18. Category 2 –Tasks that may be delegated by a health professional to the local authority
18.1 The tasks in this category are nursing tasks, which in appropriate circumstances can be delegated to social care staff. They all require training specific to the individual service user on a one to one basis by a health care professional who will assess the GCC Care staff or independent care provider staff against a series of pre-defined competencies. Competence to perform these tasks must be re-assessed annually by the health professional delegating the task or the line manager, whoever is the most appropriate and this should be recorded on the staff record. The health professional must provide written procedures for the care staff to follow and specify regular review dates.
18.2 Negotiable Care Tasks List
Complex care
- Fitting prescription support stockings, following advice from an appropriate health professional as to how frequently this task should be performed
- Changing a two piece system of stoma
- Assisting with obtaining midstream urine specimens, or a faecal specimen which has been medically requested. (N.B. this includes obtaining a specimen by way of an in-dwelling catheter but not be intermittent catheterisation)
- The taking of a capillary blood test (finger prick test)
- Applying a replacement dressing, without otherwise cleaning or treating the site
- Gastrostomy/jejunotomy tube feeding, by inserting water through the tube before and after the feed and attaching the pump giving set to the gastrostomy /jejunotomy
- Cleansing of gastrostomy/ jejunotomy sites, including advancing and rotating a gastrostomy as directed
- Cleansing and inserting false eyes
Treatments
- Administering laxative suppositories but this procedure must be linked to a review by a health professional
- Assist a person to self-administer routine, pre-measured doses of prescribed medicines via an inhaler or nebulizer as a regular procedure for chronic conditions only. The health professional must regularly monitor and review this process
- Administering pre-set doses of insulin by pen (Residential Homes only)
- Administering medication via a gastronomy/ jejunotomy tube but only where staff have received accredited medication training and there are no family or carers who are able/willing to perform the task
- Assist a person to administer oxygen via a pre-set facility
- Fitting transcutaneous Nerve Stimulation (T.E.N.s) machines, only where their use has been approved by the GP or other appropriate health care professional
- Taking of temperatures only when there are clear guidelines in any written procedure from a health professional on what action to take to alert health staff if the temperature should exceed certain pre-defined limits. Care staff should never be expected to interpret any temperature readings
Emergency Care Procedures
- Administering rectal Diazepam (Stesolid) or buccal Midazolam, only as an emergency procedure and subject to ongoing review
- Oral aspiration of excess saliva from the front of the mouth with suction equipment
- Administering anaphylactic pens, as an emergency procedure only
This list is not exhaustive and there may be occasions when managers would be willing to negotiate to establish an individual procedure, based on the experience and willingness of staff to be trained and the nature of the task.
