Welcome, Care Nurse
This tool is a dedicated Clinical Decision Support reference. It contains local guides, condition details, medication files, and an integrated Gemini clinical chatbot.
This tool provides information support only. It does not replace local policy, MAR charts, GP or prescriber instructions, pharmacist advice, NICE guidance, or emergency services. Always follow your care home's protocols. In an emergency, always call 999 immediately.
Quick Escalation Reference
- Chest pain (suspected MI)
- Collapsed or unresponsive
- Not breathing / agonal gasps
- FAST stroke signs
- Severe allergic reaction / anaphylaxis
- Major / uncontrolled bleed
- New confusion / acute delirium
- Fall with suspected injury
- Sudden physical deterioration
- Suspected infection + high temp
- Uncontrolled or severe pain
- Medication interaction queries
- Crushing advice & alternatives
- Missed doses & side effect queries
- NHS 111: Urgent non-emergency
- Safeguarding: Abuse/neglect concern
Guideline Pulse Auto-updated from NICE / BNF / CQC via AI
Browse Libraries
Quickly find guidelines on conditions, medicines, administration details, or safety instructions using the sidebar or search.
Conditions Library
UK Care Home condition definitions, red flags, and care considerations.
Medication Reference Library
Detailed profiles of medicines commonly encountered in care homes.
What Can Make This Worse?
Condition-by-condition references warning against medicines that increase risks or exacerbate symptoms.
High-Risk Medicines Reference
Medications requiring extreme care, timing precision, and regular monitoring checks in care homes.
Falls & Medication Reference
Comprehensive reference on how medications influence falls and how to mitigate risks on shift.
Why Medications Increase Falls Risk
In the elderly, age-related changes in drug metabolism (pharmacokinetics) and brain sensitivity (pharmacodynamics) render them vulnerable to specific drug effects. These manifest as:
Blood pressure drops significantly upon standing, causing sudden dizziness or blackouts. Caused by antihypertensives, diuretics, nitrates, tricyclic antidepressants.
2. Drowsiness & SedationDulled reflexes, slowed reaction times, and poor balance. Caused by benzodiazepines, z-drugs, sedating antihistamines, strong analgesics.
Stiffness, shuffling gait, and tremors leading to instability. Caused by antipsychotics and dopamine-antagonist antiemetics (e.g. metoclopramide).
4. Reduced Alertness & Impaired VisionBlurry vision or slowed adaptation to lighting changes. Caused by anticholinergics and bladder spasm drugs.
Practical Falls Prevention Checklists for Staff
- Ensure residents stand slowly and sit on the edge of the bed for a minute before rising.
- Conduct hydration audits: dehydration exacerbates postural hypotension.
- Review the MAR: Highlight high-risk fall agents and cross-check with recent blood pressures.
- Perform lying/standing BP checks for residents complaining of lightheadedness.
What to Document & Review After a Fall
- Timeline: Witnessed vs unwitnessed, exact time.
- Symptoms Prior: Dizziness, confusion, palpitations, chest pain.
- Observations: Complete NEWS2, neuro-obs if head injury.
- Medication Review: Immediately flag GP/pharmacist for medication review, especially if on multiple antihypertensives or sedatives.
Clinical & Administration Reference Guide
Essential clinical screening tools, UK legal frameworks, and practical medication administration guidelines.
📋 Clinical Scales & UK Frameworks
💊 Medication Administration Safety
Clinical Safety Recommendations
Crucial safety procedures that must be integrated into every care shift.
- Always check the MAR chart and allergy status before administering any medicine. Never proceed under assumption.
- Check the indication — what is this medicine for and is it still needed? Query long-term medicines without documented indications.
- Consider falls, confusion, constipation, and dehydration risks for every medicine in an elderly resident.
- Be aware of polypharmacy — residents on multiple medicines are at extreme risk of interactions and adverse drug reactions.
- Consult the pharmacist about drug interactions, whether tablets can be safely crushed, timing, alternative formulations, and covert administration policies.
- Escalate red flags early — do not delay escalation to wait and see if symptoms improve if a resident is deteriorating.
- Document everything clearly — if it is not documented in the care notes/MAR, it did not happen.
- Prioritise Parkinson's medicines — must be given at exact prescribed times. Delay leads to rapid deterioration.
- Never give methotrexate more than once weekly — check the prescription day carefully. A daily dose can be fatal.
- When in doubt, ask — it is never incorrect to seek advice from a senior nurse, GP, or pharmacist.
