[BCM] [JHA] [E3] [PD] [CBF] [1] Personal Care and 24-Hour Supervision

Business Continuity Recovery Procedure for CBF-1 Personal Care and 24-Hour Supervision

About this chapter

A Business Continuity Recovery Procedure tells named roles what to do, in what order and by when, so that a critical function keeps running or returns within its agreed timeframes after a disruption.

The continuity strategies chosen earlier in this series decide what Jamiyah Home for the Aged (JHA) will rely on in a disruption. The recovery procedure turns them into actions a shift in-charge can carry out at three in the morning, with incomplete information and no one to ask.

How Recovery Procedures Support the Business Continuity Plan

JHA's Business Continuity Plan (BCP) sets the overall framework: scope, activation criteria, the Crisis Management Team (CMT), communications and the Corporate Minimum Business Continuity Objective (MBCO). Each Critical Business Function (CBF) has its own recovery procedure that plugs into that framework.

ISO 22301 (clause 8.4) requires documented procedures for responding to a disruption and recovering activities within predetermined timeframes. ISO 22313 guides their content, and ISO 22361 how crisis decisions are made and escalated. This chapter is the CBF-1 answer to those requirements.

Preparedness, Response, Recovery and Restoration

The procedure is organised into three phases. Each depends on the one before it: what is not prepared cannot be executed, and what is not reviewed will fail again.

Why recovery activities must be assigned in advance

In a disruption there is no time to negotiate who does what. Every activity here has an owning role, an alternate and a timeframe, so whoever is in charge of the shift, often a senior care officer at night, can act immediately and with authority.

The procedure refers to roles, not names; the emergency contact list maps roles to people. All timings and quantities are illustrative and must be validated against JHA's resident profile, staffing and licensing conditions before adoption.

Guidance Notes for Implementing Critical Business Function

PD: Business Continuity Recovery Procedure for CBF-1 Personal Care and 24-Hour Supervision

Part 1: Purpose and Importance of CBF-1 Personal Care and 24-Hour Supervision

What CBF-1 covers

CBF-1 is the hands-on care and continuous oversight every resident receives, day and night: help with washing, dressing, toileting, eating and moving; prevention of falls, pressure injuries and wandering; supervision rounds; recognising and escalating deterioration; safeguarding; and recording and handing over care. It comprises fourteen Sub-Critical Business Functions, CBF-1.1 to CBF-1.14.

Business purpose and criticality

The purpose of CBF-1 is to keep every resident safe, clean, comfortable, nourished and treated with dignity, 24 hours a day, and to detect deterioration or harm before it becomes serious.

No other function at JHA is less able to pause. Residents are elderly, many are frail, some live with dementia, and most have no family able to step in. Within an hour without supervision or essential care, a resident may fall, wander, choke or deteriorate unnoticed. CBF-1 is also how medication (CBF-2), meals (CBF-3) and infection control (CBF-5) reach the bedside.

Major operational outcomes

• Every resident accounted for at each headcount, with no unwitnessed absence.
• Essential personal care, feeding and hydration assistance delivered as planned.
• Falls, pressure injuries and choking incidents prevented or minimised.
• Deterioration recognised and escalated promptly to a doctor or emergency services.
• Incidents reported, and residents protected from abuse and neglect.
• Accurate care records and safe shift handovers.

Key stakeholders

Residents come first, then next of kin or guardians where they exist. Care and nursing staff deliver the function; visiting doctors and hospitals rely on its observations and escalations; MSF and MOH expect it to be maintained; the Board of Jamiyah Singapore, as managing agent, is accountable for it; and SCDF and the Police support it in emergencies.

Regulatory obligations

• Social Residential Homes Act 2025, in operation since 1 July 2026, under which JHA is a licensable Social Residential Home (Welfare Home). Its General Regulations and the MSF Code of Practice set expectations including for resident management and incident management.
• MOH requirements on infection prevention and control and on the notification of infectious diseases.
• Code of Governance for Charities and IPCs (2023), which expects the Board to oversee risk and the continuity of the charity's services.
• Personal Data Protection Act 2012, which continues to apply to resident information held on paper during a disruption.

Part 2: Pre-Crisis Preparedness for CBF-1 Personal Care and 24-Hour Supervision (Reduce Phase)

Objective

Preparedness ensures that the people, information, supplies and arrangements needed to hold CBF-1 at its MBCO already exist, are known to staff and have been tested. With a continuous RTO, there is no window in which to improvise.

