Market Failure Policy
Document Control
Document Ref:
MPS 2015
Date Created:
Version:
1.1
Date Modified:
Revision due
March 2018
Author:
Karen Felgate
Owning Service
Care Commissioning Housing and Safeguarind
Equality Impact
Assessment: (EIA)
Date undertaken:
18/3/15
Issues (if any):
None
18/3/15
Sign & Date:
Change History
Version
Date
1
18/3/15
2
7/4/15
3
Description
Format Changes
Change ID
Contents
1. Purpose ............................................................................................................................... 3
2. Applicability .......................................................................................................................... 3
3. Background.......................................................................................................................... 3
4. Market Oversight.................................................................................................................. 4
5. Service Interruptions other than Market Failure ................................................................... 4
6. Planned Closure of a Service .............................................................................................. 5
7. Enforced Closure of a Service ............................................................................................. 7
8. Emergency Closure of a Care Home Provider ..................................................................... 8
9. CQC Enforcement Action..................................................................................................... 8
10. Care Home Closure in another local authority area ............................................................. 9
11. Implementation .................................................................................................................... 9
12. Roles and Responsibilities ................................................................................................... 9
13. Failure to comply with this Policy ....................................................................................... 10
14. Review ............................................................................................................................... 10
Glossary ..................................................................................................................................... 11
Other Relevant Documentation ........................................................................................................ 11
Appendices
1
2
3
Early Warning System
Provider Failure Flowchart
Care Home Emergency Plan
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1. Purpose
1.1 The purpose of this policy is to set out the roles and responsibilities of West
Berkshire Council in the event of Market Failure in an Adult Social Care service.
This includes having good knowledge of the provider market in this area, offering
assistance to a provider if it is facing closure and what happens when a provider
closes. The document contains procedures covering the areas of responsibility for
the Council, which are set out below.
1.2 The Care Act Programme Board have approved the Market Failure Policy.
2. Applicability
2 . 1 This Policy applies to all providers of social care services (community, domicilary,
care homes, nursding homes etc.) to residents of West Berkshire.
3. Background
3.1 Provider failure occurs when a provider is unable to exercise its normal day-to-day
duties, due to a specific set of circumstances, such as;




the appointment of an administrator
a receiver is appointed
a winding up order is made
an application for bankruptcy is submitted
 the charity trustees of the provider become unable to pay their debts
 force majeur
 Care Quality and Safeguarding issues
3.2 The Care Act 2014 outlines a specific set of duties that local authorities should
exercise in the event of provider failure:

Market oversight – Local authorities should understand how providers in their area
are coping with the current trading conditions through discussions with the providers
themselves. Authorities can achieve this without the collection of detailed financial
metrics, accounts and business plans that CQC might utilise in respect of the major
corporate providers in the regime. The business failure of providers outside the
CQC regime will be on a smaller scale, usually with lesser impact, and local
authorities should take a proportionate approach to anticipating or getting early
warning of business failure.

Response to planned closures of providers - the actions that will be taken if the
Council is given sufficient notice of three to six months that a provider is going to
close. This may also include ongoing issues with regard to safeguarding and care
quality which could result in notice being served and the service being wound up.

Response to emergency closure of providers - this includes market closure,
cancellation of a registration through Care Quality Commission (CQC) enforcement
action, management/staffing changes, fire and flood.

“Temporary duty” or “duty” means the duty on local authorities to meet needs in
the case of business failure. “Temporary” means the duty continues for as long as
the local authority considers it necessary. The temporary duty applies regardless of
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whether a person is ordinarily resident in the local authority area. The duty applies
from the moment the authority becomes aware of the business failure.
3.3 The following sections cover the arrangements that are in place and the steps that
will be taken in response to an event occurring.
4. Market Oversight
4.1 West Berkshire Council works with care providers continually as part of its core
business. The Council will ensure that it has a good understanding of the market in
its area and will be aware quickly when a provider is facing some form of difficulties
that may affect its viability to continue delivering a service.
4.2 West Berkshire Council has both a proactive and reactive role when working with
providers. The Council will be proactive to help anticipate and if appropriate work with
a provider to prevent or delay closure. The Council will share concerns it has about a
provider with other relevant organisations such as Clinical Commissioning Groups
(CCG’S).
4.3 West Berkshire service providers are required to have a business continuity plan in
place. The providers are required to supply West Berkshire Council copies of their
business continuity plans as set out in their contract.
4.4 The proactive element of the work will be led by Care Commissioning Housing and
Safeguarding in conjunction with the Head of Adult Social Care which includes the
Quality Assurance and Service Improvement team (Care Quality) and the Contracts
and Commissioning team who procure the services.
4.5 The Council will gather intelligence and information on providers and will share this
with relevant stakeholders as appropriate.
4.6 The Care Quality Team receives a regular list of latest inspections across the South
East. The Care Quality team will check these reports to ascertain whether any
providers are reported overall as ‘improvements ‘required’ or are ‘inadequate’. This
list will then be sent to the Safeguarding Manager and the Contracts and
Commissioning team for action. Please see Appendix 1 flowchart which outlines this
process in more detail.
All new providers will be subject to a financial and quality assurance check before
becoming a West Berkshire Council care provider.
4.7 All staff in Care Commissioning Housing and Safeguarding and Adult Social Care
have a responsibility to identify early warning signs in regards to a provider failure.
Appendix 2 sets out the procedure to be undertaken in the event of market failure.
5. Service Interruptions other than Market Failure
5.1 If a provider has not failed, it is primarily the provider’s responsibility to meet the
needs of individuals receiving care in accordance with its contractual liabilities. West
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Berkshire Council will support providers to ensure that care is maintained in
accordance with care plans.
5.2 The responsible Heads of Service for Adult Social Care and Care Commissioning
Housing and Safeguarding (CCHS) will use their own judgement to assess the level
of seriousness of each situation and therefore how these procedures and protocols
should be applied.
5.3 West Berkshire Council is responsible for ensuring that if care provision fails, people
continue to receive the care and support they receive, regardless of who funds their
care. Sections 18 and 20 of the Care Act set out when a local authority must meet a
person’s eligible needs.
5.4 Section 19(3) permits a local authority to meet needs which appear to it to be urgent.
This is likely to be the case in many situations where services are interrupted but
business failure is not the cause.
5.5 Further to the Council’s statutory social services functions, duties and powers, the
Council may, and sometimes must, make provision to meet the needs of persons in
their area who have eligible social care needs and to safeguard adults at risk of
harm.
5.6 The Council will seek to minimise the disruption to the people receiving care. The
Council will aim to provide as similar a service as is possible, whist recognising that
the Council has discretion about how those needs will be met and it may not be
possible or necessary to arrange for the exact same combination of services that
were previously supplied.
5.7 In deciding how an individual’s needs will be met, the Council will involve the person
concerned, and carer that the person has, or anyone the person asks the authority to
involve. If the individual lacks capacity, or requires support; the Council will involve
an IMCA, independent advocate or other agreed representative to support the client
through the process
5.8 West Berkshire Council will work with providers on an ongoing basis as part of
business as usual to help prevent a provider from closing. This includes providing
comprehensive training to staff, planned quality assurance and contract monitoring
visits and information sharing at regular Providers Forums to ensure quality of care is
maintained
6. Planned Closure of a Service
6.1 Business failure of a major provider is a rare and extreme event and does not
automatically equate to the closure of a service.
6.2
Local Authorities are under a temporary duty to meet people’s needs where a
provider is unable to continue to carry on the relevant activity in question because of
business failure. The duty applies when the provider’s business has failed and as a
result a service can no longer be provided. If the providers business has failed but
the service continues to be provided then the duty is not triggered. This may happen
in insolvency situation where an Administrator is appointed and continues to run the
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service. In insolvency situations, the Council will cooperate with the Administrator if
requested.
6.3 The duty also applies where a failed provider has been meeting needs in the
authority’s area, whether or not the Council has a contract with the provider or if all
those affected are self-funders. The duty is in respect of people receiving care by the
provider in the local authority area. It does not matter which local authority made the
arrangements to provide those services.
6.4 West Berkshire Council has a good understanding of the provider market in its area
and how providers are performing. As a result of this knowledge and understanding,
the Council is in a position to know if a provider might be facing closure and how it
can assist a provider in this scenario.
6.5 In the event that a service is planned to close the Head of Care Commissioning
Housing and Safeguarding, in conjunction with the Head of Adult Social Care, will
nominate a Senior Manager to oversee and coordinate the closure process with the
provider.
6.6 A planned closure of a residential, nursing or domiciliary care provider will need to
take the following into account:

