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Registration Number: {{org_field_registration_no}}

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Managing Service Users Living with Diabetes

1. Purpose

The purpose of this policy is to outline the approach taken by {{org_field_name}} to ensure the safe, effective, and person-centred management of diabetes for the people we support. This policy ensures compliance with Regulation 9 (Person-Centred Care), Regulation 12 (Safe Care and Treatment), and Regulation 14 (Meeting Nutritional and Hydration Needs) under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014​​​. Our aim is to promote the well-being, independence, and dignity of service users while ensuring that diabetes management is tailored to individual needs.

2. Scope

This policy applies to all service users diagnosed with diabetes, whether Type 1, Type 2, or other forms. It also applies to all staff, including care workers, nurses, kitchen staff, and senior management, who have a role in supporting individuals with diabetes. The policy covers all aspects of diabetes care, including monitoring, medication administration, nutritional management, physical activity, prevention of complications, and emergency response.

3. Legal and Regulatory Framework

This policy aligns with:

• Regulation 9 – Person-Centred Care (Ensuring care is tailored to individual health needs)​
• Regulation 12 – Safe Care and Treatment (Ensuring effective diabetes management, including medication safety and monitoring)​
• Regulation 14 – Meeting Nutritional and Hydration Needs (Ensuring dietary requirements are met to maintain optimal blood sugar control)​
• The NICE Guidelines for Diabetes Management in Care Homes
• The Mental Capacity Act 2005 (Ensuring consent and decision-making are person-centred)
• The Equality Act 2010 (Ensuring all service users have equal access to high-quality diabetes care)

4. Person-Centred Diabetes Management

At {{org_field_name}}, diabetes care is tailored to each individual’s needs, preferences, and medical requirements. Each service user with diabetes will have a personalised Diabetes Care Plan, which includes:

• Type and severity of diabetes
• Blood glucose monitoring schedule
• Medication and insulin administration
• Dietary preferences and nutritional guidance
• Exercise and mobility considerations
• Signs of hypoglycaemia and hyperglycaemia
• Emergency contact details and escalation protocols

5. Blood Glucose Monitoring

• Blood sugar levels are monitored as per each individual’s care plan, considering GP and diabetic specialist recommendations.
• Only trained staff administer and interpret blood glucose tests, using calibrated equipment.
• Records of blood glucose readings are maintained in the service user’s care notes and reviewed regularly to detect trends or concerns.
• If abnormal readings are recorded, staff follow escalation procedures, including notifying healthcare professionals where necessary.

6. Medication and Insulin Administration

• Medication is administered in line with the Medication Management and Administration Policy (CH21) and Regulation 12 (Safe Care and Treatment)​.
• Insulin is stored securely and at the correct temperature, with regular monitoring to ensure compliance with manufacturer guidelines.
• Only competent and trained staff administer insulin injections or assist with insulin pumps.
• Staff ensure that residents take their medication before or after meals, as prescribed.
• Any missed or incorrect doses are recorded as incidents and reported following internal protocols.

7. Managing Hypoglycaemia (Low Blood Sugar)

• Hypoglycaemia is recognised by symptoms such as sweating, confusion, dizziness, shaking, and irritability.
• Immediate response includes giving fast-acting carbohydrates such as glucose tablets, fruit juice, or sugar water.
• If the individual is unconscious, an emergency response is initiated, and 999 is called.
• Hypoglycaemic events are recorded in the care notes and discussed in care reviews to prevent recurrence.

8. Managing Hyperglycaemia (High Blood Sugar)

• Symptoms include frequent urination, thirst, dry mouth, and drowsiness.
• Blood sugar levels are tested, and fluids are encouraged if safe to do so.
• If blood glucose levels remain elevated despite intervention, the GP or diabetes specialist nurse is informed.
• Emergency action is taken if the person shows signs of diabetic ketoacidosis (DKA) or Hyperosmolar Hyperglycaemic State (HHS), including contacting 999.

9. Dietary and Nutritional Considerations

• Meals are planned to ensure balanced carbohydrate intake, avoiding excessive sugar and refined carbohydrates.
• The kitchen team is trained on diabetes-friendly meal preparation.
• Residents are supported in making informed choices about their diet, with adaptations available for cultural or personal preferences.
• Snacks are available to prevent blood sugar fluctuations, especially for those on insulin.
• Fluid intake is monitored to prevent dehydration, which can exacerbate blood sugar imbalances.

10. Physical Activity and Mobility

• Service users are encouraged to engage in gentle physical activity, such as walking or seated exercises, where appropriate.
• Exercise plans are personalised to each resident’s mobility level and health status.
• Staff monitor for exercise-induced hypoglycaemia, ensuring safe participation.

11. Foot Care and Preventing Complications

• Daily foot inspections are conducted for those at risk of diabetic foot complications.
• Staff assist with hygiene and nail care, referring concerns to podiatrists or GPs.
• Comfortable, well-fitting footwear is encouraged to prevent foot ulcers.
• Routine eye tests and kidney function monitoring are arranged in collaboration with healthcare providers.

12. Training and Competency of Staff

• All care staff undergo diabetes awareness training, covering signs, symptoms, medication, nutrition, and emergency response.
• Staff administering insulin receive specialist training and competency assessments.
• Regular refresher courses ensure compliance with best practices and regulatory requirements.

13. Mental Capacity and Decision-Making

• Residents are encouraged to manage their diabetes independently where possible, with support tailored to their needs.
• If a service user lacks capacity to make diabetes-related decisions, a best interest decision is made in line with the Mental Capacity Act 2005.
• Where necessary, family members or legal representatives are consulted.

14. Emergency Protocols and Hospital Transfers

• If a service user experiences a severe diabetic emergency, staff immediately follow emergency response procedures and call 999.
• Hospital transfers are documented in care notes, and information is shared with medical teams to ensure continuity of care.
• Post-emergency reviews take place to assess lessons learned and preventive measures.

15. Record-Keeping and Communication

• All diabetes-related interventions, observations, and incidents are documented in care records.
• Regular multi-disciplinary team meetings ensure a collaborative approach to diabetes management.
• Care plans are reviewed at least every six months, or sooner if there are changes in health status.

16. Related Policies

This policy should be read in conjunction with:

• CH07 – Person-Centred Care Policy
• CH11 – Safe Care and Treatment Policy
• CH12 – Meeting Nutritional and Hydration Needs Policy
• CH21 – Medication Management and Administration Policy
• CH18 – Risk Management and Assessment Policy

17. Policy Review

This policy will be reviewed annually or sooner if regulatory updates or changes in best practice require amendments. Updates will be communicated to all staff, and training will be provided as necessary.

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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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