HOW

2.1 Governance. The Board approves this procedure as part of the BCP. The Superintendent is accountable; the Nursing and Care Lead owns and maintains it; the BCM coordinator checks consistency with other CBF procedures. Review it annually, after every activation or major exercise, and after material changes in licensing, residents or staffing.

2.2 Recovery team responsibilities. The CBF-1 Recovery Team is drawn from existing roles so that no one has to learn a new job during an incident.

2.3 Succession planning. Keep every key role three deep. A written delegation of authority allows the Shift In-Charge, without prior approval, to call emergency services, activate the BCP at Level 1, stop non-essential activities and extend a shift. A skills matrix shows who is trained in medication support, dementia care, safe transfers and evacuation, so every shift has the right mix.

2.4 Training and awareness. Brief all staff on this procedure at induction and annually. Build the skills a disruption demands: evacuating non-ambulant residents, recognising deterioration, PPE and isolation, dementia care (CBF-1.11) and paper documentation (CBF-1.14). Give agency staff and volunteers a one-page briefing card.

2.5 Resource readiness. Approve a safe minimum roster for each shift (CBF-1.3), with at least one medication-competent staff member. Maintain a call-out list, a standby pool, agreements with at least two care staffing agencies, and mutual aid with other Jamiyah homes such as Jamiyah Nursing Home, subject to formal agreement. Hold reserves of continence products, linen, hydration supplies and PPE (at least 14 days, per the Corporate MBCO), plus torches, evacuation aids and spare mobility equipment on each floor.

2.6 Alternate workplace arrangements. For CBF-1, the workplace is wherever residents are. Plan relocation in three steps: refuge zones within the Home; temporary placement at a partner home, coordinated with MSF; and hospital transfer for clinically unstable residents. Pre-agree transport, staff escort ratios and a one-page grab sheet for each resident.

2.7 ICT preparedness. List the technology CBF-1 relies on (care documentation system, nurse-call, door access and wander alerts, CCTV, telephones) and the fallback for each. Put nurse-call and door alarms on backup power where feasible, keep charged spare phones and two-way radios, and print an offline resident census and critical-information sheet daily.

2.8 Disaster recovery readiness. Agree with the CBF-9 owner and IT provider the restoration order for CBF-1 systems, confirm backups make critical resident information available within 4 hours (per the MBCO chapter), and test restoration annually.

2.9 Supplier preparedness. CBF-1's critical suppliers provide continence products, PPE, linen and laundry, agency staff, and maintenance of hoists, beds and pressure-relieving mattresses. Include continuity commitments in contracts, keep a second source for each, and confirm their continuity arrangements annually.

2.10 Communication readiness and emergency contact lists. Maintain a role-based call tree and contact list covering staff, visiting doctors, the MSF officer, MOH, SCDF, the Police, next of kin and critical suppliers, in print and offline, verified monthly. Prepare templates for staff call-out, next-of-kin updates, MSF notification and a media holding statement.

2.11 Document management and vital records. Keep controlled copies of this procedure in the duty office and each downtime pack. CBF-1's vital records are the resident census with recent photographs, summary care plans, allergies and advance care planning status, falls, wandering, choking and pressure-injury risk lists, and next-of-kin details, held in sealed, inventoried packs in line with the Personal Data Protection Act.

2.12 Dependency verification. Each quarter, confirm that CBF-6 can fill a shift at short notice, CBF-4 can restore critical power within its RTO, and CBF-9's paper fallbacks are current. Log any gap with an owner and due date.

2.13 Preventive controls. Maintain falls-prevention (CBF-1.6) and pressure-injury (CBF-1.5) programmes, wandering risk assessment and exit controls (CBF-1.11), hand-hygiene audits and vaccination (CBF-1.9), staff vetting and safeguarding training (CBF-1.13), and planned maintenance of care equipment. Monitor indoor temperatures during prolonged heat, a realistic climate-related stress for frail residents.

2.14 Testing and exercising. Run a programme that tests the procedure as it would be used, including at night.

2.15 Readiness checklist. The Nursing and Care Lead confirms the following each month and reports exceptions to the Superintendent:

• Safe minimum roster met for every shift in the coming month, with named alternates for key roles
• Emergency contact list and call tree verified within the last 30 days
• Downtime packs complete on every floor, with the census printed within the last 24 hours
• Reserve stocks of continence products, linen and PPE at or above agreed levels
• Torches, radios, spare phones and evacuation aids present and working
• Nurse-call, door alarms and backup power tested
• Second-source suppliers and agency agreements current
• Training and exercise records up to date, and open corrective actions on track

Part 3: Within T+24 Hours for CBF-1 Personal Care and 24-Hour Supervision (Response, Recovery and Resume Phase)

Objective

The first 24 hours are about protecting life, stabilising the situation and holding CBF-1 at or above its MBCO, while giving the CMT an accurate picture. With a continuous RTO and a one-hour MTPD, the aim is never to let CBF-1 fall below the minimum for more than minutes.

