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Registration Number: {{org_field_registration_no}}

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Enteral Feeding Policy

1. Purpose

The purpose of this policy is to ensure that all enteral feeding provided by {{org_field_name}} is carried out safely, hygienically, and in a way that promotes the dignity, wellbeing, and person-centred needs of the individuals we support. Enteral feeding, which includes the delivery of nutrition via nasogastric (NG), percutaneous endoscopic gastrostomy (PEG), or jejunostomy (JEJ) tubes, is a critical clinical task requiring robust governance and highly competent care. This policy supports compliance with Regulation 12 (Safe Care and Treatment), Regulation 14 (Meeting Nutritional and Hydration Needs), Regulation 9 (Person-Centred Care), and Regulation 10 (Dignity and Respect) under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

2. Scope

This policy applies to all care staff involved in the provision, assistance or monitoring of enteral feeding to individuals in their own homes. It also applies to team leaders, care coordinators, registered nurses (if applicable), and those managing training and quality assurance. It ensures that our approach to enteral feeding supports safety, informed choice, consent, dignity, and effective nutritional care.

3. Related Policies

• CH07 – Person-Centred Care Policy
• CH08 – Dignity and Respect Policy
• CH11 – Safe Care and Treatment Policy
• CH12 – Meeting Nutritional and Hydration Needs Policy
• CH13 – Safeguarding Adults from Abuse and Improper Treatment Policy
• CH17 – Infection Prevention and Control Policy
• CH27 – Staff Supervision, Training, and Development Policy
• CH34 – Confidentiality and Data Protection Policy

4. Policy Statement and Principles

4.1 Individualised Assessment and Care Planning
Before enteral feeding commences, a full assessment is carried out in partnership with healthcare professionals such as dietitians, speech and language therapists (SALT), GPs and district nurses. A detailed care plan is created that includes the type of feeding tube used, nutritional requirements, feeding times, equipment instructions, medication administration, oral care needs, and how to recognise and report complications. This care plan is reviewed regularly and updated if there are any changes in health status, preferences, or care objectives.

4.2 Consent and Mental Capacity
Before supporting any enteral feeding, valid and informed consent must be obtained from the individual. Where a person lacks capacity, decisions are made in line with the Mental Capacity Act 2005, using best interest principles and involving family, advocates or legal representatives where necessary. The individual’s views, wishes and prior statements are always considered. Consent is recorded in the care plan and reviewed regularly.

4.3 Safe Administration and Monitoring
Enteral feeding is only undertaken by trained and assessed competent staff. Staff follow strict protocols for hygiene, preparation, administration and post-feed care. Key responsibilities include:

• Verifying the correct tube placement (where appropriate and within scope)
• Checking expiry dates and correct storage of feeds
• Ensuring correct rate and volume of feed, as prescribed
• Positioning the individual safely before, during and after the feed
• Observing for signs of intolerance, infection, aspiration, leakage, or dislodgement
• Documenting feeding times, volumes and any observations on fluid and nutrition charts
  We work closely with community nurses or clinical teams to escalate and refer any clinical concerns immediately.

4.4 Infection Prevention and Equipment Care
All feeding equipment must be handled in accordance with our CH17 – Infection Prevention and Control Policy. This includes:

• Using PPE during feed setup and administration
• Washing hands before and after handling feeding tubes or equipment
• Cleaning and storing equipment correctly between uses
• Disposing of feed containers, syringes, and tubing safely
  Care staff are trained to clean around the stoma site and observe for redness, swelling, discharge or discomfort. All concerns must be reported promptly to a health professional and recorded.

4.5 Staff Competency and Training
Only staff who have completed specific enteral feeding training and competency assessments may support this activity. Competencies are assessed by qualified trainers or healthcare professionals and reviewed annually or following a change in clinical needs. Training includes:

• Tube types and functions
• Feed preparation and administration
• Recognising complications
• Record keeping and hygiene protocols
• Person-centred and dignified care
  Competent staff are listed on an internal register maintained by the Deputy Manager {{org_field_deputy_manager_first_name}} {{org_field_deputy_manager_last_name}}.

4.6 Dignity, Respect and Communication
Care staff must deliver enteral feeding in a manner that preserves dignity, privacy, and comfort. Individuals must be involved in every stage of their care, encouraged to express their wishes, and supported with communication aids if needed. The impact of enteral feeding on emotional well-being, social inclusion and body image is acknowledged and support offered as needed.

4.7 Medication via Enteral Feeding
Where medication is prescribed to be administered via a feeding tube, staff must be guided by a registered nurse, pharmacist or GP. Staff must never crush or dilute medications without professional direction. Medicines must be administered separately, flushed between doses, and any incompatibilities or reactions must be recorded and reported immediately.

4.8 Emergency Situations and Escalation
Staff must be alert to complications including blocked tubes, vomiting, diarrhoea, dehydration, infection at the insertion site, aspiration or dislodged tubes. Emergency protocols are in place, and staff are trained to:

• Stop the feed immediately
• Position the individual safely
• Contact emergency services or a community nurse
• Notify the Registered Manager {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
  All incidents are reported via our incident reporting procedures and reviewed for learning.

4.9 Record Keeping and Confidentiality
Accurate records of each feed, medication administration, and observations must be maintained on the individual’s care notes. Records are confidential and stored securely in line with CH34 – Confidentiality and Data Protection Policy. Records are audited regularly to ensure compliance and quality assurance.

4.10 Multi-Agency Collaboration
We work closely with external clinicians including GPs, dietitians, SALT teams, community nurses and hospital discharge planners to ensure enteral feeding is safe, effective and based on up-to-date medical advice. We seek expert guidance where needed and promote integrated care planning and communication.

5. Policy Review

This policy will be reviewed annually or sooner if there are changes in clinical guidance, legislation or care practices. Updates will be communicated to all relevant staff and training will be updated accordingly. The latest version of this policy is available from {{org_field_email}} and on our website at {{org_field_website}}.

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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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