PERSONAL HYGIENE SUPPORT POLICY AND PROCEDURE 1. Background It has been widely recognised that there are significant potential risks associated with the bathing of service users in the social care environment. The main risks are two-fold, firstly there is the risk of drowning, secondly, there is the risk of scalding that is clearly linked to the temperature of the water and the capabilities of the patient. The problem is not to be underestimated, as there have been several deaths in recent years following whole body immersion in water by drowning or scalding. Scalding can also result in serious injury. In addition, supporting service users with their personal hygiene needs can often be overlooked because of cultural sensitivities. Within the social care setting, personal hygiene support is an assumed skill, takes place behind closed doors and so can be difficult to implement good practice guidelines. This revised policy is therefore a response to these issues. 2. Purpose To ensure that the very highest levels of support are provided when supporting a service user with their personal hygiene whilst using toilet and bathing facilities and reducing the risk of death and serious injury, especially from drowning and scalding when supporting service users to bath themselves. 3. Procedure A: Supporting Service Users with their toileting needs 1. Only members of staff who meet the following requirements will support ELHAP service users with their toiletting needs: a) Have been cleared via the Criminal Records Bureau (CRB) Enhanced Disclosure and employment/personal references checks. b) Are at least 18 years of age. c) Have been assessed by a senior ELHAP member of staff for competency in supporting ELHAP users with their personal hygiene needs. d) Ideally has been vaccinated against Hepatitis B. 2. Service Users, wherever possible, will be involved in discussions about their toiletting needs. It is essential that staff explain what they are doing to ensure that service user is fully aware of the support being offered.
3. It is preferable that there is consistency in the staff who provide personal hygiene support, rather than the whole staff team at one time or another. 4. All service users should be supported by 2 members of staff at all times. One staff member should not be left alone in the toilet with a service user. This is to protect both service user and staff. The need for staffing numbers must be carefully considered and assessed by each project providing 2 staff may not always be possible, so senior staff must plan for such situations (i.e. on outings, lone working etc). 5. All personal hygiene care must be recorded on the daily personal hygiene records. 6. Always operate universal precautions by always wearing disposable protective gloves and aprons, regardless of whether you are likely to come in contact with bodily fluids. Any skin breakages must also always be covered by a plaster or other suitable covering. Always take off all jewellery. 7. Always wash your hands before and after changing a service user, especially if contact is going to be made with bodily fluids. It is good to encourage the person you are changing to wash their hands afterwards, regardless of whether they have been in contact with their own bodily fluids 8. Whenever possible toileting should be gender appropriate, i.e. male staff with male users and female staff with female users. Male staff cannot toilet female users at any time. If in any doubt consult a senior member of staff.. 9. Think about the needs of the person before you start towards the toilets. Do you need to get personal items from their bags? Do you need spare clothes to change them into? Toileting doesn't need to be rushed; it should be calm and dignified. 10. If you are unsure of the particular needs of an ELHAP service user, you must request advice and guidance from a more experienced member of staff. It is inappropriate and disrespectful to support a user without knowing their basic personal hygiene needs. 11. Always treat people with dignity and respect whilst toileting, think about how you would feel if somebody had to take you to the toilet. Remember that privacy is more than just closing the door behind you; it means not having to share the most private parts of ourselves with everyone. 12. Wash any body fluids off your skin with hot soapy water. 13. Disinfect changing mats, toilet seat, taps, sink and door handles with disinfectant provided in cupboard, and ensure that the cupboard is locked when you leave the changing area. 14. Ensure that all clinical waste from the toilets is placed in the yellow bags provided each day. Clinical Waste is collected weekly by Redbridge Environmental service.
4. Procedure B: Supporting Service Users with their Bathing Needs 1. Only members of staff who meet the following requirements will support ELHAP service users with their bathing needs: a) Have been cleared via the Criminal Records Bureau (CRB) Enhanced Disclosure and employment/personal references checks. b) Are at least 18 years of age. c) Have been assessed by a senior ELHAP member of staff for competency in supporting ELHAP users with their personal hygiene needs. d) Ideally has been vaccinated against Hepatitis B. 2. Staff must check the temperature of the bath prior to service user s entering the water with a bath thermometer. Never presume that the thermostatic controls are working and so always manually check the temperature. Bath water must always conform to the following temperatures: a) Children and Young People (aged under 18 years) 37 C or less. b) Adults (aged 18 and over) 43 C or less. 3. Service Users, wherever possible, will be involved in discussions about their bathing needs. It is essential that staff explain what they are doing to ensure that service user is fully aware of the support being offered. 4. It is preferable that there is consistency in the staff who provide personal hygiene support, rather than the whole staff team at one time or another. 5. All service users should be supported by 2 members of staff at all times. One staff member must not be left alone in the bathing area with a service user. This is to protect both service user and staff. 6. All personal hygiene care must be recorded on the daily personal hygiene records. 7. Always operate universal precautions by always wearing disposable protective gloves and aprons, regardless of whether you are likely to come in contact with bodily fluids. Any skin breakages must also always be covered by a plaster or other suitable covering. Always take off all jewellery. 8. Always wash your hands before and after bathing a service user, especially if contact is going to be made with bodily fluids. It is good to encourage the person you are changing to wash their hands afterwards, regardless of whether they have been in contact with their own bodily fluids 9. Whenever possible bathing should be gender appropriate, i.e. male staff with male users and female staff with female users. Male staff cannot bath female users at any time. If in any doubt consult a senior member of staff.. 10. Think about the needs of the person before you start the bath. Do you need to get personal items from their bags? Do you need spare clothes to change them into? Bathing doesn't need to be rushed; it should be calm and dignified.
11. If you are unsure of the particular needs of an ELHAP service user, you must request advice and guidance from a more experienced member of staff. It is inappropriate and disrespectful to support a user without knowing their basic bathing needs. 12. Always treat people with dignity and respect whilst bathing, think about how you would feel if somebody had to support you in bathing. Remember that privacy is more than just closing the door behind you; it means not having to share the most private parts of ourselves with everyone. 13. Clean and disinfect the bath and bathing area after use. 5. Dealing with Staff Breaches of the Policy and Procedure 1. This policy will be implemented and monitored by the Trustees and senior staff at ELHAP. 2. Failure to adhere to this policy may lead to action being taken under the ELHAP Disciplinary Policy and Procedure. A. PERSONAL HYGIENE (TOILETTING) DAILY RECORD Date Time Service User s Name Staff (1) attending Staff (2) attending
B. PERSONAL HYGIENE (BATHING) RECORD Date Time Bath Temperature Service User s Name Staff (1) attending Staff (2) attending