Consultation with families and residents in conjunction with other organisations
such as CCG’s

An options appraisal for each resident. This will be carried out by Care
Management. A new assessment of residents will need to be undertaken to
understand their current needs such as their links to community and family.
Consideration will need to be made whether family or local community can assist
with care provision
6.7 The provider will be responsible for ensuring West Berkshire Council receives a list of
all relevant properties and individuals within those properties containing relevant
information about each client. Should the provider refuse to co-operate CQC have
legal right to request this information.
6.8 Residents consent for transfer of information and records will be obtained. If the
person does not have capacity then an Independent Mental Capacity Advocate or
other suitable representative will be used
6.9 The Care Manager who carried out the assessment should make a list of the client’s
needs which will include medical arrangements, GP, equipment, aids, finances and
arrangements for packing.
6.10 In working with residents, the Council will use its understanding of the local market
and the supply of other suitable accommodation available and their cost.
6.11 The Contracts and Commissioning Team will be responsible for sourcing vacancies
for clients.
6.12 Date of transfer will be confirmed in writing with the new provider, the client, their
family and the closing home.
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6.13 Following a transfer, a review should be held within 6 months by the Care Manager
to ensure the Care Plan is meeting existing needs
7. Enforced Closure of a Service
7.1 The enforced closure of a service may occur for a number of reasons including
cancellation of a registration through Care Quality Commission (CQC) enforcement
action, management/staffing changes, fire or flood. In such an event the Council will
take the following actions.
7.2 A strategy meeting will be convened to understand all relevant information to enable
the Council to carry out an initial risk assessment. The strategy meeting will include
Contracts and Commissioning, Care Quality, Safeguarding. Health and CQC will also
attend as required.
7.3 A contingency plan will be drawn up by West Berkshire Council. The plan will consist
of a proposed plan following the cessation of the service should the provider agree to
a managed transfer and an alternative plan should alternative accommodation be
required for the clients affected.
7.4 The outcome of enforcement action by CQC will be passed to the Head of Care
Commissioning, Housing & Safeguarding. When CQC make the decision that an
application for the cancellation of registration is to be made to the court or other
urgent action is taken, the Head of Service should be informed.
7.5 The Head of Service for Care Commissioning Housing and Safeguarding in
conjunction with the Head of Adult Social Care must agree funding to be made
available during the managed period. West Berkshire Council may seek to recoup
costs from the provider.
7.6 A senior manager will always be nominated as the lead officer. The senior manager
will carry out a risk assessment in relation to:



Maintaining the existing service
Staffing needs
Clients’ needs
7.7 The senior manager will work in conjunction with Care Management, Contracts and
Commissioning and Care Quality to ensure that suitable alternative provision is
sought for clients.
7.8 In working with residents, the Council will use its understanding of the local market
and the supply of other suitable accommodation available and their cost.
7.9 Residents consent for transfer of information and records will be obtained. If the
person does not have capacity then an IMCA or other suitable advocate will be
sought.
7.10 The Care Manager who carried out the assessment should make a list of the
individuals needs which will include medical arrangements, GP, equipment, aids,
finances and arrangements for packing.
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7.11 The contracts and Commissioning Team will be responsible for sourcing vacancies
for clients.
7.12 The date of transfer will be confirmed in writing with the new provider, client, family
and the closing home.
7.13 Following a transfer a review should be held within 6 months by the Care Manager to
identify the Care Plan is meeting existing needs
8. Emergency Closure of a Care Home Provider
8.1 This covers processes and procedures that will need to be followed in the eventuality
that a care home provider closes as a result of a civil emergency (for example a fire
or a flood).
8.2 The Corporate Director, the relevant CCG lead if applicable and the Portfolio Member
must be alerted that the provider is closing as a result of an emergency.
8.3 West Berkshire Council will be responsible for overseeing and coordinating the
response to an emergency closure of a care home provider. This will be done by
Care Commissioning Housing and Safeguarding in conjunction with the Civil
Contingencies team.
8.4 Appendix 3 sets out the procedure for the emergency closure of a Care Home in
more detail.
9. CQC Enforcement Action.
9.1 From April 2015, the financial “health” of certain care and support providers will
become subject to monitoring by CQC. The Care and Support (Market Oversight
Criteria) Regulations 2014 set out the entry criteria for a provider to fall within the
regime. These are intended to be providers which, because of their size, geographic
concentration or other factors, would be difficult for one or more local authorities to
replace, and therefore where additional national oversight is required. CQC will
determine which providers satisfy the criteria.
9.2 Delivery of CQC market oversight role will include:

monitoring financial sustainability and assessing the likelihood of business failure
of difficult-to-replace adult social care provider organisations.

