Code of conduct for care workers

The Code: who it covers, and whether it is law

The Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England was published by Skills for Care and Skills for Health in 2013, and Skills for Care says it “sets the standard expected of all adult social care workers and healthcare support workers in England”. It “describes the standards of conduct, behaviour and attitude that the public and people who use health and care services should expect”. The employer guide explains that the Department of Health asked for a single code because employers had used different codes in different ways, so that “standards for Healthcare Support Workers and Adult Social Care Workers could vary greatly from organisation to organisation”. The Code itself says meeting its standards “is essential to protect people who use health and care services, the public and others from harm”, and tells each worker: “You are responsible for, and have a duty of care to ensure that your conduct does not fall below the standards detailed in the Code.”

It applies to an adult social care worker in England working “in an independent capacity (for example, as a Personal Assistant); for a residential care provider; or as a supported living, day support or domiciliary care worker”, and to healthcare support workers who report to a registered nurse or midwife. It does not apply to social work assistants, and healthcare support workers who report to other healthcare professionals “are not currently included”.

It is not a legal requirement. The employer guide, Guidance on the Code of Conduct for employers, says “there is no legal requirement for employers to use this Code of Conduct”, but that it “outlines ‘best practice’ and could be used to inform objective setting, personal development reviews, investigation and complaints procedures”, and that organisations “may wish to refer to their adoption of the Code of Conduct as evidence of their good practice” in CQC inspections. Skills for Care's Code of Conduct page adds that it “replaces the codes of practice previously developed by General Social Care Council (GSCC)”, and that it is commonly used alongside the Care Certificate: the Code “describes how a support worker should behave and the Care Certificate describes the minimum things they must know and be able to do”.

The legal duties sit with the provider. Regulation 18(2)(a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 requires that staff “receive such appropriate support, training, professional development, supervision and appraisal as is necessary to enable them to carry out the duties they are employed to perform”, and Regulation 19 requires staff to be of good character and able to do the work. The Code gives a provider a shared, national description of the conduct it is supervising against.

The seven standards, and what they mean on a shift

Each standard begins “As a Healthcare Support Worker or Adult Social Care Worker in England you must”, followed by guidance statements. The ones that most often decide a supervision conversation or an investigation are quoted here.

1. Be accountable by making sure you can answer for your actions or omissions. Work within your competence and job description; “always behave and present yourself in a way that does not call into question your suitability”; “establish and maintain clear and appropriate professional boundaries”; “never accept any offers of loans, gifts, benefits or hospitality from anyone you are supporting or anyone close to them which may be seen to compromise your position”; and report actions or omissions that compromise safety, using whistleblowing procedures if necessary.
2. Promote and uphold the privacy, dignity, rights, health and wellbeing of people who use health and care services and their carers at all times. Act in the person's best interests; “always gain valid consent before providing healthcare, care and support”; respect a capable person's right to refuse; “never abuse, neglect, harm or exploit” people; “challenge and report dangerous, abusive, discriminatory or exploitative behaviour or practice”; and take comments and complaints seriously.
3. Work in collaboration with your colleagues. Value your part in the team, work openly with colleagues, other agencies, people and their families, and “honour your work commitments, agreements and arrangements and be reliable, dependable and trustworthy”.
4. Communicate in an open and effective way. Communicate with people and carers “in an open, accurate, effective, straightforward and confidential way”; explain care before giving it; and “maintain clear and accurate records of the healthcare, care and support you provide. Immediately report to a senior member of staff any changes or concerns you have about a person's condition.”
5. Respect a person's right to confidentiality. “Treat all information about people who use health and care services and their carers as confidential”, and “only discuss or disclose information … in accordance with legislation and agreed ways of working”.
6. Strive to improve the quality of healthcare, care and support through continuing professional development. Keep statutory and mandatory training up to date, and “maintain an up-to-date record of your training and development”.
7. Uphold and promote equality, diversity and inclusion. Do not discriminate or condone discrimination, and report concerns about equality, diversity and inclusion to a senior member of staff “as soon as possible”.

