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CH190-Continence Care Policy

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Continence Care Policy

1. Purpose

The purpose of this policy is to ensure that all residents living at {{org_field_name}} receive safe, sensitive, dignified and person-centred continence care that promotes health, comfort, independence, choice, privacy and well-being. Continence care must be provided in a way that recognises each resident’s individual needs, wishes, communication needs, cultural needs, mental capacity, clinical risks and personal routines.

This policy supports compliance with the Health and Social Care Act 2008, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and CQC’s current regulatory expectations, including Regulation 9 (Person-centred care), Regulation 10 (Dignity and respect), Regulation 11 (Need for consent), Regulation 12 (Safe care and treatment), Regulation 13 (Safeguarding service users from abuse and improper treatment), Regulation 14 (Meeting nutritional and hydration needs), Regulation 15 (Premises and equipment), Regulation 17 (Good governance), Regulation 18 (Staffing), and Regulation 20 (Duty of candour).

The policy also reflects CQC’s current assessment framework, including the quality statements under the Safe, Effective, Caring, Responsive and Well-led key questions. Continence care must be planned, delivered, monitored and reviewed so that residents are protected from avoidable harm, neglect, infection, skin damage, dehydration, constipation, urinary tract infection, catheter-associated infection, loss of dignity and social isolation.

2. Scope

This policy applies to all staff, agency staff, volunteers, managers, nurses where employed, and any person delivering or supporting continence care within {{org_field_name}} care home. It applies to all residents who require support with urinary continence, bowel continence, toileting routines, continence products, catheter care, stoma-related continence support where applicable, constipation prevention, skin care linked to incontinence, and monitoring of changes in bladder or bowel function.

This policy applies to residents with temporary, occasional, long-term, progressive or complex continence needs, including residents living with dementia, frailty, physical disability, learning disability, autism, sensory impairment, neurological conditions, reduced mobility, end-of-life care needs or fluctuating mental capacity.

Where continence care involves clinical procedures, catheter management, prescribed medicines, bowel management plans, stoma care or delegated healthcare tasks, staff must only act within their role, training, competence, care plan instructions and any written delegation or guidance from an appropriately qualified healthcare professional.

3. Related Policies

4. Legal and Regulatory Framework

Continence care at {{org_field_name}} must be delivered in accordance with the following legislation, regulations and guidance, as applicable:

Managers must ensure that this policy is reviewed against changes in legislation, CQC guidance, NICE guidance, Department of Health and Social Care guidance, local Integrated Care Board guidance, local authority safeguarding procedures and continence service requirements.

5. Policy Statement and Principles

5.1 Person-Centred Assessment and Planning

All continence care begins with a comprehensive assessment of the individual’s needs, preferences, lifestyle, and medical conditions. Assessments are carried out collaboratively with the individual, their family or advocate (where appropriate), and relevant health professionals. We document specific continence needs in the individual’s care plan, including product preferences, toileting routines, fluid intake, diet, privacy preferences, and any underlying conditions. Care plans are regularly reviewed and updated as needs change. Our approach promotes autonomy and choice wherever possible.

5.2 Maintaining Dignity and Privacy

Continence care is delivered in a way that upholds the individual’s dignity and promotes self-esteem. Care workers must always ensure privacy when delivering continence support by closing doors, drawing curtains, and explaining each step of the care process. Where appropriate, we respect requests for same-gender care workers and support individuals in managing their own continence where possible. Respectful language must always be used, and no one should be made to feel embarrassed or ashamed due to incontinence.

5.3 Supporting Health and Well-being

We ensure that continence care supports the individual’s overall health and well-being. This includes encouraging regular toileting routines, appropriate fluid intake, and a balanced diet high in fibre (where suitable) to avoid constipation and dehydration. We work in collaboration with GPs, district nurses, and continence advisors to ensure any underlying medical issues are identified and treated. If the person supported is prescribed continence products, staff assist with ordering, storing, and using them correctly and hygienically.

5.4 Infection Prevention and Control

All continence care is provided in line with our CH17 – Infection Prevention and Control Policy. Staff must wear appropriate PPE, including gloves and aprons, and dispose of waste in line with local authority and clinical waste disposal procedures. Soiled clothing or bedding must be handled carefully to avoid contamination. Hands must be washed before and after delivering care, and all surfaces cleaned with appropriate disinfectants. Equipment such as commodes and urinals must be cleaned after each use.

5.5 Choice and Continence Products

People supported have the right to choose which continence products they prefer, whether provided by the NHS or purchased independently. Staff will assist individuals in understanding different options such as pads, pull-ups, catheter care, urinals, commodes, or toileting schedules. Product use must always align with the individual’s preferences and clinical advice. Products must be stored safely, labelled clearly, and never shared between individuals. Staff must check expiry dates and replace stock as necessary.

5.6 Bowel and Bladder Monitoring

For individuals with ongoing continence issues, staff may be required to monitor bowel movements and urination frequency as part of a care plan. These observations help identify constipation, dehydration, infection, or decline in condition. Records must be documented accurately and shared with health professionals when needed. Any changes in patterns or concerns (e.g. blood in urine, pain, retention, or persistent incontinence) must be reported promptly to the Registered Manager and appropriate healthcare contacts.

5.7 Training and Staff Competency

All staff involved in delivering continence care must receive induction and ongoing training that includes dignity in care, infection control, safe handling of products, managing urinary and bowel care, and communication with individuals experiencing incontinence. Staff must demonstrate competency before delivering unsupervised personal care. Additional support or refresher training is provided as necessary. The Deputy Manager {{org_field_deputy_manager_first_name}} {{org_field_deputy_manager_last_name}} oversees training compliance and support.

5.8 Safeguarding and Consent

All continence care must be delivered with the person’s valid consent, or in their best interest if they lack capacity, in accordance with the Mental Capacity Act 2005. Staff must remain vigilant for signs of neglect, abuse, or improper treatment related to continence, including failure to change soiled products, lack of privacy, or inappropriate use of restraints or denial of toileting. Any concerns must be reported immediately in line with our CH13 – Safeguarding Policy.

5.9 Communication and Documentation

Staff must record all continence care provided, including any concerns, refusals, product use, or changes in condition. Accurate, timely documentation ensures continuity of care and accountability. Records are stored securely in line with our CH34 – Confidentiality and Data Protection Policy. Communication with individuals must be sensitive, respectful, and adapted to their communication needs, including the use of visuals or advocates if required.

6. Policy Review

This policy will be reviewed every 12 months or earlier if there are changes in guidance, best practice, or the needs of the service. Updates will be shared with all staff and the most recent version will be available through {{org_field_email}} and on our website {{org_field_website}}.

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.

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