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

1. 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.

2. Sources to verify before adoption

• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 9 (person-centred care): https://www.legislation.gov.uk/uksi/2014/2936/regulation/9
• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 12 (safe care and treatment): https://www.legislation.gov.uk/uksi/2014/2936/regulation/12
• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 17 (good governance): https://www.legislation.gov.uk/uksi/2014/2936/regulation/17
• 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

3. 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

4. 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.

5. 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

6. 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

7. 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

8. 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.

9. 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.

10. 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.

11. Recording, reporting and notifying

• 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.

12. 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.

13. 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.