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					       Rapid Response
         Healthcare




         Staff Handbook




Rapid Response Healthcare Legal Documents/ Staff Handbook Reviewed Sept 2010

                                              1
  INTRODUCTION

  This Staff Handbook contains a summary of the policies and procedures that operate within
  Rapid Response Healthcare Ltd. It should be read in conjunction with your terms of
  agreement as both documents form part of your terms and conditions of engagement.

  GENERAL TERMS

  The following terms and conditions of registration will apply to you on each occasion that work
  is undertaken for the Employment Business known as Rapid Response Healthcare Ltd
  refered to as (RRH) in this document. RRH reserves the right to alter or amend your terms
  and conditions from time to time and will provide you with notification of such changes in
  writing.

  The existence of this agreement does not guarantee that work will be offered to you. This
  agreement represents that you have been accepted to be included on the RRH Register only.

  For the avoidance of doubt, both parties agree and understand that nothing in this agreement
  is intended to create a contract of employment between you and RRH and that your
  registration and engagement with RRH does not represent any obligation on the part of the
  agency to offer you suitable assignments, nor does it represent any obligation on your part to
  accept assignments offered. You further agree that you shall not, at any time, hold yourself
  out as an employee or agent of RRH.

  During periods of engagement with RRH your relationship with the agency shall be that of an
  independent contractor and not of employee.


PLACE OF WORK AND DUTIES

  Whilst working with RRH your place of work will vary depending on the work offered and
  accepted under this agreement. No allowance will be granted for any expenses or time
  incurred in travelling to/from the allocated place of work. Your duties and responsibilities will
  vary according to each assignment and may need to be amended from time to time in light of
  service

  Requirements at the work location on a day to day basis you will be accountable to the House
  Manager at the place of assignment as specified by the agency in respect of each work
  placement. You will also be professionally accountable to RRH.

PAYMENT

  Your basic hourly rate of pay will be dependent on the type of work that you undertake and
  will be in accordance with RRH pay rates. You will be paid in weekly instalments directly into
  your bank or building society account by Bank Credit transfer each Friday of the week after
  the period in which the assignment was undertaken and on condition that RRH are in receipt
  of requisite timesheets.

  You are required to submit a weekly timesheet to the RRH office by 2pm each Monday for
  payment that Friday and 2pm Wednesday for invoicing purposes following the week worked.


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   Deductions of tax and NI under the PAYE scheme shall be made from the payment but this is
   for administrative convenience only and is not intended to imply an employment relationship
   between the parties.

HOURS OF WORK

   You are registered with RRH on an ad hoc casual basis. RRH does not guarantee work will
   be available on any particular day or week. There is no obligation on the part of the RRH to
   provide any work or for you to accept any work so offered. Your services on any one
   assignment can be terminated without prior notice being given.

   You are at liberty to refuse any work offered. If you accept work and then subsequently
   become unavailable you must notify the RRH office at the earliest opportunity. It is your
   responsibility to present yourself for duty at the appropriate and agreed location on time, and
   to be immediately and suitably prepared to commence your duties.

   You are permitted to work a maximum of 6shifts per week. You will have individual
   responsibility for the number of hours worked and RRH will assume that you do not work
   more than 6shifts per week. You must notify RRH immediately if this is not the case.

PUBLIC/BANK HOLIDAYS

   Any assignment that is offered to you to undertake on a Public/Bank holiday will be paid at an
   enhanced rate of pay in accordance with RRH pay rates.


MEDICAL FITNESS

   It is a condition of any offer of work made by RRH that you are fit to carry out the duties. RRH
   may request evidence of such fitness in order that an offer of work may be made.

CRIMINAL RECORDS BUREAU CHECKS

   Registration with RRH is subject to satisfactory CRB clearance. You may be requested by
   RRH to pay such application fees for the enhanced disclosure check that may from time to
   time be required. Alternatively you are entitled to obtain the CRB check via a third party
   organisation specialising in applications for disclosure checks.


BEHAVIOUR MANAGEMENT

   Whilst undertaking assignments on behalf of RRH you are expected to achieve and maintain
   acceptable standards of conduct, attendance and performance. Unacceptable standards of
   conduct, attendance and performance may result in you being temporarily suspended or
   removed from the RRH register, pursuant to an appropriate investigation to ascertain the
   circumstances of the case. For example, swapping shifts without express approval of the
   RRH office may result in suspension from registration at RRH.




   SICKNESS BEHAVIUOR
   In the event you fall sick prior to commencement of or during an assignment you are required
   to give at least two hours notice by phoning the office on the booking line
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   (01732424021)/(07713118402). This would allow us ample time to find a replacement for you.
   The agency is operational 24 hours a day.




CONFIDENTIALITY

   You must not disclose any confidential information relating to RRH or in respect of which RRH
   owes an obligation of confidentiality to any third party during or after you engagement except
   as required by law. The expression “confidential information” shall include but is not limited to

Service users‟ treatments, diagnoses, personal information, all documents and other information
    relating to RRH business and services; RRH‟s personnel records, accounting information and
    details relating to its financial arrangements; and RRH‟s computer software.

HEALTH AND SAFETY

   RRH will take all reasonably practicable steps to ensure your health, safety and welfare
   during the periods that you are on RRH premises. You must have regard at all times for your
   own health and safety and of other workers and visitors to RRH‟s premises. Any hazards to
   such health and safety or accident must be reported immediately. You are required to comply
   with health and safety policy regulations relating to Clients‟ premises as stipulated by the
   Client whilst on assignment.


SMOKING

   RRH has a policy restricting smoking to designated areas as part of its responsibility for the
   promotion of health. Smoking is not permitted in any public area. All persons attendant on
   RRH‟s premises are expected to comply with this policy. Whilst you undertake an assignment
   on Clients‟ premises, you are required to comply with their smoking policy with immediate
   effect.

PERSONAL BELONGINGS

   RRH cannot accept responsibility for loss by theft or otherwise, or damage of your personal
   belongings either on company premises or Client premises. You are advised to ensure that
   you have adequate personal insurance to cover such loss/damage should it occur.


IDENTIFICATION BADGES

   Once you are issued with a photo identification badge it should be clearly visible at all times
   whilst you are on assignment. You should not wear your identification badge if you are not on
   an assignment. However you should carry it with you as a form of official identification to
   show on request. You must inform RRH immediately if you lose your identification badge.

