SCIE Practice guide 7: Making referrals to the POVA list

Deciding to make a POVA list referral

Practice point: Who can be referred to the POVA list?

Care workers and adult placement carers

The POVA scheme currently covers care workers in registered (and registering)

• care homes
• domiciliary care agencies
• adult placement schemes.

The procedures apply to any workers in care positions in a registered service who have regular contact with a vulnerable adult in a care home or are providing personal care through a domiciliary care agency. For adult placement schemes, it means anyone in the registered placement service who regularly sees clients, including the adult placement carer and scheme staff - see POVA referral for adult placement.

The definition of a care worker is very wide and includes anyone who has regular contact with vulnerable adults:

• managers, care assistants, voluntary workers and ancillary workers such as cooks, gardeners or cleaners
• workers supplied by employment agencies and businesses
• visiting practitioners such as chiropodists, hairdressers, therapists, priests and other religious leaders, other practitioners.

Even the most informal of connections and voluntary work are covered by the POVA scheme. Even where no money changes hands, voluntary, community-based and other organisations and individuals working for providers of care in an agreed capacity constituting a care position, whether or not under the terms of a contract, will come within the scope of the scheme.

Because job titles and job descriptions vary so much across the country, the examples given below provide only a general guide to who is eligible for referral - it is clearly a matter for employers and managers to judge. The following questions will help them in making this decision:

• Is the person employed or deployed as a care worker?
• What type of service are they employed in? This is more important than who actually employs them.
• What type of work are they doing?
• If employed in domiciliary care, are they providing any personal care to service users?
• Do they have any regular contact with vulnerable adults - for example, daily, weekly, monthly?
• Have they been POVA checked? You can also refer people who have not been checked.

Examples of regular contact

• A care home administrator, as an agreed part of his formal duties, daily assists at meal times to ensure that severely disabled or frail residents make their way to the dining room and are assisted in eating their food. This is considered to be 'regular contact' with vulnerable adults. (Note: In this example, the administrator has received appropriate training.)
• A cook not only runs the kitchen of a care home, orders food and prepares menus and meals but also pays weekly visits to residents in their rooms to ascertain and check what meals are required and their other dietary needs. The cook also helps severely disabled residents eat their food.
• An administrator with a domiciliary care agency works in the agency's office, and also, in times of staff shortages and high demand, stands in for the agency's home-help staff by providing less intensive forms of personal care to service users in their own homes. It is likely that a POVA check would be required in this situation. (Note: In this example, the administrator has received appropriate training.)
• A chiropodist has a contract with a care home to provide weekly sessions for the residents.
• An adult placement scheme organiser pays regular visits to the home of an adult placement carer to monitor the placement.

Examples of eligible care workers in care homes

• Registered managers
• Deputy and assistant managers
• Administrative, finance, clerical and reception staff
• Care assistants
• Nurses in care homes that provide nursing on the premises
• Cooks
• Cleaners
• Maintenance workers, gardeners, handy-persons, and so on
• Volunteers (such as 'friends of the care home')
• People coming into the home to provide services under arrangements made with the home, such as chiropodists, hairdressers, priests or other religious leaders, persons providing library services, and so on.

Examples of care workers in domiciliary care agencies

• Registered managers
• Deputy and assistant managers including home-care organisers
• Administrative, finance and clerical staff
• Home-care workers and domiciliary care workers
• Home helps, home support workers and domiciliary care assistants
• Volunteers (including those recruited by agencies such as Crossroads or the Red Cross to visit vulnerable adults in their homes).

Responsible individuals

The CSCI will also refer individuals who are responsible for organisations and the owners or directors of companies or services where this is warranted in terms of harm or risk of harm to vulnerable adults.

Former employees

Some employers have referred individuals who had left their employment before 26 July 2004 when the POVA scheme was introduced. This was due to their particular concerns about these individuals and their suitability to be employed as care workers.

Former employees may be referred to the POVA list in two situations:

• where information about a care worker who left a care position after 26 July 2004 subsequently comes to light
• where an employer considers that including on the POVA list a care worker who left a care position before 26 July 2004 is in the interests of the protection of vulnerable adults.

In both cases, the same criteria for referral apply as those for existing employees or approved carers.

There is no specific guidance about how far back in a person's work history employers can go in making these referrals. Some have checked their records back to the year 2000, and others have referred only when they had very serious concerns about a former worker. These employers point out that it is more difficult to make a fully evidenced case in these types of cases, where supporting information may be less clear and where witnesses may no longer be available. The POVA team and local adult protection staff can advise on this.

Individual referrals

Referrals on the grounds of misconduct that caused harm or risk of harm should be made only in relation to individuals. Block referrals - for example, of whole staff groups - cannot be considered, as each individual must be subject to a separate referral. While links between referrals will be noted, each case will be treated individually and the POVA team will need evidence to show the involvement of each person.

In such cases, employers, managers and regulators should show that there is a link between referrals by noting this on each form and by sending the referrals together in the same envelope. This helps the POVA team to see the broader context of the referrals, and they will make a joint submission to the Secretary of State for Health.