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THE CARE CERTIFICATE WORKBOOK

Duty of Care

The CARE CERTIFICATE

Standard

What you need to know

THE CARE CERTIFICATE WORKBOOK STANDARD 3

Your duty of care is also to other workers, for example, in a hospital, to doctors, nurses

and healthcare support workers but also to caterers, cleaners and maintenance workers. If

you are a home care worker you will probably work alone in a variety of homes, but there

may well be other people in the premises, as well as whoever you are there to support.

Your duty of care is to each individual and to the other workers you come into contact with

in the community.

The duty of care is part of the code of conduct for healthcare support workers and adult

social care workers in England and will most likely also be in your job description. It is

important that you have the knowledge and skills to act on your duty of care in your role

but that you don’t work beyond it.

As part of your duty of care you should pass on any concerns you have about wellbeing.

Every employer has agreed ways of working to respond to possible harmful situations

which will include how to report any concerns. Concerns could be about anything from

poor working conditions or equipment to untrained workers, as well as suspected abuse.

In any situation, if you do not know what you should do, ask your manager. Providing

guidance about how to deal with abuse and violence or substance misuse or how to

handle toxic substances or carry out risk assessments are all part of making sure that

the duty of care is carried out. Fire drills, agreed ways of handling medication as well as

cooking and food storage procedures are some of the routine ways for making sure that

everyone knows how to fulfil their duty of care. The agreed ways of working vary from one

workplace to another, so you need to check them if you move to a new job in social care

or health. Agreed ways of working should be documented, but even if you are told about

them only in conversation, you must still work to them.

Duty of care

You have a duty of care

to all those receiving care and

support in your workplace. This

means promoting wellbeing and

making sure that people are kept

safe from harm, abuse and injury.

Wellbeing

Wellbeing could be defined as the

positive way in which a person feels

and thinks of themselves.

Code of conduct

The code of conduct tells you how

you are expected to behave as a care

worker.

Duty of care is a legal requirement; you cannot choose whether to accept it. It applies

as soon as someone has care or treatment. Breaking this duty, for example through

negligence, could result in legal action.

THE CARE CERTIFICATE WORKBOOK STANDARD 3

Supporting independence

The code of conduct says that you must work in ways that respect and protect the

individual’s rights, including their right to live as independently as possible, to make their

own choices and to take risks.

There may be times when they make choices that you think are unwise, unsafe or that you

disagree with. For example when someone with a disability wants to try a new physical

activity or when someone chooses not to eat less fatty foods. You should make sure that

they have as much information as possible about their choices and what could happen. If

they still choose to make a risky choice a risk assessment may identify ways in which risks

can be reduced and the individual can be supported to make those decisions. But the right

to make decisions that they are legally capable of making must not be taken away from

them by the social care or health workers.

Your employer will give you guidance on risk assessments, risk enablement and health

and safety. Whatever you come across you have to consider the individual’s wellbeing as

your main priority. If you are unsure about any situation, ask your manager. Other sources

of support might be the individual’s friends or family, a befriender or an advocate, their

GP, or another care worker.

Advocate

An advocate is a trusted, independent person who can speak and act for the individual.

They can advise on matters such as welfare benefits and can ensure that the

individual’s point of view is heard in care planning meetings, to make sure that

decisions are made in the interests of the individual. The importance of advocates and

advocacy services is emphasised by the Care Act 2014.

Individuals make decisions all the time and should be supported to do so. Sometimes an

individual may not be able to understand and retain the information they need to make a

decision or communicate their choice. If this is the case they may lack the mental capacity

to make the decision. They may be able to make day-to-day decisions, for example what

to wear and what they want to eat, but not able to make decisions about money or medical

issues. In situations where you are not entirely sure about an individual’s capacity, please

seek additional advice or guidance. You will look at issues about people’s capability

(‘capacity’) to make decisions for themselves, with varying levels of support, especially if

they have mental ill-health, dementia, or learning disabilities, in more detail in standard 9.

Comments and complaints

You have a duty to make sure that each individual knows that they have a right to complain

or comment about their care or support. It is important that this is able to happen quickly

and in a positive way. They should be taken seriously and explored so that any learning

can be used to keep doing the right things or to make improvements. Positive comments

can be encouraging and used to show how good ways of working are making a positive

difference. Ask your employer to tell you about what to do when someone wants to

complain or comment.

