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Managing sickness and absence in domiciliary care is rarely simple. When a carer calls in sick, the impact is immediate. Visits may need to be rearranged, colleagues take on additional pressure and continuity of care for vulnerable people can be disrupted. For Registered Managers, this means making quick decisions while still staying fair, consistent and compliant with employment law and regulatory expectations.
Sickness and absence are also closely linked to wider workforce challenges. Issues such as staff wellbeing, workload pressure, clear communication and structured processes all influence how often absence occurs and how well it is managed. According to workforce insights from Skills for Care, staffing pressures and retention remain ongoing challenges across adult social care, which means every absence can have a greater operational impact than it might in other sectors.
Many managers struggle because sickness and absence decisions do not exist in isolation. They sit alongside performance concerns, risk assessments, reasonable adjustments and everyday leadership decisions. The most effective approach is usually a structured one.
In this guide, you will learn how to manage sickness and absence more effectively. We will look at how to build clear policies, document audit trails properly, use risk assessments to support decision-making and create a working culture that helps reduce avoidable absence over time.
Build Sickness and Absence policies
Strong sickness and absence policies give managers a clear structure to follow when decisions need to be made quickly. In domiciliary care, where missed visits can affect safety and continuity, having clear expectations in place makes day-to-day management far easier.
Here are the steps to follow in building a sustainable sickness and absence policy for your service.
Make reporting simple and clear
Staff should know exactly who to contact when they are unwell, how early they must report sickness, what information they need to provide and what happens next once absence is reported.
When your service’s reporting processes are unclear, managers will definitely spend valuable time chasing information instead of organising safe cover.
Set expectations around communication
Regular contact during sickness absence should feel supportive rather than intrusive. Simple check-ins will help you understand recovery timelines, identify adjustments that needs to be made and maintain engagement with the team
Guidance from ACAS highlights that consistent and respectful communication reduces misunderstandings and helps prevent issues from escalating.
Focus on consistency, not rigidness
Managers often face very different situations, but the process should remain consistent. A clear policy ensures:
- similar cases are handled fairly
- decisions can be justified if challenged
- staff understand what to expect
Consistency also protects against claims of unfair treatment, particularly where protected characteristics or health conditions are involved.
Balance support with accountability
Effective sickness and absence policies should support staff wellbeing while maintaining professional standards. This means encouraging honest conversations about health, offering support where appropriate and reinforcing the importance of reliable attendance for safe care delivery
Document sickness and absence audit trails
When managing sickness and absence, documentation is not just administrative work. It is what protects your decisions, supports fair treatment and creates clarity if questions arise later. Many of the challenges faced by service providers is documentation.
In domiciliary care, where decisions often need to be made quickly, having a clear audit trail helps managers show that actions were reasonable, consistent and based on evidence rather than assumptions.
Below is how to keep an appropriate documentation of staff sickness and absence audit trails;
Record conversations early and consistently
Documentation should begin from the first discussion, not only when issues escalate. This includes initial sickness notifications, return-to-work conversations, informal wellbeing discussions, patterns of repeated short-term absence
Even brief notes or follow-up emails creates a reliable record. Reduces misunderstandings and ensures both the manager and staff member have the same understanding of what was agreed.
Create a clear timeline of events
A strong audit trail allows you to track when absence was reported, what support was offered, any adjustments discussed and outcomes of meetings or reviews
This becomes particularly important if absence patterns change over time or if performance concerns overlap with sickness and absence.
Protect decision-making with evidence
Employment decisions are judged on whether they are reasonable and consistent. Keeping records helps demonstrate:
- fairness across the team
- that conversations took place before formal action
- that decisions were not influenced by bias
Care Quality Commission Regulation 17 emphasises maintaining accurate records when managing attendance issues, as this supports both employers and employees if disputes arise.
Keep clear documentation
Managers often worry about creating too much paperwork. The goal is not lengthy reports. Instead, focus on clear, factual notes that answer:
- what happened
- what was discussed
- what actions were agreed
A simple, consistent approach to documentation strengthens governance, supports compliance and makes managing sickness and absence far less stressful over time.