identifying and responding to risks in respect of financial sustainability.

providing early warnings of business failure to local authorities.

assisting in coordinating a response in the event of business failure.
9.3 The West Berkshire Council Care Quality Team will maintain a relationship with the
Care Quality Commission (CQC) with a view to early warnings where provider
compliance issues may lead to CQC enforcement action or threaten the ongoing
operation of the CQC regulated service.
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9.4 When CQC state intention to take enforcement action that will lead to a service
ceasing to operate on a permanent or temporary basis a notification should be made
to West Berkshire Council Head of Care Commissioning Housing and Safeguarding
who will appoint a senior manager to manage the process.
9.5 Where the provider is subject to the CQC oversight regime, the Council will work with
the CQC to develop a remedial action plan.
9.6 There maybe an interim period that needs to be managed pending the resettlement
of residents into alternative accommodation, or the sourcing of a new registered care
provider (where registration is temporary suspended) during the resolution of the non
compliance issues.
10. Care Home Closure in another local authority area
10.1 In the event that West Berkshire Council is notified by another local authority that a
provider in their area is closing, and the Council has individuals placed with that
provider (either funded by the Council or a self funder) then the Head of Care
Commissioning Housing and Safeguarding will nominate a senior manager to be
involved in the coordination of that closure process.
10.2 West Berkshire Council will cooperate with the host local authority and attend all
relevant meetings in relation to the closure.
10.3 Equally if a provider closes within West Berkshire geographical boundaries and other
local authorities or health providers have funded or self funded clients in that
property, West Berkshire Council will inform other funding authorities or the individual
that the provider is closing.
11. Implementation
11.1 This Policy will be supported and implemented by the development and publication
of Standards (requirements), Procedures (how to) and Guidance (advice).
12. Roles and Responsibilities
12.1 The overall responsibility for the Market Failure Policy within West Berkshire Council
rests with the Head of Care Commissioning, Housing and Safeguarding.
12.2 West Berkshire Council has established a Care Quality Board which includes health
and CQC and other relevant stakeholders to support the Market Failure framework
and periodically review the Market Failure Policy.
12.3 The responsibility for day-to-day management of Market Failure throughout West
Berkshire Council rests with the Head of Care Commissioning Housing and
Safeguarding in conjunction with the Head of Adult Social Care; they are also
responsible for maintaining this Policy, for reviewing all other related policies and
procedures and for providing advice and guidance on their implementation.
12.4 All relevant managers and staff in Adult Social Care and Care Commissioning,
Housing & Safeguarding are responsible for ensuring that this policy is fully complied
with.
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13. Failure to comply with this Policy
13.1 This document provides staff and others with essential information regarding Market
Failure and sets out conditions to be followed. It is the responsibility of all to whom
this Policy document applies to adhere to these conditions. Failure to do so may
result in the disciplinary processes being invoked.
14. Review
14.1 This policy will be reviewed to respond to any changes and at least every 3 years.
14.2 The Service responsible for reviewing and maintaining this Policy is Care
Commissioning Housing and Safeguarding.
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Glossary
ASC
CCG
CQ
CQC
CCH&S
IMCA
Adult Social Care
Clinical Commissioning Group
Care Quality
Care Quality Commission
Care Commissioning Housing and Safeguarding
Independent Mental Capacity Advocate
Other Relevant Documentation
14.3 Other procedures/legislation and good practice guidance which has a bearing on this
work include:
Care Act 2014
Safeguarding Adults, ‘A framework for the protection of vulnerable adults from abuse’
CQC The stability of the Adult Social Care Market and Market Oversight in England
February 2014
CQC standards: Outcome 7, Safeguarding people who use services from abuse and
Outcome 6, Cooperating with other providers within CQC’s essential standards for safety
and quality.
Health and Social Care Act 2008 and CQC enforcement policy
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Appendix 1
Early Warning System
Caution List received by email
from neighbouring Local Authorities
CQC Report
received by email
Saved at: I:\Care Commissioning, Housing and
Safeguarding\Quality Assurance & Service
Improvement\Care Quality\Cautions lists
West Berkshire Council has placements
with provider
No one placed
No Action
List emailed to Adult Care Managers asking
providers to ensure service users are reviewed
and any concerns fed back.
No Concerns
No Action
Concerns about provider Visit by relevant Care Manager
Visit by Care Quality Officers
Appendix 2
(Insert setting’s name) Care Home Emergency Plan
Appendix 3
CARE HOME PLAN
Version: 1.0
Date: February 2013
Author:
1
(Insert setting’s name) Care Home Emergency Plan
Document Control Information
Title:
Emergency plan for xxxxx Care Home
Plan Number:
Each printed copy of the plan should have a unique number inserted
here.
Date:
February 2013
Version:
1.0
Classification:
Internal to Care and Residential Homes
Authors:
Brett Dyson, Reading Borough Council,
Justin Patient, Reading Borough Council
Peter Stuart, Wokingham Borough Council
Quality Assurance:
Elizabeth Standing, Wokingham Borough Council
CQC registration number:_______________________
Version
DATE
Draft
January 2013
1.0
February 2013
DESCRIPTION
Draft
Additions by Berkshire EPO’s
Approvals
Title
Name
Signature
Date
Audit/Plan Reviews Date:
© Berkshire Emergency Planning Group. The Plan is licensed and may be used by any
residential/care home in Berkshire but this copyright notice must be maintained on all copies.
2
(Insert setting’s name) Care Home Emergency Plan
Contents
What to do in an emergency – Ensure the safety of staff, residents and guests ........................ 7
External contacts ....................................................................................................................... 9
Add contacts, names and phone numbers that may be of use during an emergency ................ 9
Communication Lines .............................................................................................................. 10
Mobile phones that can be used as communication lines ........................................................ 10
Emergency Response Team ................................................................................................... 10
Incident manager
10
Staff and residents welfare
Finance and insurance
Procurement and suppliers
10
11
11
Incident/Operations Log ........................................................................................................... 12
1
Introduction ........................................................................................................................ 13
2
Objectives of the Emergency Plan ..................................................................................... 13
3
Inventory ............................................................................................................................ 13
4
Actions/Systems to prevent an emergency from occurring ................................................ 13
5
Actions to be taken in advance of an emergency to reduce its impact ............................... 13
6
Plan for - Loss of Staff ....................................................................................................... 14
7
Plan for – Missing Person .................................................................................................. 14
Missing Person Procedure
14
8
Plan for – Incident off-site .................................................................................................. 15
9
Plan for – Infectious Disease Outbreak .............................................................................. 15
10 Plan for - Loss of Utilities ................................................................................................... 16
11 Plan for - Denial of Access ................................................................................................. 17
12 Nursing Home Evacuation ................................................................................................. 17
13 Plan for - Loss of IT/Phones............................................................................................... 18
14 Plan for – Low or loss of Stock........................................................................................... 18
15 Plan for – Loss of service by External Suppliers ................................................................ 18
16 Plan for – Severe Weather ................................................................................................. 19
17 Maps and Plans ................................................................................................................. 19
3
(Insert setting’s name) Care Home Emergency Plan
18 Circulation List ................................................................................................................... 20
19 Plan Testing / Real Incidents ............................................................................................. 20
20 Emergency Kits .................................................................................................................. 20
21 Copies of all supporting documents ................................................................................... 21
22 Lockdown Guidance .......................................................................................................... 21
22.1
Introduction 21
22.2
Purpose and Scope
21
22.3
Duties and Responsibilities
21
22.4
Types of Lockdown
22
22.5
Procedure
23
22.6
Approval, Ratification and Review Process
Site Profile Template 25
Building Profile Template
26
Security Profile Template
27
Staff Action Card Template 28
24
4
(Insert setting’s name) Care Home Emergency Plan
Care Quality Commission
People who use services benefit from a service that:

