Reading time 3 mins

Missed Call Toolkit

This toolkit supports consistent recording, investigation and learning from missed or late domiciliary care calls and service visits. It helps organisations identify root causes, mitigate immediate risks (including time‑critical medicines), trigger safeguarding where required, and evidence corrective actions that improve reliability and compliance.

Legislative Requirements

• Care Act 2014 — providers must promote wellbeing, prevent deterioration and assure continuity of care. Missed or late visits that interrupt essential care or medicines support must be risk‑assessed, mitigated and escalated; systemic failures should inform contingency and market oversight responses.
• Mental Capacity Act 2005 — where a person refuses or appears to decline visits, record capacity assessments and best‑interest decisions. Lack of capacity does not remove the duty to escalate missed visits that place the person at risk.
• Data Protection Act 2018 / UK GDPR — process monitoring, call records and safeguarding information on lawful bases; minimise identifiable data in reviews, maintain audit trails of disclosures and secure communications with external partners.

Regulatory Guidance

CQC (England)

• Regulation 12 (Safe care and treatment): systems must prevent omissions and mitigate foreseeable risks from missed/late visits (e.g., timed medicines).
• Regulation 9 (Person‑centred care): care plans should specify timing criticality, contingency arrangements and communication routes for missed/late visits.
• Regulation 13 (Safeguarding): treat omissions that indicate neglect as safeguarding concerns.
• Regulation 17 (Good governance) and Reg 18 (Staffing): require assurance on rostering, resilience and oversight of missed‑call trends; Reg 20 (Duty of candour) applies where omissions cause reportable harm.

Care Inspectorate (Scotland)

• Providers must evidence reliable scheduling, notification of serious incidents and cooperation with Adult Support & Protection (ASP) where omissions create harm. Use Health & Social Care Standards to demonstrate person‑centred reliability.

Care Inspectorate Wales (CIW)

• Under RISCA and associated guidance, domiciliary providers must maintain governance and operational systems to prevent/mitigate missed visits; omissions causing harm may trigger notifications and enforcement action.

CQC Key Questions

• Safe — Systems prevent omissions; time‑critical tasks are delivered or promptly mitigated.
• Effective — Care plans include contingency for missed/late visits and medicines governance aligns with NICE expectations.
• Caring — People and representatives are informed promptly and respectfully when visits are missed.
• Responsive — Dynamic rescheduling, prioritisation and escalation pathways operate effectively.
• Well‑led — Board oversight of reliability metrics, workforce planning and trend‑based improvement is evident.

Statutory Guidance

• Accountability — missed visits are a failure of scheduled care and must be auditable within governance systems.
• Duty of Candour — apply when an omission causes, or could lead to, notifiable harm (moderate or greater).
• Safeguarding — escalate missed visits that place people at risk to local safeguarding/ASP arrangements.
• Reporting — notify regulators and commissioners of significant service failures where thresholds are met.

HealthCare Guidance

• DHSC — transparency and market oversight expectations influence how providers capture and report reliability (e.g., Capacity Tracker where used).
• Scottish Government — co‑operate with ASP and local authorities when omissions create risk; follow local notification requirements.
• Welsh Health & Social Services — ensure regulatory compliance, governance and contingency for domiciliary services.
• NICE — QS123 (Home care for older people) Quality statement 2 requires a plan for missed/late visits; NG21 and NG67 set expectations for visit reliability and medicines support when visits are missed.

Evidence Based Practice

• Embed QS123 Quality statement 2 into care plans: record how the provider will respond to missed/late visits (communication, emergency contacts, alternative arrangements, risk assessment).
• Flag time‑critical tasks (medicines, catheter care) in scheduling systems and prioritise them for redirection or urgent mitigation.
• Use systems analysis (not blame) to identify contributory factors: rostering, travel time, scheduling algorithms, staffing levels, communications and access issues.
• Maintain lawful, proportionate information sharing for safeguarding and clinical mitigation; preserve minimal necessary evidence for investigations.

Clinical governance and Safety (NHS)

• Missed visits are within NHS patient safety incident scope where they cause or risk harm. Capture them in incident systems, risk registers and QI programmes to close the loop.
• Record hazards (recurrent omissions, medicines omissions) in clinical hazard logs with owners and assurance checks.
• Provide leadership assurance on reliability metrics and improvement initiatives to boards and commissioners.

