UK Care World ← All courses
Care fundamentals & your role · Care Certificate Standard 3

Duty of Care (Including Duty of Candour)

This course covers the third of the fifteen Care Certificate standards. It explains how your duty of care shapes safe practice, how to support individual choice, how to handle complaints and comments, how to respond to incidents, and how to manage confrontation and difficult conversations.

11 sections≈ 35 min
0 of 11 sections complete

Topics covered in this course

  1. Defining "Duty of Care"
  2. How your Duty of Care may affect your Work Role
  3. Your Duty of Care and an Individual's Rights
  4. Duty of Candour
  5. Dilemmas and Conflicts
  6. Responding to Complaints and Comments
  7. Recognising Adverse Events, Incidents, Errors and Near Misses
  8. Case Study: Mrs Parker
  9. Factors and Situations That Can Cause Confrontation
  10. Case Study: Mr Brook
  11. Accessing Support & Agreed Ways of Working

What is Duty of Care?

A duty of care is a legal obligation to:

  1. Always act in the best interest of individuals and others.
  2. Not act, or fail to act, in a way that will cause harm to others.
  3. Act within your competence, and not undertake anything you do not believe you can reasonably do.

As a care worker, you owe a duty of care to the people you support, your colleagues, your employer, yourself, and the public interest.

As a care worker, you have a duty of care to your service users to ensure all aspects of their health, safety and wellbeing are attended to. Your responsibilities include safeguarding and providing a service of care that maintains their needs.

Your duty of care is not just the day-to-day physical duties you've been designated — it also includes providing feedback to your manager when they are lacking the services, facilities and support individuals have the right to.

Duty of care in your work role therefore includes:

  • Your designated duties as a care worker
  • Providing non-physical support
  • Responsibility to act ethically towards all individuals
  • Maintaining awareness of individuals' physical and emotional states
  • Maintaining a safe environment
  • Engaging individuals in communication so they can express their needs, wishes and preferences

Dilemmas in care settings often involve conflicts between the care worker's duties and the individual's right to their own choice and individuality. For example:

  • An individual's right to say "no", and the implications on their health
  • An individual's right to choose what they wear or eat, and the implications on their safety
  • An individual's right to confidentiality, and the implications for their wellbeing
Example — refusing medication: The service user has the right to refuse their medication, but your duty is to ensure their health is not put at risk. You are not allowed to force them to take it, even though this may pose a severe risk to their life.
Example — unsuitable clothing: A service user may insist on wearing particular clothing because of an emotional attachment to it, even if it's unsuitable because it's unclean, exposes them to excessive cold or heat, risks tripping, or is flammable.
Example — confidentiality vs safety: A service user may display abnormal physical or emotional changes but ask you not to tell anyone, fearing the consequences. They have a right to the confidentiality they seek — but you also have a duty to safeguard them from potential harm.

As well as a Duty of Care, every care professional has a Duty of Candour — a legal duty to be honest and open with service users and your organisation about care and treatment if it goes wrong.

Before giving care, you must:

  • Discuss risks with the service user before giving treatment or care
  • Discuss the risks of any alternative treatment options
  • Check that the service user understands these risks

If something goes wrong and causes (or will cause) harm or distress, you must:

  • Tell the service user that something has gone wrong as soon as possible
  • Apologise to the service user
  • Offer a remedy or support
  • Explain the long- and short-term effects of the error
  • Answer any questions honestly, and explain if there are still uncertainties

If the service user doesn't want to know the details, you must respect that decision after explaining the consequences — but you must still record the information, and let them know they can ask for more details later if they change their mind.

If the service user has died, lost consciousness, or lost capacity, follow these same steps with their family or guardians instead (unless they had previously asked you not to disclose their information). In a multidisciplinary team, only one staff member — usually the lead clinician — needs to take responsibility for informing the service user and resolving the situation.

Remember to record everything in the patient's record, including the apology given, the options offered, and any refusal of information.

Advice for apologising:

  • Tell them what happened
  • Explain what can be done to help them (remedy, support, further treatment)
  • Explain how you'll prevent harm coming to others in future
  • Give distressing information considerately, respecting privacy and dignity
  • Give the patient your team's contact details for further questions
  • Give the contact details of relevant support services
  • Offer a personalised apology — "I'm sorry," rather than "We regret this situation"

You must also be honest and open with your organisation when reporting incidents and near misses, following your organisation's policy — they have a duty to support you in reporting these errors.