Much of the Code points back to the employer. Its glossary defines “agreed ways of working” as including “policies and procedures where these exist”, and several standards are met by following them – reporting observations, handling complaints, disclosing information. A Code adopted on top of policies that do not exist, or that staff have never seen, cannot be followed.

Adopting the Code: sign-up, supervision and appraisal

The employer guide sets out what an organisation using the Code should do, and most of it is about supervision rather than paperwork:

• Give each worker “a named workplace supervisor to monitor their progress towards achieving and maintaining all the standards in the Code of Conduct”.
• “Incorporate the Code of Conduct into your organisation's agreed ways of working”, mapping it to any existing competence checks.
• Decide when workers sign up. The guide recommends “this happens early on in their working life and before they work without direct supervision” – in home care, before the first lone visit.
• Choose how to evidence it: “there is no prescribed way of gaining evidence that your worker is working to the Code of Conduct”; it can be referenced in the job description or signed formally.
• Link sign-up “directly … into your appraisal process”, so that performance against the Code is reviewed.
• Brief managers on the HR process to follow “should a worker not meet the standards set out in the code”.

The named supervisor “must give your worker a copy of the Code of Conduct and the Code of Conduct in Action user guide”, check that the worker “recognises the purpose of the code and understands the depth of detail contained within each point”, and “regularly check that your worker is meeting the code”. That is the same supervision and appraisal Regulation 18 already requires, which is why the Code works best as the structure of supervision records rather than as a separate signature at induction. The guide is equally plain about the other side: support workers “will only be able to meet their obligations under the Code of Conduct if you, as an employer, provide the right support, training and development and work environment for them”.

When a care worker falls short of the Code

A breach of the Code is not a single kind of event, and the first job is to decide which route applies. A training or confidence gap – a worker unsure how to record a refusal – belongs in supervision, with support and a review date. A conduct concern – a rude exchange with a relative, a borrowed £20, an unreported fall – goes through the provider's disciplinary procedure. A concern that someone has been harmed or put at risk is a safeguarding matter first, reported under the provider's procedure and to the local authority, and the disciplinary process follows it rather than replacing it.

Where discipline is involved, follow the Acas Code of Practice on disciplinary and grievance procedures: Acas says “the procedure an employer follows and an employee's actions will be taken into account if the case reaches an employment tribunal”. The Code of Conduct gives the investigation a published standard to measure the conduct against, which is fairer to the worker than a manager's view of what is acceptable, provided the worker was given the Code and it is part of the employer's agreed ways of working.

Some outcomes create a legal duty. A regulated activity provider must refer a worker to the Disclosure and Barring Service when it withdraws permission for them to work in regulated activity, or would have done had they not left, and it thinks they have harmed or put a vulnerable adult at risk of harm, satisfied the harm test, or received a relevant caution or conviction. DBS's guidance on making barring referrals says this “applies even when a referral has also been made to a local authority safeguarding team or professional regulator”, and that it covers a worker who “resigned, retired, or left”. CQC may also need a notification of an allegation of abuse, and the duty of candour may apply if a person was harmed.

The Code also protects the worker who raises a concern. Standard 1 requires workers to report unsafe practice and to use whistleblowing procedures if necessary, so a provider that disciplines someone for raising a concern under the Code is in an indefensible position; the whistleblowing policy has to give that duty a working route.

The records that show the Code is working

An inspector, a commissioner or a tribunal will judge the Code by its records, not by a poster on the noticeboard. Keep:

• The sign-up record for each worker: the date they received the Code and the user guide, who explained it, and their signature or acknowledgement, with the version of the Code.
• Supervision and appraisal notes that refer to the standards, with any development actions and their review dates.
• Training records, which standard 6 asks the worker to keep as well, and which are the provider's evidence of the training Regulation 18 requires.
• A gifts and hospitality register, because standard 1 forbids accepting anything that may compromise a worker's position, and the only defence of a box of chocolates accepted on a birthday is a record that the manager knew.
• Conduct concern and investigation records: what was alleged, the evidence, the standard it was measured against, the outcome, and any referral to the local authority, CQC or DBS.
• Complaints that name staff conduct, linked to the investigation they triggered.

