Your role as a domiciliary care professional

Key insights from Paula Cashmore, independent care quality consultant and NACAS Employee Director.

As a domiciliary carer, it’s easy to feel overwhelmed by the expectation of the role. We, at the National Association of Care and Support Workers (NACAS), understand the plethora of information and the weight of responsibility you face.

In this article, we have tried to pull out some of the vital responsibilities of the role which are highly important to keep on top of to try and bring some focus to the areas which cannot be ignored.

Accurate documentation, meticulous medication management, and comprehensive notetaking are crucial aspects that can significantly enhance the quality of care provided and ensure care delivery remains legal and compliant.

By adhering to these best practices, Domiciliary Care Professionals can ensure they meet the highest standards, safeguard their clients' wellbeing, and contribute to a better overall healthcare system.

The Importance of Accurate Medication Recording

One of the primary responsibilities of Domiciliary Care Professionals is accurate medication recording. Medication administration is not just a routine task but a critical component of client care. There are several key points to be aware of:

1. Verification of Medication: As a carer, you must rigorously check the medication that you are administering against the prescription and the Medication Administration Record (MAR) sheet. This step is vital because changes in dosage or medication type can occur, and these must be accurately reflected in the records to prevent errors.

2. Importance of Signatures: Missing signatures on MAR sheets can lead to significant issues. A missed signature might suggest that medication was not given, potentially leading to overdoses or missed doses if other carers or family members step in. Missed signature could also raise questions about the care provided, potentially leading to safeguarding concerns.

3. Proper PRN Documentation: When administering PRN (as-needed) medication, it is essential to document the reasons and outcomes. This information helps track the patient’s condition and ensures that subsequent carers have the complete context, preventing issues like medication overuse or unaddressed health problems.

Completing Tasks and Documentation

Beyond medication, the broader scope of task completion and documentation is of paramount importance:

1. Task Completion and Accountability: Every assigned task, from putting up bed rails to ensuring a patient's mobility aids are within reach, is critical for patient safety and comfort. Failure to complete or document these tasks accurately can be seen as neglect and might harm the company's reputation.

2. Comprehensive Notetaking: While electronic devices can streamline task management, they should not replace detailed notetaking. Carers should provide context to their tasks, describing the patient’s condition and responses. For instance, noting that a patient enjoyed their breakfast and was cheerful provides a more comprehensive picture than simply ticking a box.

3. Person-Centred Care: Detailed documentation supports person-centred care by allowing carers to monitor changes in a patient's condition accurately. This approach aligns with the new CQC assessments focusing on personalised care, thereby potentially improving inspection ratings.

Accurate Check-In and Check-Out Procedures

It is hugely important to ensure that check-in and check-out times are accurately recorded for the following reasons:

1. Accurate Time Logging: Precise logging of visit times is crucial for both your accountability and patient safety. Any discrepancies can lead to serious questions if incidents occur shortly after a visit.

2. Protecting Carers and Clients: By diligently logging visit times, you protect yourself and your clients, ensuring there is a clear record of when care was provided. If, for example, there is a discrepancy between the record of an incorrect medication administration and your leave time, serious questions will be asked.

Professionalism and Continuous Improvement

NACAS advocates and promotes change in the sector. We aim to raise the profile of the Care Professional to give hardworking carers, like you, the recognition and respect we believe you deserve. For change to happen, you need to see your role as professional and critical to patient safety. To support this professionalism, you should be open to:

1. Ongoing Training: Regularly refresh training, especially regarding medication management, to stay competent and compliant with evolving standards.

2. Openness to Improvement: Acknowledging and learning from mistakes is crucial. Take an open and honest approach to errors, ensuring continuous improvement in care quality.

3. Collaboration and Support: Good documentation and task management are part of a broader team effort. By supporting each other and maintaining high standards, you  contribute to a better work environment and higher quality care.

From meticulous medication management to comprehensive task documentation and professional accountability, these practices are essential for delivering safe, effective, and person-centred care. As the domiciliary care landscape continues to evolve, embracing these principles will help you meet the highest standards, raise the profile of the role and improve outcomes for your clients.

Paula Cashmore is a nurse with 40 years’ experience in health and social care, and is now an independent care quality consultant. Paula tirelessly promotes the recognition of care and support workers as the foundation of all health and social care services, which would crumble without their valued input. As Employer Director at NACAS, she encourages care providers to enrol all their employees as members.