THE CARE CERTIFICATE WORKBOOK STANDARD 3

The Local Authority Social Services and NHS Complaints (England) Regulations 2009

are the legislation for complaints in health and social care. The Department of Health

also published the NHS Constitution in 2011, which tells you about guiding principles and

patients’ rights. There should be a recorded process to follow which may differ depending

on the type of workplace and have a time limit in which the complaint has to be made after

the situation happened. If someone wants to make a comment or complaint you should

deal with it in line with your organisations agreed ways of working.

Depending where you work, that could include:

 arranging to talk in private

 making sure the individual knows that you may need to

pass on information if there is a risk to the safety

of themselves or others

 listening calmly and actively, assuring them that you are

taking them seriously

 not judging or becoming emotional

 offering your support but not trying to answer the issue

before the agreed way of working has taken place

 explaining what will happen next, who the complaint will

be passed to and when the person will get some feedback.

Thank them, tell your manager what has been said, and make a record as soon as

possible.

Often an organisation has one named person who deals with complaints. Depending on

the size of the organisation there may be a complaints section such as the NHS’s Patient

Advice and Liaison Service (PALS). You should ask who is the ‘responsible person’ or

‘accountable officer’ for your workplace. Smaller workplaces might not have anything in

writing but will still have agreed ways of working for when complaints are made.

Incidents, errors and near misses

Sadly, having the best ways of working, the code of conduct and the duty of care, doesn’t

always protect vulnerable adults from harm. All health and social care workplaces involve

workers collaborating towards the wellbeing of those needing care or support. Mistakes

happen through things like lack of knowledge, poor communication or not sharing

information, stress, negligence or being distracted. Mistakes are seen as being one of the

following:

Adverse events:

action or lack of

action that leads

to unexpected,

unintended and

preventable harm.

Incidents:

specific negative events. In health and social care serious incidents are described as

events which need investigation as they caused severe harm or damage to either the

person receiving care or the organisation.

Errors:

not doing something

as it should have been

done, for example

through bad planning

or being forgetful.

Near misses:

situations where an

action could have harmed

the individual but, either

by chance or purpose,

was prevented.

THE CARE CERTIFICATE WORKBOOK STANDARD 3

The first thing to do after something has gone wrong is to do what you can to improve the

wellbeing and meet the immediate needs of the individuals involved.

Your workplace will have a form which you should complete to record incidents, accidents

and near misses. You should record the date, time and facts. This is used to make your

manager aware straightaway. Do not blame other workers or suggest to those involved

why the incident might have happened, even if you have an idea why it was. If your

thoughts turned out to be wrong you could lose the individual’s and family’s trust and

respect.

Legislation

For health and social care work a variety of legislation sets standards on how to handle

issues to improve services and positive outcomes.

Care and compassion

Think clearly and carefully about the potential reasons for someone’s distress. Use

your person-centred approach and knowledge of them as an individual, as you may

be able to de-escalate a challenging situation by recognising their unmet needs and

responding to these with supportive care and/or additional services.

THE CARE CERTIFICATE WORKBOOK STANDARD 3

The Control of Substances Hazardous to Health Regulations 2002 (COSHH)

This requires employers to assess the risks of potentially harmful substances and

take precautions to minimise these. They include, for example, cleaning materials and

medication.

www.hse.gov.uk/coshh/

The Provisions and Use of Work Equipment Regulations 1998 (PUWER)

Anyone responsible for work equipment should ensure that it is suitable for the job, well

maintained, inspected regularly and only operated by well-informed and trained staff.

