{{org_field_logo}}

{{org_field_name}}

Registration Number: {{org_field_registration_no}}

---

Leg Ulcer Management and Prevention Policy

1. Purpose and Commitment

The purpose of this policy is to outline how {{org_field_name}} ensures the efficient, safe, and effective management and prevention of leg ulcers among service users. Our commitment is to promote high standards of care that prevent leg ulcers from developing, facilitate the healing of existing ulcers, and improve the quality of life for individuals receiving our services.

This policy aligns with the National Institute for Health and Care Excellence (NICE) guidelines, the Health and Social Care Act 2008, and Care Quality Commission (CQC) standards. Our approach prioritises early intervention, evidence-based care, staff competency, and service user education.

2. Scope

This policy applies to all employees, including care staff, administrative staff, volunteers, contractors, and agency workers involved in providing care to service users. It covers:

• Prevention of leg ulcers.
• Identification and assessment of leg ulcers.
• Treatment, management, and monitoring.
• Education and support for service users and their families.

The policy applies across all domiciliary care settings, ensuring consistency in care delivery and adherence to best practices.

3. Policy Statement

{{org_field_name}} is committed to:

• Promoting early detection and prevention of leg ulcers.
• Delivering evidence-based wound care.
• Ensuring staff are trained and competent in leg ulcer management.
• Educating service users on self-care and prevention strategies.
• Collaborating with healthcare professionals for holistic care.

We adopt a person-centred approach, ensuring that service users’ preferences, dignity, and well-being are prioritised.

4. Understanding Leg Ulcers

4.1 Definition of Leg Ulcers Leg ulcers are open wounds that occur on the lower leg, typically between the knee and ankle, and fail to heal within six weeks. They are often caused by underlying health conditions such as venous insufficiency, arterial disease, diabetes, or pressure damage.

4.2 Types of Leg Ulcers

• Venous Ulcers: Caused by poor venous circulation, often characterised by shallow wounds with irregular edges and associated with swelling and skin discoloration.
• Arterial Ulcers: Result from reduced arterial blood flow, presenting as deep, well-defined wounds, often painful and located on pressure points.
• Diabetic Ulcers: Associated with diabetes, typically on the feet or lower legs, caused by neuropathy and poor circulation.
• Pressure Ulcers: Develop due to prolonged pressure, commonly on bony areas.

4.3 Risk Factors Risk factors include:

• Poor circulation (venous or arterial).
• Diabetes and peripheral neuropathy.
• Immobility and pressure damage.
• Obesity and poor nutrition.
• Advanced age and frailty.

5. Prevention Strategies

5.1 Risk Assessment We conduct comprehensive risk assessments for all service users upon admission and regularly thereafter. This includes:

• Evaluating medical history and underlying conditions.
• Assessing skin integrity and circulation.
• Identifying mobility limitations and nutritional status.

5.2 Skin Care and Hygiene Proper skin care reduces the risk of ulcer formation. Staff ensure that:

• Skin is kept clean, moisturised, and dry.
• Regular skin inspections are conducted.
• Appropriate continence management is in place.

5.3 Mobility and Pressure Relief Promoting mobility and reducing pressure are key prevention strategies:

• Encouraging regular movement and repositioning.
• Using pressure-relieving devices, such as cushions and mattresses.
• Supporting safe exercise within service users’ abilities.

5.4 Nutrition and Hydration Adequate nutrition and hydration support skin integrity and wound healing. Staff promote:

• A balanced diet rich in protein, vitamins, and minerals.
• Adequate fluid intake.

5.5 Health Promotion and Education We educate service users and families on:

• Maintaining healthy circulation.
• Recognising early signs of skin breakdown.
• Practicing proper foot and leg care.

6. Identification and Assessment

6.1 Early Detection Early identification improves outcomes. Staff conduct regular skin checks, noting:

• Redness, swelling, or skin discoloration.
• Dry, flaky skin or eczema.
• Pain, tenderness, or warmth in the lower legs.

