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.

Latest Questions

Should Night Care Workers Be Paid For Breaks?

Sheila do night care workers have to be paid for breaks which they take whilst on duty at night? They would not be leaving the building and are provided with food.

  Dear T,   Thank you for your question.   The first place to look is the contract of employment. What does that say?   I asked Chris King an Employment Law Specialist from the Employment team...

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Is A Residential Care Home Obliged To Provide A Reference For An Ex-Employee?

Good afternoon I am struggling to get a reference from an ex-employer as I have a new job in a hospital. They just keep telling me they are too busy. I left on good terms. Is there anything that I can say to them to get this reference as I am on the understanding that because the care industry (residential care home) is regulated they are obliged to provide a reference? If they don’t I could lose the job offer.

Many thanks

  Dear E,   Thank you for your question. I have received several questions along the same lines about the difficulty of obtaining references from some former employers.   I asked Chris King an Employment...

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Is it Acceptable to Reduce Staff 1:1 Meetings to Four Times Per Year?

I work as an HR Manager for a Learning Disability Centre that historically has carried out supervisions every 6 weeks on all its care staff. I appreciate there is much controversy on this topic and having read what the CQC have to say on the matter, it appears it is very much what we do here that does matter. My intention is to adjust this 6 weekly (not only impracticable given the type of work we do, but is time-consuming etc. etc.) to 4x per annum, once a quarter. I have now separated the 1:1 and appraisal documents as they are for different reasons. In your experience and with your knowledge will the CQC accept 4x a year for 1:1s?


Dear W,   Thank you for your question.   This is a decision to be made by the Registered Manager and I am sure that the Registered Manager would make that decision in consultation...

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Is It Wrong To Transfer A Service User’s Care Plan Along With The MAR Chart To Hospital?

Hi I transferred a care plan to hospital along with MAR charts –  am I wrong in doing so?

  Dear N,   Thank you for your question.   This is my advice.   A care home should retain both the care plan and the MAR charts in the home always.   These are important documents that you...

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Should A Sleeping Resident Be Woken Up And Asked If They Want To Get Up?

Hi. Please can you tell me if a resident is sleeping should they be woken up and asked if they want to get up? I have always been led to believe that if they are asleep that they must be still tired.

  Dear R,   Thank you for your question and the answer would normally be no.    You should refer to the individual's care plan and that should record the wishes of the service user.   So...

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Will I Be Told If I Am On The Barred List of a DBS?

Will I be told if I am on the barred list of a DBS and how long before I know?

  Dear J,   Thank you for your question.   The Disclosure and Barring Service (DBS) was designed to assist organisations to recruit safely and most importantly to prevent unsuitable candidates from working with vulnerable...

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Who Do I Need To Inform When Opening A Day Centre For Adults With Learning Difficulties?

Hi Sheila

I am wanting to start a day centre for adults with learning difficulties. We will do craft sessions and health and well-being sessions. They will run from a house purchased with this in mind. Do I have to inform local authorities?

  Dear P,   Thank you for your question.   Day Care has never been an activity regulated by the Care Quality Commission (CQC). The Government has, from time to time, said that they will...

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How Can I Prevent Other Residents Entering My Husband’s Room?

My husband is in care and other residents coming into his room really agitate him. His condition is Huntingdon’s and he is immobile so just gets very stressed when people he refers to as ‘horrible man or woman’ come into his room. I have requested a baby gate but this has been refused on the grounds of entrapment. Is there any way around this?

  Dear D,   Thank you for your question.   I have consulted both Philippa Shirtcliffe, QCS's Clinical Policy Lead and Leah Cooke, QCS's Nursing and Residential Care Specialist and this is our best advice:   It must be...

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Is it Necessary to Notify the CQC of the Death of a Service User who Passes Away in Hospital?

If a service user passes away in hospital and not in the Care Home does the care home still have to notify the CQC as a ‘notification of death of a service user’?

Dear E, Thank you for your question which is not as straightforward as I would have expected. My initial thought was that the answer should be yes, you should submit a notification. The...

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Can a Relative with a Health and Welfare LPA Object to Hospital Admission for a Resident?

Can a relative holding Health And Welfare Lasting Power Of Attorney on behalf of one our residents refuse to allow the person to be admitted to hospital for a medical examination? The circumstances are, the person lacks the capacity to make a decision through living with dementia, they have had a fall and has a suspected fractured ankle and is in a great deal of pain. The GP wants the resident to go to hospital for an x-ray but the family with LPA say no because of the fear and confusion the resident would suffer as a consequence. We feel that allowing this would be a breach of our duty of care and would place us in the invidious position of having to raise a safeguarding concern against the family. In the event, we admitted the person to hospital accompanied by our dementia lead carer and obtained grudging approval from the family after the event, but as a similar disagreement seems likely to occur again it would be helpful to understand what our position is if we are concerned about a decision made by the person holding the Health And Welfare LPA.

  Dear A,   Thank you for your question which is one of the most challenging I have ever received.   Luckily at QCS we have many knowledge specialists  ( who are experts in their particular...

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