- Use local policy as primary — this tool supports reference only and does not replace local care home protocols.
- NICE and BNF are the gold standards — always consult the BNF for definitive prescribing and administration guidelines.
SBAR Clinical Communication Reference Guide
A shift-friendly clinical reference for structuring professional communications with GPs, NHS 111, or Emergency Services (999) under UK clinical standards.
SBAR Structure & Pre-Call Checklist
S - Situation: State your name, role, care home, resident name/room, and the immediate reason for calling. Keep it to a single punchy sentence.
B - Background: Summarise relevant medical history, admission date, diagnoses, allergies, and the resident's baseline state (e.g. usual mobility or cognitive baseline).
A - Assessment: Provide current vital signs (including NEWS2 score), active symptoms, clinical signs (e.g., chest sounds, abdominal rigidity, calf pain), and what you suspect is happening.
R - Recommendation: Clarify your request. State the urgency (immediate 999, GP home visit, or phone review), what temporary actions you have taken, and confirm the monitoring plan.
📋 Check before dialing:
- Assess the resident directly. Check vital signs.
- Calculate the NEWS2 score.
- Review the resident's Care Plan and latest progress notes.
- Have the MAR chart and allergy record in front of you.
- Verify the resident's DNACPR/ReSPECT status.
- Keep a pen and pad ready to record the clinical advice.
Escalation Thresholds & Communication Rules
1. Emergency Services (999): Call immediately for acute red-flag symptoms. Do not wait for GP review. State "Red Flag Sepsis", "FAST positive Stroke", or "Suspected Neck/Femur Fracture" to call handlers.
2. General Practitioner (GP): Contact for same-day acute issues that are not immediately life-threatening (e.g. NEWS2 score 3-4, suspected cellulitis, persistent vomiting).
3. NHS 111 (Out of Hours): Call NHS 111 (Option 9 for Health Professionals) for urgent clinical queries when the GP surgery is closed.
SBAR Clinical Scripts Exemplars
These script examples provide word-for-word SBAR structures for common care home clinical escalations. Use them as a reference template when structuring your phone calls.
Deprivation of Liberty Safeguards (DoLS) & Mental Capacity Act (MCA) Reference
A comprehensive, UK-compliant legal guide regarding mental capacity assessments, deprivation of liberty, and restrictive practices in a care home setting.
The Mental Capacity Act (MCA) 2005 Core Guide
The 5 Statutory Principles:
- Presumption of Capacity: A person must be assumed to have capacity unless established otherwise.
- Support to Make Decisions: Do not treat a person as unable to make a decision unless all practicable steps to help them have been taken.
- Unwise Decisions: A person is not to be treated as lacking capacity simply because they make an unwise decision.
- Best Interests: Any act or decision made on behalf of a person lacking capacity must be done in their best interests.
- Least Restrictive Option: Select the option that is least restrictive of the person's basic rights and freedom.
The 2-Stage Capacity Test:
A formal capacity assessment must be decision-specific and time-specific.
- Stage 1 (Diagnostic): Does the person have an impairment of, or disturbance in the functioning of, their mind or brain (e.g., dementia, delirium, head injury)?
- Stage 2 (Functional - The 4 Tests): Due to the impairment, is the person unable to:
- Understand the information relevant to the decision?
- Retain the information long enough to make the decision?
- Use or weigh the information as part of the process?
- Communicate their decision (by any readable means)?
DoLS "Acid Test" & Legal Timelines
The Cheshire West "Acid Test" & June 2026 Legal Update:
A deprivation of liberty occurs when a resident lacks mental capacity to consent to their care arrangements and meets the standard criteria:
- Is the person subject to continuous supervision and control?
- Is the person not free to leave?
DoLS Authorization Process:
If the Acid Test is positive, the care home must apply to the Supervisory Body (Local Authority):
- Urgent Authorisation (Form 1): Can be granted by the care home manager themselves for up to 7 days (can be extended by 7 days under specific circumstances) while the standard application is processed.
- Standard Authorisation (Form 2): Applied for in advance. Granted by the Local Authority after assessor reviews, lasting up to 12 months.
Restrictive Practice Guidance Reference
Restrictive practices limit a resident's freedom. They must be legally justified under the Mental Capacity Act and audited regularly. Review the safety checklists below:
🔒 Keypad Locks & Secure Units
Keypad door locks that restrict exit require a documented capacity assessment regarding residence and care arrangements. A DoLS authorization must be submitted. Ensure family consultation, best interests review, and emergency override buttons are tested daily.