6.2 Comprehensive Assessment If a leg ulcer is suspected, a thorough assessment includes:

• Measuring wound size, depth, and location.
• Assessing wound edges, exudate, and signs of infection.
• Checking peripheral pulses and skin temperature.
• Evaluating pain levels and impact on daily activities.

6.3 Documentation All findings are documented in the service user’s care plan, including photographs (with consent) for monitoring progress.

7. Treatment and Management

7.1 Individualised Care Plans Care plans are developed in collaboration with healthcare professionals and include:

• Wound cleansing and dressing protocols.
• Pain management strategies.
• Mobility and pressure relief measures.
• Nutrition and hydration support.

7.2 Wound Care Staff follow evidence-based wound care practices, including:

• Cleaning wounds with saline or prescribed solutions.
• Applying appropriate dressings based on wound type and exudate levels.
• Using compression therapy for venous ulcers (under medical guidance).

7.3 Infection Prevention and Control To prevent infection, staff:

• Follow strict hand hygiene and PPE protocols.
• Monitor for signs of infection (redness, swelling, increased pain).
• Escalate concerns promptly to healthcare providers.

7.4 Pain Management Effective pain management improves comfort and promotes healing. This includes:

• Regular pain assessments.
• Administering prescribed analgesics.
• Using non-pharmacological methods, such as elevation and cold compresses.

8. Monitoring and Evaluation

8.1 Regular Monitoring Wound progress is monitored regularly, including:

• Measuring wound size and assessing healing progress.
• Evaluating the effectiveness of current interventions.
• Documenting observations and communicating with healthcare professionals.

8.2 Escalation of Concerns If healing is delayed or complications arise, staff escalate concerns by:

• Contacting the GP, district nurse, or tissue viability nurse.
• Arranging further assessments, such as Doppler studies.

9. Collaboration with Healthcare Professionals

9.1 Multidisciplinary Approach Effective leg ulcer management requires collaboration with:

• General practitioners (GPs).
• District nurses and tissue viability specialists.
• Dietitians and physiotherapists.
• Podiatrists for foot care and offloading strategies.

9.2 Care Coordination Staff ensure seamless communication between healthcare providers, service users, and families through regular case reviews and updates.

10. Education and Empowerment

10.1 Service User Education We empower service users to take an active role in their care by providing education on:

• Proper leg and foot care.
• Identifying early warning signs.
• Maintaining healthy lifestyle practices.

10.2 Family and Caregiver Support Families and caregivers receive guidance on:

• Assisting with wound care.
• Promoting mobility and pressure relief.
• Encouraging adherence to care plans.

11. Training and Competency

11.1 Staff Training All staff involved in leg ulcer care complete comprehensive training, including:

• Risk assessment and prevention.
• Wound assessment and dressing application.
• Infection prevention and control.
• Pain management and holistic care.

11.2 Competency Assessment Regular competency assessments ensure staff maintain high standards of care, including:

• Observing wound care practices.
• Reviewing documentation accuracy.
• Providing feedback and refresher training as needed.

12. Record-Keeping and Documentation

12.1 Accurate Record-Keeping Staff maintain detailed records of:

• Risk assessments and skin checks.
• Wound assessments and care plans.
• Dressing changes and wound progress.
• Communication with healthcare professionals.

12.2 Secure Storage All records are stored securely and accessed only by authorised personnel, ensuring confidentiality and data protection.

13. Quality Assurance and Continuous Improvement

13.1 Audits and Reviews We conduct regular audits to evaluate:

• Compliance with care plans and protocols.
• Wound healing outcomes.
• Staff training and competency levels.

13.2 Feedback and Improvement Service user feedback informs continuous improvement, ensuring care remains person-centred, effective, and responsive to individual needs.

14. Compliance and Policy Review

14.1 Legal and Regulatory Compliance This policy aligns with:

• NICE guidelines for leg ulcer management.
• The Health and Social Care Act 2008.
• CQC standards for safe and effective care.

14.2 Policy Review This policy is reviewed annually or following significant changes in best practices, legislation, or feedback from staff and service users.

---

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.