guidance for home visiting for all clinical staff within the pct

Clinical Policy Document
GUIDANCE FOR HOME VISITING FOR ALL CLINICAL STAFF
WITHIN THE PCT
For use in: All areas of the Trust
For use by: All Trust staff
Used for: Clinical Staff
Document Owner: Professional Development Manager
Board approved: Yes
Policy Indexed ClinPol7
Controlled Document No HSHPCTClinPol7
Version Number 1
Status: Clinical Policy
Statutory and legal requirements Lone Worker Policy
Implementation Lead Professional Development Manager
Implementation Process Policy to be circulated via Service
Managers
Managers to monitor staff compliance
The Trust is committed to an environment that promotes equality and embraces diversity
both within our workforce and in service delivery. This document should be implemented
with due regard to this commitment
This document seeks to uphold the duties and principles contained within the Mental Capacity
Act. All Staff within the PCT should be aware of its implications
This policy is due for review in March 2009
After this date, policy and process documents may become invalid. Policy users should ensure
that they are consulting the current version of this document.
Rationale
Issue Date: March 2007 Author: Linda Spooner – Prof. Dev. Manager Page 1 of 8
Review Date: March 2009 Lead Director: – Director of Workforce

This procedure is to help staff understand their responsibilities when visiting clients at
home.
It is also intended to provide some advice to staff who may find themselves in a difficult
situation and to offer support to staff who by the very nature of their roles, work out in the
community, often entering into unknown situations.
The PCT has a duty of care to provide health services to the population of Halton and St
Helens; however, this does not mean staff have to accept inappropriate
behaviour/manner being displayed.
Staff must use their professional knowledge, and to take some personal responsibility for
their own safety.
Whether staff work daily, or infrequently in patients homes all staff should ensure that
they familiarise themselves with this procedure.
Issue Date: March 2007 Author: Linda Spooner – Prof. Dev. Manager Page 2 of 8
Review Date: March 2009 Lead Director: – Director of Workforce

Guidelines for Home Visiting
ACTION RATIONALE
Staff to adhere to their service
specification on criteria for home visits.
Visits where possible should be planned
a minimum of one day ahead.
An inventory of proposed visits must be
kept in a paper diary and a copy left in
the office.
Staff must report back into base after
the last visit of the day. If this is not
possible, then the Team Leader or
another team member should be aware
where the last visit of the day is taking
place and the intention of the staff
member to go home from that point.
If staff are expected back at base and
are delayed, every effort should be
made to contact their base with this
information.
Managers/Team Leaders should keep a
list of make, colour and registration
number of all staff cars, which should be
kept up-to-date.
Staff must keep a record of all daily
visits in a diary.
Where possible, contact client/patient to
indicate visit date and time.
Introduce yourself on the door step and
show your identity card which should be
worn at all times.
Identify that you have the correct
client/patient.
Explain the reason for your visit, and
who referred you to the client/patient.
To make appropriate use of health
professionals time.
To ensure a correct inventory of visits
can be kept.
Staff whereabouts can be identified in
case of an emergency.
Safeguard the member of staff.
To ensure safety of staff and prevent
any unnecessary concerns.
To enable a quick source reference in
the event of an incident occurring,
should other services need the
information.
For audit and activity purposes.
Good client/patient communication.
Patient safety.
To ensure client/patient receives
correct treatment.
Informed consent.
Issue Date: March 2007 Author: Linda Spooner – Prof. Dev. Manager Page 3 of 8
Review Date: March 2009 Lead Director: – Director of Workforce

ACTION RATIONALE
Before leaving, leave your full name
and contact number and notification of
any future visits. Ensure client/patient
understands future care plan.
Ensure that the date and time of next
visit is suitable for the client/patient.
Ask the client/patient to inform your
base if the appointment becomes
inappropriate.
If patient/client is expecting you, as in a
regular pattern and you cannot gain
access:-
Knock loudly
Knock on window
Check through the window for signs
that the client is in, eg inner doors
open, fire on.
If appropriate, knock at adjoining house
to check if neighbour has seen or heard
patient/client.
If you are concerned and you feel that
the patient/client is in the house, either
contact Social Services or other
agencies that have key access or
contact the police.
If you are concerned that a child/young
person is in the home inappropriately
alone/unsupervised contact the
Halton CSC Duty Officer straight away
to make a child protection referral and
complete the appropriate referral form
within 24 hours in line with Halton
LSCB Child Protection Procedures.
Contact your manager and the child
protection manager to discuss your
observations or to seek immediate
advice from them if you are uncertain
whether the child is
alone/unsupervised.
To ensure client/patient is fully
informed and participating in their care.
To avoid failed visits.
To avoid failed visits.
To ensure patient/client is not at home.
To ascertain if patient/client may be at
risk.
To ensure patient/client safety.
To ensure that children/young people
are protected and that child protection
procedures are complied with.
Issue Date: March 2007 Author: Linda Spooner – Prof. Dev. Manager Page 4 of 8
Review Date: March 2009 Lead Director: – Director of Workforce

