This procedure / guidance forms part of Incident Management Policy P057

Appendix C2: Procedure for Supporting Staff following an
Unexpected Death; Serious Incident; Complaint from a service user
or a Claim by a service user

Introduction

Staff will need support following any event which they feel challengestheir professional practice. This may occur when someone dies unexpectedly; when there is a serious incident or a complaint or claim is made. Supporting staff at these times is a core part of all managers’ roles, and most teams have well established systems for supporting their staff. This procedure intends to support these well-functioning arrangements. It is an attempt to learn from them, and to distil some of the principles and good practice which have emerged from staff’s experiences of dealing with such issues.For the purposes of this guidance ‘staff’ is used to include temporary staff; students; volunteers and contractors, as well as permanent paid employees.

  1. General Principles
  • Staff are likely to be affected in different ways. If a service user dies unexpectedly, for example, some members of the team will be more affected than others. Some staff will have had a closer working relationship with the service user than others. However, for a variety of reasons, staff who were less directly involved with the service user’s care may experience the incident as particularly distressing. Assumptions should not be made about who will need support in these circumstances. Similarly, it may not be possible to predict accurately who will be most affected by other serious incidents or what the effect of a complaint or claim will be on the staff involved.
  • Staff are likely to experience a range of emotions at different times. Some staff may initially decline support that they later find they need. Support should be re-offered tactfully and periodically.
  • Staff may feel obliged to ‘keep going’ and continue to provide a service. Staff may need permission to take a break or go home. Managers may need to be alert for and ‘keep an eye’ on staff who may not recognise that they need help.
  • Staff may feel guilty about an action they have taken or an omission they made. This is particularly true when someone has died or is seriously injured. It is rare for this guilt to be justified. This Trust supports an approach which seeks to move away from asking “Who was to blame?” and ask instead “Why did this happen?” In many cases staff will need to be reassured about any guilt they feel.
  1. Immediate actions

a)Ensuring that staff know about an unexpected death.

Once the Care Co-ordinator has been made aware of the incident, they should ensure that others who need to know are informed. This should be done verbally if possible. If a Care Co-ordinator has not been allocated (e.g. for someone newly referred to the service), then the Team Manager should take on this task. All members of the AWP care team currently working with the service user should be informed. However, others may also need to be informed, including the GP, other voluntary and statutory agencies, and other services who have current or recent contact with the individual (e.g. Psychiatric Liaison Services). It should be noted that those who have previously been involved in the care plan may wish to be informed, particularly if their input was long-standing or intensive.

b)Ensuring that staff know about other serious incidents

Once the Care Co-ordinator has been made aware of an incident they should ensure that others who need to know are informed, paying due regard to the confidentiality of any service users involved. Should the incident be relevant to the risks posed to or by a service user then the risk assessment and CPA care plan should be updated as per CPA policy.

c)Informing staff about a complaint or claim made against them by a service user

Staff may be contacted directly regarding a complaint or claim made against them. If this is not the case, then the Clinical Director is responsible for ensuring that staff are informed of a complaint and the Head of Patient Safety Systems is responsible for informing staff of a claim.

d)Immediate support following an unexpected death or serious incident

If a member of staff is distressed following a particular incident, s/he should be offered support promptly. This may include taking him/her to another area away from the place of the incident and offering time out from work and support. It may be appropriate, with management approval, for the individual to be sent or escorted home if they are very affected. If it is immediately clear that further support may be needed, then advice should be sought from AWP’s Staff Trauma Support Service.

e)Determining whether staff can continue in their usual role following an unexpected death, serious incident, complaint or claim

Although this is exceptional, there are two principle reasons why staff may not be able to continue in their usual role:

1. A disciplinary investigation warrants this

2. There is some other reason why it may not be appropriate – e.g. continuing in their usual role puts the member of staff at risk

Managers should obtain early HR advice if either of these situations occurs and staff involved should be informed promptly if there is to be any disciplinary investigation.

3. Ongoing actions

a)Individual support/counselling

If an individual is significantly affected by an incident, complaint or claim then it may be necessary to provide a greater degree of support than can be appropriately offered by their colleague, line manager or union representative/professional organisation. In these cases, staff should be signposted to the independentstaff counselling service. Duties may need to be temporarily reassigned. Occupational Health advice should be sought if there are any concerns about a member of staff’s fitness to work.

b) Team support in the event of an unexpected death or serious incident

In the event of an unexpected death or a serious incident, astaff support meeting should be held at an appropriate time to provide the opportunity to talk through the incident in a supportive environment. AWP’s Staff Trauma Support Serviceshould be contacted to arrange a facilitator for this. A balance may need to be struck when organising a staff support meeting between including those staff involved and undertaking the session in a timely fashion. Teams are urged to be inclusive and to think across team boundaries in determining who should be invited to the meeting (e.g. it is likely to be appropriate to invite both inpatient and community staff when both services were actively involved in the care plan). Alternative support must be offered to any staff who are affected by an incident, but are unable to attend a team support meeting.

c)Expressing condolences and paying one’s respects following an unexpected death

In the event of an unexpected death, the Team Manager should write to the family expressing condolences on behalf of the team/service. Other members of staff may wish to write individually, although the appropriateness of this will need to be judged on a case-by-case basis. The Being Open Policy provides guidance on communicating with service users and families following a serious incident. In the event of a death, staff and other service users may wish to attend the funeral and the Trust would support this if the family are in agreement. The family’s wishes must always be respected in this regard. If the family do not wish Trust staff to attend, it may be appropriate to organise a memorial services for staff and service users as an alternative.

d)Support through the internal investigation and external processes

Ongoing support must be offered to staff until the issue is fully resolved. In the case of an unexpected death, for example, this may take many months or even years – until the Coroner’s Hearing has taken place. The intensity of the support needed by staff is likely to vary over time. They must be kept fully and regularly appraised of ongoing events in relation to the incident, complaint or claim (e.g. investigations, inquest, etc.).Guidance on appearing as a witness in Court is given in appendix C8 of the Incident Policy.

  1. Monitoring

Actions taken to support staff will be subject to ongoing review. Actions to support staff following serious incidentswill be recorded as part of the Root Cause Analysis investigation. Indicators with respect of staff wellbeing will be monitored internally and as part of the staff survey.

Procedure /Guidance Version No / Policy Expiry Date / Page:
3.0 / 21 Oct 2016 / 1 of 4