who gives some of the doses and the single record that prevents a double dose, entry by key safe, a sharps container in a family home with visiting grandchildren, and what the household watches for between calls. In supported accommodation: a sharps container in a building other people's children walk through, a needle found in a close, a shared fridge, the cold chain when the close loses power, and what the neighbours assume about somebody who injects.
How The Organisation supports a person with diabetes, whether they are visited at home under the care at home half of the registration or supported in a tenancy or supported accommodation under the housing support half. The governance and procedure are identical on both halves: recognising and treating hypoglycaemia, which every worker must be able to do whether or not they hold any delegation; blood glucose testing as a delegated intervention; insulin declined by default with a narrow exception route; never acting on a number; ketoacidosis and hyperosmolar state; sick day rules; and feet. What differs is the setting. On a domiciliary package: call times that are clinical on a round that drifts, the tea call pulled forward, the unstaffed night between the bedtime call and breakfast, no answer at the morning door, family carers, and a hypo that leaves the next call waiting. In supported accommodation: where the hypo treatment lives when the kitchen is shared, a staffed night and why a sensor is not a member of staff, meal times set by the house, and a hypo in a close taken for drunkenness. In either: a cold home and diabetic feet.
How The Organisation supports a person with epilepsy, whether they are visited at home under the care at home half of the registration or supported in a tenancy or supported accommodation under the housing support half. The governance and procedure are identical on both halves: seizure first aid, which every worker does without any delegation; timing the seizure; status epilepticus and the 999 triggers; rescue medication declined by default with a narrow exception route; the individual protocol; the seizure diary; and sudden unexpected death in epilepsy. The night is the sharpest question and it differs by setting. Section 7 sets out what seizure monitors do and do not detect, how the choice between a monitor and a waking night is made where staff can be on site, why a monitor used to avoid staffing a waking night is a restrictive practice and a privacy question, and, at section 7.8, the domiciliary night, where a monitor alerts a family carer or a community alarm service and the arrangement may depend on one relative being at home. Also: medication calls on a round, a family carer trained to give rescue medication, other residents who witness seizures, a controlled drug in a shared building, and how a crew reaches somebody at three in the morning.
How The Organisation prevents pressure damage and handles wounds for the people it supports, whether a person is visited at home under the care at home half of the registration or supported in a tenancy or supported accommodation under the housing support half. The clinical procedure and the governance are identical on both halves. Covers prevention as core personal care work needing no delegation, SSKIN, the blanching test, the categories in the words a worker will use, moisture damage as a different thing, competence, wound care declined by default with a narrow director-approved exception, the duty of candour question asked every time a pressure ulcer develops and referred for an external clinical opinion, tissue viability referral and wound photography. Then what differs in practice: who repositions and who answers a mattress pump alarm between domiciliary visits, the family carer nobody asked, getting a profiling bed into a terraced house or a second floor flat, a power cut in a private house or a close, the person who sits in one chair from the morning call to the lunch call, where a month of dressings is stored and who restocks, household and shared bin store waste, odour and what it does to a tenancy, a cold home as a healing problem, getting a crew through a key safe or a close door, and whether overnight repositioning makes a supported accommodation night a waking night.
How The Organisation supports a person with a syringe driver at the end of life, whether they are visited at home on a domiciliary care at home package or supported in a tenancy or supported accommodation under the housing support registration. Governance and procedure are identical on both halves: the driver is set up, filled, monitored, re-sited and taken down entirely by the district nursing service, nothing about it is delegated to our workers under any circumstance, and our workers observe and escalate. Sets out what a worker checks at every visit, what to do when the pump alarms, when the site looks wrong, recognising pain and distress in somebody who cannot say so, when 999 is and is not the right call, anticipatory medicines in the home, resuscitation decisions and the point of death, and the limits. Then what differs in practice between the two settings: who hears the pump and who they ring in the hours between domiciliary visits, storage and restocking, lone working, what family, visitors, flatmates and neighbours are told and what they must never be told, getting a district nurse or an ambulance to the bedside at three in the morning through a key safe or past a controlled close entry, power cuts, consent before anything is fixed to a wall, and the duty of candour route this service cannot operate alone.
