{{org_field_logo}}

{{org_field_name}}

Registration Number: {{org_field_registration_no}}

---

Best Practice in Intimate Personal Care Policy

1. Purpose

The purpose of this policy is to ensure that all staff at {{org_field_name}} deliver intimate personal care in a manner that is safe, respectful, dignified and person-centred, in line with the Regulation and Inspection of Social Care (Wales) Act 2016, the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017 (as amended) and the Welsh Government Statutory Guidance for Care Home and Domiciliary Suppliers (Version 3, March 2024), as well as the Social Services and Well-being (Wales) Act 2014, the Mental Capacity Act 2005 (and current Deprivation of Liberty Safeguards requirements), and relevant Care Inspectorate Wales (CIW) expectations for domiciliary support services.

{{org_field_name}} operates a culture of openness, honesty and transparency. Where something goes wrong in the delivery of intimate personal care, staff must promptly report to their manager and the service will respond in line with the duty of candour requirements, including being open with the individual (and their representative where appropriate), providing information about what happened and the outcome of any review/investigation, and offering an apology where appropriate.

This policy ensures that intimate personal care is delivered in a way that upholds dignity, privacy, autonomy, and the well-being of service users while safeguarding them from harm, abuse, or improper treatment. Staff must ensure that service users feel safe, comfortable, and in control when receiving personal care and that their individual needs, cultural preferences, and rights are fully respected.

2. Scope

This policy applies to:

• All care staff responsible for providing intimate personal care to service users.
• Registered Managers, Care Coordinators, and Responsible Individuals overseeing care quality.
• Service users receiving personal care and their families or representatives. External professionals involved in personal care planning.

It covers:

• Principles of dignity and respect in personal care.
• Individualised care planning and risk assessments.
• Consent, capacity, and safeguarding considerations.
• Infection control and hygiene.
• Supporting independence and choice.
• Managing cultural and personal preferences.
• Reporting and escalating concerns. Staff training and competency.

2.1 Definitions – Intimate personal care

For the purpose of this policy, intimate personal care includes any care activity that involves close physical contact and/or exposure of private areas of the body. This may include (but is not limited to): bathing/showering, washing genital or anal areas, toileting support, continence care and pad changes, catheter/stoma support where commissioned and trained/assessed as competent, changing soiled clothing, applying creams to intimate areas, and any care where the individual may feel vulnerable due to nudity, touch, embarrassment, pain or distress.

Intimate personal care must always be delivered in line with the individual’s personal plan, recorded preferences, assessed risks and communication needs.

3. Principles of Best Practice in Intimate Personal Care

3.1 Dignity, Respect, and Person-Centred Care

Providing intimate personal care requires a compassionate and respectful approach. Staff must:

• Ensure that service users feel valued and respected.
• Encourage independence and choice wherever possible.
• Communicate with empathy, using reassuring and professional language.
• Always explain what they are about to do before beginning any task.
• Work at the service user’s preferred pace and respect their comfort levels.
• Ensure the environment maximises privacy (e.g., close doors/curtains/blinds where available, cover the individual with towels/blankets, expose only the area being washed/treated, and keep the individual warm).
• Ensure only the minimum necessary people are present. Do not invite other staff/visitors into the room during intimate care unless required for safety and with the individual’s agreement (or best-interest rationale recorded where the person lacks capacity).
• Offer the individual choice about who provides intimate care, including same-gender care where reasonably practicable, and record preferences in the personal plan.

Care must be tailored to the individual’s needs, preferences, and abilities, ensuring that personal care is not rushed or treated as routine but as a moment of support and respect.

3.2 Individualised Care Planning and Risk Assessment

Each service user must have a detailed, personalised care plan outlining their specific personal care needs, including:

• The type of assistance required (e.g., washing, toileting, dressing, continence care).
• The service user’s preferences regarding care delivery (e.g., gender preference of caregiver, bathing vs. showering).
• Any mobility, sensory, or cognitive impairments that may affect personal care.
• Identified risks such as falls, skin conditions, or medical needs.
• Cultural, religious, or personal beliefs that influence care preferences.

