The Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England sets out seven statements describing the standards of behaviour expected of every unregistered care worker: be accountable, uphold dignity and rights, work with colleagues, communicate openly, respect confidentiality, keep improving, and promote equality. It was published by Skills for Care and Skills for Health in 2013 and it remains the professional standard for support workers, care assistants and healthcare assistants who have no regulator of their own.
This guide is for registered managers, deputies and owners of care homes. It explains each statement in plain English with examples from an ordinary shift, shows how the code fits with the Care Certificate and the 6 Cs, and sets out how to use it properly in induction, supervision and conduct cases so that it does real work rather than sitting in a personnel file.
The short answer
The code of conduct for healthcare support workers is a voluntary professional standard, not a law and not a register. It tells care workers how to behave and tells employers what to expect and support. Its seven statements cover accountability, dignity and rights, collaboration, communication, confidentiality, professional development and equality. For a care home the code is most useful as the shared language of conduct: signed at induction, referenced in job descriptions, used to structure supervision, and applied fairly when something goes wrong. Combined with the 15 Care Certificate standards, it is the closest thing unregistered care staff in England have to a professional framework, and inspectors expect to see it in use.
What is the code of conduct for healthcare support workers?
The code is a short document, written in plain language, that describes how a healthcare support worker or adult social care worker should conduct themselves. It applies to workers in the NHS and in adult social care in England, whatever their job title: care assistant, support worker, healthcare assistant, senior carer. It does not apply to registered nurses, social workers or other regulated professionals, who have their own codes.
The code has two parts. The first is the seven statements, each with a short list of what the worker must do. The second is guidance for employers, setting out what organisations should do to support workers to meet the code: induction, training, supervision, clear policies and a culture where concerns can be raised.
Each statement begins with the words as a healthcare support worker or adult social care worker in England you must. That wording is deliberate. The code is not aspirational. It describes a minimum.
Where the code came from
The code was one of the recommendations of the Cavendish Review, published in July 2013, which examined the training and support of healthcare assistants and social care workers following the Francis report into Mid Staffordshire. Camilla Cavendish found that the largest group of people delivering hands-on care had the least training and the least clear standards, and recommended a common code of conduct and a common set of minimum training standards.
Skills for Care and Skills for Health published the code and the national minimum training standards in 2013. The training standards were replaced by the Care Certificate in 2015. The code has remained in place, unchanged in substance, and is referenced by CQC, by Skills for Care in its guidance for employers, and by most care providers in their job descriptions and disciplinary policies.
Understanding this history helps managers explain the code to staff. It was written because people were harmed, and because the people who cared for them had been given responsibility without standards or support. The code is the sector's answer to that.
Who the code applies to
The code applies to any worker in England who provides direct care or support and is not registered with a professional regulator. In a care home that includes care assistants, support workers, senior carers who are not nurses, activities staff who provide personal support, and bank and agency workers. Domestic, catering and maintenance staff are not covered by the code as written, although the home's own staff code should apply the same values to everyone.
The code is not statutory. There is no register of care workers in England, unlike Scotland, Wales and Northern Ireland, and no body can strike a worker off for breaching it. Its force comes from the employer: by adopting the code in the job description and the contract, the home makes it a contractual standard, and breaches become conduct matters under the disciplinary policy.
Registered nurses in nursing homes are governed by the Nursing and Midwifery Council code instead, which covers similar ground with the additional weight of registration. Managers running mixed teams should know both.
At a glance: the seven statements
| Statement | What it means on shift | What evidences it |
|---|---|---|
| 1. Be accountable for your actions and omissions | Own what you do and what you miss; work within your competence; report errors | Incident reports, honest daily notes, competency records |
| 2. Promote privacy, dignity, rights, health and wellbeing | Knock, ask, explain, cover, respect choice, support health | Observation, care plans, feedback |
| 3. Work in collaboration with colleagues | Handover, teamwork, challenge poor practice, support new staff | Handover records, team meeting minutes |
| 4. Communicate openly and effectively | Listen, explain, record, tell families and professionals what they need | Daily logs, contact records, care plan reviews |
| 5. Respect confidentiality | Share only what is needed with those who need it; secure records | Access logs, policy confirmations |
| 6. Improve through continuing professional development | Complete training, take feedback, ask when unsure | Training matrix, supervision, appraisal |
| 7. Uphold and promote equality, diversity and inclusion | Treat people fairly and as individuals; challenge discrimination | Care plans, incident records, feedback |
Statement 1: be accountable
The first statement says the worker must be accountable by making sure they can answer for their actions or omissions. In practice it means four things. Work within your training and competence, and say when something is outside it. Follow the care plan and the policies, and if you depart from them for a good reason, record why. Own your mistakes: report a medicines error, a fall you did not witness, a chart you forgot. And do not do something because you were told to if you believe it is unsafe.
