Standard 5

Principles for implementing duty of care

Your Name:

Workplace:

Start Date:

Completion Date:

Contents
1.

Understand how duty of care contributes to safe practice

2.

Know how to address dilemmas that may arise between an

individuals rights and the duty of care

3.

Know how to recognise and handle comments and complaints

4.

Know how to recognise and handle adverse events, incidents, errors

and near misses

5.

Questions

CIS Assessment Induction Workbook Five

Standard 5
Principles for implementing duty of care
1.

Understand how duty of care contributes to safe practice

1.1 Explain what it means to have a duty of care in your work role
Every individual should be supported and enabled to live in an environment which is free from
prejudice and safe from abuse. Your responsibilities under the duty of care are to do
everything reasonable within the definition of your job role to make this happen.
Duty of Care means providing care and support for individuals within the law
and also within the policies, procedures and agreed ways of working of your
employer. It is about avoiding abuse and injury to individuals, their friends
and family and their property.
A negligent act could be unintentional but careless or intentional that results in abuse or
injury. A negligent act is breaching the duty of care. If an individual has evidence that you
have been negligent, you are likely to be disciplined. You could lose your job and you could
have legal action taken against you.

1.2 Explain how duty of care contributes to the safeguarding or protection of

individuals
In your role you have a duty of care to raise any concerns you may have about any aspect
of your work. These can range from inadequate working conditions, poor equipment, poor
practice by other staff; to raising concerns about potential abuse cases and situations of
neglect.
It is your duty of care to safeguard individuals from harm. All employees
should report any concerns of abuse they have. These might include evidence
or suspicions of bad practice by colleagues and managers, or abuse by another
individual, another worker or an individuals family or friends.
If you do not work in this way, you could be considered negligent or incompetent. If you are
in any doubt at any time, you must discuss any issues you have with your supervisor /
manager.
Local authorities have Safeguarding Adults policies and procedures that will be published on
their websites or available from their Safeguarding team. You will learn about Safeguarding
in more detail in Standard 6. It links closely with your duty of care.

Locate the Safeguarding Adults policy and

procedures that are in place for your local area
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2.

Know how to address dilemmas that may arise between an individuals rights
and the duty of care

2.1 Be aware of potential dilemmas that may arise between the duty of care and
an individuals rights
During your work you may find yourself in situations where the individuals you are supporting
do not agree with what you believe is best for them.
Who knows best?
The individuals you support or you, a carer, the family?
In situations where there is a conflict of interest or a dilemma between an individuals rights
and your duty of care, it is best practice to make sure the individual is aware of the
consequences of their choice and that they have the mental capacity to understand the
risks involved in their choice. It is their right as an individual to be able to make informed
choices about their own lives even if you disagree with their choice.
It is the right of every individual in your care to make choices and take risks. It is your
role to assist them in making those choices and reducing the risks without compromising their
rights. An individual may be restricted if his or her behaviour presents a serious risk of harm
to his or herself or to other people.
People who receive care and support are considered to be at risk, and as such the
law requires that an assessment be carried out to look at any possible risks there might be to
the individual or to others. The aim of this assessment is not to remove the individuals right
to take risks, but to recognise and reduce them where possible to an acceptable and
manageable level.
Mental Capacity Act 2005
We looked at the Mental Capacity Act (MCA) in Standard 1. Outcome 3.2. MCA has a set of
criteria to determine whether a person is able to make informed decisions and choices.
The term a person who lacks capacity means a person who is
unable to make a particular decision or take a particular action for
themselves at the time the decision or action needs to be taken.
It is important you are familiar with what the MCA says as you may be concerned that an
individual you are working with shows signs of lacking the capacity to make decisions for
themselves. This could happen to an individual at any time and you will need to ask for
professional support to determine if the individual does lack capacity.