HOW

The steps below are chronological. Steps 4 and 5 run in parallel with Step 3 once the response is under way.

Step 1 (T+0 to T+15 minutes): Protect, account and notify. Owner: Shift In-Charge

1. Make residents safe. Move anyone in immediate danger, and call 995 for fire or medical emergencies.
2. Conduct a headcount against the census. If a resident is missing, start the wandering search procedure immediately (CBF-1.11).
3. Assign each staff member on duty to a zone, and stop all non-essential tasks.
4. Notify the Recovery Team Leader and the Superintendent by phone. Report what happened, where, when, which residents are affected, staff on duty, actions taken and help needed.
5. Open the incident log and record the time of every action from this point.

Step 2 (T+15 to T+60 minutes): Assess and activate. Owner: Recovery Team Leader

1. Safety assessment. Is the building safe? Are power, water, lighting and fire systems working? Is there a risk of infection? Are staff safe to continue?
2. Damage and impact assessment. Which sub-CBFs are affected, which staff, systems and supplies are unavailable, and for how long is this likely to last?
3. Identify residents at highest risk: those with dementia who may wander, high falls or choking risk, bedbound, acutely unwell or at end of life. Assign them closer supervision.
4. Decide the activation level, as set out below, and notify the call tree accordingly.

Step 3 (T+1 to T+4 hours): Mobilise and restore priority sub-CBFs. Owner: Recovery Team Leader

Resource mobilisation. The Staffing Coordinator activates the call-out list, extends shifts within safe limits and requests agency or mutual-aid staff. The Records and Logistics Officer issues downtime packs and reserve supplies and records resource use.

Prioritisation of recovery activities. Sub-CBFs are restored and protected in the order below. A lower priority never draws staff away from a higher one.

Manual workarounds. Staff switch to the pre-agreed workaround as soon as a dependency fails, without waiting for approval.

Recovery site activation. If the building cannot be made safe, or essential utilities cannot be restored within CBF-4's RTO, the CMT Lead decides on relocation with MSF and the visiting doctor. Residents move first to refuge zones, then to a partner home or hospital, each with a grab sheet, medication and staff escort; every departure and arrival is logged.

ICT recovery. The CBF-9 owner and IT provider restore, in order: telephones; nurse-call and door alarms; the care documentation system; other systems. Staff stay on paper until the Recovery Team Leader confirms a restored system is reliable.

Supplier coordination. The Records and Logistics Officer contacts critical suppliers, confirms delivery capacity, activates second sources where the primary cannot deliver, and requests emergency laundry or linen support.

Step 4 (T+1 to T+12 hours): Communicate, notify and escalate. Owner: CMT Lead, supported by the Communications Officer

Communication with stakeholders. Brief staff each shift, reassure residents in plain language, inform next of kin of residents directly affected, and update visiting doctors on residents whose care has changed. The CMT Lead approves all external messages.

Regulatory notifications. Notify MSF of serious incidents in line with the Code of Practice and within MSF's timeframes, and MOH of suspected infectious disease outbreaks as it requires, coordinated with CBF-5. Report to the Police and SCDF as needed, and brief the Board of Jamiyah Singapore at Level 3.

Escalation procedures.

Decision-making responsibilities. The Shift In-Charge decides immediate safety actions and emergency calls; the Recovery Team Leader decides workarounds, reduced care and Level 2 activation; the CMT Lead decides Level 3 activation, relocation, external statements and emergency spending within delegated authority.

Step 5 (T+4 to T+24 hours): Stabilise, report and record. Owner: Recovery Team Leader

1. Recovery progress reporting. Issue a situation report to the CMT every 4 hours, or as directed: residents accounted for and their condition; each sub-CBF's status against its MBCO (green, amber or red); staffing for the next 24 hours; supplies; incidents; and decisions required.
2. Plan the next 72 hours. Confirm rosters, supplies and any agency or mutual-aid cover beyond the first day. Protect staff welfare with rest breaks, meals and limits on consecutive extended shifts.
3. Documentation of actions taken. Maintain the incident log (time, action, by whom, reason), paper care records, resident movement log, expenditure record and communications log. Keep all originals.
4. T+24 hours review. The CMT decides whether to continue the response, move to restoration, or escalate further.

