Visit scheduling, missed and late visits policy (domiciliary care)

1. What the regulation says

The care and treatment of service users must be appropriate, meet their needs, and reflect their preferences. (Reg 9(1): the headline duty)

carrying out, collaboratively with the relevant person, an assessment of the needs and preferences for care and treatment of the service user (Reg 9(3)(a): collaborative assessment)

The full text of the regulation is at https://www.legislation.gov.uk/uksi/2014/2936/regulation/9. Where this policy and the regulation diverge, the regulation wins.

2. Plain-English summary

Care and treatment must be appropriate, meet the service user's needs, and reflect their preferences. The regulation lists nine specific things you have to do to deliver person-centred care, including: assessment with the service user, designing care to meet their preferences, involving them and the people supporting them in decisions, providing information, making reasonable adjustments, and considering well-being when meeting nutritional and hydration needs.

3. Purpose

For a person who depends on care at home, a late visit can mean missed medicine, a missed meal or being left without help to get up. A missed visit can cause real harm. This policy sets out how the Service plans visits so they can be delivered on time, how it watches visits as they happen, and what it does the moment a visit runs late or is at risk of being missed, so that no one is left without the care they need.

The Service must verify this policy against current regulations and its own commissioning contracts before adoption, as many local authority contracts set their own missed-visit reporting rules.

For the medicines side of the same risk, pair this policy with the domiciliary care medication support policy template.

4. Scope

This policy applies to:

• every planned visit the Service delivers
• visits that arrive outside their agreed time, and visits that are not delivered at all
• the people who plan rounds, the workers who deliver visits, and the office and on-call staff who monitor and respond

5. Roles and responsibilities

• Registered Manager: owns this policy, approves late and missed-visit definitions, reviews serious or repeated failures and ensures improvement actions close.
• Care coordinator or rota lead: plans realistic rounds, monitors live visit status, arranges cover and records late, missed and no-access events.
• On-call lead: responds to late, missed and no-access events outside office hours and records the decision trail.
• Care workers: record visit start and finish times accurately, report delay early, follow the no-access procedure and do not mark care as delivered unless it was delivered.
• Safeguarding lead or nominated senior: reviews missed or late visits where harm, neglect, self-neglect, medication omission or significant risk may be involved.
• Medicines lead, where appointed: advises on time-critical medicines affected by late or missed visits.

6. Scheduling and live-monitoring procedure

The Service follows this procedure:

1. Agree the visit plan. Record the agreed visit time, length, task, criticality, time-sensitive needs and any preferred worker or access requirement.
2. Build a deliverable rota. Add realistic travel time, worker availability, skills, continuity, break time and known route risks.
3. Identify critical visits. Flag visits involving time-critical medicines, food, fluids, continence care, pressure-area care, getting up or going to bed, or a person who may be unable to seek help.
4. Monitor visit start. Check live call-monitoring or manual confirmation so a late visit is seen while there is still time to act.
5. Act on the flag. Contact the worker, arrange cover where needed, tell the person or representative and record the action.
6. Escalate risk. Where essential care cannot be delivered safely, contact health, social care, safeguarding, emergency services or the commissioner as appropriate.
7. Close the event. Confirm whether care was delivered, late, shortened, missed or replaced by another safe action.
8. Review patterns. Review repeated late starts, routes, workers, areas, call lengths, travel assumptions and commissioner requirements through governance.

7. What counts as a late or a missed visit

The Service uses clear definitions so that staff respond at the right moment:

• Late visit: the worker arrives outside the time window agreed with the person. The Service states the size of the window (for example, a stated number of minutes either side of the planned time).
• Missed visit: a planned visit that is not delivered at all.
• Critical visit: a visit where being late or missed is likely to cause harm, for example visits that include time-critical medicine, insulin, food or fluids, or help that the person cannot safely do without. Critical visits are identified in the care plan and given priority.

The Service confirms these definitions and time windows and records them.

8. Planning visits so they can be delivered

The Service plans rounds that can realistically be delivered:

• travel time between visits is built into the round, so a worker is not set up to be late
• visit times are agreed with the person and reflect their routine and any time-critical needs
• continuity is planned so that, as far as possible, the person sees familiar workers
• the plan names which visits are critical, so cover is arranged for those first
• there is enough staff and on-call cover to absorb sickness and travel problems

9. Watching visits as they happen

The Service monitors visits in real time so that a problem is seen quickly rather than discovered later:

• the worker records the start and end of each visit (for example through an electronic call-monitoring system or app)
• a visit that has not started by a set point after its planned time is flagged to the office automatically
• the office acts on each flag rather than waiting for the person or a family member to call

10. When a visit is running late

When a visit is flagged as late, the office:

1. contacts the worker to find out where they are and how long they will be
2. for a critical visit, or where the delay is significant, sends another worker so the person is not left without care
3. tells the person, and their family or representative where appropriate, that the visit will be late and roughly when to expect it
4. records the late visit and the action taken

11. When a visit is at risk of being missed

If a visit cannot be delivered by the planned worker, the office arranges cover urgently. A visit is never simply dropped. For a critical visit, cover is arranged as the first priority, and if no worker can attend in time the office contacts the person, their family or representative, and where there is a risk to health, the relevant health service, so the person's essential need is met another way.

