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Registration Number: {{org_field_registration_no}}

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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 individuals in their own homes is carried out safely, hygienically, and in a manner that promotes dignity, comfort, and personal wellbeing. This policy provides clear guidance to staff on their responsibilities, the scope of care they are authorised to provide, and the procedures for managing risks related to nail care. It ensures compliance with Regulation 9 (Person-Centred Care), Regulation 10 (Dignity and Respect), Regulation 12 (Safe Care and Treatment), and Regulation 13 (Safeguarding from Abuse and Improper Treatment) under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

2. Scope

This policy applies to all domiciliary care staff who are involved in supporting people with personal care tasks, including hand and foot hygiene, basic nail care, and referrals to appropriate professionals where advanced or specialist care is required. It applies to fingernail and toenail care provided in a home care setting.

3. Related Policies

• CH07-Person-Centred Care Policy
• CH10-Visiting and Accompanying in Care Homes and Hospitals Policy
• CH11-Safe Care and Treatment Policy
• CH13-Safeguarding Adults from Abuse and Improper Treatment Policy
• CH17-Infection Prevention and Control Policy
• CH40-Assisting with Personal Care Policy

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 is only provided where it has been assessed as appropriate and agreed upon during the initial assessment and care planning process. The individual’s preferences, medical conditions, and skin integrity are reviewed. Consent must be obtained for each episode of nail care and documented in the care notes. If the person lacks capacity, staff must follow the Mental Capacity Act 2005 and act in the person’s best interests.

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
Strict hygiene practices must be followed. Staff must wash their hands, wear gloves and PPE as appropriate, and use clean or single-use files. Equipment used for nail care must be cleaned or disposed of in accordance with our CH17-Infection Prevention and Control Policy. Staff must never share equipment between individuals without full sterilisation.

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.

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

All staff involved in basic nail care receive training as part of their personal care competencies. Staff must not perform any task beyond their level of training or the permissions in the care plan. Where advanced nail care is needed, referrals are made and documented in accordance with policy.

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. 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.

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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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