How The Organisation supports a person with a spinal cord injury, whether they are visited at home on a domiciliary care at home package or supported in a tenancy or supported accommodation under the housing support registration. Governance and procedure are identical on both halves. Autonomic dysreflexia as the emergency every worker must recognise without any delegation, its signs, the order of actions beginning with sitting the person up and checking the catheter, why a blocked catheter is the commonest cause, and when to call 999. Bladder and bowel routines as clinical times, skin in somebody who cannot feel it, transfers and equipment that are never improvised, breathing, temperature and blood pressure, independence and control, recording and the limits. Then what differs in practice between the two settings: what happens if dysreflexia starts between visits when the person is alone, overnight routines and repositioning, storing a wheelchair, a hoist and a month of supplies, consent and funding for a ceiling track hoist or a wet room whether the person rents or owns, what a power cut does to a powered wheelchair or a profiling bed, getting a 999 crew to the bedside when minutes matter, and the duty of candour route through A10.
How The Organisation supports a person on home peritoneal dialysis, whether they are visited at home under the care at home half of the registration or supported in a tenancy or supported accommodation under the housing support half. The procedure and the governance are identical on both halves. The renal unit manages the treatment entirely, exit site care is usually the delegated task, exchanges and machine set up are declined by default with a narrow exception route, and cloudy drained fluid means peritonitis until the renal unit says otherwise, telephoned at any hour with the bag kept. Covers the room, the hands and the light, exit site and tunnel infection, fluid balance and weight as arithmetic, automated machines and alarms, recording and the limits. Then what differs in practice: the day's regimen set against the visit times, the family carer trained by the renal unit, the first and last call checks and the escalation card, a cycler alarm at two in the morning with nobody else there, the night in supported accommodation, storing a month of fluid in a family house or a flat with one cupboard and who reorders, a dedicated socket by tenure, why a cycler has no meaningful battery backup and what a power cut in a private house or across a close means mid-cycle, getting a crew through a key safe or a close door, household and shared bin store waste, and the duty of candour route through A10.
How The Organisation accepts and delivers delegated healthcare interventions involving medicines given by the enteral, subcutaneous, rectal, transdermal and buccal or sublingual routes, whether the person is visited at home under the care at home half of the registration or supported in a tenancy or supported accommodation under the housing support half. The procedure and the governance are identical on both halves. Covers who may delegate each route, the default positions this library takes on injections, insulin and rescue medication, route specific competence, step by step procedure, the signs that something is wrong, escalation to the district nursing team, NHS 24 on 111 and 999, equipment, infection prevention, recording and the limits. Then what differs in practice: storing sharps, opioid patches and enteral equipment in a family home or a small flat and who restocks, what happens between domiciliary visits and overnight, who in the household or the building may be told what, getting a 999 crew through a key safe or a close door, lone working during the intervention, and the duty of candour route through A10.
How The Organisation supports a person who needs medicine or clinical care to the eyes, ears or nose, whether the person is visited at home under the care at home half of the registration or supported in a tenancy or supported accommodation under the housing support half. The procedure and the governance are identical on both halves. Covers where the line falls between ordinary drops under D16 and delegated interventions, with drops after eye surgery or for a sight-threatening condition such as glaucoma delegated; eye drops and ointments, order and spacing, punctal occlusion, ear drops and why nothing goes into an ear canal, nasal drops and sprays, eye cleaning and the care of an eye that will not close, the eye red flags, chemical splash, nosebleeds, clean technique, recording and the limits. Then what differs in practice: whose drops are whose in a shared bathroom or a married couple's kitchen drawer, the doses that fall between domiciliary visits and who gives them, protecting an eye at night when nobody is there, getting a crew through a key safe or a close door, working alone with an eye or nose emergency, and the duty of candour route through A10.
How The Organisation supports the measurement of vital signs as a healthcare intervention delegated by a registered health professional to a named worker, for a person visited at home under the care at home half of the registration and for a person in a tenancy or supported accommodation under the housing support half. The clinical procedure and the governance are identical on both halves and the policy says so. It covers what each measurement means, how each is taken properly, the National Early Warning Score 2 as it is used across NHS Scotland including the second oxygen saturation scale, the person's own baseline and written escalation triggers, the soft signs that appear before any number moves, what a care worker does and does not do with a score, equipment, recording, and the limits of a care worker's role. It then deals with what differs in practice: who responds between visits and overnight when no worker is there, how the clinician's instruction is tied to visit times or hours of support, getting an ambulance crew through a key safe or a controlled close door quickly enough for the early warning to matter, storage and restocking, lone working during the intervention, and the duty of candour route through A10 after a missed trigger. Read with I20, which is the response.