12. When a worker gets no answer at the door

If a worker arrives and cannot get into the home or gets no reply, they do not simply leave. They follow the no-access procedure:

1. try to contact the person, by knocking, ringing and phoning
2. check for an agreed reason for no access (for example the person is out, in hospital, or has another arrangement that day)
3. contact the office or on-call contact
4. follow the agreed access route, such as a keyholder, family member or key safe, where one exists (see the entry to the home, keys and access policy)
5. where there is reason to fear for the person's safety, call the emergency services and stay until help arrives, unless told otherwise

The Service records the steps taken and the outcome of every no-access event.

13. Telling the person and those who matter to them

When a visit is late or missed, the Service tells the person and, where agreed, their family or representative, plainly and promptly. It says what happened, what is being done, and when care will arrive. The Service is honest about a missed visit rather than letting it pass unmentioned.

14. Records, reporting and register links

• Every late visit, missed visit and no-access event is recorded.
• Missed visits are reported to the commissioner where the contract requires it, within the time the contract sets.
• Where a missed or late visit may have caused harm or placed a person at risk, the Service raises a safeguarding concern under local procedures and considers whether a notification to the regulator is required.
• The Service treats a missed critical visit as a serious event and reviews it.

The record should include:

• planned visit date, time, length and worker
• agreed time window and whether the visit was critical
• actual start and finish time, or reason the visit was not delivered
• person, family, representative, commissioner or professional contact made
• cover arranged, alternative support or emergency escalation
• medication, nutrition, hydration, continence, pressure-area or safety impact
• no-access steps and outcome where relevant
• whether an incident, complaint, safeguarding concern, notification, risk entry or improvement action was opened
• root cause and action owner

Late and missed visits that create risk are linked to the incident register. Repeated patterns are added to the risk register or improvement-actions register. Complaints about visit timing are linked to the complaints register so the pattern view is not split.

15. Learning from patterns

The Service reviews late and missed visits together at the governance meeting. It looks for patterns by round, area, time of day and worker, and asks whether the cause is scheduling, staffing, travel or something else. Where a pattern points to a fixable cause, the Service raises an improvement action and tracks it to completion with evidence.

16. Training and supervision

Staff involved in scheduling, monitoring or delivering visits must be trained on the Service's late, missed and no-access definitions, real-time monitoring process, escalation thresholds, commissioner reporting rules, safeguarding triggers, recording expectations and honest communication with people and families.

Supervisors should review late and missed-visit records in supervision where a worker repeatedly starts late, fails to report delay early, records visit times inaccurately or does not follow the no-access process.

17. Audit cadence

The Service checks, on a stated cadence, that:

• rounds are planned with realistic travel time and adequate cover
• the real-time monitoring system is working and flags are being acted on
• late, missed and no-access events are recorded, and missed visits reported to commissioners on time
• critical visits are identified in care plans and prioritised
• patterns are reviewed and improvement actions completed

The Registered Manager reviews the results and records the improvement actions that follow.

18. Sources and further reading

This template is based on CQC's guidance for providers and managers, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and other topic-specific legislation and guidance listed below. It is a starting point for adaptation, not a substitute for legal, clinical, HR, safeguarding or specialist professional advice.

• CQC Regulation 9: Person-centred care (https://www.legislation.gov.uk/uksi/2014/2936/regulation/9)
• CQC Regulation 12: Safe care and treatment
• CQC Regulation 17: Good governance
• CQC Regulation 18: Staffing
• NICE NG21: Home care, delivering personal care and practical support to older people living in their own homes
• The Service's own commissioning contracts and any local authority missed-visit reporting requirements
• Local safeguarding procedures, for when a missed visit may have caused harm
• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (https://www.legislation.gov.uk/uksi/2014/2936/regulation/9)

19. Related reading

• Guide: Domiciliary care compliance guide
• Article: CQC compliance for domiciliary care: the evidence inspectors expect
• Related policy: Domiciliary care medication support policy template
• Related policy: Lone working and personal safety policy
• Checklist: Domiciliary care missed and late visits checklist

20. When to seek further advice

Seek specialist advice where the issue involves serious harm, safeguarding, deprivation of liberty, restraint, children, professional misconduct, controlled drugs, radiation, termination of pregnancy, infection outbreak, water safety, employment dismissal, DBS barring referral, or regulatory enforcement.

21. Document control

This sample policy template was issued by Verivius. It is a template, not a substitute for legal advice or the tenant's own policy-development process. Where this template and live law or regulator guidance diverge, the live source wins.