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

How quickly should a risk assessment be completed?

What is the time frame for a provider to complete a risk assessment (urgent/rapid response) considering a service user that lacks capacity?

Dear Olasunkanmi,This question is as much about leadership as it is about the time frame.Your questions is specific; it is about an urgent/rapid response risk assessment for a person who...

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How do I demonstrate compliance and outstanding?

How I can implement and demonstrate compliance with KLOEs in my service and what kind of evidence can I put in my file to show to demonstrate we are working towards achieving outstanding rating for my service?
I look forward to a detailed reply.
Thanks Sheila.

Dear Qasim,Thank you for your question.You do not say what category of service you are providing but the principles are the same whatever the service.The first thing you need to...

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Using photos of residents to identify rooms?

Is it advisable to have photos of residents on their bedroom doors?

 Dear Roger,Thank you for your question. I presume that you are providing care for people with dementia. I believe that it is a question that you have to decide the answer...

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Can we use a CRB from another home?

Should a person with a two-month-old CRB check, done by another home, be sufficient to employ that person whilst we await another CRB check (bearing in mind that it is only two months old)?

Many thanks,


Dear Vishnu, Thank you for your question. Enquiries are always more complex than about almost anything else related to Adult Social Care but there are a number of useful pieces...

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Who pays for extra incontinence pads?

On last week’s TV programme investigating Bupa Care Homes, it was stated that if a person had run out of incontinence pads the home should provide more. Now the fact that the NHS does not provide enough seems to be quite a common problem.

Who should pay for extra, the person using them or the care provider?

 Dear M,Thank you for your question. This is a very important question which I am hearing more and more. I discussed this with a colleague and this is her opinion "You must...

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Carer under the influence of drugs?

If l suspect that a carer is working under the influence of drugs, e.g. Marijuana, what can l do?

 Dear Paula, Thank you for your question. I asked our HR expert Chris King a solicitor with Napthens for his opinion and this is what he said: “If a carer is under the...

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How can I get more clients?

I have just been newly registered by CQC but I’m really struggling to attain clients, could you please advise me?

Dear Nancy,Thank you for your question. You do not say if you are providing care in a care home or home care.The principles though are much the same.You need...

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How can I help a service user self-manage their medication while maintaining theirs and others safety?

Dear Sheila,

Firstly thank you for all the advice you and your team impart, evaluable in this sector.

I have a question on CD medication. Our home follows standard procedures and polices, however recently we have a new residents who has asked that she retain her Tamazepam in her room. She prefers to take the medication when she is ready to go to sleep and says this is not always at a set time. We have said that staff can work around this, and that she need only ring her call bell for assistance, however the resident would prefer that we left the medication so that she could take when she would like without the need to ring staff.

The resident has capacity to self medicate and we have relevant risk assessments and consent forms in place, however, our normal procedure would be to hold the CD drugs in our CD cupboard in the treatment room and then administer them as per the prescribed administration information. time and the MAR sheet.

Policy indicates that as a care home we need to ensure safe and precise practice when receiving, handling and administering all medication and in particular robust processes around CD medication.

Our dilemma is that we feel it would be person centred for the resident and relieve her anxiety around this if we could work to provide a lockable cabinet to store the Tamazepam in her room, however we would then need to ensure robust process to check and sign across (?) we cannot find any information that indicates that this meets requirements in a care home setting.

Our reflective thoughts in discussion with the resident and their family are that, as a residential care home we work to maintain independence and to foster a safe, home like person centred environment

The residents and thir son have expressed the view that when living at home, the pharmacy delivered the same medication and she then administered them at home herself each day at a time she felt comfortable with just before he went to sleep. They feel our regulations and procedures seem to detract from this.

We have checked NICE guidelines and with other providers, however as yet have not been able to find any information in this respect.

Are you able to advice, I fear we are so absorbed with policy that we may miss the true meaning of person centred care for this resident and assisting them to retain their independence and feel at home, however I also need to maintain the safety of the resident (and other residents) as well as keep my staff team safe and sure in their administration.

Many thanks Sheila

I look forward to your advice.


Ann Stuart

General Manager
St Wilfrids Care Home

Dear Ann,Thank you for your question. Quality Compliance Systems (QCS) has recently reviewed its policy on Controlled drugs so I asked Philippa Shirtcliffe our Clinical Lead who was responsible for...

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Can a care worker refuse to go in the home of a smoker?

Hi Sheila,

Can a care worker refuse to go in the home of a smoker?

Kind regards,


Dear Dawn, We sent your question to our Health and Safety adviser Dave Bennion and this is his response. Following the Health Act 2006 which came into force 1st July 2007 under...

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Is CQC registration required?

Dear Sheila,

Can I just confirm whether a small day centre for elderly people (including those with dementia) would require CQC registration if it provided personal care i.e. assisting service users to the toilet? Also, does the need to register differ depending on whether it is just one self-employed staff member or a staff member supported by multiple volunteers?

Thank you for your time.

Kind regards,


Dear Beth, Thank you for your question. I get so many questions about registration by CQC and Day Centres. There is really useful guidance on the CQC website about Day Centres: The opening paragraph...

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