🛏️ Bed Rails & Sensor Mats
Bed rails are physical restraints. They require a specific Bed Rail Risk Assessment (balancing entrapment/climbing risk against fall risk), TVN consultation, and an MCA/Best Interest review if the resident cannot consent. Check bumper pads daily.
💊 Covert Medication Administration
Giving medication disguised in food/drink is a restriction. It is only legal if the resident lacks capacity, a covert MDT pathway meeting has been held (GP, pharmacist, nurse, family), pharmacist advice on crushing is documented, and it is reviewed monthly.
Nursing Documentation & Care Notes Library
High-quality, UK-compliant care note exemplars. Select a category below to view and copy standard documentation templates to guide your shift entry.
Documentation Guide
Every nursing entry must follow NMC code requirements:
- Write clearly, objectively, and chronologically.
- Document issues, symptoms, and actions immediately.
- Avoid vague language like "had a good day" — use specific clinical observations.
- Clearly specify signed nurse name and PIN.
Select Reference Template
Choose an entry below to display the clinical note exemplar text inside the reader box.
Clinical Note Reference Text
MDT Referral Routing & Escalation Directory
Clinical pathways, contacts, and pre-referral checklists for multidisciplinary team escalation in UK care structures.
Pressure Care: SSKIN Bundle & Wound Staging Reviewed Jun 2026
The SSKIN Bundle — 5 Elements of Prevention
S — Surface
Ensure the right support surface is in place. Assess whether the current mattress (foam, dynamic, static air) matches the resident's risk level. High-risk residents (Braden ≤12) require a dynamic alternating-pressure mattress. Check mattresses for "bottoming out" — if you can feel the bed frame through the mattress under the resident, it has failed.
S — Skin Inspection
Inspect all pressure points at every repositioning: sacrum, heels, ischial tuberosities, greater trochanters, elbows, shoulders, occiput, ears, toes. Press on redness — if it blanches (turns white and recovers), it is Category 1 (non-blanchable = at risk or early damage). Document using a body map and wound assessment chart.
K — Keep Moving
Reposition bed-bound residents every 2 hours (minimum). Use the 30° tilt, never 90° lateral as it directly loads the greater trochanter. Chair-bound residents: encourage 15-minute micro-lifts or weight shifts every hour. Heels must be entirely off the mattress using foam wedges or heel boots — not just elevated.
I — Incontinence
Moisture from urine and faeces is a major risk factor for skin breakdown (moisture-associated skin damage / MASD). Change pads promptly. Apply barrier cream (e.g. Cavilon, zinc oxide) to protect skin. Do not use talcum powder. Consider containment devices for high-risk residents. Document incontinence episodes on the fluid/continence chart.
N — Nutrition & Hydration
Poor nutrition directly impairs wound healing and skin resilience. Complete a MUST score on admission and monthly (or after significant change). Refer to dietitian if MUST ≥2. Ensure adequate protein intake — high-protein supplements (e.g. Fortisip) for those at risk. Aim for 1.5–2 litres fluid daily. Document all food intake on a food chart if there are concerns.
EPUAP/NPIAP Pressure Ulcer Classification
Localised area of redness on intact skin that does not blanch when pressed. May be painful, firm, soft, warmer, or cooler than adjacent tissue. Action: Increase repositioning frequency, relieve all pressure from the area, apply transparent film dressing if needed. Review risk assessment. Escalate to senior nurse same shift.
Partial thickness skin loss with exposed dermis. Presents as a shallow open wound with a pink/red wound bed, or an intact / ruptured blister. Action: Mandatory incident report. Wound assessment and dressing by trained nurse. Photograph. Escalate to GP if signs of infection. Wound review every 1–3 days.
Full thickness skin loss where subcutaneous adipose (fat) tissue is visible but bone, tendon, or muscle is not exposed. Slough or eschar may be present but does not obscure depth. Action: Immediate SI review. GP/district nurse referral. Wound specialist nurse involvement. Family notification. Dynamic mattress mandatory.
Full thickness skin and tissue loss with exposed or directly palpable fascia, muscle, tendon, ligament, cartilage, or bone. Slough or eschar may be present. Often undermining and tunnelling present. Action: Hospital referral. Surgical assessment may be required. Mandatory CQC notification consideration. High risk of osteomyelitis.