A breach of any of these regulations is a crime in the UK and therefore needs to be

reported immediately. If any person suffers harm as a result, the offender may be taken to

court.

www.hse.gov.uk/work-equipment-machinery/puwer.htm

The Health and Safety at Work etc. Act 1974

This is the main piece of legislation covering occupational health and safety in the UK. It

places a duty on employers and employees for the health, safety and welfare of persons in

the workplace.

www.hse.gov.uk/legislation/hswa.htm

The Management of Health and Safety Regulations 1999

Workplaces should have a procedure in place for recording, reporting and evaluating all

serious incidents. They should take measures to avoid them happening again.

www.legislation.gov.uk/uksi/1999/3242/contents/made

The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013

(RIDDOR)

This places duties on responsible persons working on the premises to report specific

workplace accidents, occupational diseases and specific dangerous occurrences or near

misses to their local Health and Safety Executive (HSE).

www.hse.gov.uk/riddor/

THE CARE CERTIFICATE WORKBOOK STANDARD 3

Managing conflict and difficult situations

There are many things that can cause conflict with and between people. Conflict or

‘behaviour that is challenging’ often happens as a result of distress or because needs are

not being met. It could be caused by a number of factors including:

 biological, for example because an individual is in pain or suffering the side effects of

medication or substance misuse

 social, for example because of being bored, wanting social contact, having a need to

be in control, not being able to communicate or understand what is being said

 environmental, for example because of loud noise or bad lighting or barriers

to mobility

 psychological, for example because of feeling left out or lonely.

Your workplace might have a policy on responding to behaviour that challenges. There will

usually be a form to report what happened, who has been involved and where and when

the incident took place. You should include whether anyone has been injured and needed

medical assistance or whether the police have been called, and sign and date the form.

This will then be used to determine any action that is needed to support the individual

better.

An open discussion with any individual, where they are treated with respect and dignity,

can often find a solution. If possible and safe, when working with a person whose

behaviour is challenging:

 take them to a quiet place

 ask questions and listen carefully to what they say

 take their feelings of being upset or angry seriously

 try to find a way forward that they understand and can agree to.

It is important that you get to know the individuals you are working with as far as possible,

so you can recognise what triggers their distress. It is also important that you don’t get

emotionally involved but keep a clear head and look out for body language and reactions.

If you feel that a one-to-one situation between yourself and an individual has the potential

to become confrontational you should try to leave the scene to give them time to calm

down.

When you recognise frustration and aggression in a person’s behaviour you will learn, as

you develop in your role, how to use your communication skills and other ways of working

to manage a situation before it becomes violent or aggressive. Your manager will provide

guidance, explain ways of working and support you to develop your knowledge and skills

as you progress in your work.

THE CARE CERTIFICATE WORKBOOK

Duty of Care

The CARE CERTIFICATE

Standard

What do you know now?

THE CARE CERTIFICATE WORKBOOK STANDARD 3

Activity 3.1a

As a social care or health

worker, you have a duty

of care to all people you

support. Use the following

words to define what is

meant by duty of care.

Define - provide a definition in your

own words to demonstrate your

understanding.

Duty of care

Responsibility Safety Obligation Wellbeing

THE CARE CERTIFICATE WORKBOOK STANDARD 3

Activity 3.1b

Thinking about your

own work role, complete

the sentences below to

describe how the duty of

care affects you in practice.

The first example has been

completed for you.

Describe - to describe means to create a

picture with words but not simply writing

a list of bullet points.

My job description states that...

I have certain responsibilities to the individuals I provide care and

support to and to my colleagues; this includes working safely and with

the interests and wishes of the individual at heart.

The organisational policies and procedures are there to...

The code of conduct means that...

I must report unsafe or abusive practices because...

THE CARE CERTIFICATE WORKBOOK

THE CARE CERTIFICATE WORKBOOK STANDARD 3

Activity 3.2a

There will be times when your duty to safeguard

the wellbeing of the individual is in conflict with

your duty to promote the individual’s right to take

risks. It is your duty to ensure an individual is kept

safe and does not experience harm but these

situations may cause you a dilemma and you may

not know the right thing to do to keep them safe at

the same time as enabling them to make their own

choices.

Think of two dilemmas that might arise in your

work and describe these in the space below.

Dilemma 1:

Dilemma 2:

THE CARE CERTIFICATE WORKBOOK

Describe - to

describe means

to create a picture

with words but not

simply writing a list

of bullet points.

THE CARE CERTIFICATE WORKBOOK STANDARD 3

For the two dilemmas that you

have described in 3.2a, complete

the table below to explain what

you must and must not do within

your role for each dilemma and

where you would get additional

support and advice to help you

resolve the dilemma.