ACTION RATIONALE
If you feel the patient/client is not at
home, leave a card to say you have
called and ask patient/client to contact
you. Document in records and arrange
a further appointment if necessary.
Where it is unusual for the patient not
to be in, discuss with your
manager/Team Leader on return to
base.
Ensure that you do not display any sign
in your car that you are a Health
Worker.
Always ensure you have easy access
to your Personal Attack Alarm or
mobile.
Avoid dark alleys – doorways or lonely
areas especially after dark
Carry loose change for the telephone or
have a mobile phone with you
Carry cards to post if patient is not at
home.
Ensure that all personal belongings etc
are kept out of sight in your car.
Do not carry any valuables with you.
Patients records and treatment cards
should not be left in cars unless
secured in the boot of the car, and
should not be left in car boot overnight.
Nursing bags should be taken into the
patients home, or locked in the car
boot.
Always plan your route – know where
you are going.
Make sure your car is in good working
To ensure effective use of clinician’s
time.
To ensure patient is not at risk.
This does not provide any special
entitlement to parking etc. and could
make you and your car vulnerable to
attack.
To ensure staff safety
To ensure staff safety
In case of emergency
To ensure patient/client is aware that
you have called.
To prevent risk of break in.
To prevent risk of loss/theft.
To prevent unauthorised access to
information.
To prevent risk of theft.
To minimise risk to staff.
To minimise breakdown.
Issue Date: March 2007 Author: Linda Spooner – Prof. Dev. Manager Page 5 of 8
Review Date: March 2009 Lead Director: – Director of Workforce

order and has enough petrol in tank.
ACTION RATIONALE
Park your car in a safe and well lit place
that also allows safe access to your
destination.
Always lock your vehicle.
Records/nursing bag must not be left in
your car overnight. Every attempt
should be made to return
records/nursing bag to base, however,
if not returning to base, bag must be
stored safely in own home.
Staff are advised to be a member of a
recovery service and call as
appropriate ie RAC/AA/Garage
If car does breakdown, contact base to
inform of situation
In the event of a breakdown ask base
to contact patient/clients to inform of
delay
In severe weather conditions do not
take risks, seek advice from your
Manager/Team Leader before planning
visits and visit urgent cases on foot if
possible.
If you cancel visits due to the weather,
inform your Manager and ring patients
where possible.
To minimise risk to car and staff.
To minimise risk of theft.
To prevent unauthorised access to
patient information and ensure patient
safety.
To ensure prompt response to the
breakdown.
Can re-allocate home visiting within
service.
Patients/clients are informed of
cancelled or delayed visit.
To minimise risks to staff.
Minimise disruption to service and
keep patients fully informed.
IN CASES WHERE A MEMBER OF STAFF IS LEFT FEELING VULNERABLE DUE
TO VERBAL, PHYSICAL OR AGGRESSIVE BEHAVIOUR OR WHERE ACTIONS
OF THE CLIENT OR OTHER MEMBER OF THE HOUSEHOLD ARE DISPLAYED
IN A SEXUAL OR INAPPROPRIATE MANNER
THE STAFF SHOULD:-
Assess the situation carefully.
To ensure correct procedure is
followed.
Consider their own personal safety. Personal safety is paramount.
Be aware of the exit routes from the To secure own personal safety.
Issue Date: March 2007 Author: Linda Spooner – Prof. Dev. Manager Page 6 of 8
Review Date: March 2009 Lead Director: – Director of Workforce

premises and leave.
Inform their Manager immediately.
To make PCT aware of the situation.
ACTION RATIONALE
Report situation on Accident/Incident
form.
To ensure risk of situation is identified.
Inform other colleagues who may be
due to visit.
After undertaking a risk assessment, if
patient/client’s home is deemed
unsuitable for the care required, an
alternative should be sought wherever
possible.
If further visits are essential eg
seriously ill patient, the Risk Manager
and manager will undertake a risk
assessment and determine if and how
the service will continue (following lone
worker guidance).
To prevent other staff going into the
situation.
To ensure procedure is followed as
there is a duty of care to the
patient/client as well as to staff.
To ensure staff safety.
When staff are aware that they will be visiting a home where there is an animal, eg
dog, about which they have a concern, the following procedure should be adopted:
If possible, telephone the patient/client,
giving an approximate time of visiting
and requesting that the animal be
removed/locked up away from the area
of treatment before the visit.
If this is refused and there is genuine
concern for safety, your Line Manager
should be informed and advice sought.
If when making a first visit, an animal is
encountered and there is a fear for
one’s own safety, then the practitioner
should withdraw, until such time as
he/she feels it is safe to enter, eg the
animal has been removed.
In the event of a practitioner being
bitten, he/she should withdraw from the
house and seek immediate first aid,
either with General Practitioner or at
the Accident/Emergency Department.
To ensure staff safety.
To ensure staff safety.
To ensure staff safety.
To secure treatment for wound.
Issue Date: March 2007 Author: Linda Spooner – Prof. Dev. Manager Page 7 of 8
Review Date: March 2009 Lead Director: – Director of Workforce

Inform Manager immediately so that
other agencies can be informed (eg
Dog Warden).
To prevent risk to other staff.
Complete an incident/accident IRI form. To ascertain risk.
MANAGEMENT OF GUIDANCE FOR HOME VISITS FOR CLINICAL
STAFF
Compiled By:
Date Written:
Ratified By:
Review Date:
Acknowledgements:
References:
Linda Spooner, Joan Pickett
Mar 2007
Mar 2008
Joan Pickett – Operational Director Adult
Services
Dot Keates – Risk Manager
Halton PCT Zero Tolerance Policy
25/01/06
Halton and St Helens PCT Health and
Safety Policy Section 24 Lone Workers
Issue Date: March 2007 Author: Linda Spooner – Prof. Dev. Manager Page 8 of 8
Review Date: March 2009 Lead Director: – Director of Workforce