VALUING DIVERSITY

   It is the aim of RRH to ensure that no temporary care worker receives less favourable
   treatment on the grounds of sex, race, colour, religion, marital status, sexuality, sexual
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   orientation, age, religion or religious belief, ethnic origin or disability.

COMPLAINTS

   If we receive a complaint you will be contacted as soon as possible. You will usually be asked
   to write a statement and may be required to come and meet with us. Potentially serious
   complaints may result in us being unable to offer work to you while the issues are investigated
   and resolved. Repetitive problems may lead to your name being removed from the RRH
   register. Issues of Gross Misconduct will lead to your contract being terminated.

   If the complainant is not satisfied with the investigation, they can write to our regulatory body
   at:

                                           CARE QUALITY COMMISSION
                                            CQC National Correspondence
                                                   PO Box 1258
                                               Newcastle upon Tyne
                                                     NE99 5AU

                                              Telephone: 03000 616161
                                            Email: enquiries@cqc.org.uk




POLICIES

   RRH takes care to adhere to all industry guidelines regarding care provision, and properly
   qualified staff. We value our commitment to providing quality, Care and ensuring that,
   whatever level of attention is required, our customers and theirs clients feel looked after and
   comfortable. We recognise that it is important to be able to trust the standards of care into
   which loved ones are placed. For this reason we are regulated both internally and externally
   to ensure high standards are maintained across our services. For more information on staff
   qualifications and industry certificates please do not hesitate to contact us.

   STATEMENT OF PURPOSE
   The management practices and procedures of RRH ltd are set out in a comprehensive set of
   policy documents. These policies ensure that we meet the statutory requirements for running
   a healthcare agency and address all aspects of staff, management, caring for our clients and
   preservation of health & safety standards as appropriate. All of our policies are regularly
   reviewed to ensure that they remain up to date. Our policies are available to you through the
   office. Address 26 kings Hill Avenue, Kings Hill, West Malling, Kent ME19 4AE


   Our Quality management systems at RRH ensure the highest standards of quality in every
   aspect of our organisation and activities to ensure that our services are appropriate for our
   clients‟ needs. We have a comprehensive self-assessment system, which requires that all our
   policies and work practices be audited at least annually to ensure that we maintain the high
   standards we have set. Any non- conforming area of activity is corrected and reviewed. In
   addition to self-assessments, RRH is also subject to the inspection regime of the Regulatory
   bodies and local offices of The Care Quality Commission to ensure that we are operating to
   relevant standards.


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HOW TO BOOK A SHIFT
To book a shift Simply telephone our main number (07713118402) anytime, as we are
fully operational 24 hours a day, 7 days a week, 365 days a year. When you telephone us
simply provide our booking staff with details of the days you are available to work including
any preferences and we will endeavour to fill your requests. You will be kept informed every
step of the way. At Rapid Response we recognise the need for continuity of care and we will
endeavour to provide consistency of care and of placements and will always aim to return
staff to organisations that they are familiar with. Rapid Response HealthCare has a minimum
4-hour charge for any shift.



SHIFT CANCELLATION
Booked Shifts, or staff availability can be cancelled at any time by giving at least 24
hours notice by telephone on 07713118402


STAFF POLICIES & PROCEDURES

RRH Ltd is committed to delivering/supplying staff of highest quality as highlighted in its
statement of purpose. As such we take seriously the implementation of laid out policies and
procedures to protect that and to meet the standards set out by all regulatory bodies and Care
quality Commission. As part of your induction all staff registered with RRH Ltd will read and
sign that they have understood the policies as set below. These set of policies should be read
in conjunction with other related documents such as Terms of Engagement, User Guide and
Staff handbook.




Policy No. 1    CODE OF CONDUCT



Policy No. 2    DUTIES & ACTIVITIES NOT TO BE UNDERTAKEN BY STAFF



Policy No. 3    PERFORMANCE APPRAISALS & TRAINING REVIEW



Policy No. 4    STAFF UNIFORM/ DRESS CODE POLICY



Policy No. 5    WHISTLE-BLOWING



Policy No. 6    CONFIDENTIALITY POLICY



Policy No. 7    GROSS MISCONDUCT

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Policy No. 8    HEALTH & SAFETY POLICY



Policy No. 9    EQUAL OPPORTUNITIES POLICY

                - Monitoring Form



Policy No. 10   COMPLAINTS AND COMPLAINTS PROCEDURE

                Record of complaints form



Policy No. 11    Medication administration policy




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                          RAPID RESPONSE HEALTHCARE LIMITED



                                  POLICIES & PROCEDURES



RRH is committed to delivering/supplying staff of highest quality as highlighted in its
statement of purpose.

As such we take seriously the implementation of laid out policies and procedures to protect
that and to meet the standards set out by the Care Quality Commission.

As part of your induction all staff registered with RRH will read and sign that they have
understood the policies as set below.

These set of policies should be read in conjunction with other related documents such as
Terms of Engagement, User Guide and Staff handbook.

Policy No. 1     CODE OF CONDUCT

Nurses and Healthcare assistants undertaking activities with clients are required to be bound
by the following Code of Conduct as a condition of undertaking assignments with RRH:

1. Nurses and Healthcare assistants must abide by all Policies, Procedures and Codes of
    Practice laid down by RRH.
2. Nurses and Healthcare assistants must act with honesty, integrity and with respect for
    clients and their property.
3. Nurses and Healthcare assistants are expected to carry out their duties so as to promote
    and safeguard the clients/patient's health, well-being and interests. This must include
    informing their immediate Supervisor or Manager of any perceived or suspected
    deterioration in a client's physical, social or mental condition or behaviour.
4. Nurses and Healthcare assistants must at all times respect and safeguard the privacy of
    clients/patients. Confidential information must not be disclosed to any third party without
    written consent of the client or appointed advocate unless it is considered to be in the
    best interests of the client's health and well-being, or is required for compliance to the
    law. In these latter cases, matters must always be referred directly to RRH management.
5. Nurses and Healthcare assistants must not be involved in any action that may prejudice
    the service or damage the reputation of RRH.
6. Nurses and Healthcare assistants must at all time respect the dignity and independence
    of clients and patients, and, for homecare patients in particular, of the rights of the client
    to make informed choices regarding his / her care and welfare.
7. Nurses and Healthcare assistants must not discriminate on the grounds of age, race or
    ethnic origin, creed, colour, religion, political affiliation, disability or impairments, marital
    status, parenthood, sexual gender or sexual orientation.
8. Nurses and Healthcare assistants must act professionally at all times. This will apply to
    relationships with peer members and other colleagues within the Organisation, and with
    other health and social care professionals with whom they come into contact in the
    course of their duties.
9. Nurses and Healthcare assistants must establish and maintain relationships with the
    client.
10. Nurses and Healthcare assistants have a duty to ensure that each client is aware of the
    Organisation's Complaints Procedure, and how to use it. Any Nurse or Healthcare
    assistant who receives a complaint from a client must notify the registered manager.

