Horizon Care and Education Group Limited BATHING AND PERSONAL CARE POLICY

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1 Purpose. The purpose of the policy is outline ensure that Horizon Care and Education Group meets it Health and Safety obligations, with regards to assisting the people we support to bathe and assisting with personal care. Scope The policy applies to all Horizon Care and Education Group Residential Support Staff. Application of Policy This policy should be referred to in conjunction with overall Health and Safety Policies; Risk Assessment Policy. H&S Personal Protective Equipment; Health and Safety Water Temperature; C3. BATHING, SHOWERING AND PERSONAL CARE C3.1. High water temperatures create a scalding risk to vulnerable people who use our support services. Those at risk from scalding/burning include children, those with reduced mental capacity, learning disability, reduced mobility and anyone with sensory impairment, or who cannot react appropriately or quick enough to prevent injury. (1) C3.2. Where ever possible we recommend the people we support, their carers or landlords install thermostatic mixing valves, but it is recognised that some premises may not be fitted with these valves. The following Policy must be followed in all settings where staff have responsibilities for bathing and showering the people we support. C3.3. There is also a significant fatal risk from failure to have appropriate support during bathing. Many of the people we support will have epilepsy or other medical conditions which may leave them susceptible to drowning, if left in a bath without appropriate personal or technological monitoring. We are aware, however, of the need to balance risk and the person s privacy and dignity. Where the risk is high and the likelihood is high then prevention of harm will take priority. C3.4. Core Principle C The duty of care relating to bathing or showering arises from the fact hat many of the people we support are unable to cater for their own personal care by virtue of frailty or incapacity. C3.5. Common Standard C All staff should be aware that immersing people in water temperatures of 43 degrees Celsius and above can lead to scalding. Health and Safety Policy Page 1 01/12/2014

2 C3.6. C C3.7. C C C C C C C C C C C C Responsibilities of all Staff. All staff who bathe or shower a person we support have a duty of care responsibility for ensuring the water temperature is safe at all times. All staff that bathe or shower a person we support must be deemed competent and confident to undertake the task. PROCEDURES The risk of scalding or drowning to the people we support is at its greatest during bathing, showering and when hand basins are being used. Staff with the responsibility for bathing or showering must follow these instructions. Risk assessment (APPENDIX A) A general risk assessment must be completed on every person in all settings that has been assessed to require assistance with their personal hygiene needs. The risk assessment must include: An assessment of bathing capability Can they get in and out, sit up wash themselves unaided? Is their sensitivity to temperature impaired? Can they recognise that the bath is too hot? Are they capable of summoning assistance if needed? Are they liable to add hot water if unattended? A moving and handling risk assessment The need for aids and adaptations Medical problems such as epilepsy /heart condition which pose a drowning risk? Number of staff necessary to assist/ supervise C3.8. C3.9. C3.10. C3.11. The risk assessment should be reviewed at the same interval as the support care plan or earlier if the person s capability appears to have changed. Support Planning The results of the risk assessment will be recorded and taken into account when developing the individual s support plan and should be reviewed at regular intervals. The support plan should also be reviewed if:- C C C C C C C C C C Pressure sores reddening of the skin or actual breaks (heel, bottom, hip, elbows or shoulders) should be reported immediately Bruises/breaks in skin many older people have bruising of the back of the hand and forearm due to skin thinning Weight loss Self Neglect Continence problems Sudden loss or decrease of physical independence in daily living Changes in patterns of Epilepsy Walking difficulties Changes in behaviour Any evidence of abuse Health and Safety Policy Page 2 01/12/2014