Risk assessments must be completed before intimate personal care is delivered, must identify any requirement for two-worker support, equipment (e.g., hoists), skin integrity risks, moving and handling needs, and communication needs, and must be reviewed immediately where there is a significant change (e.g., new wounds/skin breakdown, increased falls risk, new pain/distress, new confusion, repeated refusals, or safeguarding concerns). Updates must be reflected in the individual’s personal plan and communicated to staff.

3.3 Consent, Capacity, and Safeguarding

Personal care must be provided only with informed consent, in line with the Mental Capacity Act 2005 and the Social Services and Well-being (Wales) Act 2014. Staff must:

• Seek verbal or non-verbal consent before beginning any personal care task.

Consent (verbal, non-verbal, or recorded agreement) must be actively checked throughout the task, not only at the start. If the individual appears distressed, resists, or withdraws consent, staff must pause/stop, reassure, explore adjustments, and escalate to a senior/health professional if required.

• Ensure that service users understand the care being provided and have the opportunity to refuse or request adjustments.
• Respect service users’ choices, even if they decline personal care, and report any refusals that could pose a risk to their well-being.

If a service user lacks capacity to make decisions about their personal care, staff must:

• Follow a best-interest decision-making process, involving family members, advocates, and healthcare professionals where necessary.
• Ensure that decisions align with the service user’s known preferences and prior wishes.
• If the care and support arrangements amount to a deprivation of liberty, staff must ensure lawful authority is in place and must act in accordance with the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (where appropriate), including the relevant Codes of Practice and any updated Welsh Government implementation arrangements as they change.

Where a mental capacity assessment is required for decisions about intimate personal care, the assessment outcome, the best-interest decision (including least restrictive options considered), and the rationale must be recorded in the individual’s records/personal plan in line with record-keeping requirements. Records must be accurate, contemporaneous and stored securely.

If staff have any concerns about abuse, neglect, or improper treatment during personal care, they must immediately report it in line with the Safeguarding Policy (DCW13)​.

3.4 Language and communication (including Welsh language active offer)

Staff must deliver intimate personal care in a way the individual can understand and participate in. This includes identifying and meeting communication needs such as preferred language, hearing or visual impairment, dementia or cognitive impairment, learning disability, speech difficulties, and use of communication aids (for example pictures, written prompts, Makaton, hearing aids, glasses, interpreters, or family/advocate support where appropriate).

Before providing intimate personal care, staff must check how the person prefers to communicate and ensure explanations are given in an accessible way, including explaining what will happen next and checking understanding throughout.

{{org_field_name}} will take reasonable steps to meet language needs, including making an active offer of Welsh language services where Welsh is the individual’s preferred language. Where Welsh language support cannot be provided immediately, this must be escalated to a manager, recorded, and arrangements made to meet the person’s needs as soon as possible.

3.5 Two-worker support, chaperones and safeguarding during intimate care

Intimate personal care can increase vulnerability for individuals and staff. {{org_field_name}} will take proportionate steps to protect individuals from abuse, neglect or improper treatment and to protect staff from unfounded allegations.

• Two-worker care must be planned and delivered where identified in the risk assessment/personal plan (e.g., moving and handling safety, severe distress, high safeguarding risk, history of allegations, or when the individual requests and it is reasonably practicable).
• Where two-worker care is not commissioned/available, staff must follow the escalation process and must not proceed if doing so would be unsafe or would place the individual or staff at unacceptable risk.
• If an individual requests a chaperone/second worker for intimate care, this request must be respected where reasonably practicable, recorded, and reflected in the personal plan.
• Staff must maintain professional boundaries at all times and must never undertake intimate care in a way that could be interpreted as sexualised, punitive, humiliating, or coercive.
• Any concern about inappropriate conduct (by staff, family, or others) during intimate care must be treated as a safeguarding concern and escalated immediately in line with DCW13.

3.6 Infection Control and Hygiene

Maintaining high standards of infection prevention and control is essential when providing personal care. Staff must:

• Follow handwashing and sanitisation protocols before and after care tasks.
• Use disposable gloves and aprons where necessary, disposing of them safely after each use.
• Ensure that wash areas, towels, and hygiene products are clean and suitable for use.
• Use safe handling techniques for continence products and waste disposal.

All infection control procedures must comply with the Infection Prevention and Control Policy (DCW17)​ and Public Health Wales guidelines.