As a care worker, you're likely to face everyday dilemmas that call your responsibilities and duty of care into question. Conflicts might be with the service user, with colleagues, or with your manager.

You're limited in how much control you have over managing conflicts, because of legislation such as Human Rights, Data Protection, and Public Interest Disclosure.

You can
  • Provide information to support others in making their own decision
  • Check if a risk assessment has been done
  • Be impartial, talk to your manager, and act respectfully and professionally
You cannot
  • Make decisions for others, or decide on their behalf
  • Dismiss a view because you disagree with it
  • Insist on your own way, or use family/peer pressure to persuade a service user

Additional support

What you can do is limited, so it can often feel confusing knowing what you can or cannot do. If you're unsure, or feel uncomfortable about anything, always ask your manager for advice — or a Data Protection Officer for confidentiality issues. Document all concerns as soon as possible, and give regular feedback to your manager so they can decide the best course of action.

Because there are formal procedures for handling comments and complaints, it's essential you know what you can and cannot do — from the initial event, through observing and experiencing it, to responding and recording it immediately.

Do
  • Record all information about an event, including how it unfolded and how it was responded to
  • Be honest about the situation
  • Discuss comments and complaints with your manager
Do not
  • Confront those you have a formal complaint about, or who are complaining against you
  • Withhold information to protect anyone, or because you feel it would break confidentiality

Advice and support

You should always be able to refer to your manager for advice in handling comments and complaints. But if the complaint is against your manager — or they've filed a complaint against you — you can approach an impartial liaison officer within the organisation instead. General advice can also be found in your organisation's own policies and procedures.

Learning from complaints and comments

Comments and complaints, constructive or personal, are a reflection of how someone has perceived an action or service — which makes them a productive way to learn how a service or way of working can be improved. Responding well to complaints can improve:

  • Professional practices
  • Training needs for employees
  • The service user's experience and safety
  • The accessibility of a service
  • The complaints procedure itself
  • Logging of a service user's, service's, and employee's development

An essential part of your duty of care is recognising and staying alert to potential risks of harm — and knowing what to do if any of these risks materialise.

Adverse events

Unfavourable and unintended experiences associated with care.

Example — fire hazard: If you notice a service user's home is unsafe with a fire hazard, notify your manager immediately and get advice on whether to contact another authority like the council.

Incidents

When something unfavourable occurs.

Example — a physical accident: Recognise obstacles or risks that might cause a fall, trip or slip. An Occupational Therapist carries out structured risk assessments for risks you can't change, but you should conduct daily risk assessments to maintain a safe environment.

Errors

A mistake that is made, which may have harmful effects.

Example — wrong diet: Be aware of the effects of giving someone with a specific diet the wrong combination of food. If it happens, seek medical advice on the risk and document the event.

Near misses

Something with the potential to cause harm, which hasn't yet caused harm.

Example — hazards: Discuss with your manager or occupational therapist to arrange further risk assessments to remove hazards.

What to do about dangerous situations

Incidents can be categorised as emergencies, or any incident (including emergencies).

What you can do
  • Support the people present at the incident
  • Record incidents as soon as possible, after attending to the people involved
  • Call the emergency services (999) if needed
  • Be aware of first aid procedures
  • Report and learn from your experiences
What you must not do
  • Ignore, wait, or cover up any incidents
  • Attempt to resolve incidents without seeking advice, unless specially trained
  • Perform emergency first aid unless trained
  • Assume experience qualifies you to handle emergencies without formal training

Reporting incidents

Document everything about an incident and how it was resolved, and report it as soon as possible — even if it has already been resolved, and even during the event if needed. It's your duty to know who to approach, when, and what procedure to follow, depending on the source:

  • Emergency situations that result or could result in significant harm — call 999 or 112. In this case: do NOT administer first aid unless trained, only act to prevent a fire from spreading and no more, and stay with the person at risk unless it's necessary to leave for help.
  • Intentional incidents that result or could result in significant harm — report to the police.
  • Instantaneous accidents or near misses — report to your manager or the service user's Occupational Therapist if the risk assessment needs reviewing.
  • Errors, risk or harm from within the organisation (such as your manager) — report to HR or another authority.
Case Study

Mrs Parker — mobilising without a zimmer frame

A care worker in a residential care home finds one of the residents, Mrs Parker, mobilising in the dining room without her zimmer frame. Mrs Parker is known to wander, and her risk assessment states she should always be encouraged to mobilise with her frame, and that if found wandering she should be escorted to a place of safety and her frame collected.