3 C3.12. Safe Practices There should not be a chain attached to the plug to reduce the risk of the chain being used as a ligature. Always fill the bath or start the shower by turning on the cold water first before adding the hot. Remember add hot water to the cold water carefully and use a bath thermometer to check the temperature of the water (43 Degrees) Immediately before the person gets into the bath or uses the shower test the temperature of the water with a thermometer. The maximum temperature is 43 degrees Celsius. Temperatures above 43 degrees Celsius can be dangerous and are likely to cause scalding. Do take into account the person s personal preferences regarding the temperature. In normal circumstances for choice to be safe, it must be at or below 43 degrees Celsius. If a person wishes to have a bath at a high temperature this must be subject to a further risk assessment and be made part of a specific support plan. Do not overfill the bath Ensure there are no slipping tripping hazards, use non-slip mats on floors and in the bath. Ensure the room is warm and maintains privacy. Gather up all the equipment necessary. Turn on any technological monitoring devices and ENSURE THEY WORK if it has been agreed in the support plan that you do not have to be present. Explain the procedure to the person, where possible. Always use any lifting equipment, which is available and always follow the instructions for use provided by the manufacturer, trainer or both. The line manager is to be asked for advice if there is a lack of clarity about the use of the equipment. Ensure adequate but discreet supervision whilst the person is bathing bathing/showering and provide assistance as appropriate or required. If a service user has an epileptic seizure or heart attack etc. whilst in the bath do not attempt to lift him or her out of the bath or shower. First pull the bath plug out and lift the service users head clear from the water. Call for assistance and the appropriate emergency services. Electricity and water do not mix; never use any electrical appliance anywhere near water due to the high risk of electric shock, severe injury or even death. As a general rule male staff should not assist female persons to bathe. The person s dignity and choice must be preserved, therefore any individual, cultural or religious preferences must be respected at all times. Health and Safety Policy Page 3 01/12/2014

4 BATHING RISK ASSESSMENT STAGE 1 RISK ASSESSMENT RECORD (Quantifiable) Rec. 1.1 Date Name of Assessors Article I. assessment Ref. number of Article II. Location of assessment Assessment subject Bathing or Showering Proposed date of review Significant Hazard Does the person need support with bathing Can they get in and out, sit up wash themselves unaided? Is their sensitivity to temperature impaired? Can they recognise that the bath is too hot? Are they capable of summoning assistance if needed? Are they liable to add hot water if unattended? Has a moving and handling risk assessment been done? Is there a need for aids and adaptations? Any medical problems such as epilepsy /heart condition which pose a drowning risk? Number of staff necessary to assist/ supervise What are the significant Hazards Identified? No. Effect of hazard A: Rating Likelihood of harm B: Rating Trivial 1 Improbable 1 Minor injury 2 Remote 2 Injury non disabling 3 Possible 3 Injury disabling 4 Probable 4 Single fatality 5 Likely/Frequent 5 Multiple fatalities 6 Certain/Imminent 6 Multiply (A) x (B) Risk rating Health and Safety Policy Page 4 01/12/2014

5 Existing control methods People affected Try to reduce the immediate risk by considering the following: Can the activity be avoided? Can the activity be substituted? Can the risk be reduced at the source? Can the people exposed be reduced? Can the exposure time be reduced? Then take the appropriate action as set out below Risk taking Action Within Copy this form to Responsible for further action 0-6 No immediate action but set date for review RCM RCM and over Stage 2 risk assessments carried out by the most senior person in the service/house. Stage 2 risk assessment carried out by the Group Manger/EMI manger Stage 2 risk assessment by the Group Manger/EMI manger 3 days 1 day 4 hrs RCM DIRECTOR OF OPERATIONAL SERVICES (DOS) DOS RCM RCM GM GM DOS Distribution (circle as appropriate) RCM Note date of circulation STAGE 2 RISK ASSESSMENT Rec. 1.1b Risk Assessment Record (Client) Use this pro-forma to record a risk assessment for the client situation where you have already assessed a level of risk by a stage one risk assessment Name of Person we Date of most recent Support assessment: Date of this Assessors Name assessment: Article III. What are the risks? Identifying the risks Health and Safety Policy Page 5 01/12/2014

6 Describe what is happening (or could happen), how often and where? Reducing the risk Describe here the immediate actions required to reduce the risk. Include; details of resources required; How staff will be organised and informed; who has the authority to change: Health and Safety Policy Page 6 01/12/2014