How every worker in The Organisation recognises that somebody has become unwell and responds, on either half of the registration: a person visited at home under care at home, and a person in their own tenancy or in supported accommodation under housing support. The response is identical on both halves and needs no delegation. Covers the pattern of deterioration at home, recognising it in people who cannot describe it, the barriers to escalation named one by one, the six step response, who to call and in what order, the time-critical conditions including sepsis, stroke, heart attack, anaphylaxis, hypoglycaemia, airway obstruction, seizures and major bleeding, how to make a 999 call that gets the right response, what to do while waiting, rural and island working, what a DNACPR form does and does not mean, and what happens afterwards. Then what differs in practice: the domiciliary worker alone on a round with the next call waiting and no reply at the door, the sole night worker in a supported building, who notices between visits and overnight, getting a crew through a key safe or a controlled close door, family carers and neighbours, and the duty of candour route through A10. The response half of the pair with I19.
How The Organisation supports people with a colostomy, an ileostomy or a urostomy, as a healthcare intervention delegated by a registered health professional to a named worker, whether the person is visited at home under the care at home half of the registration or supported in a tenancy or supported accommodation under the housing support half. The procedure and the governance are identical on both halves. Covers the three types and how they differ, what a healthy stoma looks like, emptying and changing appliances, cutting a flange from the person's template, peristomal skin care, output observation and recording, high output and the dehydration and sodium loss that follow it, the signs of a blockage and what to do, the stoma emergencies including a dark or prolapsed stoma, urostomy night drainage and why mucus is normal, supplies, infection prevention, stoma care at the end of life, recording and the limits of a care worker's role. Then what differs in practice: which half of the registration carries the task, finding room for a genuinely large monthly delivery in a family home or a small flat and who reorders, who empties the bag and connects the night bag between domiciliary visits and overnight, how output between visits is captured, getting an ambulance crew through a key safe or a close door for a stoma emergency, household and shared bin store waste, and the duty of candour route through A10.
How every worker in The Organisation recognises sepsis and escalates it, on either half of the registration: a person visited at home under care at home, and a person in a tenancy or supported accommodation under housing support. The procedure is identical on both halves and needs no delegation. Covers what sepsis is, why it looks different in an older person, who is at higher risk and why each risk is named in the person's own plan, the signs and the soft signs that come first, what is not reassuring, the sources this service sees, what the worker does in order, saying the words I am worried about sepsis, why a worker never waits for a manager, where observations and NEWS2 fit, what happens when a person refuses, why urine dipsticks are not used, the hours between domiciliary visits and overnight when no worker is present, where the escalation card and any observation equipment are kept, lone working on a round and in a supported building, getting a crew through a key safe or a close door, prevention, the look-back review after every escalation, the duty of candour route through A10, and support for the worker. Includes a pocket card with the six red flag signs marked, and a personal sepsis risk summary.
How every worker in The Organisation recognises anaphylaxis and responds to it, on either half of the registration: a person visited at home under care at home, and a person in a tenancy or supported accommodation under housing support. Governance and procedure are identical on both halves. Covers what anaphylaxis is and what sets it off, the second wave, the airway, breathing and circulation signs, why a rash may be absent, the legal position under the Human Medicines Regulations 2012 (planned administration on the prescriber's directions under a named delegation, and the regulation 238 exemption that lets any person give adrenaline to save a life), another person's device, why no spare devices are held, consent and capacity, the individual protocol, competence and trainer devices, dialling 999 first, giving the adrenaline, why a person is never stood up, the second dose at five minutes, why everybody goes to hospital, preventing exposure through shopping, substitutions, meals left for later, shared kitchens and visitors, keeping devices usable and who restocks them, the hours between visits and overnight, lone working and getting a crew in, outings, a worker who has the allergy, recording, the limits, the review after every episode and support for the worker. Includes a pocket card, an individual protocol template, a device register and episode record, and a competence record.
What every worker in The Organisation does on finding a person who appears to have died, on either half of the registration: a person visited at home under care at home, and a person in a tenancy or supported accommodation under housing support. Governance and procedure are identical on both halves. Covers the Scottish arrangements, which are not the English ones: confirmation (verification) of death by a suitably trained registered healthcare professional in any circumstances under the Chief Nursing Officer's guidance DL(2017)9, certification by a doctor and review by the Death Certification Review Service, registration within eight days at any registration office, and reporting to the Procurator Fiscal rather than a coroner. Sets out precisely what a care or support worker who is not a registered healthcare professional may and may not do; the expected death pathway agreed in advance; a domiciliary worker arriving alone at a scheduled visit and finding the person dead, from the key safe or no reply to the rest of the round; the expected and unexpected sequences; resuscitation and the call handler's role; police attendance; where it is not clear; a death in supported accommodation and the other residents; deaths found between visits; care after death; property, medicines, keys and pets; the home afterwards for an owner and a tenant; telling people; registration in plain words; notification, review and candour; support for the worker; recording and the limits.
