Ask Sheila

Sheila will try to answer as many of your questions as possible, giving priority to frequently asked questions and questions regarding current events and trends.

Sheila Scott OBE from National Care Association (NCA). Care is Sheila’s life; she possesses a strong command of the issues facing the care sector informed by her long career as a nursing professional, the owner and manager of a care business and as a leader in the care sector.

Sheila will try to answer as many of your questions as possible, giving priority to frequently asked questions and questions regarding current events and trends.

Please note that Sheila can not offer answers to matters requiring legal advice. If your matter concerns a specific service provider, please contact the CQC.

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Latest Questions

Can stair gates be used in a dementia care home?

Are the use of stair gates acceptable and within the standards of restraint in a dementia care home?

 Dear J, Thank you for your question which like so many issues is complex and each case is different. I have recently been working in a nursing home which did use a...

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What do I need to put in place for self-medicating resident?

Hi Sheila,
We had a new lady move into our residential home. She made the decision to move alone and has total capacity, she also wishes to self-medicate. I have received confirmation from her GP and signature that she does have full capacity. We have purchased a lockable medicine box for her bedroom, from our pharmacy. We have listed all medication and done an audit which we will do every month, more frequent if we have any concerns. The resident has also signed a form confirming her capacity, is there anything else we need to put in place?

 Dear S, Thank you for your question. I think that there is one more thing. You need to be sure that you have a self-medication policy. If you are a customer of...

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Are handwritten signatures required on references?

Do we have to have handwritten signatures on references? Will an electronic signature suffice?


 Dear Kristy, Thank you for your question which I am sure many people will have had concerns about these days when so much of our correspondence is done by email. We asked...

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I’m a registered manager, can I transfer my registration to a new workplace?

I am a registered manager of a small care home but planning to transfer into Domiciliary agency.

My question is – can I transfer my registration to the new workplace?  I was reading CQC guidelines but I cannot find an answer to my query.

Many thanks in advance


 Dear C, Thank you for your question. This answer is my opinion. Your registration as a Manager is related to one provider so if you are transferring within an organisation it may be...

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Cutting budgets… and dignity?

One of my clients cares for her son who has cerebral palsy. They are having a review and the social worker is looking to cut the budget. One of the ways they said costs can be reduced is for him to wear pads at night, so that a care worker is not needed to toilet him. He is not incontinent and does not like using a bottle, he likes to use the toilet. His mum is obviously not very happy about this and has refused. A district nurse who checks her son out and said his skin was perfect, with no sores, said she shouldn’t allow this as he could start to get pressure sores. Do they have rights to say no?

Thank you

 Dear C,It would be shocking if the social worker actually put this forward at the review, and possibly proposed abuse of the service user. People with any form of disability are...

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Are flannels unhygienic?

I work in a care home, our manager has said due to the fact we are using too many wipes per week (dry wipes we wet to wash services user’s personnel places i.e. bottoms), we are now having to use dark colour flannels that get washed in the laundry and get used by all.

My concern is this is unhygienic and puts services users at risk of infection and cross contamination. I would like to know if this way of washing is considered ok and common practice, as I think disposable wipes surely must be the correct way?

 Dear J, Thank you for your question. The first thing that I would say is that I often read that wipes are not environmentally friendly and they are not biodegradable. However, they...

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Is the Care Certificate required before lone working?

Dear Sheila,

Are all new staff expected to have fully completed the Care Certificate before they can do any lone working or work without direct supervision supporting any vulnerable adults with a learning disability, or could a thorough and detailed induction process, allow them to carry out their duties whilst they work towards achieving the Care Certificate within the first few months of their employment?

I look forward to hearing from you


 Dear M, Thank you for your question. Formal induction should be given to the worker before they begin working alone. The worker should not be expected to deliver any care unless the service...

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Who takes care of pressure ulcers?

In the prevention and management of pressure ulcers, who takes responsibility for this in a care home? Is this primarily a nurse’s responsibility? What role/responsibility would operations and management have in this?

 Dear Amy, There are two aspects to your question. The first relates to the training and awareness of the prevention of pressure sores for staff in a care home. In some areas there is...

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Is hair washing abuse?

Hi, I work in a care home and I’ve been told that washing a resident’s hair can be classed as abuse. The lady in question is unable to give permission as she is unable to talk. She has not had her hair washed in months. Is this true, is hair washing abuse?

Many thanks.

 Dear Tessa, I wonder who told you that washing someone's hair is abuse. As this lady is unable to talk, does that mean that she lacks capacity to make a decision? I suspect...

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Are day care activities inspected by the CQC?

Do day care activities services get inspected by CQC?

 Dear Julie, Day Care facilities are not a registered service and therefore are not inspected by CQC. However, they are subject to other parts of the law including Health and Safety and...

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