On shift, accountability looks like a support worker saying they have not been signed off for the new stand aid and asking for someone who has. It looks like a care assistant who signs the MAR only after the tablets are swallowed. It looks like an honest note that says a resident was not repositioned at 2pm because two staff were dealing with a fall, rather than a tick that says she was.
Managers evidence accountability through incident reports that staff have written about their own errors, competency records that show the limits of each worker's role, and daily notes that describe what happened rather than what should have happened. A home where nobody ever reports their own mistake is not a home with no mistakes.
Statement 2: privacy, dignity, rights, health and wellbeing
The second statement is the longest in the code and covers what most people would call good care: promoting and upholding the privacy, dignity, rights, health and wellbeing of people who use services and their carers at all times. It includes always acting in the person's best interests, respecting their right to make choices, treating them as an individual, and taking action if you believe they are being harmed.
On shift this is the knock and wait, the closed door, the explanation before personal care, the choice of clothes offered rather than assumed, the refusal respected and recorded. It is noticing that a resident is quieter than usual and telling the senior. It is supporting a person to see the GP rather than deciding their pain is normal for them. It is the same standard Regulation 10 requires and the same behaviour the Caring quality statements describe.
The phrase at all times matters. Dignity that is upheld when the manager is watching and dropped on a short night shift is not dignity. Inspectors know this, which is why they observe at different times and ask residents directly.
Statement 3: work in collaboration with colleagues
The third statement requires the worker to work in collaboration with colleagues to ensure the delivery of high quality, safe and compassionate care and support. It includes understanding and valuing the roles of others, working as a team, supporting new colleagues, and, importantly, challenging colleagues whose practice is unsafe or unkind.
Collaboration on shift is a good handover, given and received. It is helping with a two-person transfer without being asked. It is telling the new starter where the PEEPs are kept. It is also the awkward part: saying to a colleague that the way they spoke to a resident was not acceptable, and telling the senior if it continues.
Managers should be clear that challenge is part of collaboration, not a breach of it. Teams that define loyalty as silence are the teams where abuse takes root. Our guide to structuring a care home handover covers the daily mechanics of collaboration; the culture behind it is set by the manager.
Statement 4: communicate openly and effectively
The fourth statement requires open and effective communication to promote the health, safety and wellbeing of people who use services and their carers. It covers communication with the person, in a way they can understand; with colleagues, through handover and records; with families and carers; and with other professionals. It includes maintaining clear and accurate records and raising concerns.
On shift this is the worker who finds out how a person with a learning disability communicates and uses that method. It is the daily note that says how the person was, not just what was done. It is the call to the family after a fall, made that day. It is the clear account given to a paramedic. Communication skills in health and social care are often treated as soft; the code treats them as a conduct standard.
Records are the tangible evidence. A daily log completed at the point of care that describes the person, a contact record that shows families were told, and a care plan that shows the person's communication method all demonstrate statement 4 in action.
Statement 5: respect confidentiality
The fifth statement requires the worker to respect a person's right to confidentiality. That means treating all information about the person as confidential, sharing it only with those who need it for the person's care or safety, following the home's policy and the law, and not discussing residents where they can be overheard or on social media.
On shift this is the worker who does not talk about one resident in front of another, who does not tell a visitor about someone else's night, who locks the screen when they walk away from the computer, and who knows the difference between a relative with lasting power of attorney and a relative who is simply curious. It is also the worker who does share information when a resident is at risk, because confidentiality is not a reason to withhold what a safeguarding lead or a paramedic needs.
Digital records make confidentiality easier to enforce and to evidence. Permissions set per person mean staff see only what their role requires, and an audit trail shows who accessed what. A breach that would once have been invisible now leaves a record.