Concerned Mrs Parker will fall, the care worker attempts to escort her back to her armchair by holding her hand instead — rather than waiting for a colleague to bring the frame. While walking, the resident falls, taking the care worker down with her. Both are helped up; a colleague fetches the frame and Mrs Parker is escorted to the lounge after a short rest.

The care worker begins to complain of back pain. The nurse on duty asks her to complete an incident form. Worried she didn't follow policy, the care worker omits that she mobilised Mrs Parker without her frame — but a witness account contradicts this. She is absent from work for a week with back pain.

What did the care worker do wrong?

  • She panicked, and did not follow the falls management policy or Mrs Parker's own care plan
  • She should have escorted Mrs Parker to the nearest dining chair, or brought a chair to her, until the frame could be fetched

Consequences

  • To Mrs Parker: she sustained a fall that may have been avoided, and was lucky not to be seriously injured when the care worker fell on top of her
  • To the care worker: a serious back injury, an investigation, possible disciplinary action for not following policy, and further disciplinary risk for falsifying her incident account
  • To the organisation: a week of staff sickness absence, and an externally investigated incident form

What causes confrontations?

  • Irritability
  • Lack of understanding of process or policy
  • Change, or attempts at change
  • Public conversations rather than private ones

Certain situations may make people more agitated, such as changing internal procedures, delivering bad or unwelcome news to a service user or their family, or suggesting changes to a care plan. Recognise the potential for confrontation when you encounter these.

Communication

Open discussion, where one party listens to the other, can often resolve conflicts. To practise good communication in a conflict:

  • Take the individual away to a quieter area
  • Ask questions, and listen to the answers
  • Take their emotions and concerns seriously
  • Try to find a compromise or a way forward together

Assessing risk

Watch for typical warning signs that someone feels threatened or is getting angrier: prolonged eye contact, heavier breathing, vigorous body language, or a change in facial colour. If you see these signs, calmly break off communication, retreat to a safe distance, and inform your manager.

Case Study

Mr Brook — the fused lights

A carer arrives at Mr Brook's home at tea time. He is elderly, frail, and walks with a zimmer frame; his property is cluttered with little space to manoeuvre. On switching on the lights, a bulb blows and fuses all the lights. The carer tells Mr Brook it's against health and safety policy for her to stand on a chair to change the bulb or touch the fuse box, and leaves once her duties are complete.

Mr Brook calls the organisation the next day to report being left in the dark, afraid he might trip and fall — he'd contacted a relative to fix it himself. Investigating the complaint, the carer, worried about getting into trouble, dishonestly claims she'd arranged for a family member to fix the lights. Nothing was recorded in the care log beyond "All care given, meds taken." It's treated as a Safeguarding issue, and the carer is disciplined for: failing to alert someone to Mr Brook's immediate risk of harm, failing to document the incident, and failing to tell the truth when questioned.

What should the carer have done?

  • Followed agency guidelines before attempting to change the bulb herself
  • Completed an incident form at the office
  • If unable to fix it, ensured a responsible person was informed — next of kin, an able-bodied friend or neighbour, Lifeline/Telecare, or the organisation's out-of-hours emergency contact
  • Considered temporary solutions, such as relocating a lamp or leaving a light on from another room
  • If no solution was possible and no responsible person available, stayed with Mr Brook until help arrived — this is a duty of care
  • Documented the incident and every action taken to resolve it and keep him safe
  • Been honest about what happened

Be honest with your manager and colleagues if you feel a situation could become a conflict. They can help you plan conversations and possible outcomes, provide emotional support, and decide whether to involve the police or other authorities. Counselling services are also available if you need support after a confrontation.

Your workplace will often have its own policy on challenging behaviour, usually including a form or paperwork for reporting an incident: who was there, when and where it took place, whether there were any injuries, whether medical attention was required, and whether the police or other authorities were informed.

Duty of care and duty of candour sit at the heart of safe, trustworthy care practice. In short: always act in the best interest of the people you support, stay within your competence, be honest when things go wrong, document everything, and know exactly who to go to — your manager, an impartial liaison officer, HR, or the emergency services — depending on what's in front of you.