Wherever it is required, has in place a planned and prepared response to
major incident and emergency situations. This prepared response should
include arrangements for sharing information with other providers,
provision of mutual aid and arrangements for engagement with
appropriate emergency planning and civil resilience partners across the
local area.

Is aware of and has arrangements in place to respond to any
requirements made of the provider by the Civil Contingencies Act 2004.

In partnership, practises, monitors and reviews all of the plans that are in
place.
Please Note
This document is made up of three sections the first dealing with the all important initial
call, communications and the formation of the Emergency Response Team. The second
section addresses the number of issues that need to be planned for and the final
section dealing with lockdown guidance and procedures.
5
(Insert setting’s name) Care Home Emergency Plan
Where the reader finds that the text has been highlighted in blue the detail referred to
should be entered to personalise this plan to the particular care home that it will cover.
6
What to do in an emergency – Ensure the safety of staff, residents and guests
Have as much of this information ready
beforehand as you possibly can
Your name ...........................................................
IN AN EMERGENCY
Who to call
1. Call 999
Facility name ........................................................
Type of home .......................................................
Telephone number you are calling from
.............................................................................
2. Form Emergency Response
Team
Contact Manager
........................................................................
Return telephone number (See page 3)
.............................................................................
Inform Local Authority – Adult Services request
information be passed to LA comms team
What has happened?
........................................................................
.............................................................................
........................................................................
.............................................................................
........................................................................
.............................................................................
........................................................................
........................................................................
.............................................................................
Add any other contact details that may be
To whom?
relevant to your business profile.
.............................................................................
Where?
.............................................................................
When?
.............................................................................
Numbers of those affected or injured
.............................................................................
Location of those affected
.............................................................................
Whether or not there is a continuing danger
.............................................................................
What has happened since?
.............................................................................
.............................................................................
.............................................................................
Which emergency services are involved?
.............................................................................
7
.............................................................................
.............................................................................
8
External contacts
Add contacts, names and phone numbers that may be of use during an emergency
Local authority emergency number
Local authority Emergency Planning
Local authority contact number
Adult Services 24 hour contact
Local Authority Commissioning Group contact
Health and Safety Executive - to report accidents
0845 300 9923
Health and Safety Executive - Infoline
0845 345 0055
The Samaritans
Insurance company (Policy No:
Water supplier
Gas supplier
Electricity supplier
Telecom provider
Broadband provider
IT support
Out of hours medicine replacement
Contractors:
08457 909090
)
Heating
Electrical
Internal and external Maintenance
Glazing
Emergency power supplier
Thames Valley Police
Royal Berkshire Fire Brigade
South Central Ambulance Service NHS Trust (SCAS)
Royal Berkshire Hospital
Wexham Park Hospital
Health Protection Unit
Health Protection Unit (Out of Hours)
Buddy establishments
101
0118 945 2888
0118 936 5500
0118 322 5111
01753 633000
0845 279 9879
0870 238 5155
9
Communication Lines
In an emergency situation use the general care home telephone number to immediately
call for help. Do not use it as a number for return phone calls from the emergency
services. This number will soon get jammed as news spreads. Mobile phones are more
appropriate because you may need to evacuate the area near the landlines.
If possible decide to allocate staff mobile phones for communication with the Emergency
Services, Next of Kin, and people in major roles within the Setting Emergency Response
Team in advance. Write these in the table overleaf. If the allocated phone is not readily
available at the time of the incident, obtain another one (remember many residents have
phones as well as staff) and write the number in the space provided. The number of
mobile phones needed depends on the scale of the incident; however, always have two
available to communicate with both the Emergency Services This will help to restore the
care home back to normal as quickly and efficiently as possible.
Mobile phones that can be used as communication lines
Phones designated in advance
Phone for
Number
Owner phone
Phones designated at time of
incident
Number
Owner of phone
Fill in columns 1 and 2 with the phone number of mobiles that would be available to your
Setting Emergency Response Team at the time of an incident. If these are not available
when an incident occurs, borrow some other mobile phones and fill in their numbers for
your reference, that way you can easily give out a return telephone number when/if the
need arises.
Emergency Response Team
In a large scale incident a small team may need to be formed to manage/supervise various
aspects of the emergency. The following tasks need to be considered:
Incident manager
The senior member of staff on duty at the time of the incident should take charge of the
incident and should act as the directing mind on behalf of the organisation.
Staff and residents welfare
One or two members of staff should be made responsible for all welfare issues and for the
supervision of all medicines etc and for the liaison with any next of kin or family members.
These individuals should also have access to staff’s next of kin contact details should they
be required.
10
Finance and insurance
One staff member should me made accountable for all financial outlay and expenditure
and to manage all communication with the insurance company. They should work closely
with those charged with dealing with procurement and supplies.
Procurement and suppliers
Liaising with the finance staff member, this member of staff should co-ordinate the
purchasing replacement of damaged items or the hiring-in of emergency equipment and
power supplies.
As time passes some of these tasks can be combined to suit staffing levels.
11
Incident/Operations Log
Open and maintain a continuing log of all factual information received, actions taken and
the time and date of those events. This is extremely important and will enable your care
home to provide detailed information should it be required at a later stage, or if an inquiry
or investigation takes place. This can be used for any incident.
DATE
TIME
PERSON
DOCUMENTING
ACTIONS TAKEN,
INFORMATION RECEIVED
12
15. Introduction
The aim of this Emergency Plan is to provide effective emergency response arrangements
that will ensure the well being and safety of all service users and staff.
16. Objectives of the Emergency Plan
The objectives of the Emergency Plan are to:
 Establish an effective framework of emergency response

