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Registration Number: {{org_field_registration_no}}

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Continence Care Policy

1. Purpose

The purpose of this policy is to provide a clear and comprehensive framework for the delivery of safe, dignified, and person-centred continence care for all individuals receiving support at {{org_field_name}}. Continence care is a fundamental aspect of maintaining dignity, independence, and quality of life. This policy ensures that staff are equipped with the knowledge, skills, and procedures necessary to assess, support, monitor, and manage continence effectively and compassionately. It is fully aligned with the Regulation and Inspection of Social Care (Wales) Act 2016, the Social Services and Well-being (Wales) Act 2014, and CIW expectations for safe, respectful, and personalised care.

2. Scope

This policy applies to all staff working at {{org_field_name}} who are involved in providing or supporting continence care. This includes care assistants, nurses, support staff, domestic staff (in relation to hygiene), and any agency or bank staff. It also applies to all individuals receiving care at the service, whether they require full continence support or minimal assistance, and includes children or adults with physical disabilities, cognitive impairment, or temporary continence challenges.

3. Related Policies

This policy should be read in conjunction with:
CHW07 – Person-Centred Care Policy
CHW08 – Dignity and Respect Policy
CHW11 – Safe Care and Treatment Policy
CHW18 – Risk Management and Assessment Policy
CHW40 – Assisting with Personal Care Policy
CHW17 – Infection Prevention and Control Policy
CHW13 – Safeguarding Adults from Abuse and Improper Treatment Policy

4. Policy Details

4.1 Person-Centred Approach to Continence Care
Continence support is delivered in a way that prioritises the dignity, privacy, autonomy, and preferences of the individual. Each resident is assessed on admission and regularly thereafter to determine their continence needs, preferences for toileting routines, level of support required, and preferred continence products. Continence plans are incorporated into personal plans and are reviewed at least monthly or more frequently if needs change. Individuals are actively involved in decisions about their care. Support with toileting is never rushed and always provided with sensitivity and discretion, respecting the individual’s emotional wellbeing.

4.2 Continence Assessments
A holistic continence assessment is completed as part of the initial and ongoing care planning process. This includes:
Baseline continence status and history
Frequency, urgency, and control issues
Cognitive, neurological, or mobility considerations
Fluid intake and diet
Medication review and impact on bladder/bowel health
Use of continence aids and assistive technology
Skin integrity and risk of pressure damage
Involvement of continence nurses or GPs where needed

Where concerns are identified, staff must refer promptly to the district nurse or continence advisory team for further clinical input.

4.3 Toileting Assistance and Promotion of Independence
Wherever possible, individuals are supported to maintain continence and independence. Staff must:
Encourage regular toileting routines and respond promptly to requests
Offer and promote hydration throughout the day to reduce infections and constipation
Monitor and support individuals in using adapted equipment (e.g. grab rails, raised toilet seats)
Support people to access the toilet safely, using safe moving and handling techniques
Assist discreetly with clothing and hygiene, ensuring appropriate privacy

Prompt, respectful assistance is essential to preserve dignity and reduce the risk of incontinence-related anxiety or embarrassment.

4.4 Use of Continence Products
Where appropriate, individuals may use continence aids such as pads, pants, urinals, commodes, or catheters. The choice of products must be based on assessment, comfort, suitability, and skin protection. Products must:
Be stored securely and hygienically
Be labelled for individual use
Be changed at appropriate intervals to prevent skin breakdown and odour
Be disposed of in line with CHW22 – Handling and Disposal of Hazardous Substances Policy
Not be used as a substitute for proper toileting support

Staff must be trained in the correct application and removal of continence aids and in recognising when products need changing or when a review is necessary.

4.5 Managing Catheter and Stoma Care
Where individuals have catheters or stomas, these are managed according to clinical protocols and infection control standards. Staff providing catheter or stoma care must be trained and deemed competent. Key actions include:
Monitoring output and signs of infection
Ensuring tubing and equipment is clean, secured, and unobstructed
Changing dressings and emptying bags using aseptic technique
Reporting concerns to the community nursing team or GP

Any clinical intervention is documented, and personal care plans updated accordingly.

4.6 Skin Care and Infection Prevention
Continence care is closely linked to skin integrity. Individuals at risk of incontinence-associated dermatitis (IAD) or pressure ulcers receive preventive skincare and monitoring. Measures include:
Using barrier creams as prescribed
Cleaning gently after each episode using appropriate wipes or soap
Monitoring the perineal area and documenting any redness or breakdown
Repositioning regularly as part of pressure care routines
Ensuring correct PPE is worn during care and that hand hygiene procedures are followed rigorously

All continence care is recorded in detail and subject to regular review through daily records, supervision, and care plan audits.

4.7 Training and Staff Competence
All care staff receive induction and annual refresher training on continence care. Training covers:
Understanding types of incontinence and underlying causes
Assessment and record-keeping
Dignity and communication in continence care
Use of continence products and safe disposal
Catheter care and infection prevention
Skin integrity and pressure area monitoring

Only staff assessed as competent are permitted to carry out personal continence care, catheter management, or related clinical tasks. Supervision and spot checks are used to ensure standards are maintained.

4.8 Safeguarding and Dignity
Any failure to provide appropriate continence support may be considered neglect or poor practice. This includes:
Leaving individuals soiled or unclean
Using continence products without consent or assessment
Failing to respond promptly to requests for toileting assistance
Using the toilet or pad changes as a form of control or discipline

Concerns must be reported to the Safeguarding Lead: {{org_field_safeguarding_lead_name}}, {{org_field_safeguarding_lead_role}}, and referred to {{org_field_local_authority_authority_name}} as required. All support must be delivered in a way that maximises privacy, prevents embarrassment, and fosters self-esteem.

4.9 Monitoring and Quality Assurance
The Registered Manager ensures audits are conducted monthly on:
Toileting logs and continence care records
Skin care and wound prevention records
Use and stock control of continence products
Staff training and supervision records

Feedback from individuals receiving care is used to improve the service. Any complaints or concerns are investigated under CHW14 – Complaints Policy, and themes are used to inform continuous improvement.

5. Policy Review

This policy will be reviewed annually or sooner if required due to updated clinical guidance, CIW feedback, staff training needs, or incidents involving continence care. It reflects {{org_field_name}}’s commitment to safe, respectful, and person-led care that upholds dignity in every aspect of daily life.

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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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