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Managing Diabetes in Home Care Policy

1. Purpose

This policy aims to ensure that all people we support with diabetes receive safe, effective, and person-centred care that promotes their well-being, independence, and dignity. It outlines the roles and responsibilities of care staff in monitoring, supporting, and responding to the needs of individuals with diabetes, in compliance with the Health and Social Care Standards (Scotland), the Care Inspectorate guidelines, and the SSSC Codes of Practice.

2. Scope

This policy applies to all employees of {{org_field_name}} who provide support to individuals diagnosed with diabetes, including those with Type 1, Type 2, and other forms of diabetes. It also applies to external healthcare professionals involved in the care of individuals supported by our service.

3. Related Policies

• Medication Management Policy
• Nutrition and Hydration Policy
• Risk Assessment and Management Policy
• Safeguarding Adults and Children Policy
• Care Planning and Personalisation Policy
• Emergency Procedures Policy
• Infection Control Policy

4. Principles of Diabetes Care

Our approach to managing diabetes in home care is based on:

• Person-centred care – Supporting individuals in managing their diabetes in a way that aligns with their needs, choices, and preferences.
• Prevention and early intervention – Identifying risks and responding proactively.
• Multi-disciplinary collaboration – Working closely with healthcare professionals such as GPs, district nurses, diabetes specialists, and dietitians.
• Safety and compliance – Adhering to national guidelines and safeguarding measures.
• Education and training – Ensuring staff are competent in diabetes management.

5. Diabetes Management in Home Care

5.1. Personalised Care Planning

Each individual supported by {{org_field_name}} with diabetes must have a detailed personal care plan that includes:

• A medical history, including type of diabetes and any related conditions.
• Medication and insulin management (if applicable).
• Dietary preferences and guidance on healthy eating.
• Monitoring blood glucose levels (if required and as per the individual’s care plan).
• Hypoglycaemia and hyperglycaemia management protocols.
• Emergency contacts and escalation procedures.
• Lifestyle support such as exercise and weight management (if applicable).

All personal care plans must be reviewed regularly in collaboration with healthcare professionals, family members, and the person we support.

5.2. Monitoring and Support

Staff Responsibilities:

• Observing and recording blood glucose levels as required.
• Recognising symptoms of high (hyperglycaemia) and low (hypoglycaemia) blood sugar.
• Administering insulin or oral medications if trained and authorised to do so, following the Medication Management Policy.
• Monitoring for complications, including foot care and vision changes.
• Providing emotional and psychological support to individuals managing diabetes.

Technology and Equipment:

• Supporting individuals in using blood glucose monitoring devices and insulin pumps.
• Keeping records of blood sugar readings and reporting any concerns to healthcare professionals.

5.3. Managing Hypoglycaemia (Low Blood Sugar)

Signs and Symptoms:

• Dizziness, sweating, shaking, hunger, confusion, blurred vision, irritability.

Immediate Actions for Staff:

1. If conscious and responsive:
   • Provide fast-acting carbohydrates (e.g., fruit juice, glucose tablets).
   • Monitor symptoms and reassess after 10–15 minutes.
   • Offer a longer-acting carbohydrate snack (e.g., a sandwich) if needed.
2. If unconscious or unable to swallow:
   • Call emergency services (999 or 112) immediately.
   • Follow individual emergency protocols as per the care plan.

5.4. Managing Hyperglycaemia (High Blood Sugar)

Signs and Symptoms:

• Increased thirst, frequent urination, fatigue, blurred vision, nausea.

Immediate Actions for Staff:

• Encourage hydration and physical movement (if appropriate).
• Check blood glucose levels if part of the individual’s care plan.
• Notify GP or district nurse if readings remain high or if the person is unwell.
• Monitor for signs of diabetic ketoacidosis (DKA), which includes confusion, fruity-smelling breath, and vomiting, and seek urgent medical help if required.

5.5. Nutrition and Meal Planning

Our responsibilities include:

• Supporting individuals with meal planning that aligns with their diabetes care needs.
• Encouraging a balanced diet rich in fibre, whole grains, lean proteins, and healthy fats.
• Avoiding processed sugars and high-carbohydrate foods unless needed for hypoglycaemia treatment.
• Coordinating with dietitians or healthcare professionals for specific dietary advice.

5.6. Foot Care and Prevention of Complications

• Checking for sores, cuts, and signs of infection.
• Encouraging individuals to wear appropriate footwear.
• Referring concerns to podiatrists or nurses if needed.

5.7. Emergency and Crisis Management

In the event of a diabetes-related emergency, staff must:

• Follow the Emergency Procedures Policy.
• Contact emergency services (999 or 112) if the person is unconscious, having difficulty breathing, or showing signs of severe hypoglycaemia or ketoacidosis.
• Record and report all incidents as per incident reporting procedures.

6. Staff Training and Competency

All care staff must:

• Complete diabetes awareness training as part of their induction.
• Receive training on blood glucose monitoring, insulin administration, and managing hypo/hyperglycaemia (where applicable).
• Be competent in recognising complications and escalation procedures.
• Undergo annual refresher courses to keep up to date with best practices.

7. Quality Assurance and Compliance

• Regular audits of diabetes care plans and incident reports.
• Feedback from people we support to ensure person-centred care is delivered.
• Compliance with Care Inspectorate and SSSC Codes of Practice.
• Annual reviews of policies and procedures to reflect best practices.

8. Policy Review

This policy will be reviewed annually or earlier if there are legislative changes, updates in best practice, or organisational requirements.

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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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