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11. Healthcare assistants who are not registered qualified nurses, whatever their other
    qualifications may be, MUST NOT UNDERTAKE TASKS OF A NURSING NATURE or
    any other task outside of the remit of the Job Description or agreed Care Service Plan for
    a client.


Policy No. 2    DUTIES & ACTIVITIES NOT TO BE UNDERTAKEN BY STAFF



Aim

This policy aims to provide clear instruction on the duties and activities NOT to be undertaken
by nurses and Healthcare Assistants registered by Rapid Response.



1. Non qualified staff must NOT administer medication. If the client is receiving prescription
    medication the Nurses and Healthcare assistant should become familiar with the dosage
    quantities and the times when medication should be taken, but The Nurses and
    Healthcare assistant's involvement must be limited to ensuring that the medication is
    taken as prescribed. Where medication is not taken, either deliberately or as an oversight,
    The Nurse and Healthcare assistant must record this in the daily notes and inform a
    qualified member of staff. If the patient develops a pattern of not taking medication, the
    matter should be reported to a RRH manager for appropriate action.
2. Similarly, where the client is receiving on-going medical / nursing care The Nurse or
    Healthcare assistant must not become actively involved, but may be required to offer
    personal assistance to the client, which may include disposing of syringes (for self-
    injecting clients) and the emptying of commodes.
3. The Nurse and Healthcare assistant must not directly accept keys to a client's home.
    Unless it is part of an agreed care plan.
4. The Nurse or Healthcare assistants must not accept money from a client for shopping etc.
    Nurse and Healthcare assistants should not take client's money.
5. The Nurse and Healthcare assistant must not borrow money from a client, or become
    involved in lending money to a client. Similarly, The Nurse and Healthcare assistant must
    not take any responsibility for looking after a client's valuables, selling or otherwise
    disposing of goods belonging to the client, and must not become involved in betting
    syndicates (such as the lottery or football pools) with the client.
6. The Nurse and Healthcare assistant should not accept food from the client for a meal
    which The Nurse and Healthcare assistant would normally provide for himself / herself.
7. Cleaning duties outside those specified in the Contract, e.g. spring cleaning, and should
    not be undertaken.
8. The Nurse and Healthcare assistant should not smoke or consume alcohol while on duty.
9. The Nurse and Healthcare assistant must not bring other members of their family, e.g.
    children, or any other unauthorized persons into the client's home. Similarly, The Nurse
    and Healthcare assistant must not bring pets into a client's home.
10. Gifts should not be accepted from a client. This does not include the normal hospitality of
    a cup of tea, etc., if this is offered. The Nurse and Healthcare assistant must be sensitive
    to the client wanting to thank them for the help they have been given, but remain mindful
    of the Company Policy towards gifts and gratuities.
11. The Nurse and Healthcare assistant MUST NOT accept any direct payment from the
    client for services rendered, and MUST NOT become involved in selling any personal
    goods or services to the client.

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12. Temporary personnel are precluded from assisting the Client in relation to making a will
    or benefiting under the terms of any cordial made by the Client.
13. The Nurse and Healthcare assistant must not use the client's property, e.g. telephone, for
    his / her personal use.
14. The Nurse and Healthcare assistant undertaking Home Care must not carry out their
    duties in an unoccupied house. If the client is absent when The Nurse and Healthcare
    assistant calls, and assuming that The Nurse and Healthcare assistant has a key, then
    this must be reported immediately to the registered manager/RRH.
15. The personal affairs of other clients of the Organization must not be disclosed under ANY
    circumstances to another client or any other third party.


Policy No. 3    PERFORMANCE APPRAISALS & TRAINING REVIEW

Aim:

These Policy summaries the systems employed within the Organisation to ensure that staff
job performances are regularly assessed against expected work standards and to identify
opportunities to enable them to improve their professional skills and personal contributions to
the Organisation‟s Aims & Objectives:

1. Each staff member will undergo a formal review of job performance every 12 months.
2. The review will be undertaken by the employee's immediate supervisor who will assess
   job performance from the following standpoints:
    General ability to do the job, and appreciation of duties.
    Overall reliability, trustworthiness and ability to work alone.
    Sickness and absence record, with particular reference to the number of
       unauthorised days taken.
    Concern for clients and their welfare.
    Inter - personal relationships, in particular with other staff and patients.
    General appearance, dress and demeanour.
    Attitude and efforts applied to job duties.
    Verbal communication skills.
    Temperament, self-control, stability and ability to cope and make sound judgments
       under pressure, and general reaction to, and management of, stressful situations.
    Leadership skills and guidance of others.
    Willingness to learn and undertake training.
3. The results of the review will be recorded on a Staff Performance Appraisal Record Form
   which will form the basis of assessment for future training requirements, job rewards or
   continuance of employment.
4. The results of all Appraisals will be kept in the employee's personal files.


Policy No. 4    STAFF UNIFORM / DRESS CODE

Aim

This policy is intended to achieve the following objectives:



To ensure that all staff present themselves in a standard of dressing and appearance
consistent with a highly professional image.


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To ensure that at all times the client becomes familiar with a particular identity for our staff,
and to foster confidence in the image and professionalism of the Service

      All staff is required to wear the RRH uniform or alternative dress code as specifically
       advised at the time of booking. This will apply to all hours spent on duty.
      Appropriate shoes should be worn at all times. High-heeled or platform shoes should
       not be worn in view of the potential safety hazards that they can present. No trainers
       or jogging trousers short trousers to be worn.
      For reasons of Health & Safety no jewellery other than plain gold wedding rings or
       plain ear-studs should be worn unless next to the skin and covered by the uniform.
      It is the responsibility of all staff to launder their uniforms and to ensure that are kept
       clean and tidy at all times.

