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Registration Number: {{org_field_registration_no}}

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Supporting Individuals with Dementia Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} provides high-quality, person-centred care to individuals living with dementia in a way that respects their dignity, maximises their independence, and enhances their quality of life. This policy outlines how we support individuals with dementia, their families, and our staff to provide safe, effective, and compassionate care while ensuring compliance with Care Inspectorate Wales (CIW) regulations and best practices.

Our objectives are to:

• Promote person-centred care, respecting each individual’s preferences, history, and needs.
• Ensure safety and well-being while encouraging independence.
• Work collaboratively with families and healthcare professionals to provide holistic support.
• Train staff comprehensively to understand the complexities of dementia care.
• Prevent and manage challenging behaviours with a compassionate, evidence-based approach.

2. Scope

This policy applies to:

• Service users diagnosed with dementia receiving domiciliary care from {{org_field_name}}.
• Families and caregivers involved in care planning and decision-making.
• All employees, including care workers, senior carers, managers, and administrative staff.
• The Registered Manager and Responsible Individual, who oversee compliance and service quality.
• Healthcare professionals, including GPs, district nurses, occupational therapists, and dementia specialists.

3. Legal and Regulatory Framework

This policy aligns with:

• The Regulation and Inspection of Social Care (Wales) Act 2016, ensuring safe and high-quality care​.
• The Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, mandating that care providers support individuals with dementia safely and effectively​.
• The Welsh Government Statutory Guidance for providers of care home and domiciliary support services (issued under the 2017 Regulations; last updated 27 March 2024), which CIW use when assessing compliance.
• The Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017 – as amended, including amendments made in 2024.
• The Social Services and Well-being (Wales) Act 2014, promoting person-centred care and the rights of individuals with dementia.
• The Mental Capacity Act 2005, ensuring that individuals with dementia are supported in making decisions where possible and that decisions made on their behalf follow their best interests.
• The Mental Capacity Act 2005, including Deprivation of Liberty Safeguards (DoLS) where applicable, ensuring any restrictions are lawful, necessary and proportionate. We keep this under review in line with any future implementation of the Liberty Protection Safeguards (LPS).
• The NICE Guidelines on Dementia Care, which provide evidence-based guidance on best practices for supporting individuals with dementia.
• Welsh Government Dementia policy and strategy, including the Dementia Action Plan (2018) and the Draft Dementia Strategy for Wales 2026–2036 (and the final strategy when published), to ensure our service reflects national priorities for dementia care, carers’ support, workforce development and quality improvement.
• The Regulated Services (Inspection Ratings) (Wales) Regulations 2025 and associated CIW guidance, requiring domiciliary support services to receive and (where applicable) display inspection ratings and support transparency for people using the service.
• Equality and human rights legislation, including the Equality Act 2010 (reasonable adjustments) and the Human Rights Act 1998, to ensure people living with dementia are supported without discrimination and with dignity.
• Information governance legislation, including the Data Protection Act 2018 and UK GDPR, to ensure confidential handling of personal data and care records.

4. Person-Centred Dementia Care

At {{org_field_name}}, we recognise that each person with dementia is unique. Our approach is:

• Individualised – Care is tailored to personal preferences, routines, and life history.
• Holistic – We address physical, emotional, psychological, and social needs.
• Strengths-Based – We focus on abilities rather than limitations.
• Flexible – Care plans are adapted as dementia progresses.

4.1 Personalised Care Plans

Upon assessment, a detailed care plan is developed that includes:

• Personal history, preferences, and routines.
• Cognitive and physical abilities assessment.
• Communication preferences and strategies.
• Risk management and safety considerations.
• Nutritional needs and eating habits.

How we manage this efficiently:

• An initial personal plan is developed before the service begins (or within 24 hours in an emergency start) and is co-produced with the individual and, where appropriate, their representative.
• The personal plan is reviewed and updated within the first 7 days of commencement following the provider’s assessment, and is then reviewed as required but at least every three months (and sooner if needs change).
• Reviews explicitly consider whether the individual is achieving their personal outcomes, and we revise the plan where required.
• A copy of the personal plan (and revisions) is provided in an appropriate language and format, and staff have access to the current version through our digital care records.

5. Effective Communication Strategies

Individuals with dementia may experience challenges in communication. Our staff are trained to:

• Use clear, simple language and give service users time to respond.
• Use visual and non-verbal cues, such as gestures and facial expressions.
• Reduce background noise and maintain eye contact to enhance understanding.
• Validate emotions rather than challenge misconceptions or memory gaps.

How we manage this efficiently:

• Training sessions include real-life dementia care scenarios to enhance staff skills.
• Communication strategies are documented in the service user’s care plan.
• Staff are encouraged to use reminiscence techniques to foster engagement.

5.1 Language, communication aids and accessibility

We take reasonable steps to meet each person’s language needs and preferred method of communication, including making an active offer of Welsh-language support where Welsh is the person’s first language. Where required, we ensure access to communication aids/equipment and provide information in a format the person can understand (for example large print, easy read, visual prompts, or supported explanations).

5.2 Advocacy, raising concerns and complaints

People living with dementia (and their representatives) are supported to raise concerns or make a complaint verbally or in writing and to do so in a way that meets their communication needs. Information is provided on how to access advocacy, including Llais (the Citizen Voice Body), and other routes of complaint where appropriate (for example the commissioning authority and the Public Services Ombudsman for Wales). Individuals will not be treated unfairly or experience any reduction/withdrawal of service as a result of raising a concern or complaint. Complaints and outcomes are recorded, monitored for themes, and used to drive improvement.

