Care Home Manager – How to manage a in house investigation

In any organisation as a manager, you will undoubtedly be required to carry out a house investigation into an untoward incident. The regulators are clear that they do not have a duty to investigate complaints or concerns, but they will require the organisation to do so and may ask to see the records.

Before commencing a house investigation, it is important to establish what you are really investigating. Then identify if the issue is something that is considered a Safeguarding matter. If you are not sure it is always best to contact your local authority safeguarding team for advice. They may ask you to investigate and act, they may ask you to investigate and report back. They may ask you to ensure the safety of the residents and not go further until they say so. This is because they may consider the matter to be something they wish to send a social worker to investigate or they may want to involve the police.

In all cases as soon as you are made aware of the issue commence a timeline, keeping a record of what you did and when. Ensure this timeline includes details of any escalation to any other agency. Do not use identifiable details of staff, residents, or members of the public in the timeline.

Consider if the issue is something that needs to be reported to the regulator and if you decide it is, make sure the initial report is timely. You can always send an update later.

Consider if the issues fall under a duty of candor, and if it does, check what your company policy is about your level of autonomy to undertake this. We would suggest a face to face meeting with the people concerned, in the first instance. Offer a genuine apology, this should not be considered an admission of guilt. Explain at this meeting, what happened, what possible harm has been caused, and what the next steps are.

Follow up this meeting with a letter confirming what action you are planning next. Provide a timeframe into when you anticipate you will be able to offer a full response.

During your house investigation, ensure that you keep evidence, this may include faulty equipment which should be taken out of service. You may need to photocopy records and other evidence and keep it in a safe place.

If you need to take statements from Staff and/or others, ask them to write their statements in their own words. Grammar/Spelling is not important it is what they write which is key.

Once you have all the information you need, you will be able to conduct an analysis into the issue, this can be known as a root cause analysis. You should consider what happened, how it happened and what other factors may have caused the issue to have occurred.

When you understand this fully decide what action you need to take to rectify the situation or what action you need to take to mitigate further risk immediately until further investigation takes place. This may involve removing staff from a situation or changing policies and procedures or purchasing new equipment, implementing training. There are an array of options open to you. You may need to involve your line manager depending on your company policy.

Once you have completed your investigation you need to make recommendations and either add the action to your service improvement plan or create a separate action plan, depending on your organisations’ policy. Either way, your actions should prevent the same issue from happening in the future.

Once the investigation is finalised if it is a duty of candor issue you should write back to the people concerned confirming what happened (as an overview) and what action you will be taking. If the investigation is because of a complaint, they should receive a letter explaining if the complaint was substantiated or not, and again what action has been taken, to prevent a similar issue in the future. Be careful not to promise you will do something if it is not achievable.

You should then keep the records of the investigation as it may be requested later by the local authority or the regulators.

Investigations can be complex and time consuming, they can often feel personal and sometimes they are. If you feel that you are not the right person to investigate an issue, do not hesitate to tell your line manager. Some providers will also ask for cases to be externally investigated. There is a real value to this if the case is complex if there is a risk to reputational damage or if the issue is ongoing and internal resolve has not been possible.

We often carry out investigations on behalf of Care Home providers, this can bring a sense of objectivity which is appreciated by the people involved. They can present the report in a way that people understand and meet the standards required by regulators, local authorities, and commissioners, all of which may require information from you.

With ongoing complaints, we often find the person raising the complaint feels they have been listened to simply because the provider has taken the complaint so seriously, they have requested an external review.

Acting promptly to an investigation is vital to prevent reputational damage, to show transparency and openness, to reassure the people concerned you are taking the issue seriously.  Therefore, our team can respond promptly when assistance is needed. We offer immediate support and advice followed by a prompt investigation process if required.