All care providers will be aware of the importance of Disclosure and Barring Service (DBS) checks, which were previously known as criminal record and barring checks.  These checks play a crucial role in helping employers to make safe recruitment decisions and ensuring that unsuitable individuals are not allowed to work with vulnerable groups.

However, the obligation to ensure appropriate DBS checks are carried out extends to areas of personal care which some care providers may not have considered and which are routinely offered by third party providers such as beauticians, chiropodists and dentists.  This briefing highlights the importance of considering this issue.  We focus here on the provision of care to adults, but similar considerations apply to DBS checks for work with children.

DBS checks

There are two types of DBS check:

  • Standard – this shows all convictions, cautions, reprimands and warnings held on the police national computer.
  • Enhanced – this shows the same information as a standard check plus any local police information which the police think is relevant and should be disclosed.  For certain roles where an enhanced check is required a check of the barred list, which shows whether a person is barred from working in a regulated activity, can also be applied for.

An enhanced DBS check with barring information is required for anyone applying to the CQC to be a registered person and for anyone working in a health or social care setting who is providing “regulated activities”.

Regulated activities

The Safeguarding of Vulnerable Groups Act 2006 sets out in detail the categories of regulated activities in relation to adults.  Where a person’s work falls within one of these categories, they should have an enhanced DBS check with barred list information.  The definition of regulated activities changed in September 2012.  Where a person’s work falls within one of the previous categories of regulated activities, but not one of the new categories, a care provider can request an enhanced DBS check without the barred list information.

Care providers are responsible for making sure that appropriate checks have been carried out for all staff and volunteers.  This responsibility extends to making sure that anyone coming into the care setting from outside has any necessary DBS checks.  Most care providers are aware that they should obtain confirmation from any employment agencies they use that agency staff have satisfactory DBS checks appropriate to their role.  However, where individuals are brought into the care setting to provide other services, care providers may not realise that a DBS check is required.

Personal care

The definition of regulated activity includes providing a vulnerable adult with relevant personal care.  Relevant personal care is:

  • physical assistance which is needed due to age, illness or disability, in connection with:
    • eating or drinking
    •  toileting
    • washing or bathing
    • dressing
    • oral care or
    • the care of skin, hair or nails
  •  prompting and supervision in relation to the above activities where a person is unable to decide to perform these activities without prompting due to age, illness or disability
  • any form of training, instruction, advice or guidance which relates to the performance of the above activities and is given because of a person’s age, illness or disability.

The activities listed above are routinely carried out by care workers who do have the appropriate level of DBS checks.  However, relevant personal care is widely defined and includes the care of skin, hair or nails.  Particularly in residential care settings, care providers will often allow beauty therapists such as hairdressers and manicurists to come in and provide services to residents.  Providing these services may well, depending on the circumstances, come within the definition of personal care.

This does not mean that anyone coming into the care setting to provide these sort of services is carrying out a regulated activity.  Guidance from the Disclosure & Barring Service indicates that where physical assistance is limited to cutting an adult’s hair, this will not be a regulated activity.  For an activity to be regulated, the personal care must also be provided to a “person who is in need of it by reason of age, illness or disability”.  Department of Health guidance gives the illustrative example that a beauty therapist who visits a day care centre once a week and provides manicures for anyone who would like one, rather than to people who need them due to age, illness or disability, would not be engaging in a regulated activity.  Care providers should assess individual roles and responsibilities in order to decide whether DBS checks are required in particular circumstances.

CQC guidance on DBS checks makes clear that the CQC has the power to take enforcement action if care providers do not ensure DBS checks are carried out where necessary, or do not seek appropriate assurances that checks have been carried out.  It is therefore vital that care providers regularly review who is coming into the care setting to ensure that no individuals who should be checked “slip through the net”.  Care providers should also bear in mind that DBS checks are only one way of ensuring their service users are not put at risk and other steps, such as checking references and employment history, should also be taken to ensure safe recruiting practices are in place.