Part 4: After T+24 Hours for CBF-1 Personal Care and 24-Hour Supervision (Restore and Return Phase)

Objective

Restoration returns CBF-1 from its minimum level to full service without creating new risks, and closes the incident properly: records reconciled, costs accounted for, regulators informed and lessons applied.

HOW

4.1 Confirm readiness to restore. The CMT approves restoration only when the cause is contained, premises are safe, utilities stable, staffing assured for 72 hours, critical systems tested and supplies replenished.

4.2 Restore full services. Reinstate deferred care in reverse order of priority: full personal care (CBF-1.4), mobility programmes (CBF-1.6), then care plan reviews (CBF-1.2) and admissions (CBF-1.1), the latter with MSF. Reassess affected residents for skin integrity, falls risk, hydration, weight and cognition, as deconditioning often appears later.

4.3 Return to the primary workplace and from alternate sites. Return relocated residents only once the building is certified safe, cleaned (terminal cleaning after an outbreak) and its utilities tested. Return in phases, with a handover for each resident, medication reconciled with CBF-2 and belongings checked. Close the resident movement log only when every resident is confirmed back or placed.

4.4 Restore ICT services and records. Confirm each system works and its data are complete to the point of failure. Re-establish nurse-call, door alarms and CCTV before withdrawing the extra staff covering them, and refresh the downtime packs.

4.5 Reconcile manual work and validate data integrity. Back-enter paper records within an agreed period, such as seven days. Use two-person checks for medication, incident and falls records, and sample other entries against the originals. Treat any gap in care delivery, such as missed repositioning, as an incident. Scan and retain the originals.

4.6 Reinstate normal staffing. End extended shifts, release agency and mutual-aid staff with a handover, and give staff time off in lieu, a structured debrief and emotional support, especially after deaths or traumatic events.

4.7 Supplier normalisation. Return to normal ordering, replenish reserves to agreed levels, and review how each critical supplier performed during the disruption.

4.8 Financial reconciliation. Record additional costs (overtime, agency fees, emergency purchases, transport, repairs) against one incident code, confirm approvals were within delegated authority, lodge insurance claims and report the total to the Board, raising funding implications with MSF.

4.9 Stakeholder communications. Tell residents, next of kin, staff, visiting doctors and any affected volunteers and donors that normal service has resumed, and what is being done to prevent a recurrence.

4.10 Regulatory reporting. Submit any final or follow-up incident reports MSF requires, confirm closure of outbreak management with MOH where relevant, and retain all records for inspection.

4.11 Operational performance monitoring. For four to six weeks, compare falls, pressure injuries, hospital transfers, incidents and complaints with the pre-incident baseline; a rise may reveal hidden harm.

4.12 Post-incident review and lessons learned. Within two to four weeks, the BCM coordinator facilitates a blame-free review with the Recovery Team, the CMT and frontline staff, including night shift: what happened, whether the MBCO held, what worked, what did not, and why.

4.13 Corrective actions. Record each finding in the corrective action register with an owner, due date and closure evidence. The Superintendent tracks progress and the Board reviews overdue actions (ISO 22301, clause 10).

4.14 BCP updates and training improvements. Update this procedure, the contact list, the downtime packs and, if shown to be unrealistic, CBF-1's MBCO, RTO or MTPD. Brief staff on changes, adjust training where skills fell short, and design the next exercise to test the revised arrangements.

4.15 Continuous improvement. Feed review findings, corrective action status and exercise results into the BCMS management review (ISO 22301, clause 9.3), so the Board can see how CBF-1's resilience is changing over time.

This recovery procedure is the working part of JHA's Business Continuity Plan for the function that matters most to residents. The BCP sets the framework; this procedure tells the Shift In-Charge, the Recovery Team and the CMT what to do for CBF-1, in what order and on whose authority.

Preparation is decisive. With a continuous RTO and a one-hour MTPD, CBF-1 cannot be rebuilt during an incident; it can only be sustained with the staff, skills, records and supplies that were put in place beforehand.

Disciplined execution is equally important. Clear priorities, pre-agreed workarounds, defined escalation triggers and a complete record of decisions let a small team under pressure keep every resident safe, and let the Home account for its actions to MSF, families and the Board.

Continual improvement completes the cycle: every activation and exercise exposes something to strengthen, and tracked corrective actions turn that experience into greater resilience. Documented, owned and tested, these procedures give JHA a defensible, humane and repeatable way to protect its residents through any disruption.

Successful recovery depends upon preparation, coordination, communication and continual improvement.