Statement 6: continuing professional development
The sixth statement requires the worker to strive to improve the quality of care and support through continuing professional development. That includes completing the training the role requires, keeping it up to date, taking part in supervision and appraisal, reflecting on practice, and asking for help or training when they identify a gap.
On shift this is the worker who asks to shadow a colleague on a task they are unsure of, who completes their Care Certificate on time, who takes feedback without defensiveness, and who says in supervision that they would like to learn more about dementia or autism. It is the senior who completes the Level 3 diploma rather than relying on experience alone.
The employer's side of this statement is heavy. Workers cannot develop if the home provides no training, no supervision and no time. The code's guidance for employers is explicit: induction, training, supervision and appraisal are the employer's responsibility. A training matrix with expiry dates and a supervision schedule is how a manager shows both sides of the bargain are being kept. Our guide to supervision in care covers the frequency and content.
Statement 7: equality, diversity and inclusion
The seventh statement requires the worker to uphold and promote equality, diversity and inclusion. That means treating every person fairly and as an individual, respecting their culture, faith, identity and choices, challenging discrimination whether by colleagues, residents or visitors, and reporting it.
On shift this is the worker who supports a resident's religious practice without comment, who uses a trans resident's correct name and pronouns, who does not assume an older resident is heterosexual, who books an interpreter rather than relying on a relative, and who tells the senior when a resident makes racist remarks to a colleague. It is also the worker who recognises that a person with a learning disability has the same rights as anyone else and supports them to exercise those rights.
The Equality Act 2010 and its nine protected characteristics give this statement its legal frame, and the care plan is where it is evidenced: culture, faith, language, identity and adjustments recorded and acted on.
The code and the Care Certificate
Candidates for training courses often search for what the care certificate and code of conduct standards include, and the answer is that they are designed to work together. The code describes how to behave. The Care Certificate's 15 standards describe what a new worker must know and be able to do. Both came out of the Cavendish Review and both are published by Skills for Care.
The overlap is direct. Statement 1 on accountability maps to Care Certificate standards 1 and 3, on the worker's role and duty of care. Statement 2 maps to standards 5 and 7, person-centred working and privacy and dignity. Statement 4 maps to standard 6, communication. Statement 5 maps to standard 14, handling information. Statement 7 maps to standard 4, equality and diversity. Statement 6 maps to standard 2, personal development.
Managers should introduce the code at the start of induction, before the Care Certificate work begins, so that the worker understands the standard they are being trained to meet. Our guide to evidencing the Care Certificate covers the assessment side.
The code and the 6 Cs
The 6 Cs, care, compassion, competence, communication, courage and commitment, were published by NHS England in 2012, a year before the code. They describe values; the code describes conduct. A home can use both without confusion if it explains the difference.
The mapping is close. Competence is statement 1 and statement 6. Care and compassion are statement 2. Communication is statement 4. Courage is the challenge and reporting elements of statements 1, 3 and 7. Commitment is statement 6 and the phrase at all times in statement 2. Managers who already use the 6 Cs in supervision can add the code as the more specific standard when a conduct issue arises.
In practice, the 6 Cs work well for values-based recruitment and for recognising good practice; the code works better for defining what went wrong when practice falls short, because its statements are written as requirements.
Is the code legally binding?
Not in itself. The code is a professional standard without a regulator behind it. There is no register to be removed from and no statutory penalty for breaching it. Its force comes through three routes.
First, the employment contract. A home that includes the code in the job description and requires the worker to sign it at induction has made compliance a contractual term, and breaches can be dealt with under the disciplinary policy up to and including dismissal. Second, the Disclosure and Barring Service. A worker dismissed for conduct that harmed or risked harm to an adult at risk must be referred to the DBS, which can bar them from working in regulated activity. Third, regulation of the home. CQC does not enforce the code directly, but a home whose staff do not behave to its standard will breach the regulations on dignity, safe care, safeguarding and good governance, and the home will be held to account.
Managers should explain this honestly to staff. The code is voluntary in law and mandatory in this home.
How to introduce the code at induction
- Give the new worker the code in full at offer stage, alongside the job description, so they know the standard before they start.
- On day one, go through each of the seven statements in conversation, asking the worker for an example of each from any setting they have worked or lived in.
- Link each statement to the home's own policies: safeguarding, confidentiality, equality, medicines, records.
- Explain how the code becomes contractual through the job description and the disciplinary policy, and what a DBS referral means.