Policy No. 5    WHISTLE-BLOWING

Aim

This policy aims to ensure that Service users who are also patients are protected from abuse
whilst being cared for by Rapid Response staff.



1. It is the policy at RRH to encourage the reporting to management all matters of serious
   concern involving a member of staff, and for persons to feel that they can do so freely and
   without fear of reprisals or intimidation. Matters of serious concern will include, but may
   not be limited to, the following:
        a. Professional malpractice.
        b. Abuse of a client.
        c. Criminal activities (theft / embezzlement / assault, etc.)


2. Persons reporting such incidents can include the following:
       a. Fellow Nurse and Healthcare assistants (peers).
       b. Clients.
       c. Family / relatives / friends of a client.
       d. Professional person acting on behalf of a client (advocate / minister of religion,
          etc.).


3. Where an incident of serious concern is alleged the person making the allegation must
   report this directly to the registered manager or office administrator. He / she will be
   assured that appropriate enquiries will be made to establish the nature / reality of the
   incident and those enquiries will be carried out discreetly and in confidence. Wherever
   possible, the identity of the person reporting the incident will be kept anonymous.


4. Where preliminary enquiries show that further investigations need to be made, then the
   registered manager will inform the staff member against whom the allegations have been
   made.


5. Where the alleged offence is of a serious nature, the following action will be taken:




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6. The Nurse or Healthcare assistant at the centre of the allegation will be removed from the
   assignment pending the outcome of the investigation. The Nurse or Healthcare assistant
   will be informed of the necessity for this action and will be assured that, at this point, there
   is no inference of guilt.


7. Where it is believed the Nurse or Healthcare assistant has committed an offence
   prescribed by relevant regulations, details will be reported to the appropriate Protection
   Registers as follows, irrespective of whether disciplinary procedures are completed and
   whether or not the employee concerned is suspended from duty:
                i. Protection of Vulnerable Adults Register
               ii. Protection of Children Register


8. Report the matter to the Police, as appropriate to circumstances.

9. A full investigation will be undertaken, interviewing all parties concerned in the allegation.
   This may include other Nurse and Healthcare assistants and a client's family, relatives
   and advocates as appropriate.


10. Following completion of the investigation:
        a. If the allegations are justified the Nurse or Healthcare assistant concerned will be
            withdrawn from subsequent assignments. Criminal charges may be brought by
            the Police or other parties, depending upon the circumstances.


        b. If the allegation is not proven, but has proven to be a malicious action on the part
           of the accusing party, then the accuser will be subject to appropriate disciplinary
           action per the Disciplinary Procedure. This may involve discretionary re-
           deployment of the accuser's duties, or dismissal, as deemed appropriate.


Policy No. 6     CONFIDENTIALITY

Aim

This policy aims to ensure that action is taken to protect confidentiality of information relating
to service users who are also patients, their carers and advocates and all nurses and
healthcare assistants registered with RRH.



1. In the course of their duties Nurse and Healthcare assistants registered RRH may
   become privy to confidential information concerning clients' and patients' private affairs:
       a. It is a condition of assignments with RRH that such information shall not be
          disclosed to any unauthorized third party without the express consent of the
          client, or if the client is unable to give consent, the client's immediate family or
          advocate.


        b. Confidential information will not be sought from a client unless expressly in the
           interests of that client‟s care.



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        c.   The client shall be kept informed at all times of the outcome of confidential
             discussions by the Nurse or Healthcare assistant concerning them.


        d. Nurse and Healthcare assistants will always consult management if they are
           unclear with respect to any item concerning confidentiality, or when made privy to
           confidential information that may have legal and / or criminal connotations (e.g. if
           a client confides that they have allegedly been subjected to sexual abuse by a
           staff member).


2. Similarly all information pertaining to nurses and healthcare assistants registered with
   Rapid Response shall be kept in confidence and will not be used for any other purpose
   other than for which they have been collected.
3.
4. Any breaches of this Policy will be dealt with severely and will result in disciplinary action
   being taken.


5. RRH will manage confidential information in a manner that complies with the
   requirements of Data Protection Act 1998.

6. All files containing personal confidential information will be kept in a fire proof lockable
   cabinet and access to any records is carefully managed as to protect the confidentiality of
   such information.

Policy No: 7 Gross Misconduct / Employee Disciplinary Procedures

Aim:

RRH wishes to ensure that any complaints about unsatisfactory work or conduct are resolved
as quickly and with as much fairness as possible and to this end have established a
Disciplinary Procedure.

This procedure applies to all employees. It is designed to help and encourage all employees
to achieve and maintain standards of conduct, attendance and job performance. Should the
standards of conduct, attendance and/or job performance of an employee fall below the
expectations of RRH, this procedure will be used in an attempt to effect improvement.

Responsibilities

   It is the responsibility of the Management of RRH to explain clearly all requirements
   regarding standards of conduct, attendance and job performance and adherence to policy
   and to ensure that these are updated and issued to all employees.

Principles

   At any stage in this procedure the employee will be informed by their supervisor of the
   nature of the complaint against her/him and will be given the opportunity to make her/his
   case before any decision is made. The notice of any meeting under this procedure must
   tell the employee the nature of the complaint being made.

   No disciplinary action will be taken against an employee until the case has been fully
   investigated. It may prove necessary to place an employee on suspension until such
   investigations are carried out. Suspension will be notified to the employee in writing and
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   will not normally exceed a period of 10 working days without review. In exceptional
   circumstances the period of suspension may be extended to allow full investigation to take
   place. Any such extension will also be notified to the employee in writing. During such a
   suspension the employee will be paid at a rate equivalent to her/his contractual earnings.

   No employee will be dismissed for a first breach of discipline except in the case of gross
   misconduct when the penalty will normally be summary dismissal, i.e. dismissal without
   notice or wages in lieu of notice.

   At all stages of the procedure, the employee will have the right to be
   accompanied/represented by her/his trade union representative or fellow employee of
   her/his choice. Any mitigating circumstances will be taken into account in reaching a
   decision.

   Any employee will have the right of appeal against any disciplinary penalty imposed.

   In appropriate cases (e.g. poor performance), an employee will be advised in writing of the
   time allowed for improvement and when and how reviews will take place. The employee
   will have the right of appeal against the time allowed for improvement.

   The procedure may be initiated at any of the stages 1-4, depending on the seriousness of
   the employee's alleged misconduct.