3.7 Supporting Independence and Choice

Wherever possible, service users should be encouraged to participate in their personal care rather than being completely dependent on care staff. This may include: Providing verbal guidance while allowing the service user to complete tasks independently. Using adaptive equipment such as grab rails or bathing chairs. Allowing service users to choose their own clothing, toiletries, and hygiene routine. Respecting personal habits and preferences, such as the time they wish to bathe.

Staff must always encourage autonomy while ensuring safety and well-being.

3.8 Cultural, Religious, and Personal Preferences

Staff must be sensitive to the diverse needs of service users and respect cultural, religious, and personal beliefs that impact personal care. This includes: Being aware of religious considerations regarding nudity and same-gender care. Respecting personal grooming preferences, such as beard care or hair covering. Using preferred toiletries or skincare products where possible. Understanding modesty requirements and adjusting care accordingly.

Where possible, service users should be supported to express their preferences openly and have them reflected in their care plan.

3.9 Reporting and Escalating Concerns

If staff encounter any issues or concerns during personal care, they must document and report them immediately. This includes:

• Changes in skin condition (e.g., pressure sores, rashes, infections).
• Bruising, unexplained injuries, or signs of neglect.
• Concerns about the service user’s physical or emotional well-being.
• Repeated refusals of personal care that may impact health.

Concerns must be recorded in the service user’s care plan and escalated to the Registered Manager or Safeguarding Lead for appropriate action.

Where an incident occurs durinstress, or a serious service failure, staff must escalate immediately so the service can respond in line with the duty of candour (open and transparent communication, apology where appropriate, and learning).

Any suspicion or allegation of abuse, neglect, improper treatment, or sexually inappropriate behlation to the safeguarding lead/manager and referral to external partners as required.

3.10 Records, confidentiality and information governance

• Staff must make clear, contemporaneous records after providing intimate personal care, including: what support was provided, skin integrity observations (e.g., redness, pressure areas, wounds), any pain/distress, any refusal/withdrawal of consent, and any actions/escalations taken.
• Where capacity/best-interest decisions are required, the capacity assessment outcome and rationale must be recorded and kept securely.
• Records must be accurate and up to date, stored securely, and handled in accordance with data protection requirements. Individuals (and their representatives where appropriate) must be informed about access to their records in line with legal requirements.

3.11 Staff Training and Competency in Personal Care

To ensure high standards of care, all staff must receive comprehensive training in:

• Best practices for personal care and hygiene.
• Safeguarding procedures and recognising signs of abuse.
• Infection prevention and safe handling of bodily fluids.
• Supporting individuals with mobility impairments during personal care.
• Communication skills to enhance dignity and trust.
• Managing continence care and appropriate disposal of waste.

Staff competencies should be regularly assessed, and refresher training should be provided annually to maintain high standards of personal care practice.

4. Efficiency in Managing Intimate Personal Care

To ensure efficient and high-quality personal care, {{org_field_name}} implements: Digital care planning, ensuring real-time updates and accurate documentation of service users’ needs. Regular quality audits, monitoring care delivery and compliance with best practices. Clear staff protocols, ensuring consistency and accountability in personal care provision. Ongoing professional development, keeping staff trained in evolving care standards. Feedback mechanisms, enabling service users and families to report concerns or suggest improvements.

These measures ensure that personal care is delivered professionally, efficiently, and in full compliance with CIW regulations, safeguarding the dignity, well-being, and rights of service users.

5. Related Policies

This policy should be read alongside:

• Safeguarding Adults from Abuse and Improper Treatment Policy (DCW13)​
• Infection Prevention and Control Policy (DCW17)​
• Risk Management and Assessment Policy (DCW18)​
• Mental Capacity and Deprivation of Liberty Safeguards Policy (DCW39)​
• Equality, Diversity, and Inclusion Policy (DCW30)
• Complaints Policy
• Duty of Candour Policy
• Data Protection Policy
• Lone Working and Staff Safety Policy

6. Policy Review

This policy must be reviewed at least annually, and immediately following any change to relevant Welsh Government legislation or statutory guidance, CIW requirements/inspection expectations, safeguarding procedures, or mental capacity law and guidance.

---

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.