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2.2 Be aware of what you can and cannot do within your role in managing
conflicts and dilemmas
If individuals insist on doing something that you disagree with, you can only advise and
encourage them. You cannot force them to do anything.
For example:
If an individual refuses to take medication and their well-being depends on this medication,
you cannot force them to take the medication. You should immediately contact you
supervisor / manager and seek advice. You should also make sure you record what has
happened and the action taken in the care or support plan.
Consider this scenario:
The care and support plan for a physically disabled individual includes; the support worker
supporting them to go to a caf or restaurant every week so they can dine out as they are
unable to do this alone.
The individual wants to eat at a McDonalds burger restaurant every week. The support
worker is vegetarian and believes that burgers are unhealthy and shouldnt be eaten that
regularly. The individual has the mental capacity to make this kind of decision and it is one of
their desires to maintaining a fulfilling life.
Which of the following should the support worker do?
1.

Refuse to take the individual to McDonalds and insist they go somewhere else

2.

Accept it is the individuals choice and support them to go to McDonalds

3.

Tell the individual the facts about eating at McDonalds and ask them if they would like
to try somewhere different. Then support them to go to McDonalds if this remains
their choice.

Scenario Answer:
The support worker should tell the individual the facts about eating at McDonalds and ask
them if they would like to try somewhere different. Then support them to go to McDonalds if
this remains their choice.
This allows the individual to make an informed choice about where and what they eat. It is
essential that the support worker uses an encouraging and supportive tone of voice and
words and that the individual does not feel bullied or harassed into doing what the support
worker wants them to do.
Dont forget you might want to consider whether the individual has the capacity to make
decisions or whether you need to seek additional advice and support from your supervisor /
manager.

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2.3 Know who to ask for advice about anything you feel uncomfortable about in
relation to dilemmas in your work
You should know the limits of your role and not do or say anything outside of this. It is
important that you know who to go for if you need advice because you are in a situation that
you are not comfortable with. Your supervisor / line manager will tell you who else you can
talk to if they are not available.
You should always seek advice from your supervisor
/ manager in relation to dilemmas in your work

3.

Know how to recognise and handle comments and complaints

3.1 Be aware of any existing comments and complaints procedures in accordance

with agreed ways of working
Comments and complaints can be made by individuals, workers, carers, family members, in
fact anyone who feels there is something wrong that needs to be addressed. Many people,
especially the individuals you support, do not know how to make comments or
complaints. Some individuals will feel uncomfortable about making complaints as they do
not want to cause trouble and they do not want to risk services being reduced or removed.
It is therefore important that you know what the procedures are and can advise them
what to do. Every employer should have a complaints procedure in place that you can
follow. This will enable people to express their displeasure of a service, person, situation etc.
It is useful if the procedure includes a flowchart of how a complaint is dealt with so you can
see and follow the process.
Every complaint should:
Be taken seriously and dealt with promptly and fully
Be acknowledged within a specified time
Have time limits for preliminary investigation
Be monitored and progress reported to the complainant
The Care Quality Commission (CQC) provide detail on how
complaints should be dealt with in their Essential Standards of
Equality and Safety.
CQC state what people who use services should experience, as:

Being sure their comments and complaints are listened to and acted on effectively.

Knowing that they will not be discriminated against for making a complaint.
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CQC state this is because providers who comply with the regulations will:

Have systems in place to deal with comments and complaints

including providing people who use services with information about that system

Support people who use services or others acting on their behalf to make comments
and complaints

Consider fully, respond appropriately and resolve, where possible, any comments and
complaints
http://www.cqc.org.uk

3.2 Know what you can and cannot do within your role in handling comments and
complaints and how you should respond
If you receive positive comments about your service or any aspect of the service your
employer provides, it is important that you record these comments and pass them on to your
supervisor / manager. If the individual making the comment is able to write, it is worth
asking them to put the comment in writing or you might be able to help them to do this.
Positive comments are motivating and supportive so people know they are doing things
right.
Your employer should give you clear and precise information about
your role and responsibilities in dealing with complaints
Some individuals may need an Independent Advocate to support them to make a
complaint and to support them until the complaint has been dealt with or resolved.
They
will be able to give impartial advice, help to write letters, attend meetings and make sure that
the person complainings views are heard, especially if the person has communication
difficulties.
Independent Advocates can usually be provided by voluntary organisations. If you use
a search engine on the internet and type in Independent Advocates you will find lots of
different organisations providing advocacy services. It would also be worth finding out what
organisations can provide Independent Advocates locally.

