Record management and Retention Policy
Reviewed by: Corinna Laurie
Last Review: 30/3/2018
Next Review: 30/3/2019
Evolve -CTS recognises that by efficiently managing its records, it will be able to
comply with its legal and regulatory obligations and to contribute to the effective
overall management of the institution. Records provide evidence for protecting the
legal rights and interests of the company and service users, and provide evidence for demonstrating performance and accountability. This document provides the policy framework through which this effective management can be achieved and audited.
1. Scope of the policy
This policy applies to all records created, received or maintained by staff
of the company in the course of carrying out its functions.
Records are defined as all those documents which facilitate the business
carried out by the company and which are thereafter retained (for a set period) to
provide evidence of its transactions or activities. These records may be
created, received or maintained in hard copy or electronically.
2 Responsibilities
The company has a corporate responsibility to maintain its records and
record keeping systems in accordance with the regulatory environment. The
person with overall responsibility for this policy is the Company Director.
The person responsible for records management in the company will give
guidance for good records management practice and will promote compliance
with this policy so that information will be retrieved easily, appropriately and in
a timely way. They will also monitor compliance with this policy by surveying
at least annually to check if records are stored securely and can be accessed
appropriately.
Individual employees and contractors must ensure that records for which they
are responsible are accurate, and are maintained and disposed of in
accordance with the company’s records management guidelines.
3. Managing Client Records
The client record should be seen as the core record charting an individual client’s progress, goals and interventions. These guidelines are based on the assumption that the client record is a principal record and that all information relating to the client will be found in the file (although it may spread across more than one file- paper and electronic).
4 Recording information
A client or their nominated representative have the legal right to see their file at any point until the record is destroyed (when the client is 25 years of age or 35 years from date of closure for clients with special educational needs). This is their right of subject access under the Data Protection Act 1998. It is important to remember that all information should be accurately recorded, objective in nature and expressed in a professional manner.
The client record starts its life when a file is opened for each new client as they are referred to Evolce-cts.
On the referral form the following information is accessible:
• Names of parents and/or guardians with home address and telephone number (and any additional relevant carers and their relationship to the child)
• Name of the school or nursery if appropriate
• Any other medical involvement e.g. speech and language therapist, paediatrician Records
•Referral and consent form
• Any reports written about the child
• Any information about a EHCP and support offered in relation to the EHCP id relevant
• Any relevant medical information
• Any correspondence with parents or outside agencies
Assessment record forms
5. Responsibility for the client record once the client is discharged
Evolve -cts is responsible for retaining the client record until the client reaches the age of 25 years. This retention is set in line with the Limitation Act 1980 which allows that a claim can be made against an organisation by a minor for up to 7 years from their 18th birthday.
6. Safe destruction of the client record
The client record should be disposed of in accordance with the safe disposal of records guidelines.
7. Storage of client records
All client records should be kept securely at all times. Paper records, for example, should be kept in lockable storage areas with restricted access, and the contents should be secure within the file. Equally, electronic records should have appropriate security.
Access arrangements for client records should ensure that confidentiality is maintained whilst equally enabling information to be shared lawfully and appropriately, and to be accessible for those authorised to see it.
8. Relationship with existing policies
This policy has been drawn up within the context of:
Data Protection policy
Privacy Notice
A copy of the Record Retention Policy can be printed from here