- Explain how to raise a concern, and tell the worker about a time a concern was raised in the home and what happened.
- Have the worker sign a statement that they have received, read and understood the code, and file it with the date.
- Return to the code at the end of the first week, asking which statement was hardest to meet and why.
- Record the induction conversation with the examples used, not just the signature.
How to use the code in supervision
As a structure for observation
The seven statements give the supervisor a lens. A short observation of a mealtime or a personal care interaction can be written up against the statements: where the worker upheld dignity, where communication was clear, where accountability was shown. This produces specific, dated, positive evidence that a training certificate never can.
As a language for feedback
When practice falls short, naming the statement takes the conversation from personal to professional. Not: you were rude to Mrs Ahmed. Instead: statement 2 requires us to uphold dignity at all times, and this morning I saw you start personal care without explaining what you were doing. What happened? That framing lets the worker respond without feeling attacked, and it creates a record that stands up.
As a development plan
Statement 6 puts development on the worker as well as the employer. Supervision should ask what training the worker wants, what they are unsure of and what they have learned since last time, and should record the answers and the actions.
Using the code in conduct and disciplinary cases
When a conduct issue arises, the code gives the manager a clear standard to test against. The investigation should identify which statement is engaged, gather evidence of what happened, hear the worker's account, and reach a finding on whether the statement was breached and how seriously.
Fairness matters as much as the standard. The worker must know the allegation, see the evidence, have the chance to respond and be accompanied. The finding should be proportionate: a first breach of statement 4 through a poorly written note is a learning conversation, not a warning; a breach of statement 2 through rough handling is potentially gross misconduct. The code does not set sanctions; the disciplinary policy does.
The code also protects workers. A worker who refused an instruction because it was unsafe has met statement 1, not breached it. A worker who reported a colleague has met statement 3. Managers who use the code only as a stick will find staff stop signing it in spirit.
The employer's side of the code
The code includes guidance for employers that is often overlooked. It says that employers should ensure workers have a proper induction and the training they need, that they are supervised and supported, that they know how to raise concerns and are protected when they do, that they have clear job descriptions and policies, and that they are given the time and resources to meet the code.
A manager who disciplines a worker for a breach of statement 6 when the home has provided no training for a year is on weak ground. A manager who expects statement 3 collaboration from a team that has had no team meeting in six months is asking for something the home has not enabled. The code is a bargain, and inspectors under Well-led look at both sides.
Evidence of the employer's side includes induction records, the training matrix, supervision records, the whistleblowing policy and log, team meeting minutes and staff feedback. A compliance view that brings HR records together with quality evidence makes it easy to show that the home holds up its end.
Building the home's own staff code on top
Most homes need a staff code of conduct that goes beyond the national code, covering matters specific to the service. It should adopt the seven statements as its foundation and add local rules.
- Professional boundaries: gifts, money, wills, personal relationships with residents and families
- Social media and personal devices, including photographs of residents
- Use of the home's digital systems, passwords and records
- Dress, identification and infection control expectations
- Alcohol, drugs and fitness for work
- Attendance, punctuality and notification of absence
- Restrictive practices and physical intervention, where relevant
- Relationships and sexuality, where the home supports adults who may be at risk
- Confidentiality after leaving employment
- How to raise a concern and the protection available
The staff code should be short, written in plain English, signed at induction and revisited at appraisal. It should never contradict the national code or the home's policies; where it adds a rule, it should say why.
The code in learning disability and mental health services
In services for people with a learning disability, autism or mental ill health, the code carries particular weight because the people supported are less able to complain and more exposed to closed cultures. Statement 2 on rights and wellbeing means supporting people to make their own choices and take reasonable risks, not managing them for convenience. Statement 3 on challenging colleagues is the main defence against poor practice becoming normal. Statement 7 on equality includes recognising that a person's behaviour is communication and that diagnostic overshadowing kills.
Support workers in these services should be told plainly that questioning restraint, seclusion, PRN use, locked doors and the tone of colleagues is required by the code, not a betrayal of the team. Managers should audit restrictive practice, ask about it in supervision and treat every concern raised as evidence that the code is working.
Common mistakes
- Filing the code as a signed document at induction and never mentioning it again.
- Using the code only in disciplinary cases, so staff experience it as a threat rather than a standard.
- Expecting workers to meet statement 6 without providing training, supervision or time.
