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On-Call Guide

Learn when and how to contact the on-call team, what situations require urgent escalation, and the steps to take during emergencies, medication incidents, safeguarding concerns, hospital admissions, complaints, and other out-of-hours issues.

Written by Jonny Bottomley

What is the purpose of the on-call service?

The on-call service ensures that carers and clients can access support outside normal office hours for:

  • Emergencies

  • Urgent care concerns

  • Safeguarding issues

  • Medication incidents

  • Service disruptions

The on-call team helps ensure continuity of care and client safety until the office reopens. The number is 020 3970 9900

When should I contact the on-call team?

You should contact the on-call team if there is:

  • An emergency

  • A safeguarding concern

  • A medication error

  • Serious illness or deterioration

  • A hospital admission

  • A serious complaint

  • No access to a client

  • An urgent staffing issue

If the matter can safely wait until the next working day, document it appropriately and hand it over to the office team.

What counts as an emergency?

Examples include:

  • Fire or smoke

  • Breathing difficulties

  • Suspected stroke

  • Client collapse

  • Missing client

  • Safeguarding concerns

  • Serious medication error

  • Carer safety concerns

  • No carer available for a live-in placement

  • Severe service failure

If someone is in immediate danger, always call 999 first.

What should I do if a client falls?

Do not attempt to lift a client manually.

If the client is:

  • Injured

  • In pain

  • Distressed

  • Unconscious

  • Unable to get themselves up

Call 999 immediately.

If the client appears uninjured and can safely get themselves up independently, follow your moving and handling training and care plan guidance.

Always:

✅ Monitor the client

✅ Inform the on-call team

✅ Document the incident

✅ Complete an event form when safe to do so

What should I do if a client becomes unwell?

Assess the situation carefully.

Call 999 immediately if the client has:

  • Breathing difficulties

  • Chest pain

  • Stroke symptoms

  • Collapsed

  • Lost consciousness

  • Severe or sudden deterioration

For non-emergency situations:

  • Contact NHS 111 if appropriate

  • Inform the on-call team

  • Notify next of kin where appropriate and consent allows

What should I do if there is a medication error?

You must:

✅ Gather all relevant details

✅ Check the medication name and dose

✅ Monitor the client

✅ Seek medical advice where required

✅ Contact NHS 111 if appropriate

✅ Call 999 if severe symptoms are present

✅ Inform the on-call team immediately

✅ Complete an event form

✅ Record accurately on the MAR chart

Examples include:

  • Missed medication

  • Double doses

  • Wrong medication administered

  • Medication given at the wrong time

What if a client or family member makes a complaint?

Remain calm, professional, and respectful.

You should:

✅ Listen carefully

✅ Avoid becoming defensive

✅ Apologise appropriately where suitable

✅ Reassure them their concerns will be investigated

✅ Escalate serious complaints to management

Do not:

❌ Argue

❌ Make promises you cannot keep

❌ Admit liability

What if there is no answer at a client’s property?

If you arrive and there is no response:

  • Check for signs of activity

  • Attempt to contact the client

  • Attempt to contact next of kin where appropriate

  • Contact the office or on-call team

  • Check whether there has been a cancellation or change of arrangements

Do not force entry.

Further action, including welfare checks, will be coordinated by management where necessary.

What should I do if a client goes to hospital?

Gather as much information as possible, including:

  • Reason for admission

  • Hospital name

  • Ward details

  • Discharge information (if known)

  • Whether next of kin has been informed

Ensure:

✅ The on-call team is informed

✅ Relevant records are updated

✅ Any changes to medication or care needs are communicated

What should I do if a client passes away?

If a client passes away:

  • Remain calm

  • Follow any end-of-life care instructions within the care plan

  • Contact emergency services or healthcare professionals where required

  • Inform the on-call team immediately

  • Support family members respectfully

  • Complete all required documentation

You are not expected to manage the situation alone. Support will be provided.

What if I feel unsafe?

Your safety is important.

If you ever feel:

  • Threatened

  • Unsafe

  • Intimidated

  • Unable to remain safely at a placement

You should:

✅ Remove yourself from immediate danger where possible

✅ Contact emergency services if required

✅ Inform the on-call team immediately

What should be documented?

You must document:

  • Incidents

  • Complaints

  • Medication errors

  • Safeguarding concerns

  • Hospital admissions

  • Significant events or calls

Documentation should always be:

✅ Factual

✅ Accurate

✅ Professional

✅ Completed promptly

What should be handed over?

Any unresolved issue must be handed over to:

  • The next on-call person

  • The Care Management Team

  • The relevant coordinator or manager

Examples include:

  • Outstanding risks

  • Hospital admissions

  • Safeguarding concerns

  • Complaints

  • Staffing concerns

  • Ongoing investigations

Good Practice Reminders

✅ Stay calm during emergencies

✅ Escalate concerns early

✅ Follow policies and training

✅ Prioritise client and carer safety

✅ Document accurately

✅ Never work outside your competency

✅ Ask for support when unsure

✅ Treat clients, families, and colleagues with empathy and professionalism

Need Help?

If you are ever unsure whether something should be escalated, contact the on-call team. It is always better to ask for advice early than to delay reporting a concern.

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