Full thickness skin and tissue loss where the depth cannot be confirmed because the wound bed is covered by slough or eschar. Until debrided, true depth cannot be determined. Cannot be staged lower than Category 3. Action: Do NOT remove eschar on ischemia/arterial wounds without vascular assessment. Refer to tissue viability specialist.
Intact or non-intact skin with localised area of persistent non-blanchable deep red, maroon, or purple discolouration, or epidermal separation revealing a dark wound bed or blood-filled blister. Often evolves rapidly to expose actual extent of tissue injury under intact skin. Action: Treat as Category 3/4. Escalate immediately. Incident report.
Braden Scale Quick Reference — Risk Assessment
Complete the Braden Scale on admission and at every care plan review (minimum monthly). Score 6 domains (1–3 or 1–4 each). Lower score = higher risk.
| Total Score | Risk Level | Required Actions |
|---|---|---|
| ≤9 | Very High Risk | Dynamic mattress, 2-hourly reposition, dietitian referral, heel protectors |
| 10–12 | High Risk | Dynamic or high-spec foam, 2–3 hourly repositioning, dietitian review if MUST ≥1 |
| 13–14 | Moderate Risk | High-spec foam mattress, 4-hourly repositioning, nutrition monitoring |
| 15–18 | At Risk | Standard preventive care, monitor skin at repositioning |
| 19–23 | Low Risk | Routine skin inspection, educate resident/family, maintain SSKIN principles |
MUST: Malnutrition Universal Screening Tool Reviewed Jun 2026
MUST Score Calculator
Complete on admission, monthly, and after any significant change in condition.
- Repeat MUST monthly in care homes
- Document weight monthly
- No immediate intervention required
- Document all dietary intake for 3 days
- Weigh weekly for 1 month
- Offer nutritional snacks between meals
- Encourage food fortification (butter, cream, cheese)
- If improving: continue monitoring
- If no improvement after 4 weeks: escalate to dietitian
- Refer to dietitian urgently
- Initiate oral nutritional supplements per prescription (e.g. Fortisip, Ensure)
- Increase calorie-dense foods at mealtimes
- Food chart every meal — document all intake
- Weigh weekly minimum
- GP notification required
- Consider SALT referral if swallowing concerns
Pain Assessment Tools Reviewed Jun 2026
Abbey Pain Scale — Interactive
For non-verbal / advanced dementia residents. Score each of 6 items 0–3. Total score guides severity.
Abbey Scale — Score Interpretation
| Score | Severity | Action |
|---|---|---|
| 0–2 | No pain | Continue monitoring |
| 3–7 | Mild pain | Non-pharmacological interventions; review PRN analgesic |
| 8–13 | Moderate pain | Administer PRN analgesic; contact GP if not responding |
| 14+ | Severe pain | Urgent GP contact; consider emergency admission if needed |
NRS (Numeric Rating Scale) — Self-Report
Ask: "On a scale of 0 to 10, where 0 is no pain and 10 is the worst pain imaginable, what is your pain level right now?"
| Score | Severity | Nurse Action |
|---|---|---|
| 0 | No pain | Document; continue monitoring |
| 1–3 | Mild | Non-pharmacological; offer PRN paracetamol if prescribed |
| 4–6 | Moderate | Administer PRN analgesic; re-assess in 30–60 min |
| 7–10 | Severe | Contact GP/prescriber for stronger analgesia review; NEWS2 |
Pain in Dementia — Key Principles
- Behavioural changes (aggression, withdrawal, refusal of care) may be the only sign of pain in advanced dementia
- Reassess pain score after any analgesic intervention — within 30 min for oral, 15 min for SC
- Use consistent documentation wording: "Abbey Pain Scale score [X]/18, consistent with [mild/moderate/severe] pain"
- If behaviour suggests pain and regular paracetamol is not prescribed, contact GP for a regular analgesic review
- Avoid NSAIDs in elderly as first-line; consider risk of GI bleed, fluid retention, and renal impairment
Controlled Drugs (CDs) — Care Home Reference Reviewed Jun 2026
Schedule 2 CDs
Must be stored in a locked, wall-fixed, dedicated CD cabinet. CD register entry required for every administration, receipt, disposal, and return.
