SCOPE OF THIS CHAPTER

This procedure is to be used when someone is unaccountably absent from a residential home and may be at risk of harm or may pose a threat of harm to others. It should be read in conjunction with the Deprivation of Liberty Safeguards Procedure.

1. Principles

Residential care homes must balance the right of individuals to personal liberty and freedom of movement with their duty to safeguard vulnerable adults. A person may be regarded as missing when they are unaccountably absent and have been so for a sufficient length of time to give rise to concern. This length of time will vary from person to person depending on their level of vulnerability.

When a missing person is located, every effort should be made to encourage him/her to return, but the service user should not ever be compelled, physically restrained or have any force used against them (physical or verbal) unless there is a specific order under the Deprivation of Liberty Safeguards (see also Deprivation of Liberty Safeguards Procedure) which authorises such treatment.

2. Procedural Steps

Step Action By Whom
1. If it is suspected that a resident of a residential care home is missing, the senior member of staff on duty should be alerted and a search of the home and immediate surroundings should be made, including asking other residents if they know where the person is. Staff on duty
2. If there are places where the missing person is likely to be (for example a friend or relative’s house or the local pub) these should be contacted to try to establish the person’s whereabouts. If the person is located at this stage, staff should attempt to persuade them to return, but the person cannot be compelled unless a Deprivation of Liberty Order is in place which authorises such action. However, their whereabouts and safety should be monitored appropriately. They would typically involve asking the missing person or another adult at the location to notify staff at the residential home when the person is likely to return or is setting off to return. Staff on duty
3. If the person cannot be located, the Registered Manager or Deputy must be informed. If the Registered Manager / deputy cannot be contacted, the Emergency Duty Team should be informed. Staff on duty
4. The Registered Manager / deputy or Out of Hours duty worker should contact the police and provide the following information:
  • Full name of the person;
  • A description of the person – age, height, gender, ethnic origin, eye colour, length, style and colour of hair;
  • What they were wearing;
  • Any jewellery they were wearing;
  • What time they were found missing and in what circumstances;
  • A photograph;
  • Relevant safety information, for example that the person is diabetic, has dementia or epilepsy;
  • Your estimate of the level of risk the person is at.

A police log number should be obtained and the person’s relatives should be informed and kept updated.

Registered Manager / deputy / Out of Hours worker
5. When the person is found, they should be persuaded to return if possible. If they refuse and have the mental capacity to make that decision, they cannot be compelled to return but every effort should be made to keep the person safe. This may include making sure the person has clothing suitable to the weather, money to pay for a bus or taxi back to the home when they do decide to return, means of contacting staff or relatives. If there is an immediate reason for them going missing which can be resolved, such as a desire to see a particular person or visit a particular location, this should be facilitated and an attempt to persuade the person to return should be repeated. If all attempts fail, any risks should be explained to the person, any action to reduce those risks should be taken including making sure the person can contact someone if and when they wish to return and the staff member should withdraw. Registered Manager / Deputy / Out of Hours worker
6. Once the staff member returns to the establishment, this should be carefully recorded and a positive risk assessment should be carried out (see Positive Risk Taking Policy). Actions should be checked to make sure everything possible has been done before withdrawing immediate support. The person’s nearest relative should be informed and everything recorded carefully. The person should have, or be given the means to contact staff and to return if they later decide to do so. Registered Manager / deputy / Out of Hours worker
7. If the person refuses to return and does not have the capacity to make that decision, an urgent application should be made for authorisation for the Deprivation of Liberty (see Deprivation of Liberty Safeguards Procedure). If the person’s life is at risk or they are at high risk of serious harm, for example outdoors in the snow in pyjamas, they can be compelled to return but any compulsion must be in the person’s best interest, be at the least restrictive level possible, and must be proportionate to the level of risk. In these cases, the police should be contacted again, quoting the police log number given when the person was reported ease link to local contacts)missing and they should be asked to return the person. Registered Manager / deputy /  Out of Hours worker
8. If the person can be persuaded to return, anyone who has been notified of them going missing should be notified of their return. A Regulation 18 notification should be faxed to the Care Quality Commission to notify them of the incident and a telephone call to the Safeguarding Team should be made to raise the concern. Staff on duty
9. Within 24 hours of the incident, the person’s risk assessment should be reviewed and protection planning should take place. If the person lacks capacity, and he / she cannot be kept safe, consideration should be given to whether a Deprivation of Liberty authorisation should be sought (see Deprivation of Liberty Safeguards Procedure). Registered Manager / deputy