   No disciplinary decision will be taken against a trade union representative until discussions
   have taken place with a full-time official of the union.

   Only when all reasonable efforts have been made to assist an employee will disciplinary
   action be taken. The procedure will be operated within the agreed time-scales.
   Responsibility to maintain confidentiality lies with all parties involved.

Informal Procedure

   It is RRH aim to encourage acceptable standards of conduct and performance. Every
   effort will be made to deal with minor problems through informal discussion and
   supervision in order to avoid the need to implement the formal procedure.

   The supervisor will arrange for provision of support, practical assistance and/or training as
   appropriate to ensure that acceptable standards of work performance and behaviour are
   met.

   When the informal procedure outlined fails, or the matter is more serious, the following
   formal procedure will be used.

Formal Procedure

   Stage 1 - Verbal Warning

   If performance or conduct is not considered satisfactory, and where (if appropriate) the
   informal procedure has established this to be within the employee's control, the employee
   will be interviewed by the line manager and given the opportunity to explain her/his
   actions.

   If the explanation is not satisfactory, a formal verbal warning will be given and recorded in
   the employee's personal file. The record must identify shortcomings, the standard of
   conduct and/or performance required and give a specific time in which improvement must
   be made. It must be conveyed verbally and confirmed in writing.
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    The employee will be informed in writing of the right of appeal.

    Stage 2 - First Written Warning

    If there is no improvement in the standard of conduct/performance following a review
    within the period specified for Stage 1, or where the seriousness of the alleged offence
    warrants immediate recourse to this stage of the procedure, the employee will be
    interviewed by the designated person and given the opportunity to explain her/his actions.

    If the explanation is not satisfactory, a First Written Warning will be issued. The First
    Written Warning should fulfil the following conditions:

    -      it should state clearly the nature of the offence
    -      if appropriate, it should state that repetition of the offence or commission of further
           offences may lead to further disciplinary action
    -      it should specify any agreed action required of both parties, including time-scales for
           improvement and methods of reviewing progress, and
    -      the employee will be informed in writing of the right of appeal.
    The warning will remain confidential to the employee, any representative of the employee,
    and the Personnel Manager. It will be filed in the employee's personal file.

    Stage 3 - Final Written Warning

    If there is no improvement in the standard of conduct/performance following a review at
    the end of the period specified for Stage 2, or where the seriousness of the alleged
    offence warrants immediate recourse to this stage of the procedure, the employee will be
    interviewed by the designated people and given the opportunity to explain her/his actions.

    If the explanation is not satisfactory, a final written warning will be issued. The final written
    warning should fulfil the following conditions:

-       it should state clearly the nature of the offence
-       if appropriate, it should state that repetition of the offence or commission of further
        offences may lead to further disciplinary action
-       it should outline any agreed action required of both parties, including timescales for
        improvement and methods of reviewing progress, and
-       it should make clear that, if there is no or insufficient improvement in performance or
        conduct after the period specified, it may result in dismissal.
-       the employee will be informed in writing of the right of appeal.
    The warning will remain confidential to the employee, any representative of the employee,
    the Director and the Chair of the Employment Sub Group. It will be filed in the employee's
    personal file.

    Stage 4 - Dismissal

    If there is still no sustained improvement in the standard of conduct/performance whilst a
    final written warning remains live. or if any new offence occurs whilst a final written
    warning remains live, or if there is any allegation of gross misconduct, the employee will
    be interviewed by the designated people.

    If an acceptable explanation is not forthcoming, dismissal will normally result, with or
    without notice as appropriate.
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   The employee will be provided, as soon as is reasonably practicable, but within five
   working days, with written reasons for dismissal, the date on which employment will
   terminate and the right of appeal.

   In cases of gross misconduct dismissal may be without notice or payment in lieu of notice.

Types of Offences

   The following are examples of the various categories of misconduct and/or poor
   performance, but the lists are not exhaustive.

   Misconduct - action taken at Stage 1 and/or Stage 2 of procedure

         poor time-keeping (repeated lateness or early leaving)
         failure to notify promptly reasons for absence in accordance with procedures
         smoking in designated No Smoking areas
   Serious Misconduct - action taken at Stage 3 of procedure

         breach of confidence not amounting to gross misconduct
         unauthorised absence
         wilful breach of Health and Safety Regulations
   Gross Misconduct - action taken at Stage 4 of procedure

Gross misconduct includes, but is not limited to:

         Fighting, physical assault or dangerous horseplay.
         Physical sexual harassment and other instances of gross immorality.
         Gross insubordination or the use of aggressive behaviour or excessive bad
          language.
         Failure or refusal to carry out a reasonable instruction given by a Manager or
          Supervisor during duty hours.
         Theft of, or wilful damage to, any property belonging to the Organisation, a client, or
          other employee.
         Deliberate fraud, including fraudulently completing timesheets, fraudulent abuse of
          the Statutory Sick Pay Scheme and Absence Policies. This will include abandoning
          contracted duties without notification or prior permission.
         Consuming alcohol while on duty. Arriving at work intoxicated will also lead to
          summary dismissal.
         Abuse of drugs, solvents and other mind-altering substances.
         Breach of safety rules and / or other actions which places at serious risk the health
          and safety of another person.
         Abuse or maltreatment of clients.
         Deliberately falsifying written records.
         Unauthorised disclosure of confidential information.

Duration of Warnings

   Stage 1 - Verbal Warning - Will remain on the employees personal record for 3 months

   Stage 2 - First Written Warning - Will remain on the employees personal record for 6
   months

   Stage 3 - Final Written Warning - Will remain on the employees personal record for 2
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   years

Appeals

   An employee has the right of appeal against any aspect of disciplinary action and penalty.
   The employee will be advised of the right of appeal and the right to representation at the
   appeal. Details of how and when to exercise this right of appeal will be given when the
   warning is issued.

   Any appeal should be made in writing to the Personnel Manager within 7 working days of
   receiving the decision against which the employee is appealing.

   The Personnel Manager will convene an Appeal Board hearing within 20 working days of
   receipt of the letter. The Appeal Board will consist of three individuals nominated by the
   Personnel Manager. No individual involved in the original disciplinary decision may be
   involved in the Appeal Board hearing, except to give evidence.

   The following information will be provided to the appellant in writing:

       - the venue where the hearing will take place

       - the time and date of the hearing

       - the right to representation, and

       - the names of those hearing the appeal and any others expected to be present.