Use Sickness and Absence Risk Assessments
Risk assessments are one of the most practical tools managers have when dealing with sickness and absence. They help move conversations away from assumptions and towards structured, balanced decision-making. In domiciliary care, where staff often work alone and support vulnerable people, understanding risk is essential before deciding what adjustments or actions are appropriate.
A risk assessment does not need to be complicated. Its purpose is simply to understand how a health condition or absence might affect the individual, the team and the people receiving care. Ensure to following steps to handle risk assessment;
Focus on real risks, not guesswork
Use risk assessments to guide reasonable adjustment
Document the decision-making process
Keep the approach collaborative
The most effective risk assessments involve open conversations with staff. Instead of assuming what someone needs, ask.
When risk assessments are used as a supportive tool rather than a formal hurdle, they help managers balance staff wellbeing with safe service delivery and make sickness and absence decisions straight to the point.
Support Staff to Reduce Sickness and Absence
Managing sickness and absence is not only about responding when someone is off work. Prevention plays a major role. Managers who focus on early support and clear communication often see fewer repeated absences and stronger team stability.
In domiciliary care, staff work in demanding environments. Travel between visits, emotional pressure and lone working can all contribute to fatigue and stress. Supporting staff early helps reduce the likelihood of absence becoming long-term or recurring.
As a registered manager or service provider, here are steps to follow in supporting your team to reduce sickness and absence;
Address staff concerns early
Many absence issues begin long before someone calls in sick. Regular check-ins give managers an opportunity to notice changes and offer support before problems escalate.
Useful approaches include:
- informal wellbeing conversations during supervisions
- asking about workload or travel pressures
- creating a safe space for staff to raise concerns
Early conversations show support while reinforcing that attendance matters for safe care delivery.
Encourage a supportive but accountable culture
Teams are more likely to manage attendance responsibly when expectations are clear and fair. This means applying policies consistently across all staff, recognising when someone needs support rather than immediate escalation and addressing patterns of absence openly and respectfully
When staff feel treated fairly, they are more likely to communicate honestly about health challenges.
Use return-to-work discussions effectively
Try to engage your staff in Return-to-work meetings and these sessions should not feel like disciplinary interviews but rather an opportunity to:
- Check if an employee is fit to resume duties
- Identify any ongoing risks or adjustments
- Reinforce expectations moving forward
The more support your staff feels, the better. If you succeed in getting to this point, congratulations because this is where your staff feel heard so they are able to express their ability or inability to return to work.
Link wellbeing to operational planning
Reducing sickness and absence also involves practical leadership decisions, such as:
- reviewing rotas to avoid excessive fatigue
- ensuring realistic visit scheduling and travel time
- recognising signs of burnout within the team
Supporting staff wellbeing is not separate from operational management. When teams feel supported and workloads are realistic, sickness and absence naturally become easier to manage while maintaining safe, reliable care services.
Common Sickness and Absence Mistakes to Avoid
Conceding a mistake when managing sickness and absence in domiciliary care has landed care providers in serious hot water with staff, families and even regulators.
Many common mistakes happen because managers want to be supportive but avoid structure, or because policies exist but are not applied consistently. Over time, this creates confusion for staff and makes decision-making harder.
Some of the most frequent mistakes seen across domiciliary care services include:
- Poor documentation, then when CQC asks for absence data or you need to defend a capability process, there’s nothing to show
- Jumping straight to disciplinary for every absence (even genuine ones)
- Ignoring patterns that are obviously linked to a disability or long-term health condition (and then getting caught out under the Equality Act)
- Having no return-to-work conversation
- Treating agency staff absences differently without any justification (CQC loves consistency)
- Failing to link absence management to service impact
Real-world HR scenarios often show that problems escalate when there is no clear process from the beginning. Managers who ask questions, document discussions and follow structured steps tend to resolve issues earlier and with less conflict.
Following the above discussed procedures will save your service unforeseen circumstances when it concerns managing sickness and absence
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