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CH212-Nail Care Policy

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Nail Care Policy

1. Purpose

The purpose of this policy is to ensure that nail care provided by {{org_field_name}} to people living in our care home(s) is carried out safely, hygienically, and in a manner that promotes dignity, comfort, and wellbeing. This policy provides clear guidance to staff on their responsibilities, the scope of nail care they are authorised to provide, and the procedures for managing risks related to nail care.

This policy supports compliance with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (as amended), 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 17 (Good governance), Regulation 18 (Staffing) and Regulation 20 (Duty of candour), and reflects relevant CQC guidance.

2. Scope

This policy applies to all care home staff who support people with personal care tasks in our care home(s), including hand and foot hygiene, basic nail care within staff competence, and referral to appropriate professionals where specialist care is required. It applies to fingernail and toenail care provided within the care home, including when a visiting clinician (e.g., podiatrist) provides treatment on site.

3. Related Policies

4. Policy Statement

{{org_field_name}} recognises the importance of regular nail care as part of good personal hygiene, comfort, dignity, and prevention of infection. However, we also recognise the associated risks, particularly in individuals with diabetes, circulatory issues, or conditions that affect skin integrity. Our staff are trained to deliver basic nail care where appropriate and to refer to podiatrists or healthcare professionals when specialist intervention is required.

5. Key Procedures and Guidance

a. Consent and Care Planning

Nail care must only be provided where it is identified in the person’s assessment and care plan as a required support need, including the agreed method (e.g., hygiene only, filing only, or nail cutting where authorised) and any restrictions. Staff must obtain valid consent at each episode and record consent (including where the person declines or withdraws consent).

Where a person may lack capacity to consent to nail care, staff must follow the Mental Capacity Act 2005, record a decision-specific assessment where required, and document any best-interest decision, including who was involved. Consent and decision-making must be applied in line with Regulation 11 (Need for consent).

b. Staff Roles and Responsibilities

Staff may assist with basic nail care such as gentle filing and cleaning of fingernails only where this is specified in the individual’s care plan and no contraindications exist. Staff must not cut nails, especially toenails, unless they have been specifically trained and assessed as competent to do so and the individual has no health conditions that would increase risk. Cutting toenails or providing care to individuals with diabetes, poor circulation, or foot ulcers is strictly prohibited and must be referred to a podiatrist or district nurse.

c. Risk Assessment

Prior to any nail care being provided, a risk assessment is carried out and regularly reviewed. The assessment considers any medical diagnoses (e.g. diabetes, peripheral neuropathy, anticoagulant therapy), history of skin infections or wounds, allergies to products, and the presence of thickened or ingrown nails. Nail care is not undertaken if there is any doubt about safety or suitability.

d. Infection Control and Equipment

Infection prevention and control measures must be applied in line with our IPC policy and the Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance. Staff must complete hand hygiene before and after the task, use appropriate PPE, ensure a clean working area, and use single-use items wherever possible (e.g., emery boards). Reusable equipment (only where permitted) must be cleaned and decontaminated strictly in accordance with manufacturer instructions and organisational procedure. Equipment must not be shared between people unless appropriately decontaminated.

e. Observations and Reporting

Staff must observe the hands and feet before and after nail care. If there is any redness, swelling, broken skin, ingrown nails, fungal infection, bruising, or reported discomfort, staff must cease the task and report the concern immediately to their line manager. Such observations must be recorded in the daily care records and, if needed, a referral made to the GP or community podiatry service.

Any skin break, bleeding, suspected infection, unexplained bruising, or worsening condition identified during/after nail care must be treated as a potential incident. Staff must provide immediate first aid within competence, seek clinical advice as appropriate, and report and record in line with the home’s incident reporting process. Where harm meets the threshold for a notifiable safety incident, the Registered Manager must ensure the requirements of Regulation 20 (Duty of candour) are followed, including timely apology, explanation, and written follow-up, with clear records of actions taken.

f. Use of External Professionals

Where nail care is beyond the scope of the staff role or where a medical condition exists, {{org_field_name}} will support the individual to access appropriate healthcare professionals. This includes referrals to NHS podiatry services, private podiatrists, or foot health practitioners. Visits and follow-up are documented in the care record, and staff may assist with arranging appointments and attending if agreed in the care plan.

g. Dignity and Respect

Nail care must always be provided in a way that respects the individual’s privacy and dignity. The individual should be made comfortable, with adequate explanation of what is being done, and given the choice to stop at any time. Gender, cultural, and religious considerations must be respected at all times.

h. Record-Keeping

Every episode of nail care must be documented in the care record, including the time, what was done, who carried it out, any observations made, and the person’s response. Any concerns, refusals, or safeguarding issues must also be recorded and escalated accordingly.

6. Staff Training and Competency

Staff involved in nail care must be trained in: infection prevention and control, recognising skin integrity concerns, consent/capacity requirements, and the limits of their role. Competency must be assessed and recorded before any staff member undertakes nail care tasks independently, and must be refreshed periodically and following any incident/near miss. Staff must not perform any nail care task beyond their training/assessed competence or what is explicitly authorised in the care plan.

7. Responsibilities

The Registered Manager {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}} is responsible for ensuring this policy is implemented and monitored. Staff are responsible for following procedures, maintaining hygiene, and reporting concerns. The care plan must clearly outline whether nail care is required and what type of intervention is safe.

8. Governance, audit and learning

The Registered Manager will ensure oversight of nail care practice through care plan audits, record checks, incident/near-miss trend review and competency monitoring, and will take action where quality or safety concerns are identified. Learning from complaints, safeguarding concerns and incidents will be used to update risk assessments, care plans, training and this policy. This forms part of the home’s quality assurance arrangements under Regulation 17 (Good governance).

9. Policy Review

This policy will be reviewed annually or sooner if changes to guidance, legislation, or CQC expectations occur. Staff will be notified of any updates and provided with refresher training as needed.

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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