Explain - to explain something you

will need to provide a clear account

of your understanding, including

details like why and how.

What you must do within

your role

What you must not do

within your role

Where would you get

additional support and

advice to resolve the

dilemma and why

Dilemma 1

Dilemma 2

Activity 3.2b & c

THE CARE CERTIFICATE WORKBOOK STANDARD 3

Activity 3.3b

For each of the three

examples below, describe

who you would ask for

advice and support in

handling comments,

concerns and compliments.

A number of individuals

you are supporting

believe that someone

has been tampering with

their medical records

You have read the

complaints procedure

but you would like to

ask for further guidance

on one section

An individual you

support has told you

that they wish to make

a complaint about the

food served at meal

times

Describe - to describe means to create a

picture with words but not simply writing

a list of bullet points.

THE CARE CERTIFICATE WORKBOOK STANDARD 3

Activity 3.3c

It is essential to learn from

comments and complaints when

providing care services. Explain

the importance of learning

from comments, concerns and

compliments in order to improve the

quality of service that you provide.

Explain - to explain something

you will need to provide a clear

account of your understanding,

including details like why and how.

THE CARE CERTIFICATE WORKBOOK STANDARD 3

Activity 3.4a & b

You have a duty of care to respond to

events and incidents in an appropriate

and agreed way. To show your

understanding, complete the table below

to describe how you would recognise

adverse events, incidents, errors and

near misses (scenarios) and explain

what you must not do in relation to each.

Decide whether this

is an example of

an adverse event,

incident, error or

near miss

Describe how you

recognise this as an

example of an adverse

event, incident, error or

near miss

Explain what you must

do and must not do

in relation to each

example

An investigation is

started after a number

of patients died

unexpectedly in care.

Adverse

event

Incident Must do:

Error Near miss Must not do:

You arrive at an

individual’s home to

support them with their

shopping to find that a

colleague has already

arrived to undertake

this task.

Adverse

event

Incident Must do:

Error Near miss Must not do:

Describe - to describe means to

create a picture with words but not

simply writing a list of bullet points.

Explain - to explain something

you will need to provide a clear

account of your understanding,

including details like why and how.

THE CARE CERTIFICATE WORKBOOK STANDARD 3

Decide whether this

is an example of

an adverse event,

incident, error or

near miss

Describe how you

recognise this as an

example of an adverse

event, incident, error or

near miss

Explain what you must

do and must not do

in relation to each

example

When serving lunch,

an individual who

has a nut allergy was

given a peanut butter

sandwich by mistake.

You notice this just

in time to change the

sandwich.

Adverse

event

Incident Must do:

Error Near miss Must not do:

An individual in the

bathroom area slips

on the wet floor. When

investigating you

notice that a wet floor

sign has not been

used.

Adverse

event

Incident Must do:

Error Near miss Must not do:

Activity 3.4a & b

continued

THE CARE CERTIFICATE WORKBOOK STANDARD 3

Activity 3.4c

Thinking about the four

scenarios in 3.4a & b, list

the legislation and agreed

ways of working that need

to be taken into account

when reporting adverse

events, incidents, errors

and near misses.

List - this term means to identify the

main points which can be written as

bullet points.

THE CARE CERTIFICATE WORKBOOK STANDARD 3

Activity 3.5a

Fill in the spider diagram

below to list the factors and

difficult situations that may

cause confrontation. One

example has been provided

for you.

Factors and

difficult situations

that may cause

confrontation

include...

An individual with

dementia may feel

misunderstood,

frustrated and

confused.

List - this term means to identify the

main points which can be written as

bullet points.

THE CARE CERTIFICATE WORKBOOK STANDARD 3

Activity 3.5b,

c & e

Thinking about the factors

and difficult situations that

may cause confrontation,

select one that relates to

your own role and answer

the questions below.

1. What is the factor or difficult situation that may cause confrontation?

2. How could communication be used to solve problems and reduce the likelihood or impact of

confrontation?

3. How would you assess and reduce the risks in this situation?

4. What is the agreed way of working for reporting confrontation in your service?

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