Common examples in care homes:- Morphine (oral liquid, MST tablets, subcutaneous)
- Diamorphine (subcutaneous — palliative care)
- Oxycodone (OxyContin, OxyNorm)
- Fentanyl patches (Durogesic, Matrifen)
- Buprenorphine patches (Butrans, Transtec)
- Methylphenidate (Ritalin — rare in care homes)
Schedule 3 CDs
Must be stored in a locked CD cabinet. Running balance not legally required but recommended by CQC. Check local policy.
Common examples:- Temazepam (requires CD register entry)
- Pregabalin (requires safe custody)
- Gabapentin (requires safe custody)
- Tramadol (requires safe custody)
- Buprenorphine sublingual (Subutex)
Schedule 4 CDs
Must be kept in a locked cupboard. No CD register legally required. No running balance required.
Common examples:- Diazepam, lorazepam, midazolam (SC)
- Clonazepam, nitrazepam, oxazepam
- Zopiclone, zolpidem (Z-drugs)
- Alprazolam, chlordiazepoxide
Schedule 5 CDs
No requirement for CD safe storage. Treated as standard medicines. Retain invoices for 2 years.
Common examples:- Low-dose codeine preparations (e.g. co-codamol 8/500)
- Dihydrocodeine 10mg tablets
- Kaolin and morphine mixture
CD Administration Rules — Every Time
- Two witnesses must be present for Schedule 2 CD administration — both must sign the CD register. One must be an RN. Check local policy for who can act as second witness (some allow a trained competent care worker).
- Check prescription — confirm drug name, dose, route, frequency, and prescriber signature before drawing up.
- Check identity — confirm resident's full name, date of birth, and check allergy wristband / MAR chart before administering.
- CD register entry (Schedule 2): Date, time, resident name, amount given, current stock balance, signatures of both witnesses. Running balance must be updated immediately after administration.
- Stock balance check: Count the physical stock and reconcile with the register balance every time the cupboard is accessed. Discrepancy = stop, lock, report immediately.
- Key control: The CD cabinet key must remain in the possession of the responsible nurse at all times on shift. Keys must never be left in the lock.
CD Destruction & Return
- Schedule 2 CDs cannot be destroyed in a care home without an authorised witness (pharmacist, Inspector from Home Office, police officer, or authorised destruction nurse under local policy).
- Unused/expired Schedule 2 CDs should be returned to the supplying pharmacy — document in the CD register.
- Patches: fold sticky side inward, document in register, return to pharmacy in a denaturing kit or sealed waste container.
- CD destruction must be recorded in the CD register: date, quantity destroyed, method, witness signature.
PRN CD Prescriptions
- PRN (as required) CDs must have a written prescription specifying: drug, dose, route, indication, maximum frequency, and maximum daily dose.
- Verbal orders are not acceptable for CDs.
- Subcutaneous breakthrough morphine dose is typically 1/6th of the total regular daily oral morphine dose — always check the valid prescription.
- Document every PRN administration in the CD register and on the MAR chart.
- If a PRN CD has been given and pain not controlled after one dose, contact GP/palliative care before repeating.
Oral Health in Care Homes Reviewed Jun 2026
Admission Oral Health Assessment
Complete within 24 hours of admission. Record findings in the care plan.
- Does the resident have natural teeth? How many? Any loose, broken, or painful teeth?
- Does the resident wear dentures (upper/lower/both)? Are they labelled? Do they fit?
- Is there any mouth pain, bleeding gums, or swelling?
- Is there evidence of dry mouth (xerostomia)? — common side effect of many medications including anticholinergics, diuretics, antidepressants
- Does the resident have a dental care plan in place? When did they last see a dentist?
- Can the resident clean their own teeth? Do they require prompting, supervision, or full assistance?
- Record: name of usual dentist and registration status
Daily Oral Care Protocol
Per NICE NG48 — oral hygiene assistance at least twice daily.
- Natural teeth: Brush with fluoride toothpaste (1000–1450 ppm) for 2 minutes, twice daily. Use a soft-bristled brush. Do not rinse after brushing — spit only.
- Dentures: Remove and brush daily with a denture brush. Soak overnight in cold water or specialist denture cleaner (not hot water — warps). Label all dentures.
- Non-verbal/dysphagia residents: Use a small-headed toothbrush or foam swabs with water/chlorhexidine gel. Position upright. Suction available if needed. Never use glycerin swabs as the sole mouth care — they dry the mouth.
- Dry mouth: Offer frequent sips of water. Prescribable artificial saliva sprays (e.g. BioXtra) may be indicated — discuss with GP.
