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Stoma Care and Management Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} provides safe, dignified, and effective stoma care for service users who have undergone a colostomy, ileostomy, or urostomy. This policy outlines best practices in stoma care, infection prevention, dignity, and holistic support, in compliance with Care Inspectorate Wales (CIW) regulations, national healthcare guidelines, and safeguarding principles.

Our objectives are to:

• Ensure service users receive personalised and professional stoma care.
• Prevent stoma-related complications, including infections and skin irritation.
• Support service users in managing their stoma independently where possible.
• Provide staff with training on best practices in stoma care and hygiene.
• Maintain a dignified, person-centred approach that promotes the well-being of service users.

2. Scope

This policy applies to:

• Service users with a stoma, including colostomy, ileostomy, and urostomy.
• Family members and carers, providing support in stoma management.
• All employees, including care workers, managers, and administrative staff.
• The Registered Manager and Responsible Individual, responsible for compliance.
• Healthcare professionals, including district nurses and stoma care specialists.

3. Legal and Regulatory Framework

This policy aligns with:

• The Regulation and Inspection of Social Care (Wales) Act 2016, ensuring high standards of care.
• The Social Services and Well-being (Wales) Act 2014, promoting person-centred care and well-being.
• The Health and Safety at Work Act 1974, ensuring a safe working environment.
• The Human Rights Act 1998, protecting dignity and respect in care.
• The Infection Prevention and Control (IPC) Guidelines, minimising the risk of stoma-related infections.
• NICE Guidelines on Stoma Care, ensuring best practice in stoma management.
• CIW Safeguarding and Dignity in Care Standards, ensuring privacy and respect in personal care.

4. Understanding Stoma Types and Care Needs

4.1 Types of Stomas

A stoma is an artificial opening created surgically to allow waste (faeces or urine) to exit the body. The three main types are:

• Colostomy – An opening from the large intestine (colon), with faeces usually being semi-formed.
• Ileostomy – An opening from the small intestine, with liquid to semi-liquid stool output.
• Urostomy – A urinary diversion, where urine is passed into a stoma bag instead of the bladder.

4.2 Common Stoma-Related Challenges

Service users with stomas may experience:

• Skin irritation and infections around the stoma site.
• Stoma leakage and odour issues.
• Psychological and emotional distress due to lifestyle adjustments.
• Difficulties in managing the stoma independently, particularly for elderly or disabled individuals.

How we manage this efficiently:

• Each service user has a personalised stoma care plan, developed in collaboration with healthcare professionals.
• Care workers receive hands-on training from stoma care nurses to provide effective support.
• Regular stoma assessments ensure early detection of issues and timely intervention.

5. Personalised Stoma Care Plans

Each service user requiring stoma care will have an individualised care plan, developed in consultation with stoma nurses, GPs, and the service user themselves.

5.1 Contents of a Stoma Care Plan

A comprehensive stoma care plan will include:

• The type of stoma and its expected output.
• Preferred stoma products (bags, adhesive rings, barrier wipes, etc.).
• Specific hygiene and cleaning procedures.
• Signs of infection or complications to monitor.
• Instructions for changing the stoma appliance and disposal procedures.
• Emergency contacts, including stoma nurses and GP details.

How we manage this efficiently:

• Care plans are reviewed regularly to ensure they reflect any changes in the service user’s needs.
• A designated key worker is assigned to oversee stoma care for each individual.

6. Hygiene and Infection Control in Stoma Care

6.1 Hand Hygiene and Personal Protective Equipment (PPE)

• Staff must wash hands thoroughly before and after providing stoma care.
• Gloves and aprons must be worn during all stoma-related tasks.
• PPE must be disposed of properly in clinical waste bins.

6.2 Cleaning and Changing Stoma Bags

• The skin around the stoma should be cleaned with warm water and a soft cloth – avoid soap with fragrances.
• Used stoma bags must be disposed of in accordance with local council waste regulations.
• A new stoma appliance must be applied securely to prevent leaks.

6.3 Preventing Skin Irritation and Infections

• Barrier creams or sprays may be used to protect the skin around the stoma.
• Ensure the correct size of the stoma appliance is used to avoid leaks.
• Service users should be monitored for signs of infection, such as redness, swelling, or unusual discharge.

How we manage this efficiently:

• Regular skin checks are documented in care notes.
• Care staff are trained to recognise early signs of infection and escalate concerns promptly.

7. Supporting Service Users in Stoma Management

7.1 Encouraging Independence

Where possible, service users should be encouraged to:

• Participate in their stoma care routine, promoting dignity and autonomy.
• Learn self-care techniques, with guidance from healthcare professionals.
• Express preferences regarding stoma care and products.

7.2 Psychological and Emotional Support

• Acknowledge and address emotional difficulties associated with living with a stoma.
• Offer counselling or peer support referrals where necessary.
• Ensure a compassionate and reassuring approach to stoma care.

How we manage this efficiently:

• Staff are trained in dignity and person-centred approaches to stoma care.
• Service users are supported to adapt to lifestyle changes with confidence.

8. Emergency Procedures and Managing Stoma Complications

8.1 Recognising Stoma Complications

Care workers must be alert for:

• Stoma blockages (abdominal pain, reduced output).
• Skin breakdown or excessive irritation around the stoma.
• Excessive bleeding or unusual stoma colour (pale, blue, or dark red).

8.2 Responding to Stoma-Related Emergencies

• Encourage hydration and gentle abdominal massage if a blockage is suspected.
• Report concerns to a GP or stoma nurse immediately.
• If a service user experiences severe pain, call 999 for emergency medical support.

How we manage this efficiently:

• Emergency protocols are outlined in each service user’s care plan.
• Staff receive scenario-based training on handling stoma complications.

9. Staff Training and Competency in Stoma Care

9.1 Mandatory Training Includes:

• Recognising different types of stomas and their care requirements.
• Correct techniques for changing and securing stoma appliances.
• Infection control measures in stoma care.
• Supporting service users with dignity and respect.

9.2 Competency Assessments

• All staff providing stoma care must complete practical competency assessments.
• Refresher training is provided annually or sooner if required.

How we manage this efficiently:

• A designated stoma care trainer oversees staff competency assessments.
• Regular audits ensure adherence to best practices.

10. Related Policies

This policy aligns with:

• Infection Prevention and Control Policy (DCW22).
• Personal Care and Dignity Policy (DCW07).
• Medication Management Policy (DCW21).

11. 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.

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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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