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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Wound Care and Management Policy

{{org_field_name}}

1. Purpose

The purpose of this policy is to establish clear, safe, and evidence-based standards for the assessment, management, and documentation of wound care provided by all registered nurses and healthcare assistants (HCAs) supplied by {{org_field_name}}. The prevention and effective management of wounds are vital to the safety, dignity, and wellbeing of service users and directly impact clinical outcomes. This policy ensures that all wound care is performed in line with the most up-to-date legislation, professional standards, and best practice guidance. It aligns with The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, NICE Clinical Guidelines, CQC Fundamental Standards, and professional codes such as the NMC Code and the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England. This policy applies to all types of wounds, including pressure ulcers, surgical wounds, leg ulcers, diabetic foot ulcers, traumatic wounds, and skin tears.

2. Scope

This policy applies to:

• All registered nurses and HCAs employed or engaged by {{org_field_name}} under zero-hours or flexible contracts
• All staff delivering wound care or involved in supporting wound prevention, treatment, or documentation while working in client organisations
• The Director and office-based staff responsible for governance, placement oversight, and incident management

3. Related Policies

• Infection Prevention and Control Policy
• Incident and Accident Reporting Policy
• Safeguarding Adults and Children Policy
• Personal Care and Dignity Policy
• Supervision and Appraisal Policy
• Communication and Record-Keeping Policy
• Code of Conduct
• Clinical Governance Policy

4. Policy Statement

{{org_field_name}} is committed to promoting safe, person-centred, and clinically effective wound management practices by all agency workers. The organisation recognises the importance of preventing avoidable wounds and managing existing wounds effectively to reduce the risk of infection, pain, complications, and avoidable harm. All wound care provided by our staff must be:

• Evidence-based
• Delivered within the scope of the worker’s competence
• Informed by service user choice and needs
• Conducted with dignity, privacy, and infection control principles
• Fully documented

5. Responsibilities

Director
The Director will:

• Lead on the implementation and governance of this policy
• Review this policy annually or earlier if needed following changes to legislation or best practice
• Ensure all registered nurses complete mandatory wound care and tissue viability training
• Provide clinical supervision and performance reviews that include wound care practice
• Investigate and manage incidents, complaints, or concerns relating to wound care
• Oversee the maintenance of a wound care training and competency register

Registered Nurses
Registered nurses must:

• Conduct wound assessments within their competence and following client protocols
• Plan, implement, and evaluate wound care using evidence-based practice
• Document all wound care activities clearly and accurately
• Work collaboratively with the multidisciplinary team (MDT) within the client organisation
• Recognise when specialist advice is required (e.g., Tissue Viability Nurse) and escalate appropriately
• Report any deterioration, concerns, or safeguarding issues immediately

Healthcare Assistants (HCAs) and Non-Nursing Staff
HCAs may only assist with wound care under the direct instruction and supervision of a registered nurse and within the policies of the client organisation. HCAs must:

• Never undertake wound assessment, dressing selection, or wound management independently
• Support the maintenance of skin integrity by implementing pressure area care, hygiene, and nutrition measures
• Report any observed skin changes, wound deterioration, or concerns immediately to the registered nurse and client staff
• Document care activities as instructed

6. Principles of Wound Management

All wound care delivered by {{org_field_name}} staff must:

• Promote healing and minimise risk of infection or deterioration
• Be appropriate to the type, size, and cause of the wound
• Respect the wishes, dignity, and comfort of the service user
• Be informed by the latest NICE guidelines, local protocols, and client-specific care plans

7. Wound Assessment

Registered nurses must undertake a full wound assessment before initiating or changing wound care interventions. This includes:

• Identifying the type, location, size, and depth of the wound
• Assessing the wound bed, surrounding skin, and signs of infection
• Recording any pain or discomfort experienced by the service user
• Identifying risk factors such as immobility, poor nutrition, diabetes, or vascular disease
• Developing an appropriate wound care plan in collaboration with the client and MDT
• Reassessing the wound regularly according to client policy and clinical judgement

8. Pressure Ulcer Prevention

All staff are responsible for contributing to pressure ulcer prevention by:

• Using recognised risk assessment tools (e.g., Waterlow, Braden) as per client policy
• Implementing appropriate repositioning schedules and pressure-relieving strategies
• Ensuring good hydration, nutrition, and skin hygiene
• Monitoring for early signs of pressure damage such as redness, discolouration, or skin breakdown
• Reporting concerns promptly to the registered nurse or senior care staff
• Supporting the service user’s comfort and wellbeing during care interventions

9. Infection Prevention and Control

All wound care must be carried out following infection control principles:

• Performing hand hygiene before and after all wound care
• Using appropriate PPE including gloves, aprons, and masks where required
• Maintaining a clean environment
• Using aseptic or clean techniques according to the client’s policy
• Safely disposing of clinical waste following client and local authority guidance
• Reporting and documenting signs of wound infection, including redness, heat, swelling, discharge, or fever

10. Documentation

All wound care activities must be fully documented in the appropriate client records, ensuring:

• Clear and accurate entries
• Timely documentation following each intervention
• Records include wound assessment details, treatment provided, service user response, and ongoing care plans
• Any advice or decisions made by external professionals (e.g., GPs, Tissue Viability Nurses) are recorded
• Incident forms are completed if harm or deterioration occurs

11. Reporting

Staff must report:

• All wound-related incidents, including deterioration or infections
• Concerns regarding pressure ulcers, including any grade 2 or above pressure damage
• Any service user safeguarding concerns relating to wound care or skin neglect
  Reports must be made immediately to the client organisation and to {{org_field_name}} following the Incident and Accident Reporting Policy.

12. Training and Competency

All registered nurses will receive:

• Mandatory wound care and tissue viability training during induction
• Annual refresher training
• Additional training if identified through supervision, incidents, or audits
  All HCAs will receive:
• Training on pressure ulcer prevention, skin integrity maintenance, and observational skills
• Instruction on when and how to report skin or wound concerns
  Competency assessments will be maintained to ensure safe practice.

13. Supervision and Support

The Director will ensure:

• Regular supervision and appraisal sessions address wound care practices
• Staff are supported to reflect on their practice and improve
• Nurses are supported when escalating wound-related concerns to clients or specialists
• Learning from incidents is shared with staff and used to improve performance

14. Collaboration with Client Organisations

Agency staff must:

• Comply with client-specific wound care protocols and documentation systems
• Work collaboratively with client teams and the MDT
• Attend client-provided wound care updates where requested
• Share concerns or observations promptly with the client’s nominated lead for wound care

15. Governance and Quality Assurance

The Director will:

• Monitor all incidents, complaints, and feedback relating to wound care
• Conduct audits of documentation and practice where applicable
• Review wound care training compliance
• Ensure that learning from audits and incidents informs future training and supervision

16. Director’s Oversight

The Director of {{org_field_name}} is responsible for:

• Ensuring full compliance with this policy
• Reviewing the policy annually
• Leading investigations into wound-related incidents involving agency staff
• Supporting staff to maintain safe, person-centred, and effective wound management
• Promoting a learning culture that values continuous improvement and best practice

17. Policy Review

This policy will be reviewed every 12 months or earlier if required due to legislative, clinical, or organisational developments.

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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}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.