When to Refer to a Dentist
- Complaint of toothache or mouth pain
- Visible broken, cracked, or decayed teeth
- Swollen or bleeding gums
- Dentures that no longer fit, causing sores
- Difficulty eating due to dental problems
- Mouth ulcers lasting more than 2 weeks — rule out oral cancer
- White patches (leukoplakia) or red patches (erythroplakia) in the mouth — urgent dental/oral medicine referral
- No dental review in the past 12 months
Medications & Oral Health
Many common care home medications cause oral problems:
| Drug / Class | Oral Side Effect |
|---|---|
| Anticholinergics, diuretics, antidepressants | Dry mouth (xerostomia) — increases decay risk |
| Amlodipine (calcium channel blocker) | Gingival overgrowth (gum swelling) |
| Phenytoin | Gingival hyperplasia |
| Antibiotics (broad spectrum) | Oral candidiasis (thrush) |
| Steroid inhalers | Oral candidiasis — advise rinsing mouth after use |
| Aspirin, bisphosphonates | Mucosal ulceration / osteonecrosis of jaw (bisphosphonates) |
Safeguarding Adults — Reference Guide Reviewed Jun 2026
Care Act 2014 — 6 Safeguarding Principles
- Empowerment — People are supported to make their own decisions and informed consent is gained
- Prevention — It is better to take action before harm occurs
- Proportionality — The least intrusive response appropriate to the risk presented
- Protection — Support and representation for those in greatest need
- Partnership — Local solutions through services working with communities
- Accountability — Accountability and transparency in safeguarding practice
10 Types of Abuse (Care Act 2014)
- Physical — hitting, restraining, over-sedating, inappropriate use of medication
- Domestic Violence — including from family members or partners
- Sexual — including in those who lack capacity
- Psychological / Emotional — threats, humiliation, coercion, gaslighting
- Financial / Material — theft, fraud, pressure over wills, financial exploitation
- Modern Slavery — exploitation, forced labour, trafficking
- Discriminatory — based on race, disability, religion, gender, sexuality
- Organisational — systemic poor care, cultural abuse, neglect in institutions
- Neglect / Omission — ignoring medical or physical needs, withholding care
- Self-neglect — extreme self-neglect endangering health and safety
Signs & Indicators of Abuse
- Unexplained bruising, burns, fractures, or injuries
- Injuries inconsistent with explanation given
- Multiple injuries at different stages of healing
- Repeated unexplained falls or "accidents"
- Poor hygiene, pressure ulcers, malnutrition that could have been prevented
- Unexplained weight loss
- Unexplained fear, anxiety, or withdrawal
- Reluctance to be alone with specific staff or visitors
- Flinching when approached or touched
- Change in behaviour or mood without clear cause
- Denial of obvious problems ("I'm fine, I fell")
- Sudden change in financial situation
Reporting Pathway — What to Do
- Ensure immediate safety — If the resident is in immediate danger, call 999. Remove them from the situation if safe to do so.
- Do not investigate yourself — Your role is to report, not investigate. Do not question the alleged perpetrator or the resident at length.
- Preserve evidence — Do not wash clothing, move items, or clean the scene until advised by the police/safeguarding team.
- Document accurately — Record what the resident said verbatim (use quotation marks). Note the time, date, setting, and your observations. Do not interpret or embellish.
- Report to your manager — The Registered Manager has 24 hours to refer to the Local Authority Safeguarding Adults team if required under Section 42 enquiry criteria.
- Notify CQC — Significant harm incidents must be reported as a Statutory Notification to CQC within 48 hours.
- LADO referral — If the alleged abuser is a staff member, volunteer, or person in a position of trust, refer to the Local Authority Designated Officer (LADO) within 1 working day.
What NOT to Do
- Do not promise confidentiality to the resident
- Do not confront the alleged perpetrator
- Do not carry out your own investigation
- Do not remove clothing to examine injuries unless medically necessary
- Do not take photographs on your personal phone without manager authorisation
- Do not discuss the concern with other residents or uninvolved staff
- Do not delay reporting — same shift, always
Key Contacts to Know
- Emergency / Immediate Danger: 999
- Local Authority Adult Safeguarding Team: Find via your local council website
- LADO (staff allegations): Via local authority children's/adults' services
- CQC Statutory Notification: CQC online portal
- Police (non-emergency crime): 101
- Hourglass (older people's abuse helpline): 0808 808 8141 (freephone)
- NMC fitness to practise (RN concern): 020 7637 7181