3.3 Know who to ask for advice in handling comments and complaints
Larger employers may have a comments and complaints specialist who you can refer people
to. In smaller organisations or if you work with an individual in their home, you may be
responsible for dealing with the complaint yourself.
Check with your supervisor / manager
what the complaints procedures are and
who you should refer people to

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3.4 Recognise the importance of learning from comments and complaints to

improve the quality of service
Comments and complaints are really important because they enable you to learn how
people perceive the support and service you provide.
This enables you to make
improvements to the overall quality which leads to better outcomes for the individuals
you work with.
Discussion about and learning from complaints can be done during supervision or
team meetings depending on the nature of the comment or complaint.
Your employer might send out surveys to individuals you support asking questions
about the quality of services or you might participate in a 360 degree feedback
about your own performance. You can use the responses to look at how well you
are doing and what areas can be improved upon.
Whilst it might seem like a negative thing to receive a complaint,
if it is handled well, it can lead to
great improvements and benefits for everyone involved

4.

Know how to recognise and handle adverse events, incidents, errors and near
misses

4.1 Know how to recognise adverse events, incidents, errors and near misses that
are likely to affect the well-being of individuals
Whilst working, it is important that you can recognise events, incidents, errors and
near misses likely to affect the well-being of the individuals you support.
It is also important to recognise near misses so that steps can be put in place to ensure they
do not become incidents or accidents in the future.
Accident: This is something that happens that results in injury, ill health or
death.
Incident: This is something that has almost or could have happened that
might not have caused harm this time but could cause injury, ill health or death
Adverse events: These are accidents and incidents.
Risk Assessments: These are simple careful examinations of what could cause harm to
individuals, so you can weigh up whether you have taken enough precautions or whether you
need to do more to prevent harm.

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Care and support plans should have formal risk assessments that will guide you but
circumstances can change every day and you will make judgments about the risks of what
you are doing before undertaking all tasks. Risks must be identified before tasks are
undertaken. Think about the four main areas you are working in:

What you have to do

The individual and their capability

The task that needs to be done

Your surroundings

You should always record any changes and contact your supervisor / manager or the
person responsible for the individuals care and support plan if you feel a risk assessment
should be formally changed.

4.2 Be aware of what you can and cannot do within your work role in relation to
adverse events, incidents, errors and near misses
You should only take action and become involved in certain situations if you have been
appropriately trained, observed or signed off as competent.
Examples:
If you are the first person to attend an incident where an individual may
need Emergency First Aid, you can only do what you have been trained
to do. You must always make a primary survey and never go straight to
the casualty without making sure the area is safe.
If you discover a Fire, you should immediately raise the alarm. You should not tackle a fire
with an extinguisher unless you have been trained to do so. You must not put yourself or
others in any danger. It is essential that you leave the building as quickly as you can
supporting others to leave where you can.
It is essential to write down what happened immediately after the event so you will be
able to refer to your notes about what happened rather than rely on your memory which
might not be accurate, particularly if you felt stressed.
You should always reflect on situations to consider if you handled things differently or
behaved in a different way, would the outcome have been any better for anyone involved.
This gives you the opportunity to consider your level of skill and your confidence and whether
you need further support or training.