Time-Scales and Notice

   Employees have the right to 5 working days notice in writing of any meeting called under
   this procedure.

   Any meeting under this procedure must take place as soon as possible, but within 20
   working days of the date of the first notice.

   Any Appeal Board hearing will take place within 20 working days of receipt of the appeal
   being lodged.



Policy No. 8     HEALTH & SAFETY



Aim:

This policy aims to ensure the health and safety and welfare of service users who are also
patients and of nurses is promoted and protected whilst using RRH or whilst working for RRH.



Introduction

It is the policy of RRH Ltd to provide and maintain safe and healthy working conditions,
equipment and systems of work for all our employees, temporary Nurses and Healthcare
assistants and to provide such information and training as they need for this purpose.



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Appropriate preventative and protective measures are, and will continue to be, implemented
following the identification of work-related hazards and assessment of the risks related to
them. It is also the policy of RRH to ensure that its business is conducted in a manner so as
to reduce the risks to members of the public. RRH may require you to attend such training
programs in order to meet the aims of the Company.

The Company accepts its responsibility for health and safety of other persons who may be
affected by the Company‟s activities.

The allocation of duties for safety matters and the identity of persons appointed with particular
responsibilities are set out in this policy.

This policy will be kept up to date, to reflect changes in legislation. To ensure this, the policy
and its effectiveness will be reviewed annually.



Rapid Response’s responsibilities

It is the duty of management to ensure the following:

     Providing and maintaining systems of work that are safe and without risk to health;
     Ensuring safety and absence of risks to health in connection with handling, storage
      and transport;
   Providing information, instruction, training and supervision;
   Maintaining all places of work in a safe condition;
   Providing and maintaining a safe working environment.
Nurses’/Healthcare Assistants’ responsibilities

All employees, nurses and Healthcare assistants have a duty in law to act responsibly and to
take reasonable care for the health and safety at work of both themselves and their
colleagues. This duty can be carried out by:

     Working safely and efficiently;
     Using any protective equipment provided and meeting statutory obligations;
     Reporting incidents that have lead to injury or damage;
     All such incidents must be recorded and copied to the registered. Any failure to
      adhere to the Company Health and Safety Policy and Procedures will be considered a
      serious disciplinary offence and is one which may lead to dismissal;
   Adhering to the Company procedures for securing a safe workplace. Individuals will
      be nominated to undertake health and safety duties as required.
Working Practices

      You must not operate any item of equipment unless trained, and authorized to do so.
      You must not remove any guarding from equipment used or deviate from your
       authorized usage of the equipment
     You must report immediately any equipment defect, and never attempt repair
     You must undertake all duties as instructed and never deviate
     In the case of Nurse or Healthcare assistants attending work on external sites, do not
       commence work until you have received a health and safety induction from the site
       manager.
In the case of RRH Ltd PAYE employees you will receive a health and safety induction from
one of our managers before you commence employment.

Hazard/Warning Signs and Notices
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      You must comply with all hazard/warning signs and notices displayed on the premises
      Working Conditions/Environment
      You must make proper use of all equipment and facilities provided to control working
       conditions/environment
    You must ensure you keep your work areas clear/tidy
    You must dispose of waste/scrap in the appropriate receptacles
Protective Clothing & Equipment

   You must wear protective equipment where required
   You must never obstruct any fire escape route, fire equipment or doors
Health

    You must report any medical condition that could affect the safety of yourself or others
    You must follow all rules pertaining to no smoking areas.
Accidents

      The Company is obliged by law to keep record showing details of all accidents, which
       occur on the premises. Therefore all accidents, however minor, to both employees
       and clients, must be reported immediately. If any accidents and sufficiently serious to
       warrant hospital treatment, these must also be reported to the local authority. A form
       must be completed.
Fire and Emergency

      You must observe the evacuation procedures laid down in the event of a fire or any
       other emergency situation
      You must be aware of the location of the emergency exits, assembly points and first
       aid kit
      Procedures to be carried out in the event of a fire or emergency will be found on the
       notice board.


Policy No. 9     EQUAL OPPORTUNITIES POLICY

Aim:

RRH Ltd is an Equal Opportunities Employer, committed to ensuring that staff abilities talents
and resources of all are utilised to the full. As such we are committed to adopting,
implementing and monitoring a Policy of Equal Opportunities for all to ensure a total absence
of discrimination in the workplace and that equal opportunities do genuinely exist.

It is the objective of this Policy that there shall be no discrimination for any reason of race or
ethnic origin, creed, colour, religion, political affiliation, disability or impairments, marital
status, parenthood, sexual gender or sexual orientation. In this respect, those with physical
disabilities will only be prohibited from positions where the job duties involve activities that
would make it impossible or inherently hazardous to perform.

In order to eliminate possibilities of discrimination or prejudice our application forms do not
include questions concerning race or ethnic origin, creed, colour, religion, political affiliation,
parenthood or sexual orientation. Thereafter, selection criteria will proceed purely according
to the merits and abilities to perform the tasks and duties required.

The Organisation provides facilities for anybody who believes them to have been treated
unfairly within the scope of this Policy to address the matter through a documented and
established Procedure.

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MONITORING THE EQUAL OPPORTUNITIES POLICY



1. The Equal Opportunities policy will apply for Nurse and Healthcare assistants with
   respect to work prospects and for clients with respect to the Care Service being provided.


2. Equal Opportunities will identify the following equalities issues throughout 1.
3. Nurses and Healthcare assistants - Equal Opportunities in respect of race, culture /
   ethnicity, religious / sectarian issues and disabilities
4. CLIENTS - Equal Opportunities in respect of:
    Observance of religious beliefs, customs and festivals which may affect food / dietary
       preferences, personal care, worship and leisure activities.
    Communications:
       a. Language physical impairments or disabilities which may make communication
            difficult to understand, e.g. speech impediments, partial / total loss of hearing or
            sight
    Impairments or disabilities:
       b. “Loss of mobility - dependency upon wheelchairs, etc." frailty" dementia
    Care of the dying and death.


5. Monitoring the success of the EO Policy will be achieved through a review of data and
   records obtained from the following sources:

6. CLIENTS / FAMILY:
   Questionnaires regarding the quality of the service offered. There are separate
   questionnaires for use by clients and their family / relatives.

