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Registration Number: {{org_field_registration_no}}

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Leg Ulcer Management and Prevention Policy

1. Purpose

This policy outlines the approach taken by {{org_field_name}} to prevent, assess, and manage leg ulcers effectively, ensuring that people we support receive the highest standard of care in line with the latest CQC regulations and clinical best practices.

Leg ulcers can significantly impact quality of life, and improper management can lead to infection, chronic pain, and complications. The goal of this policy is to:

• Ensure early identification and prevention of leg ulcers.
• Provide effective and evidence-based treatment for individuals with leg ulcers.
• Minimise the risk of infection, pain, and complications.
• Promote multi-disciplinary collaboration between care staff, nurses, GPs, and tissue viability specialists.
• Uphold CQC standards for safe, person-centred care in compliance with:
  • Regulation 9 (Person-Centred Care)​.
  • Regulation 10 (Dignity and Respect)​.
  • Regulation 12 (Safe Care and Treatment)​.
  • Regulation 13 (Safeguarding People from Abuse and Improper Treatment)​.

This policy applies to all staff involved in direct care, including nurses, carers, and healthcare assistants, ensuring that they are trained, competent, and supported in leg ulcer prevention and management.

2. Scope

This policy applies to:

• People we support who are at risk of developing leg ulcers or require treatment.
• Registered nurses, care staff, and senior carers, who are responsible for ulcer prevention and management.
• External healthcare professionals, including GPs, tissue viability nurses, podiatrists, and wound care specialists.
• Management staff, who must ensure compliance with this policy and support staff training.

3. Legal and Regulatory Compliance

Leg ulcer management at {{org_field_name}} adheres to:

• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014:
  • Regulation 9 (Person-Centred Care) – Ensures that care plans are tailored to individual needs and preferences​.
  • Regulation 10 (Dignity and Respect) – Ensures that wound care is provided with compassion and respect​.
  • Regulation 12 (Safe Care and Treatment) – Ensures that evidence-based clinical guidelines are followed​.
  • Regulation 13 (Safeguarding Service Users from Abuse and Improper Treatment) – Protects individuals from neglect and poor wound care​.
  • Regulation 17 (Good Governance) – Ensures that policies, procedures, and training are in place for staff​.
• NICE Guidelines (National Institute for Health and Care Excellence) – Adherence to best practice wound care and ulcer prevention strategies.
• Tissue Viability Nursing (TVN) and Wound Care Guidelines – Evidence-based approaches to managing chronic wounds.
• Infection Prevention and Control (IPC) Standards – Ensuring that ulcer management prevents cross-contamination and infections.

4. Leg Ulcer Prevention Strategies

4.1. Risk Assessment for Leg Ulcers

All people we support must receive a skin integrity and pressure area risk assessment upon admission and regularly thereafter. Staff must assess:

• Medical history, including diabetes, varicose veins, deep vein thrombosis (DVT), or vascular conditions.
• Mobility levels and risks of prolonged immobility.
• Nutritional status, as malnutrition increases the risk of poor wound healing.
• Skin condition, identifying early signs of dryness, swelling, redness, or skin breakdown.
• Blood circulation, identifying poor venous return or arterial insufficiency.
• Foot and leg care habits, including hygiene and footwear choices.

Any at-risk individuals must have a personalised care plan with preventive measures to avoid ulcers.

4.2. Preventative Measures

To reduce the risk of leg ulcers, staff must:

• Encourage mobility – Regular movement promotes blood circulation and reduces pressure risks.
• Support healthy nutrition – Encourage a balanced diet rich in protein, vitamins, and hydration to promote skin health.
• Provide proper skin care – Regular cleansing, moisturising, and checking for skin integrity issues.
• Promote compression therapy – Individuals with venous insufficiency should be supported with prescribed compression stockings or bandages.
• Ensure proper foot and leg positioning – Elevating legs to reduce swelling and avoid prolonged sitting or standing.

5. Managing Leg Ulcers

5.1. Identifying and Documenting Leg Ulcers

If a leg ulcer develops, it must be identified early and documented accurately. Staff must:

• Describe the wound (size, depth, colour, exudate, surrounding skin condition).
• Photograph wounds (with consent) for medical documentation and monitoring progress.
• Complete a wound assessment chart and escalate concerns to senior care staff or registered nurses.
• Monitor pain levels and ensure pain relief is provided where necessary.

5.2. Wound Care and Dressing Application

Wound care must be carried out by trained nurses or under clinical supervision, following an individualised wound care plan. Key principles include:

• Cleaning the wound – Using sterile solutions and non-alcoholic antiseptics.
• Applying the appropriate dressing – Based on the wound type (e.g., hydrocolloid, foam, or antimicrobial dressings).
• Ensuring regular dressing changes – As per wound care plan or when dressings become soiled.
• Monitoring for signs of infection – Redness, swelling, warmth, pus, increased pain, or fever must be reported immediately.

Staff must follow infection control measures, including:

• Hand hygiene before and after dressing changes.
• Using gloves and sterile wound care kits.
• Safely disposing of used dressings following clinical waste procedures.

5.3. Referral and Escalation

Severe or non-healing ulcers must be referred to specialist healthcare professionals, such as:

• GPs and community nurses for medical evaluation.
• Tissue Viability Nurses (TVNs) for advanced wound management.
• Podiatrists if ulcers are related to foot conditions or diabetes.
• Vascular specialists if surgery or advanced interventions are required.

6. Staff Training and Responsibilities

All staff must receive training in:

• Recognising early signs of leg ulcers and skin breakdown.
• Basic wound care and dressing application (for nursing staff).
• Safeguarding against neglect or poor ulcer management.
• Infection prevention and control in wound care.
• Pain management strategies for individuals with leg ulcers.

Regular competency assessments will be conducted to ensure that all staff delivering wound care are fully competent.

7. Monitoring and Continuous Improvement

• Care plans and wound assessments are reviewed weekly for individuals with leg ulcers.
• Monthly audits are conducted to assess ulcer prevalence and evaluate care effectiveness.
• Feedback from people we support is gathered to ensure satisfaction with care.
• Incident reporting is mandatory for any complications, such as wound infections, delayed healing, or hospitalisation.

8. Related Policies

This policy should be read alongside:

• CH11 – Safe Care and Treatment Policy​.
• CH13 – Safeguarding Adults from Abuse and Improper Treatment Policy​.
• CH16 – Health and Safety at Work Policy​.
• CH17 – Infection Prevention and Control Policy​.
• CH27 – Staff Supervision, Training, and Development Policy​.

9. Policy Review

This policy will be reviewed annually or sooner if required due to updates in clinical guidelines or CQC regulations.

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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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