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4.3 Know the procedures and to whom you should report any adverse events,
incidents, errors and near misses
Informing individuals of their choices and the risks involved enables you to support their
empowerment and independence. If you witness anything you feel is risky or unsafe,
it is necessary to report your concerns to your manager or supervisor.
It takes a great deal of courage for an individual to raise concerns about poor practice or
abuse in their organisation. As a care worker, it is your duty of care to report anything
that is likely to affect the wellbeing of the individuals you support.
An approach of zero tolerance must be taken to ensure that adults at risk are protected.
If you have suspicions or evidence that an individual or individuals might be being abused,
you have a duty of care to report this. The Public Interest Disclosure Act protects
employees from victimisation if they should need to report abuse or neglect.
Whistle Blowing
Your organisation may have a Whistle Blowing policy, which will protect you
and your employment if you report your concerns. Whistle blowing is about
reporting incidents of suspected or actual abuse or neglect.
If a policy exists, it is recommended that you read this if you are in the
position of needing to report something about your colleagues or employer.
To Blow the Whistle on somebody or something means to report somebody for
doing something wrong or illegal, especially within an organisation.

Source Online Encarta English Dictionary.

If you are not satisfied that a concern you have raised has not been addressed, then
consult the policy again and follow instructions on who to contact next.
All concerns should be reported accurately. If your concerns are not taken seriously, you
must try another route. You must ask for help if you feel out of your depth with a
particular individual or issue.

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Questions: Understand how duty of care contributes

to safe practice
1.1

Explain what it means to have a duty of care in your work role

What does having a duty of care mean to you in your work role?

1.2

Explain how duty of care contributes to the safeguarding or protection of

individuals

How does your duty of care contribute to the safeguarding and protection of individuals?

1.3

Be aware of potential dilemmas that may arise between the duty of care and
an individuals rights

Give an example of a dilemma you might have at work where you believe your duty of care
conflicts with an individuals rights and say what you would do?

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What does the Mental Capacity Act say about an individual who lacks capacity?

2.2 Be aware of what you can and cannot do within your role in managing
conflicts and dilemmas
What should you do if an individual wants to do something that you think is risky?

What should you do if an individual refuses to take their medication?

2.3 Know who to ask for advice about anything you feel uncomfortable about in
relation to dilemmas in your work
Who should you ask for advice about anything you feel uncomfortable about in relation to
dilemmas in your work?

3.1 Be aware of any existing comments and complaints procedures in accordance

with agreed ways of working
What procedures or agreed ways of working are in place to raise comments and complaints
in your work place?

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3.2 Know what you can and cannot do within your role in handling comments and
complaints and how you should respond
What should you do if an individual would like to make a complaint but they find it difficult
to explain things?

3.3 Know who to ask for advice in handling comments and complaints
Where can you get additional support and advice in handling complaints?

3.4 Recognise the importance of learning from comments and complaints to

improve the quality of service
Why are comments and complaints useful?

4.1 Know how to recognise adverse events, incidents, errors and near misses that
are likely to affect the well-being of individuals
What is an accident and give an example?

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What is an incident and give an example?

4.2 Be aware of what you can and cannot do within your work role in relation to
adverse events, incidents, errors and near misses
Describe what you would do if you came across an individual in their own home on the
floor. Your answer should be based on the level of training you have had to date. You
may wish to update your answer below if you receive further training.

Update of previous answer:

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You are in an individuals home and while you are putting the shopping away, the individual
you are supporting is making a cup of tea. You notice that they are having difficulty holding
the kettle whilst they are pouring boiling water into the teapot and nearly drop the kettle
completely. What would you do?

4.3 Know the procedures and to whom you should report any adverse events,
incidents, errors and near misses
If an incident occurs while you are supporting an individual, who would you tell and where
would you record this information?

What is Whistle Blowing?

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Shall we find out what you have learnt?

Now that you have completed this section you can have a go at the online assessment for
Common Induction Standard 5.
To do this you will need to visit www.cis-assessment.co.uk and log on by entering your
username and password in the boxes provided.
You will then be able to select Common Induction Standards then Standard 5. Dont forget
to read the instruction page before you start.
Once you have completed this assessment and had a discussion about the results with your
line manager, you may want to do a little more learning and / or return to your results and
record additional evidence.
You can also print out the results pages (which include any additional information you have
added) for your Induction Folder and CPD Portfolio.

http://www.cis-assessment.co.uk

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