Maintain high standards of welfare and duty of care arrangements for service users
and staff

Ensure that actions and decision making during the emergency incident is properly
recorded

To minimise service disruption to users

To facilitate the return to normal working arrangements at the earliest time
This care home is reliant upon the following contractors/suppliers:
Contractor/supplier name
Service provided
17. Inventory
It is essential that an inventory is created and maintained containing details of critical items
of equipment and those items that are covered by any content insurance. It is
recommended that this is reviewed at least three times a year to ensure accuracy. The
inventory will prove invaluable should there be an insurance claim and will also greatly
assist in obtaining replacements.
18. Actions/Systems to prevent an emergency from occurring
List here the control measures that are in place to prevent an emergency occurring in your
building/s, e.g.:
 Fire suppression systems
 Back up power
 Back up computer systems etc
19. Actions to be taken in advance of an emergency to reduce its impact
List here all things which may make an incident run smoothly, e.g.:
 All relevant numbers are added to the teams mobile phones
 Minimum stock levels for a) Food, b) PPE, c) medicines, d) bedding and linen
13
20. Plan for - Loss of Staff
Care homes have a heavy reliance upon staff to provide support/care to vulnerable
residents. Causes of staff loss can be varied but the consequences are the same. Causes
include:
 Illness

Widespread illness/infectious disease

Lottery win/syndicate

Unable to get to work (snow etc)
In this section of the plan you should list all your contingencies for loss of staff.
Remember to plan for loss of all grades of staff in the organisation (i.e. managers as well
as other staff groups). Consider the following:

Are you reliant on a particular member of staff? If so, is there anyone else who can
undertake their role if they are away from work?
Consider multi-skilling of other staff members and ensure that good succession
planning is in place and list it within this section of the plan. What plans are in place
to deal with the long term loss of the Manager?
Who should be notified?

Day to day you will be short of staff due to annual leave or sickness, and it will be
normal business to prioritise. If staff were unable to attend work in larger numbers
(i.e unable to get to work due to heavy snowfall blocking roads) you may need to
reorganise care packages.
List the criteria with which you would prioritise the provision of care. List other
options for obtaining additional staff (i.e. recruitment agencies, obtaining staff from
another care home, cancelling annual leave, changing the duty rota, prioritising staff
roles; is this built into job descriptions e.g. domestic to care staff, care staff to cook
etc)?
21. Plan for – Missing Person
Support staff should always remain vigilant and be aware of any resident(s) who are
prone to wandering or who may be at risk of getting lost by reason of their mental state.
These situations can occur:

Where a resident has not returned from or has got lost during an arranged activity
or walk.

Where the resident cannot be found within the care home or its grounds and there
is no prior knowledge which would explain their absence.
If it becomes clear that the resident may be missing it is essential that all staff work as
a team and follow a defined procedure.
Missing Person Procedure
Immediately they suspect that a resident may be missing staff at the care home should
follow a routine which includes:

A thorough search of the building and its immediate grounds
14

Contact relatives and friends, neighbours and other places where the resident may
have gone or where they have been known to visit on a regular basis.
If the resident is not located it will be important to raise a wider alarm by contacting the
police. In as far as possible provide the police with the following information:

Where and when the resident was last seen, and by whom.

A general description of the resident including what they were last seen wearing.

Any special risk factors involved with that individual.
Where appropriate the local authority commissioning team should be contacted as well as
the next of kin who should be asked to contact the police should the relative make contact.
The Care Home Manager should ensure that the next of kin are regularly updated even if
there is no new news.
22. Plan for – Incident off-site
Planned trips should be documented with anticipated departure and arrival time, where
and for how long the activity will last, and the anticipated return departure and arrival time.
The mobile phone number of the activity leader should be known and be readily available
should it be required. In the case of a resident or guest going missing on the trip the
missing person procedure above should be followed.
23. Plan for – Infectious Disease Outbreak
The biggest impact of an infectious disease outbreak for your organisation is likely to be
staff loss. Although there is a section above specifically relating to staff loss, the impact of
an outbreak on the smooth running of your organisation is likely to be so severe and wide
ranging that a separate section is required.
The following will need to be considered when managing an appropriate response to an
infectious disease outbreak:

Keep an eye on the media and in particular the NHS and Health Protection Agency
websites as key national messages and guidance will be issued via those routes

Keep in contact with your nominated contacts at the local authority. Each local
authority emergency planning officer will be coordinating the council’s response to
infectious disease alongside Public Health and this will include close
engagement/liaison with the Community Care/Care Procurement Teams.Public
Health advice can be sought via these routes within the local authority in line with
health protection guidance. Hygiene issues– Staff may require additional personal
protective equipment such as masks, although these are only likely to be required
for aerosol generating procedures involving an infected resident/customer. Shared
desk areas may also require increased cleansing regimes. General cleansing
regimes may need to be reviewed / increased.