7. NURSES AND HEALTHCARE ASSISTANTS:
   Through their perceptions of the EO Policy, particularly where staffs themselves are of an
   ethnic minority, or are disabled etc. and through disciplinary records i.e. are any equality
   issues apparent?

8. APPLICATIONS:
   Is there a suitable provision on the Application Form for applicants to declare issues
   which may be relevant to Equality of Opportunity, e.g. race, culture, disabilities, etc.?
   Review Job Application Forms and the follow-on Interview Notes for both successful and
   unsuccessful applicants.

9. COMPLAINTS LOG:
    Focus on complaints involving the following:
    Harassment / abuse / preferential or unfair treatment with respect to the equalities
     issues identified for both clients and staff.
    The display of offensive material within the offices.
    Inadequate methods of communication with respect to language, loss of sight or
     hearing, or other impairments such as dementia.

10. The data collected will focus upon the equalities issues listed above, identifying areas of
    possible discrimination and / or exclusion.


11. A review of this data will be made on a 12-monthly basis with a view to assessing:
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       Opportunities for improvement (also to be discussed with clients / family).
       Action needed to make these improvements.
       Responsibilities for action, and follow-up monitoring to ensure that the action taken
        has been effective.
12. The Equalities Action Plan will also contain a simple system for the ethnic and disabled
    monitoring of both clients and Nurse and Healthcare assistant staff as a Discrimination
    Profile within the Organisation. This will be based upon a person's self-declaration against
    the following ethnic categories, as recorded in the original Care Plan (for clients) and Job
    Application Forms (for staff), and registered disabilities:

                 WHITE (UK)

                 WHITE (other EUROPEAN)

                 WHITE (other)

                 IRISH

                 BLACK AFRICA CARIBBEAN

                 BLACK AFRICAN

                 BLACK (other)

                 INDIAN

                 PAKISTANI

                 BANGLADESHI

                 ASIAN (East African origin)

                 ASIAN (other)

                 CHINESE

                 MIXED PARENTAGE

                 OTHER

This data will be recorded on Ethnic & Disabled Discrimination Monitoring Forms which will be
reviewed on a six monthly basis by the Registered Manager to identify possible areas of
exclusion or discrimination, based upon race or ethnicity.

Policy No. 10    MANAGEMENT OF COMPLAINTS AND COMPLAINTS PROCEDURES

Aim:

The aim of this policy is to ensure that Service users are confident that all their complaints will
be listened to, taken seriously and acted upon.

Introduction

At RRH, we take all complaints seriously, and will investigate them fully before taking any
action. Our complaints procedure takes into account the needs of clients and agency Nurse
and Healthcare assistants to have clear policies for reporting and resolving complaints.

1. Each instance of complaint, verbal or written, must be reported / routed to the Registered
   Manager. Upon receipt of the complaint they will complete the appropriate sections of a
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    Complaints Record Form for appropriate action. We aim to respond with an
    acknowledgement to all written complaints within 3 working days.

2. We keep a full written record of the nature and details of each complaint received and the
   action taken to resolve the complaint.


3. The severity of the complaint and the wishes of the complainer will determine whether
   immediate suspension of the assignment or duties is appropriate.


4. Every effort will be made to resolve the complaint and to provide a full response to the
   complainant within 20 working days from the date of receipt of the complaint. The
   individual circumstances of the complaint may however render this timescale
   unachievable.


5. At every stage of the investigation of the complaint all parties to the complaint are kept
   informed. As appropriate we provide written statements, keep all parties informed of any
   discussions that may take place.


6. The Agency Nurses and Healthcare assistants are always informed of any complaint
   against them except where the complaint is of fraud or a Confidential Reference. We
   always seek to resolve the complaint and to obtain full responses from the complainer
   (i.e. the Nurse and Healthcare assistant who is the subject of the complaint). With the
   Nurse and Healthcare assistant we will fully explore the basis and fairness or otherwise of
   the complaint and develop demonstrable action for remedying the complaint and to
   ensure that the complaint does not reoccur.


7. If necessary the agency Nurse or Healthcare assistant is called in for a private interview
   with the agency and the areas of complaint are discussed fully with them, an action plan
   is agreed with the agency Nurse or Health care assistant and monitored for success.


8. Where a trained nurse is considered to have breached the NMC Code of Professional
   Conduct, the agency is required to report to the council, outlining the complaint. Breaches
   of conduct are notified to the NMC in writing. The agency Nurse would be suspended
   from the agency's books immediately following suspension from the NMC register.


9. For certain domiciliary care services if we are unable to satisfactorily resolve the
   complaint within a reasonable time period the complainant has the right to refer the
   complaint to CQC


10. Once the complaint has been resolved we will complete the relevant sections of the
    Complaints Record Form. The agency always provides a written outcome relating to each
    complaint.


11. The Personnel Department is responsible for maintaining all records relating to a
    complaint, using an appropriate Complaints Record Form as the basis for monitoring the

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    progress made in resolving the complaint. Records will include all written complaints
    received, and copies of all statements from relevant parties.


12. Complaints will be reviewed on a regular basis for apparent adverse trends in service
    quality through an annual audit.


13. Please note that incidents involving the police or where a nurse is considered to have
    breached the NMC Code of Professional Conduct, the current regulations require us to
    report this to the CQC.


14. If you are dissatisfied with the way Rapid Response has dealt with your complaint you
    have the right to refer to the CQC.

Policy No 11. Administration of Medication

Aim:
To state the rules, regulations and responsibilities regarding the administration of medication
to patients/service users by Rapid Response Staff.

This policy is intended to protect all patients/service users, clients and staff when
administration of medication is involved.

Legislation
National Minimum Standards-Nurses Agency – Standard 9

The policy has been developed from the NMC policy on Medication Management and is
intended to be a guide. All nurses are required to be familiar with the NMC code of conduct on
Medication Management and will be bound by their code of professional conduct.

Definitions
A Medicinal product is:
“Any substance or combination of substances presented for treating or preventing disease in
human beings or in animals. Any substance or combination of substances which may be
administered to human beings or animals with a view to making a medical diagnosis or to
restoring, correcting or modifying physiological functions in human beings or animals is
likewise considered a medicinal product.” Council Directive 65/65/EEC

Use of the word “Patient”
Throughout this document where the word „patient‟ is used this refers to whoever the
medication may be administered e.g. patient, client and user

Use of the word “Nurse”
Throughout this document where the word “nurse” is used this refers to nurses, who are
registered on the Nursing and Midwifery Council Register.