How The Organisation keeps three things apart for every person it supports: their home, their housing support and their care at home. Changing, reducing or ending either half of the combined registration never puts the person's home at risk and never affects the other half; a person may take one half from us and the other from somebody else. Covers the conflict where The Organisation is also the landlord or holds the lease, the practical dependency of a care at home client on care being available, the rule that nobody here presents a care home as the consequence of refusing care, handing back a domiciliary package, the information boundary with landlords, and retendering of either half.
The kinds of agreement under which people supported by the housing support half of the combined registration hold their homes, what each one gives them, how a worker reads an agreement and records what it says, and the things no worker on either half may ever do with somebody else's tenancy. Applies only to the housing support half: a person receiving care at home only has no agreement with The Organisation, the care at home half takes no part in their tenancy, and J01 sets out what a domiciliary worker does with a tenancy problem noticed on a visit. A person who receives both has their agreement dealt with entirely by the housing support half.
How the housing support half of The Organisation's combined registration works to keep people in their homes: the warning signs that a tenancy is in trouble, what we do about each one, the actual stages of the eviction process in Scotland for each kind of agreement, and the action required at every stage from the first arrears letter to the day after an order is granted. Applies to the housing support half. A person receiving care at home only is not given tenancy sustainment by the care at home half, but a notice or warning sign seen on a domiciliary visit is escalated the same day under section 6.7 and the Registered Manager arranges advice or housing support. For a person receiving both, the housing support half does the work and the care at home half keeps visiting, unchanged.
How the housing support half of The Organisation's combined registration supports people to understand and pay their rent and service charges, what we do at each stage as arrears build, the difference between eligible and ineligible service charges, and how the conflict is managed where The Organisation is also the landlord. Applies to the housing support half only: the care at home half has no part in anybody's rent, a charge for care at home is never rent or a service charge, and a rent problem seen on a domiciliary visit is passed on under J01 and J04. Neither housing support nor care at home is ever reduced as a sanction for arrears.
For the housing support half of a combined registration: how housing costs are met for the people The Organisation supports in their tenancies and in supported accommodation, why supported accommodation sits outside the Universal Credit housing costs element and continues to be met by Housing Benefit, what specified and exempt accommodation mean and which landlords can qualify, how status is established before anybody moves in, what evidence a claim needs, and what we do when a claim is refused, suspended or fails. A person who receives care at home only lives in housing of their own and their housing costs are their own business: a worker notices, records, passes on and signposts, and section 3 says how. For a person who receives both, there is one housing costs file, and a change on either half of what we provide is treated as a change the claim needs to know about.
How The Organisation helps the people it supports to claim what they are entitled to across three separate systems: Social Security Scotland, the Department for Work and Pensions and the council. Covers Adult Disability Payment and the other Scottish payments, the Scottish Welfare Fund, Discretionary Housing Payments, Council Tax Reduction, and the boundary between supporting a claim and giving regulated financial or debt advice, which we do not do. Applies to the housing support half of this combined registration, where help with benefit claims is a prescribed housing support service, and to a person who receives both services, whose benefit check is done once, by the housing support keyworker, using care at home visit records as evidence with consent. A person who receives care at home only does not have a benefit check under this policy: section 3 sets out the limited things a care at home worker does instead.
How The Organisation recognises that somebody we support is homeless or at risk of becoming homeless, what the statutory homelessness duties are and who actually holds them, what the Housing (Scotland) Act 2025 ask and act duty requires and of whom, and what we do at every stage even where the duty is not ours. Applies to the housing support half of this combined registration and to a person who receives both services, who is screened once by the housing support keyworker. For a person who receives care at home only, section 3 sets out the narrower steps a care at home worker and coordinator take, and the care continues whatever happens to the housing.
What Housing First actually requires of a support service, why housing is never conditional on treatment, abstinence or engagement, how harm reduction works in somebody's own tenancy, what open-ended support means for caseloads and rotas, and how rapid rehousing changes the work of a housing support service. Applies to the housing support half of this combined registration. Where a Housing First tenant also receives care at home from us, section 3 sets out how the two fit together: the care package is no more conditional than the tenancy, and a scheduled personal care visit is never treated as a dormant contact. A person who receives care at home only is not in scope of this policy.
How people reach the service, what we need at referral, how eligibility is decided, why the allocation of accommodation and the decision to provide support are two separate decisions taken and recorded separately, the reasons for which we may legitimately decline, the reasons for which we may not, and how we hold ourselves to not selecting only the people who are easy to support. Applies to the housing support half of this combined registration. Section 3 sets out how a referral is triaged between the two halves: a referral that is really for personal care goes through the care at home assessment route under D02 and D03 instead, and a referral for both services gets one assessment visit and two access decisions, neither conditional on the other.
