Duty of Candour Policy & Procedure

What is the duty of candour?

The duty of candour is the legal duty to be open and honest with people when things go wrong in their care. It is set out in regulation 20 and applies to all health and social care providers that CQC regulates. It has two parts: act openly with people about their care, and follow set steps when a notifiable safety incident happens.

This duty of candour policy and procedure is written for care homes, home care and supported living.

When is an incident notifiable?

A notifiable safety incident is an unintended or unexpected incident affecting a person during their care. In the reasonable opinion of a health care professional, it must appear to have caused one of these:

• a death linked directly to the incident, not to the natural course of an illness

• harm to sensory, motor or intellectual functions lasting, or likely to last, at least 28 days in a row

• changes to the structure of the body

• prolonged pain or psychological harm, meaning at least 28 days in a row

• a shorter life expectancy

Treatment needed to prevent death, or to prevent an injury that would lead to one of those outcomes, also counts. Unsure? The template says to treat the incident as notifiable until the facts are clear.

The seven-stage procedure

1. Make the person safe and record the facts on the same shift

2. Decide whether the incident is notifiable

3. Check other duties, such as CQC notifications, safeguarding and RIDDOR (reporting certain injuries to the Health and Safety Executive)

4. Tell the person, or someone lawfully acting for them, face to face, with a true account of the facts and a sincere apology

5. Follow up in writing and keep the records

6. Record each attempt if the person cannot be reached or declines to talk

7. Learn from the incident and close the record

Saying sorry is not an admission of liability, and CQC says that to meet the duty you must apologise for the harm caused, whoever was at fault.

What to add first

Name the people who will lead candour meetings and add your on-call details. Regulation 20 sets no number of days for the written follow-up, so add a local target of your own, then delete the service-type lines that do not apply.

Incidents go on the Accident & Incident Log, and harm that may be abuse also follows the Safeguarding Policy & Procedure. The Complaints Policy & Procedure also asks staff to check each complaint for a notifiable incident.