Methods of administration of medicines
Nurses must only administer medicinal products in accordance with the following processes
    Patient Medicines Administration Chart (may be called Medicines Administration
       Record (MAR)
    Homely Remedy Protocol
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    Prescription Forms
Nurses must check any direction to administer a medicinal product.
Nurses will not be allowed to transcribe medication from one “direction to supply or
administer” to another form of „direction to supply or administer”.

The nurse must ensure all medicinal products are stored in accordance with any instruction
on the label or local policies and in accordance with the patient agreement. This includes a
locked cabinet in the patient‟s home.
As a nurse, in exercising your professional accountability in the best interests of your
patients:

    • You must check the following: Identity of the patient to whom the medicine is to be
        administered.
    • The patient is not allergic to the medicine before administering it.
    • You must know the therapeutic uses of the medicine to be administered, its normal
       dosage, side effects, precautions and contra-indications.
    • Patient‟s plan of care (care plan/pathway)
    • The prescription or the label on medicine dispensed is clearly written and unambiguous.
    •The expiry date (where it exists) of the medicine to be administered.
    • The dosage, method of administration, route and timing.
    • Administer or withhold in the context of the patient‟s condition (e.g. digoxin not usually to
        be given if pulse below 60) and co-existing therapies e.g. physiotherapy.
    • Must contact the prescriber or another authorised prescriber without delay where
        contra-indications to the prescribed medicine are discovered, where the patient
        develops a reaction to the medicine, or where assessment of the patient indicates
        that the medicine is no longer suitable.
    • Must make a clear, accurate and immediate record of all medicine administered,
        intentionally withheld or refused by the patient, ensuring the signature is clear and
        legible; it is also your responsibility to ensure that a record is made when delegating
        the task of administering medicine.
     You must obtain informed consent from the patient in all aspects of care and an
        awareness of the purpose of the treatment including medication administration.

In respect of Controlled Drugs:
    • These should be administered in line with relevant legislation and local standard
          operating procedures.
    • It is recommended that for the administration of Controlled Drugs a secondary signatory
          is required within secondary care and similar healthcare settings.
    • In a patient‟s home, where a nurse is administering a Controlled Drug that has already
          been prescribed and dispensed to that patient, obtaining a secondary signatory
          should be based on local risk assessment.
    For Guidance on the administration of Controlled Drugs, go to:
          http://www.dh.gov.uk/prod_consum_dh/idcplg?IdcService=GET_FILE&dID=122755&
          Rendition=Web
    • In cases of direct patient administration of oral medication from stock in a substance
          misuse clinic, it must be a registered nurse who administers, signed by a second
          signatory (assessed as competent), who is then supervised by the nurse as the
          patient receives and consumes the medication.
In exceptional circumstances, where medication has been previously prescribed and the
prescriber is unable to issue a new prescription, but where changes to the dose are
considered necessary, the use of information technology (such as fax, text message or email)
may be used but must confirm any change to the original prescription.
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A nurse must not prepare substances for injection in advance of their immediate use or to
administer medication drawn into a syringe or container by another practitioner when not in
their presence.

A nurse should never administer any medication that has not been prescribed, or acquired
over the internet without a valid prescription. A nurse must dispose of medicinal products in
accordance with legislation. Unlicensed medicines or must follow local procedures.

Management of Adverse events/Drug Errors

As a nurse, if you make an error you must take action to prevent any potential harm to the
patient. Follow local protocol and report as soon as possible to the prescriber, your line
manager and your employer.

In the event that a nurse makes a drug error in the patient‟s own home the nurse must seek
immediate advice from the out of hours GP or the patient‟s own GP. Contact details for the
GP are located in the patient‟s file or can be obtained from Rapid Response office. Further
advice can also be obtained from NHS Direct on 0845 4647 and the Medical Toxicology Unit
on 0207 7715370. In emergency call 999.

 In the event of an adverse drug reaction to a medication the nurse must take any action to
remedy harm caused by the reaction. You must record this in the patient‟s notes, notify the
prescriber. Check vital signs and reassure the patient.

Nurses are required to report all incidents of drug errors or adverse reactions to drugs to RRH
within 1 hour of the incident. Where this is not possible at the earliest possible time.

Nurses will be required to provide a detailed statement of events within 24hrs of the incident.
This will enable RRH to complete a speedy investigation into the incident and take necessary
steps to prevent further risk to the patient.

All incidents of medication errors will be treated seriously and will be investigated thoroughly.
Necessary actions will be taken including review of the nurses competency on medication
management.

All nurses are expected to keep up to date with current practices on safe administration of
medication.

As a registrant, nurses are accountable for their actions and omissions. In administering any
medication, or assisting or overseeing any self-administration of medication, nurses must
exercise their professional judgement and apply their knowledge and skill in the given
situation.

Healthcare Assistants MUST NOT administer medication of any kind under normal
circumstances. Those service users unable to administer their own medication can be
provided with assistance subject to a clear care plan and competency assessment carried out
by the registered manager. This assistance must have been identified through Care Needs
Assessment be part of a care plan. The NMC welcomes and supports the self-administration
of medicinal products and the administration of medication by carers wherever it is
appropriate.


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  RRH will disseminate to all Nurses information relating to medical alerts by email/post as
  necessary.




  Declaration

  I confirm that I have read and understood the contents of the handbook including Rapid
  Response polices.

  Name:……………………………………………………………………………………………………..

  Signature:………………………………………………………………………………………………

  Date:……………………………………………………………………………………………………..



TERMINATION OF AGREEMENT

  You are free to end your availability to work with RRH without notice.

  RRH can terminate this agreement and remove you from the register if you

  Fail to achieve and maintain acceptable standards of conduct, attendance and/or
  performance.

  If you do not undertake any work for RRH for a continuous period of 6 months, then this
  agreement will automatically come to an end and you will be required to undergo the full
  recruitment process again to register with RRH.




  SIGNED: ………………………………………………….

  DATE: …………………………………………………….

  DESIGNATION: …………………………………………

  I hereby accept being placed on the RRH register subject to the terms and conditions outlined
  above and in accordance with my terms of agreement.


  SIGNATURE: …………………………………………………….

  DATE: …………………….

  PRINT NAME: …………………………………………………………




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