Keep employment and disciplinary records under the provider's retention schedule and data protection policy, and keep safeguarding and barring-related records for as long as the provider's safeguarding guidance requires.

Where conduct is visible first: the messages

Most of the Code is about behaviour face to face with a person, but a surprising amount of it is now tested in messages. Standard 5, confidentiality, is breached in a staff group chat when a photograph of a person's wound is shared with everyone on the rota, including the bank worker who has since left. Standard 1's professional boundaries are crossed when a care worker swaps personal numbers with a client's daughter and the messages drift from visit times to favours. Standard 4's duty to “immediately report to a senior member of staff any changes or concerns” is often met – honestly and promptly – by a text to the team leader's personal phone at nine in the evening.

When one of those becomes a complaint or a disciplinary case, the evidence is the messages, and the employer usually holds none of them. The worker has their own phone; the family has screenshots; the team leader who received the concern may have changed jobs. A fair investigation under the Acas Code needs both sides' evidence, and a provider that cannot produce what its own staff said and were told is relying on screenshots chosen by someone else. It also cannot show that the worker who reported a concern at 9pm did exactly what standard 4 asked.

The answer is not a rule that care workers must never message, which nobody keeps. It is an approved route for work messages about the people the service supports, written into the agreed ways of working the Code refers to, kept where the provider can find it, and with everyone in it told that it is a record. The question for the next management meeting: if a concern about a colleague's conduct was raised by message last night, could the service produce that message and show what it did next?

Questions people ask

What is the national code of conduct for health and social care workers in England?

The national code is the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England, published by Skills for Care and Skills for Health in 2013. It sets seven standards of conduct, behaviour and attitude for adult social care workers in residential, home care, supported living, day services and personal assistant roles, and for healthcare support workers who report to a registered nurse or midwife.

What are the 7 standards of the code of conduct for care workers?

The seven standards are: be accountable by making sure you can answer for your actions or omissions; promote and uphold the privacy, dignity, rights, health and wellbeing of people who use services and their carers; work in collaboration with colleagues; communicate in an open and effective way; respect a person's right to confidentiality; strive to improve quality through continuing professional development; and uphold and promote equality, diversity and inclusion.

What are the 5 principles of the code of conduct?

The Code of Conduct for care workers in England has seven standards, not five, each with its own guidance statements, so check which document a list of five comes from before relying on it.

Is the code of conduct for care workers a legal requirement?

No. The Skills for Care employer guide says “there is no legal requirement for employers to use this Code of Conduct”, and Skills for Care describes it as “voluntary but … a sign of good practice”. The legal duties are the provider's, under Regulations 18 and 19 of the 2014 Regulations, and the employer guide suggests adopting the Code through the job description or a formal sign-up linked to appraisal.

Official guidance and your next step

Read the Code of Conduct itself, which is thirteen pages; the Skills for Care employer guide and its user guide for workers; CQC's guidance on Regulations 18 and 19; the Acas Code of Practice; and DBS's guidance on barring referrals. Wales, Scotland and Northern Ireland set their own standards for social care workers: Social Care Wales's Code of Professional Practice for Social Care Workers, the Scottish Social Services Council's Codes of Practice for Social Service Workers and Employers, and the Northern Ireland Social Care Council's Standards of Conduct and Practice for Social Care Workers. This guide covers England.

This guide is a summary for employers and is not legal or HR advice. A disciplinary case or a barring decision needs advice on its own facts.

Then do one thing: pick three workers at random and check that each has a dated record of receiving the Code, and that their last supervision note mentions it. If either is missing, the Code is a document, not yet a standard.