Working from home – can any staff work from home in order to reduce the chance
of infection spreading?
15

Information for residents’ family members – You will need to consider informing
family members of any changed/increased hygiene protocols and any changes to
the way that care is being delivered.
Posters, letters, emails and other methods of informing family members should be
considered

Flu vaccinations – residents and staff members may be eligible for flu vaccinations.
Management should look into the criteria for such vaccinations and promote them.
The local authority may work with the local health agencies to provide flu
vaccination clinics.
Management should consider promotion of flu vaccinations and keep in close
contact with the local authority and health agencies for further advice.
24. Plan for - Loss of Utilities
Care homes rely heavily upon electricity, gas and water to maintain appropriate levels of
service to their customers. The following issues require a plan in case utilities are lost:

Cookers – Even some gas cookers rely on electricity to function.
You should have plans to cope with loss of heated food. Obtaining heated food from
elsewhere, using gas hobs, or provision of cold food are often suitable
contingencies

Swipe card door systems – These systems are reliant upon power and often fail to
open when the power is lost.
Back up power on the door entry systems obviously mitigate this but where back up
power is unavailable other options must be planned for in order to minimise the
chances of opportunist crime or to prevent harm to residents/customers. This is an
especially important issue to consider where the residents suffer from dementia.
Placement of staff on entry/exit points is a suitable mitigating contingency in these
circumstances.

Lifts/Hoists – In the event of power loss these will fail unless back up power is
available.
Back-up power duration should be documented within your plan, if it is available
and contingencies for continuation of service delivery without the use of lifts or
hoists should be planned for.

Failure of fire alarms, call systems or other safety related equipment
Consideration should be given to providing temporary alternative arrangements
which can be quickly implemented to ensure the continuous safety of residents.

Emergency Lighting
Consideration should be given to purchasing wind-up
lanterns which can be used to provide a degree of lighting.
Cyalume sticks can be used to mark out safe routes
An interruption in the following services that last longer than a continuous period of 24
hours must be reported to the Care Quality Commission.
 Loss of electricity, gas or water

Loss of fire alarms, call systems and other safety related equipment

The blockage of the sewage system
16
25. Plan for - Denial of Access
Care homes rely on the building in order to provide care to its residents. Access to the
care home can be denied for many reasons including, but not limited to:
 Fire within the premises

A serious incident adjacent to the premises with the potential to effect the care
home (i.e. police or the fire service ask you to evacuate)

Serious crime scene

Flooding
You should have a plan that caters for the total evacuation of your premises for an
unspecified period of time (i.e. the next step of your fire evacuation plan which will cater for
the longer term)
In-house options such as transferring residents to another suitable care home owned by
your company, is obviously the easiest option, if it is available but you should also consider
transfer of residents to other care homes outside the company. You should ensure that the
local authority is aware as soon as an evacuation of this nature occurs.
When planning for a full evacuation/decant to another care home you will need to consider
transport options, especially out of hours options, as these are likely to be severely
reduced.
Setting up reciprocal arrangements with other care homes is an excellent contingency.
26. Nursing Home Evacuation
Resources/Evacuation
 What resources/equipment are available to move residents from various floors and
without the use of any lifts?

Where is this equipment stored?

Is there an inventory of this equipment?

Are the residents who would need this equipment identified?

How are they identified and how is this updated?

Are staff trained to use the equipment and how often do they exercise its use?
Evacuated Residents destination
 Do residents have a pre-determined destination to ensure that any medical needs
are continued (other nursing home, hospital or temporarily home with their family)?

What protocol is used to determine this?

Where is this information kept and how is it kept current?
Records and Supplies
 What medical/care records need to accompany the resident?

What medicine needs to be organised to accompany the resident (minimum of 3
days supply)?

If the medicine is a controlled substance what protocol will ensure its security?
17

Where is this information kept and how is it kept current?
Personal Effects
 Who decides what personal effects can be evacuated with the resident?

How is this accounted for?
Transportation
 Considering the pre-determined destination of a resident what method of
transportation needs to be organised (mini bus, taxi, ambulance)?

Where is this information kept and how is it kept current?
Next of Kin notification
 What is the procedure for notifying next of kin?
 Where is this information kept and how is it kept current?

Who is responsible for this process?

How is it achieved?