- Confusing the code with the Care Certificate, or teaching one without the other.
- Treating challenge of colleagues as disloyalty, which breaches statement 3 from the manager's side.
- Applying the code to care staff but not to seniors, managers or agency workers.
- Investigating breaches without fairness, so the finding collapses at appeal or tribunal.
- Telling staff the code is voluntary and leaving it there, without explaining how it becomes contractual.
What good looks like on inspection day
The inspector asks a support worker what standards they work to, and the worker names the code and the Care Certificate and can describe two or three of the statements in their own words with examples. The inspector asks what they would do if a colleague was unkind to a resident and the worker describes challenging them and reporting it, and says they would be supported. The personnel file shows the code signed at induction with a record of the conversation, the job description referencing it, and supervision notes that use the statements to structure feedback.
The inspector observes practice and sees statements 2 and 4 in action: knocking, explaining, choice, records written at the time. The training matrix shows statement 6 is enabled. The whistleblowing log shows statement 3 is real. A conduct case in the last year shows the code applied fairly, with the statement identified, the worker heard and a proportionate outcome.
None of this needs to be assembled for the inspection. If the code is the home's working language of conduct, the evidence accumulates on its own in the care records, the HR files and the supervision notes.
Final conclusion
The code of conduct for healthcare support workers and adult social care workers is short, plain and thirteen years old, and it still describes exactly what a care home needs from its staff and what its staff need from the home. Seven statements: accountability, dignity, collaboration, communication, confidentiality, development and equality. Introduce it properly, make it contractual, use it as the structure for observation and feedback, apply it fairly when things go wrong, and hold up the employer's side. Do that and the code stops being a document in a file and becomes the way the home works.
Frequently asked
What is the code of conduct for healthcare support workers?
It is a voluntary professional standard published by Skills for Care and Skills for Health in 2013 that sets out seven statements describing how healthcare support workers and adult social care workers in England must behave. It covers accountability, dignity and rights, collaboration, communication, confidentiality, professional development and equality, and includes guidance for employers.
What are the seven statements of the code of conduct?
The statements are: be accountable for your actions and omissions; promote and uphold the privacy, dignity, rights, health and wellbeing of people and their carers; work in collaboration with colleagues; and communicate in an open and effective way. The remaining three are to respect a person's right to confidentiality, to strive to improve through continuing professional development, and to uphold and promote equality, diversity and inclusion. Each begins with the words you must.
Is the code of conduct legally binding?
Not in itself, because there is no register of care workers in England and no regulator enforces it. It becomes binding through the employment contract when the home adopts it in the job description, through DBS referral where a worker is dismissed for conduct that harmed an adult at risk, and indirectly through CQC regulation of the home.
What do the Care Certificate and code of conduct standards include?
The code describes how workers must behave through seven statements. The Care Certificate sets out 15 standards of knowledge and skill that new workers must achieve during induction, covering role, development, duty of care, equality, person-centred working, communication, dignity, nutrition, mental health and learning disability awareness, safeguarding adults and children, basic life support, health and safety, handling information and infection control. The two are designed to be used together.
Who does the code of conduct apply to?
Any worker in England who provides direct care or support and is not registered with a professional regulator, including care assistants, support workers, healthcare assistants, senior carers who are not nurses, and bank and agency staff. Registered nurses follow the Nursing and Midwifery Council code instead.
How should a manager use the code of conduct in supervision?
Use the seven statements as a lens for observing practice and writing up specific, dated examples of good and poor conduct. Name the relevant statement when giving feedback so the conversation stays professional rather than personal. Ask about development under statement 6 and record the actions.
How does the code of conduct relate to the 6 Cs?
The 6 Cs describe values: care, compassion, competence, communication, courage and commitment. The code describes conduct, written as requirements. They map closely, with competence in statements 1 and 6, compassion in statement 2, communication in statement 4 and courage in the challenge and reporting elements of statements 1, 3 and 7. Homes can use the 6 Cs for recruitment and recognition and the code for defining standards.
Sources
- Skills for Care and Skills for Health: Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England
- The Cavendish Review: an independent review into healthcare assistants and support workers in the NHS and social care settings (2013)
- Skills for Care: The Care Certificate standards
- NHS England: Compassion in Practice (the 6 Cs)
- Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
- Equality Act 2010
- Nursing and Midwifery Council: The Code
