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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Head Lice and Nits Prevention and Management Policy

1. Purpose

The purpose of this policy is to provide clear guidance on the prevention, identification, and management of head lice and nits (the eggs of head lice) at {{org_field_name}}, in a manner that protects the health, dignity, and comfort of all individuals receiving care, while minimising disruption and the risk of transmission. Head lice are a common, non-serious condition, but if left unmanaged, they can cause discomfort, irritation, and social stigma. This policy ensures that our care home adopts a calm, respectful, and evidence-based approach to managing head lice outbreaks, in line with Public Health Wales advice and CIW’s expectations for infection prevention, safeguarding, and person-centred care.

2. Scope

This policy applies to all residents, staff, agency workers, volunteers, and visitors at {{org_field_name}}. It includes any person receiving care who may be affected by, or at risk of, head lice infestation. It also applies to any staff member providing personal care, assisting with grooming, or involved in cleaning and laundry procedures during an outbreak.

3. Related Policies

This policy should be read in conjunction with:
CHW11 – Safe Care and Treatment Policy
CHW17 – Infection Prevention and Control Policy
CHW08 – Dignity and Respect Policy
CHW13 – Safeguarding Adults from Abuse and Improper Treatment Policy
CHW18 – Risk Management and Assessment Policy
CHW40 – Assisting with Personal Care Policy
CHW24 – Management of Accidents, Incidents, and Near Misses Policy

4. Policy Details

4.1 Understanding Head Lice and Nits
Head lice are small insects that live on the human scalp and feed on blood. They spread primarily through direct head-to-head contact and are not caused by poor hygiene. Nits are the empty egg shells left behind after lice hatch. Lice do not carry disease, but they can cause intense itching, scratching, and discomfort. In a care home, prompt identification and discreet management are essential to prevent spread while safeguarding the dignity of the individual affected.

4.2 Prevention and Early Detection
While head lice cannot always be fully prevented, we take proactive steps to reduce the risk of infestation through:
Routine visual checks of hair and scalp during personal care tasks (not formal screenings)
Encouraging regular hair washing and grooming as part of personal hygiene routines
Discouraging the sharing of combs, hairbrushes, hats, or headwear between individuals
Maintaining high standards of environmental cleanliness, particularly around communal areas, soft furnishings, and bedrooms
Raising awareness among staff about signs of head lice (itching, scratching, visible eggs or insects on hair shafts)

Staff are trained to approach suspected cases sensitively and confidentially, reporting concerns to the Registered Manager.

4.3 Identification and Assessment
If staff suspect that a resident has head lice, they must report it to the senior on duty and ensure the individual is assessed privately. Signs include:
Persistent itching of the scalp
Small white or yellowish nits attached to hair near the scalp
Presence of live lice crawling on the scalp or hair shafts
Redness or sores caused by scratching

A trained senior carer or nurse will confirm the presence of head lice and document the finding in the individual’s care records. If appropriate, a notification is made to the GP or community nurse, particularly if the individual has open wounds or secondary infection.

4.4 Management and Treatment
Head lice management at {{org_field_name}} is carried out in a discreet and person-centred way. The following procedures apply:
The affected individual is informed (or their representative if capacity is lacking), and consent is obtained before any treatment is applied
Treatment is non-pharmaceutical in the first instance, using the wet combing method with conditioner and a fine-toothed nit comb, unless otherwise advised by a GP or pharmacist
If medication is required, such as dimeticone lotion or other prescribed treatments, these are administered in accordance with CHW21 – Medication Management Policy
Hair care is carried out in private, ensuring dignity is maintained at all times
The person’s bedding, towels, and clothing are laundered at high temperature (60°C) to kill lice and nits
Personal grooming tools are cleaned or replaced

Treatment is repeated according to product instructions or 7 days after the first wet combing to remove newly hatched lice.

4.5 Managing Multiple Cases and Infection Control
In the event that more than one case is identified, an internal outbreak log is maintained. The Infection Control Lead, {{org_field_infection_control_lead_name}}, {{org_field_infection_control_lead_role}}, coordinates the response, which includes:
Informing all relevant staff and updating risk assessments
Increasing environmental cleaning, especially of soft furnishings and hairdressing tools
Ensuring no shared use of grooming items between residents
Encouraging all residents to receive supportive hair and scalp checks during personal care without targeting individuals
Providing advice and reassurance to families and staff to reduce anxiety or stigma

We do not isolate individuals with head lice, as this is not necessary and may breach dignity or human rights. The home remains open unless Public Health Wales advises otherwise.

4.6 Communication and Confidentiality
All cases of head lice are managed confidentially. No individual is named or singled out publicly. Staff must not discuss suspected or confirmed cases with other residents or visitors. If the person lacks capacity, their representative is informed. Staff and families are provided with reassurance and accurate information on transmission, treatment, and prevention. Communication materials may be shared (e.g. Public Health Wales leaflets), but only as general information and not directed toward any specific individual.

4.7 Staff Considerations
Staff who suspect they may have head lice must report this confidentially to the Registered Manager. They will be supported to access treatment and return to work as soon as they are lice-free. Staff are not excluded from work if they are receiving appropriate treatment. Reasonable adjustments, such as limiting contact during personal care, may be implemented during treatment if necessary. Staff must not provide treatment to colleagues or other staff members—any personal issues are addressed privately and respectfully.

4.8 Safeguarding and Wellbeing
Repeated untreated infestations or signs of poor personal care may indicate a need for further support or safeguarding intervention. Where concerns arise, these must be reported to {{org_field_safeguarding_lead_name}}, {{org_field_safeguarding_lead_role}}, and may be referred to {{org_field_local_authority_authority_name}} as appropriate. Psychological support is offered to individuals who feel embarrassed, anxious, or distressed about the issue. Our approach is always non-judgemental and inclusive.

4.9 Monitoring and Quality Assurance
The Registered Manager ensures that any incidents or outbreaks are logged, reviewed, and used to improve future practice. Infection control audits, supervision, and training records are updated to reflect lessons learned. Staff knowledge is reviewed during spot checks and team meetings. Any complaints relating to how head lice were managed are investigated under CHW14 – Complaints Policy.

5. Policy Review

This policy will be reviewed annually or sooner if updated guidance is issued by Public Health Wales or CIW, or if a significant outbreak highlights the need for improvement. Our approach ensures responsive, dignified, and clinically safe management of head lice that supports individual well-being and community health.

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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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