6. Promoting Independence and Well-being

Encouraging individuals with dementia to remain as independent as possible improves their well-being. We support independence by:

• Providing assistive technologies, such as memory aids and dementia clocks.
• Encouraging participation in daily tasks, such as dressing and preparing simple meals.
• Maintaining familiar routines to provide comfort and reduce anxiety.

How we manage this efficiently:

• Occupational therapists are consulted to recommend adaptations that support independence.
• Care plans incorporate strengths-based approaches, ensuring individuals engage in activities they enjoy.

7. Managing Challenging Behaviours Compassionately

Some individuals with dementia may exhibit distressed behaviours, such as agitation, aggression, or wandering. Our approach includes:

• Identifying triggers and reducing environmental stressors.
• Using distraction techniques and meaningful activities.
• Providing reassurance and emotional support.
• Avoiding restraint or restrictive practices unless absolutely necessary and following legal guidelines.

Restrictive practice and deprivation of liberty:

Any restrictive practice (including physical restraint, environmental restriction, or restrictions on freedom of movement) is used only as a last resort, for the shortest time, and must be the least restrictive option to prevent immediate harm. Where restrictions are planned or recurring, these must be risk-assessed, recorded, reviewed, and built into the personal plan with clear triggers, de-escalation strategies and alternatives. If restrictions may amount to a deprivation of liberty, we follow the Mental Capacity Act 2005 and DoLS processes (or any successor framework when introduced) and escalate promptly to the Registered Manager for lawful authorisation and oversight.

How we manage this efficiently:

• All staff are trained in Positive Behaviour Support (PBS) to handle challenging behaviours effectively.
• A dementia lead oversees behavioural management strategies and provides additional staff support.

8. Nutrition and Hydration Support

People with dementia may experience reduced appetite or difficulty swallowing. To ensure proper nutrition:

• We provide meals that reflect personal preferences and cultural needs.
• Staff use visual cues, such as showing food before serving, to encourage eating.
• We monitor hydration levels and prompt individuals to drink regularly.

How we manage this efficiently:

• Speech and language therapists (SALT) assess swallowing difficulties where necessary.
• Food and fluid intake is monitored and recorded to identify changes in eating habits.

9. Safeguarding and Risk Management

Dementia can increase vulnerability to financial abuse, neglect, and harm. Our safeguarding measures include:

• Staff training in safeguarding adults at risk.
• Implementing home safety checks to reduce fall risks.
• Ensuring that staff report concerns immediately to the Safeguarding Lead.

How we manage this efficiently:

• A safeguarding risk assessment is completed for all individuals with dementia.
• Emergency response procedures are in place for incidents such as wandering or self-neglect.

9.1 Duty of Candour (openness and transparency)

We act in an open and transparent way with individuals receiving care and support and, where appropriate, their representatives. When things go wrong, we will explain what happened, what we are doing to put it right, and what we are doing to reduce the risk of recurrence. Where appropriate, we offer a sincere apology and keep clear records of communication and actions taken. This supports a learning culture and aligns with Social Care Wales expectations for professional practice.

10. Supporting Families and Carers

Families play a vital role in dementia care. We offer:

• Regular meetings and updates on care progress.
• Guidance on coping strategies and emotional support.
• Signposting to specialist dementia services, support groups, and respite care options.

How we manage this efficiently:

• Family feedback is incorporated into care plans.
• A dementia care coordinator is available to provide guidance.

11. Staff Training and Development

All care staff must complete specialist dementia training, covering:

• The progression of dementia and its impact on daily living.
• Communication techniques and person-centred approaches.
• Strategies for managing behavioural and psychological symptoms.
• Mental capacity and safeguarding considerations.
• Duty of Candour (openness and transparency) and learning from incidents.
• Equality, human rights and communication accessibility, including Welsh language awareness/active offer.
• Preventing and reducing restrictive practices, and how to recognise/escalate potential deprivation of liberty.

How we manage this efficiently:

• Annual refresher training is mandatory for all dementia care staff.
• Supervision sessions provide opportunities to discuss challenges and share best practices.

12. Related Policies

This policy aligns with:

• Safeguarding Adults Policy (DCW13)​.
• Mental Capacity and Deprivation of Liberty Safeguards Policy (DCW39)​.
• Person-Centred Care Policy (DCW07)​.
• Risk Management and Assessment Policy (DCW18)​.
• Duty of Candour Policy (or Incident Management & Duty of Candour Procedure).
• Complaints & Representations Policy (including signposting to Llais).
• Equality, Diversity & Human Rights Policy (including Welsh language / communication accessibility).
• Records Management / Data Protection & Confidentiality Policy.
• Restrictive Practice / Control & Restraint Policy (or Positive Behaviour Support framework).

13. Policy Review

This policy will be reviewed annually or sooner if required due to legislative changes, business needs, or CIW updates. The Registered Manager and Responsible Individual are responsible for ensuring compliance. This policy will also be reviewed following any changes to CIW inspection methodology or requirements, including inspection ratings requirements, and following publication of the final Dementia Strategy for Wales 2026–2036.

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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}}
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