Who is responsible for ensuring the notification programme is completed?
27. Plan for - Loss of IT/Phones
Care homes do not usually have a heavy reliance upon IT or phones to continue “critical”
service provision. However, loss even in the short term is likely to cause some disruption
to day to day tasks. If IT is lost in the longer term it is likely to have a more serious effect.
Your plan should ensure that the care home has at least one mobile phone for emergency
calls in the absence of a landline. It is wise to store all contact numbers from this plan in
the mobile phone so they are available when required.
Your plan should cover the loss of IT. If you have a database or record keeping system
that is essential for the smooth, efficient and particularly safe running of the establishment,
you should ensure that these are backed up as far as is reasonably practicable, and that a
suitable restoration time is chosen that will allow a minimum level of disruption.
28. Plan for – Low or loss of Stock
Care homes have many different types of stock the loss of which need to be planned for.
Quite often plans are already in place to minimise the effects of stock loss or a missed
delivery which has become part of normal working practice.
Food – Have you set a minimum stock level for food on the shelves or in the freezers – do
you have a plan to share food with other units?
Bedding and linen – Do you have sufficient spare stocks or could you acquire
replacements from other sources.
PPE – Have you got a large enough stock of PPE at all times to cater for a supplier going
bust? Do you have multiple suppliers?
Medicines – Have you got a suitable stock? Can you obtain medicines out of hours?
29. Plan for – Loss of service by External Suppliers
Care homes often contract services to outside organisations. Commonly occurring
contracts include:
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Lift maintenance – Lifts are often critical for transport of residents, food and other items.
Does your lift maintenance contract specify a suitable repair time, does the contract
include an out of hour’s service, and does it include a regular maintenance service?
IT – If you contract out IT, does the contract meet your business need? Has the IT contract
been checked since the preparation of your Business Continuity plan to make sure that the
two dovetail together?
Catering/Laundry – If these are contracted out; can the company continue to provide the
service during times of bad weather (flooding/snow)?
Clinical waste collection
30. Plan for – Severe Weather
Although severe weather generally causes “loss of staff” or “denial of access” a separate
plan is a good idea due to the wide ranging issues generated by severe weather. You
should follow the guidance as provided by the Department of Health particularly in
connection with the two adverse weather campaigns listed below:
Heatwave (NHS HeatHealth Watch)
st
th
1 June – 15 September
Cold Weather Watch
st
st
1 November – 31 March
Expectation of significantly higher than average temperatures in
one or more regions of England and Wales; thresholds are predetermined regionally via the Heat-Health Watch system.
There are two different thresholds for the Cold Weather Alert
service. Only one of the thresholds needs to be breached for a
warning to be issued. The thresholds were formulated with advice
from the Department of Health and the Health Protection Agency to
pinpoint when winter weather would affect peoples health. The
thresholds are: mean temperatures below 2Oc for 48 hours or
longer; and heavy snow and/or widespread ice.
Is your building located within a flood zone? This is easy to check on the Environment
Agency website by simply typing in the postcode at:
http://www.environment-agency.gov.uk/homeandleisure/floods/31650.aspx
If your building is located within a flood zone you should sign-up to the Environment
Agency’s free Flood Warnings Direct service to receive timely warnings of potential
flooding. Visit for further details.
Do any of your staff live within a flood zone causing staff shortages in the event of a flood?
Are any of your suppliers based in a flood zone?
Does your organisation subscribe to the Met Office Severe Weather Warning service to
allow you to receive messages about all kinds of severe weather?
31. Maps and Plans
A map covering a 1km radius from the care home should be included and should contain
likely external hazards that may impact on the home such as petrol stations, railway lines,
major industrial establishments and risk site such as Broadmoor hospital or AWE etc.
19
Insert the building layout plan indicating where key utilities can be turned off/on and
indicate on the plan where any hazardous material is stored.
Any maps associated with the plans should be inserted in this section
If you have an alternative building highlighted in the Denial of Access plan you should
include a map of its location in this section.
32. Circulation List
Who has a copy of your plan and where is that copy stored? Key staff should have a hard
copy which should be kept at home. Keep a list of plans issued to ensure that all copies
are recalled and updated and eliminate the use an out of date version. Each uniquely
numbered copy should be assigned to a particular person and listed in the table below.
Plan
Number
Issued to:
1
2
3
33. Plan Testing / Real Incidents
When any element of this plan has been tested (live incidents can also be classed as
tests) the table below should be completed by team management, for audit purposes.
Testing of this plan can include, requesting team members to work from alternative
locations, testing access to various applications from different locations on back up
computers, home working, using alternative suppliers or even live incidents.
Date of testing:
Manager carrying out the testing:
Description of testing completed:
Issues arising:
Signed off by:
34. Emergency Kits
Your facility should consider establishing two emergency kits; one should be placed in a
secure location, which is accessible to all staff (e.g. office, staff room, store cupboard), the
other should be stored at your buddy establishment or safe haven (some items could, by
arrangement, be reciprocal with the content of your buddy establishment’s kit). If one kit is
inaccessible due to the incident (e.g. a fire) you should be able to access the other one.
Ensure that all staff know where they are kept.
Example content of an emergency kit comprises:
 A waterproof bag

HiViz vests for Emergency Response Team

Hard copy of this plan
20

Hard hats

First aid kit

Mobile phones; they do not need to be stored in the bag but should be evacuated
with the bag when necessary. Include spare batteries / charging cables.

Bottled water

20 x emergency foil blankets

20 x patient identification bracelets

Wind up torch
35. Copies of all supporting documents
Keep a copy of any mutual aid arrangements with other care homes, e-mails to support
agreements in place etc.
36. Lockdown Guidance
36.1
Introduction
Lockdown is the process of controlling the movement and access (both entry and exit) of
people (staff, residents and visitors) around a site or other specific building/area in
response to an identified risk, threat or hazard that might impact on the security of
residents, staff and assets.
36.2
Purpose and Scope
A decision to lock down may be taken in collaboration with Thames Valley Police or
Royal Berkshire Fire & Rescue Service as a result of a major incident. However, there
may be occasions when the home manager will need to achieve a lockdown, for
example in the event of a missing resident, and in order to avoid precious moments
being lost, commence the process for securing an area.
The purpose of this guidance is to provide managers and staff with a toolkit that will
enable them to follow appropriate steps and develop a robust plan to achieve a
lockdown of the site that they manage/occupy.
36.3
Duties and Responsibilities
The Manager holds the overall responsibility on behalf of the company as the
Accountable Officer.
Their responsibility includes:
 Ensuring that the aims and objectives of this guidance and procedure are met.

Ensuring that adequate resources are made available.

Ensuring that any processes in place for management of a lockdown are reviewed by
the management team.
The Estates Team will lead on issues relating to the functionality of buildings and
building resilience. They will have an in-depth knowledge of the structure and systems
that operate within any building, their knowledge will be invaluable when determining
whether it is possible to achieve a full or partial lockdown.
21
All Operational, Service and Departmental Managers are accountable for ensuring that:
 They work with their teams,

Estates representatives to identify and document the critical assets within the site;

Develop a lockdown profile for their site/department taking into consideration local
circumstances and the services provided.

Determine if a lockdown (or partial lockdown) is achievable.

Identify appropriate resources to undertake a lockdown.

Share details of the agreed lockdown plan with their teams to ensure that if, or when
implemented, all staff are aware of their role and responsibility.

That plans are tested for robustness and appropriate amendments or revisions are
cascaded.
All Employees have a responsibility to take reasonable care of their own safety and
security, as well as the safety and security of others and to participate as required, in the
event of the implementation of a lockdown. In order to support a lockdown, staff are
likely to have to carry out activities that are outside of their normal job description.
All Visitors are requested to follow directions to support a lockdown; however it is noted
that the containment of any person against their will is prohibited.
36.4
Types of Lockdown
In locking down a facility, there are three
movement of people on a site or part of
movement of people, or a mixture of the
lockdown is to either exclude or contain
key elements; preventing the entry, exit and
a building. In preventing the entry, exit or
three, the overarching aim of implementing a
staff, residents and visitors.
A lockdown is the process of preventing freedom of entry to, exit from, or movement
within a site. In this way either contain or exclude staff, residents and visitors. A
lockdown may be characterised as either partial (static or portable), progressive or full.
Controlling access or the exit of members of the public in the event of a lockdown.
When following assigned duties in the event of a lockdown all employees must remember
that because the home is usually open to friends and families, these individuals might
think they have an implied licence to enter them regardless. However, the owner of any
such premises has the right to refuse access.
While staff can give direction within their premises (for example, stating which exit
someone can use), it is unlawful to forcibly prevent exit from the premises.
Nonetheless, there may be circumstances when a lockdown from premises (or part of
them) is desirable. If this occurs, staff can only appeal to individuals to stay in the site
and/or building identified for lockdown. If individuals choose to leave, a safe route must be
available for them to do so.
Partial Lockdown (Static or Portable)
A partial lockdown is the locking down of a part of a building. The decision to implement a
partial lockdown will usually be in response to a localised incident. This response will help
22
ensure that identified critical assets such as personnel, residents and property are
protected.
A partial lockdown which may have been static in nature may evolve into a portable
lockdown whereby, an on-going lockdown is moved from one location to another.
Progressive Lockdown
A progressive or incremental lockdown can be a step-by-step lockdown of a site or
building, in response to an escalating scenario.
Full Lockdown
A full lockdown is the process of preventing freedom of entry to and exit from either an
entire site; specific building or premises.
It is important to take into consideration that preventing freedom of access to a
premises at a particular entry point, may result in attendees seeking other points of
access.
36.5 Procedure
By using the appendices that accompany this guidance, the Manager of each home will
be able to develop a lockdown profile which may be categorised as ‘adequate lockdown
capability’ or ‘additional resources required’.