PSIRF

• Treat omissions as patient safety incidents. Select a proportionate learning response (rapid review, thematic analysis or in‑depth investigation) based on harm severity, recurrence and learning potential. Engage people affected in reviews.

Using the Toolkit — Practical Steps

1. Log the missed call — capture reporter, person, scheduled visit time, actual discovery time, location, task(s) due (including time‑critical medicines) and initial harm/risk assessment.
2. Acknowledge & Mitigate — contact the person/representative immediately, arrange urgent attendance or alternative support, escalate to clinical leads for medicines omission and notify commissioners if required by contract.
3. Triage — apply predefined thresholds to identify safeguarding risk, service continuity impact or regulator notification need.
4. Preserve Evidence — retain call logs, GPS/rostering records, staff statements, access notes and any communications about the visit to support investigation.
5. Investigate Proportionately — choose local operational review, structured systems analysis or multi‑agency enquiry depending on harm, recurrence or learning value.
6. Assign Actions & Owners — record corrective actions (rostering changes, route optimisation, training, policy updates), owners, deadlines and verification evidence.
7. Communicate & Support — follow Duty of Candour if harm occurred, inform the person/family as appropriate, and provide staff support/debrief where needed.
8. Analyse & Learn — aggregate missed‑call data to detect themes (time of day, staff, routes, travel times) and implement targeted improvements.
9. Review & Close — verify completion of actions, monitor for recurrence and feed outcomes into governance and commissioning reviews.

Templates & Data Fields (recommended)

• Event reference, status, priority and incident category (missed, late, partial visit)
• Reporter name/role, date/time scheduled, date/time discovered, location
• Person details (anonymise where required), care plan flags (time‑critical tasks, DNACPR/ACP), baseline risk
• Task(s) due (medicines, personal care, clinical tasks), medicines details and last administration time
• Immediate actions taken: contact attempts, alternative attendance, clinical escalation, commissioner notification
• Corroborating evidence: call monitoring logs, GPS/rostering data, staff statements, access/entry records
• Investigation: level selected, investigator(s), findings, contributory factors and root/system analysis
• Action plan: description, owner, due date, completion evidence and verification
• Safeguarding flag, duty of candour flag, regulator/commissioner notification flag, data protection lawful basis

Monitoring, Audit and Reporting

• Maintain a missed‑call register to track open items, ageing, overdue actions and repeat themes by team, route and time period.
• Dashboards: counts by category, time to mitigation, proportion escalated to safeguarding, medicines omissions, repeat service users affected, action completion rates.
• Audit completeness of call logging, timeliness of mitigation, quality of communications with people/representatives and preservation of evidence.
• Provide regular reports for quality committees, commissioners and the board demonstrating oversight, trend analysis and improvement activity.

Value Proposition

• Delivers a single, auditable workflow to capture missed/late visits consistently and lawfully.
• Supports rapid mitigation for time‑critical tasks (medicines) and reduces risk of harm through prompt escalation.
• Enables system learning: identifies operational root causes (rostering, routing, capacity) and evidences corrective actions to commissioners and regulators.
• Integrates safeguarding, duty of candour and PSIRF‑aligned learning to demonstrate closed‑loop improvement and organisational assurance.

References

• Care Act 2014
• Mental Capacity Act 2005
• Department of Health & Social Care (DHSC)
• Scottish Government — Health & Social Care Directorate
• Health & Social Services Group (Wales)
• CQC Regulations (2014)
• Care Inspectorate Health and Social Care Standards
• CIW / RISCA (Wales)
• NICE QS123, NG21, NG67
• NHS Clinical Safety Standards
• NHS Patient Safety Incident Response Framework (PSIRF)
• UK GDPR / Data Protection Act 2018

Disclaimer

Radar Healthcare provides configuration templates and implementation guidance to support effective use of the platform. Any data protection, regulatory or clinical examples are for general guidance only and do not constitute legal, clinical or compliance advice. Radar Healthcare acts as a data processor under customer instruction. The customer, as data controller, remains responsible for assessing and managing risks, determining lawful processing and ensuring compliance with applicable regulations.