What The Organisation does in the twelve weeks after somebody gets the keys: setting the house up so it can be lived in, getting the money and the meters right, registering with a GP and a dentist, writing the personal plan inside the 28 days regulation 5 allows, and reading the early signs that a tenancy is not going to hold while there is still time to do something about it. Applies to the housing support half of this combined registration. Where the person also receives care at home from us, section 3 sets out how the care is put in place before the first night and how the two teams share one moving in record. A person who moves home and receives care at home only does not receive this policy's settling-in support, but section 3 sets out what the care at home side does to keep their care safe through the move.
How support ends without the tenancy ending, how a planned move-on is done, what a landlord must actually do before treating a property as abandoned, what happens when a tenant dies including succession rights and belongings, and why The Organisation has no authority to clear a property. Applies to the housing support half of this combined registration. Ending housing support does not end a care at home package for the same person, and ending care at home does not end housing support: section 3 sets out how each half ends on its own terms. For a person who receives care at home only, J02 governs the ending of the package and D29 governs a death.
How people who did not choose each other live together in shared supported accommodation: what a house agreement can and cannot do, who owns communal space, how conflict between residents is handled, what happens when one person's distress affects neighbours who cannot leave, relationships between residents, and the narrow limits of The Organisation's authority over what an adult does in their own home. Applies only to the housing support half of a combined registration. A person who receives care at home only lives in a household The Organisation has no part in organising, and the worker on a scheduled visit is a visitor there under D11, D44 and D45. A resident of shared accommodation who receives both is covered in full, and section 3 sets out how scheduled care at home visits are delivered inside a shared property without taking it over.
How The Organisation supports a person to get repairs done and adaptations fitted in their own home, without taking the tenancy over: the repairing standard and the tolerable standard, who reports a repair and how we help them do it, the right to repair, the damp and mould timescales, what to do when a landlord will not act, and the assessment, consent and funding routes for adaptations and aids. Applies to the housing support half of a combined registration. A person who receives care at home only is not taken onto the repair log or the escalation ladder: F02 and F19 section 6.2 cover a defect found on a domiciliary visit, D44 covers a key safe on a rented home, and F15 and D22 cover equipment. Section 3 sets out the parts of this policy that apply on both halves, and how a person who receives both is covered.
How The Organisation supports people to get and keep a safe, affordable energy and water supply in their own home: prepayment meters and self-disconnection, the Priority Services Register, supplier obligations, fuel poverty as a Scottish statutory target, energy debt, the referral routes to Home Energy Scotland and Warmer Homes Scotland, and the line between helping somebody and giving regulated financial advice. Applies to the housing support half of a combined registration. For a person who receives care at home only we do not run their supply or their energy debts, but every worker notices cold and self-disconnection and acts on it, and Priority Services Register entry is part of the care at home assessment for anybody who depends on power. Section 3 sets out which parts apply to whom.
How The Organisation records what belongs to the person, what belongs to the provider and what belongs to the landlord, how contents insurance is offered and explained, what happens to belongings when somebody moves, goes into hospital, abandons a tenancy or dies, and the rule that staff never dispose of anything. Applies to the housing support half of a combined registration. For a person who receives care at home only we do not keep an inventory, raise contents insurance or deal with property when they move, but the rules on loss and damage by our workers, holding property, the disposal rule and what happens after a death apply in the same terms, and section 3 adds the small items most often lost during personal care.
How The Organisation decides what overnight cover a person needs, the difference between a sleepover and a waking night and what each is actually for, the pay and working time position including the effect of Royal Mencap Society v Tomlinson-Blake, the welfare of the worker who sleeps on the premises, and the point at which a repeatedly disturbed sleepover has become a waking night and must be re-graded. Written for the housing support half, where building-based overnight cover exists. The pay, working time, re-grading and technology rules also apply to a worker present all night in the home of a person who receives care at home only, while night visits on the care at home round are scheduled visits governed by D34, D44 and D46. Section 3 sets out which parts apply to what, and why a scheduled night care task is never added to a sleepover.
For the housing support half of a combined registration: the tenant's right to exclude anybody from their home including The Organisation, the only circumstances in which a worker may enter and on what authority, how keys, fobs, key safes and door entry codes are held and recorded, when a key we hold may be used if there is no answer, and why we have no power to bar a visitor from somebody else's tenancy even when that visitor is doing them harm. A person who receives care at home only is covered instead by D44 for keys and getting in on a domiciliary visit, D45 for visitors present during a visit and D46 for a visit where nobody answers. For a person who receives both, section 3 says which policy governs which visit, and requires one record of any key or code the two halves share.