Develop a Site Profile (see Site Profile template) taking into account the physical
geography of the site, and detailing the size of the site, indicate the perimeter,
access and egress points, the location and route of communications and the
number of buildings on the site. Up to date site maps, floor plans and aerial maps
in conjunction with a live walk through, should facilitate the development of this
profile.

Create a Building Profile (see Building Profile template) to review the functionality
and capability of the buildings to lockdown either fully, partially or progressively. This
will include a full inventory of doors and windows and their locations, the ratio of
glazing and the ability to control access either manually or automatically. The
condition of the premises, its shape and height, whether it has air conditioning and the
location of power supplies will all need to be documented.

Security Profile (see Security Profile template) this will concentrate on existing
security measures and is important to establish any vulnerabilities that may threaten
the ability to lock down fully, partially or progressively. In simple terms when reviewing
the site it should be considered in concentric rings, the outer perimeter, building
perimeter and interior of the buildings. It is recommended that these rings enclose the
critical asset, so that the robustness of security measures increase towards it. In this
way we may have multiple sets of concentric rings within a single site, depending on
the location of critical assets.
Following the review of the site, building and security of the premises, managers will be
able to develop a planned approach to implementing a lockdown whether it is partial, full
or progressive.
23
Staff members should be allocated tasks and responsibilities and these should be
documented on staff action cards (see Staff Action Card template) to ensure the incident
is managed. Additional training may be required in communication or conflict resolution,
for those who may have the responsibility for keeping visitors and Residents either inside
or out of the area.
Once a plan has been developed, it is appropriate to test the plan to ensure its
effectiveness; to identify and capture any areas of weakness and to feed these into the
development of improved procedures. When testing, it is important to consider the
implications of a real event taking place at different times and whether in different
circumstances the plan would have succeeded. The implications of a lockdown on
Monday at 10am may be significantly different from Friday at 5pm.
36.6
Approval, Ratification and Review Process
This policy will be reviewed every three years, or earlier in the light of changing
circumstances or legislation.
24
Site Profile Template
Item
Details
Location
General Description of location, plus strategic access
Area
In square feet
Site characteristics
Number of buildings on site?
Landscape summary
General description of the site, shape and slope
Local road access
Description of types of roads and number of them onto
site
Traffic movement around
site
Direction and movement of traffic on site
Neighbouring land usage
Is neighbouring land used for residential purposes,
industrial estate, farming, and energy supplies?
Describe usage
Car parking facilities
Number of them? Where are they situated? How many
access or egress points do they have? How are they
controlled?
Number of buildings on
the site
How are the buildings spread across the site?
Total number of official
and unofficial access and
egress points on the
site/building.
Where are the access and egress points? (Mark on site
plan).
25
Building Profile Template
Item
Description of building’s
present use
Details
What is it used for? Is it multi- occupancy?
Is it an un-zoned area (i.e. unrestricted movement
within the building)?
Basic shape
Basic shape of the building, size of it and space that
surrounds it
Height of building,
number of floors and their
use
Include what each level and area of the building is used
for
Condition of the building
General description of the building
Corridors
How many corridors?
Do they interconnect, where do they lead to?
Access and egress points
in the building
Number of access points in each building and their
location
Number of egress points in each building and their
location
Car parking facilities for
the building(s)
Number of spaces
How close are they to the main building
External and internal
doors
For each building or part of the building, how many
doors facilitating access and egress are there?
Air conditioning facilities
and vents
Does air conditioning exist in all or part of the
site/building?
If so, where is it controlled from? (maybe more than
one point)
Who is responsible for maintaining it?
How quickly can it be turned off?
How is the building
powered?
Where is the power supply located and how is it
controlled?
Is the power supply secure from tampering? Is
uninterrupted power supply available?
26
Security Profile Template
Item
External doors (external
or perimeter of buildings)
Details
Generally speaking, how are the doors locked? By
access control system or manually? Who is responsible
for the access control system?
How many doors do not have any security
arrangements?
Internal doors (interior of
building)
Where are they located?
How are they locked? By access control system or
manually?
Windows
Has a risk assessment been taken as to which windows
have to be locked?
How can they be secured? What is their locking
device?
If they are manually locked, who holds the keys?
CCTV
Is CCTV in place
Where are the cameras located? Is there a map of their
locations?
What are they trained on?
Can they be used to monitor people approaching the
building in the event of a lockdown?
Security lighting
Which buildings have security lighting?
How is this controlled? How is it activated?
Alarms on specific
buildings
Which buildings have security alarms?
How is this controlled? How is it activated?
Security at car parking
sites
Where are the car parks? What size are they?
Are the car parks staffed?
What are the existing security arrangements?
27
Staff Action Card Template
(Complete for all staff and include appropriate duties)
Document actions to be taken in the event of a lockdown (examples):

Deployment to (where)

Actions to take at all stages of lockdown:

Where to report

What to do (may include encouraging Residents/visitors/residents to stay or keeping
residents/visitors/staff from entering the premises)

Document names of anyone refusing to stay in premises

Who to report to

What to report

How often to report

Monitor CCTV footage (to ensure continued surveillance of area concerned if a partial
or progressive lockdown)
28