CHW40-Assisting with Personal Care Policy

Registration Number: {{org_field_registration_no}}

Assisting with Personal Care Policy

1. Purpose

The purpose of this policy is to ensure that all personal care provided at {{org_field_name}} is safe, dignified, respectful, person-centred and outcomes-focused. Personal care must be delivered in line with the individual’s assessed needs, personal plan, preferences, communication needs, cultural, religious and spiritual beliefs, and any risks identified to their well-being.

This policy supports compliance with the Regulation and Inspection of Social Care (Wales) Act 2016, the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017 as amended, the Social Services and Well-being (Wales) Act 2014, the Mental Capacity Act 2005, and relevant Welsh Government, Care Inspectorate Wales (CIW), Public Health Wales and Social Care Wales guidance.

The policy is intended to ensure that individuals are supported to maintain privacy, dignity, autonomy and independence, to communicate in their preferred manner and language, including Welsh where this is their language of need or choice, and to receive personal care in a way that promotes their personal outcomes, well-being and human rights.

2. Scope

This policy applies to all employees, agency staff, bank staff, students, contractors and volunteers, where relevant to their role, who are involved in or may observe, supervise, record or review personal care within {{org_field_name}}.

For the purposes of this policy, personal care includes support with washing, bathing, showering, dressing, grooming, shaving, nail care where appropriate, oral care and denture care, toileting, continence care, menstrual care, skin care, pressure area care within the staff member’s competence, use of prescribed continence products, assistance to use sensory aids, and associated recording, reporting and escalation.

This policy applies to routine personal care, planned interventions, short-term changes in need, urgent or unplanned care, and end-of-life personal care where required. It must be read alongside the individual’s personal plan, risk assessments and any specialist guidance in place for that individual.

3. Principles of Personal Care Assistance

Dignity, respect and rights-based care: Personal care must always be provided in a way that protects and promotes the individual’s dignity, privacy, safety, autonomy, equality and human rights. Staff must knock before entering, explain what support is proposed, seek consent at each stage, preserve modesty, use preferred names and forms of address, and ensure the person is not exposed unnecessarily. Intimate personal care must be provided in a dignified way, in accordance with the individual’s wishes and preferences, and these preferences must be clearly recorded in the personal plan.

Person-centred and outcomes-focused care: Personal care must be delivered in line with the individual’s current personal plan, provider assessment and risk assessments, and must support the individual to achieve their personal outcomes. Care must reflect what matters to the individual, including their usual routines, preferences for male or female staff where possible and appropriate, cultural identity, religion or belief, communication method, language of need and choice, and the level of support they wish to receive. Staff must not provide task-led care that ignores the person’s expressed wishes, assessed needs or preferred routines.

Consent, capacity and lawful decision-making: Valid consent must be sought before personal care is provided and reaffirmed throughout the intervention. Staff must assume capacity unless it is established otherwise and must provide information in a way the individual can understand so they can make or participate in decisions. Where there is doubt about capacity for a specific decision, this must be assessed and recorded in line with the Mental Capacity Act 2005.

If an individual lacks capacity for a particular decision, staff must act in the person’s best interests, use the least restrictive option, consult lawful representatives and relevant professionals where appropriate, and ensure that any restrictions on liberty or movement are lawful, necessary and proportionate. Personal care must never be forced except where lawful authority exists and immediate action is necessary to prevent harm. Any use of restraint or restrictive practice must be exceptional, recorded, reported and reviewed in line with the service’s policy on control, restraint and restrictive practice.

Promoting independence and positive risk-taking: Staff must encourage and support individuals to do as much as possible for themselves and to retain or regain daily living skills. This includes using prompts, adapted equipment, assistive technology, environmental adjustments and graded support. Staff must balance safety with choice and positive risk-taking, and any agreed approach must be reflected in the personal plan and risk assessments.

Safeguarding: Personal care must be provided in a manner that protects individuals from abuse, neglect and improper treatment. Staff must remain alert to indicators such as unexplained bruising, pain, fearfulness, changes in presentation, sexualised injury, poor hygiene not consistent with the person’s usual presentation, repeated refusal of care linked to distress, and any sign that care is being delivered in an undignified, punitive or rushed manner. Any allegation, suspicion or evidence of abuse, neglect or improper treatment must result in immediate action to protect the individual, prompt reporting in accordance with the Wales Safeguarding Procedures and the service safeguarding policy, appropriate external referral, and a clear contemporaneous record of the concern, action taken and outcome.

Infection prevention and control: Staff must carry out personal care in accordance with current infection prevention and control procedures, including hand hygiene, use of personal protective equipment, safe disposal of waste, safe handling of linen, cleaning and decontamination of reusable equipment, and management of body fluids. Staff must not undertake personal care if they are unsure of infection control requirements and must seek advice where there is known or suspected infection, outbreak status, or additional transmission-based precautions in place.

Privacy, confidentiality and record security: Staff must protect privacy during personal care by closing doors, curtains and screens, minimising interruption, and limiting the presence of others to those necessary for safe care or requested by the individual. Personal information must only be shared on a need-to-know basis and records relating to personal care, capacity, risk, safeguarding concerns and outcomes must be accurate, up to date, secure and accessible to authorised persons only.

Communication, sensory needs and Welsh language
Staff must take reasonable steps to meet each individual’s communication and language needs during personal care. This includes using the person’s preferred language, pace, tone and method of communication; checking understanding; supporting the use of hearing aids, glasses and other communication aids; and adapting care for people with cognitive or sensory impairment.

{{org_field_name}} will actively offer services in Welsh to individuals whose language of need or choice is Welsh and will not require the individual to request Welsh language support before this is considered. Communication needs and language preferences must be identified, recorded in the personal plan and reflected in the way personal care is provided.

4. Procedures for Providing Personal Care

Assessment and Planning:

Personal care must be based on an up-to-date assessment, provider assessment, personal plan and any associated risk assessments. Before or on commencement of the service, the service must ensure that the individual’s needs, preferences, routines, communication needs, language of need and choice, cultural and religious requirements, risks, level of independence, moving and handling needs, continence needs, skin integrity risks, oral care needs, use of sensory aids and any specialist guidance are identified and recorded.

Personal care arrangements must be co-produced with the individual and, where appropriate, their representative and relevant professionals. The personal plan must clearly state how day-to-day personal care is to be provided, what the individual can do independently, what prompts or assistance are required, any preferred timing or sequence of care, any preferred gender of staff where possible, risks and mitigation, and how the person will be supported to achieve personal outcomes.

The personal plan must be reviewed whenever needs change and at least every three months, and earlier if the individual’s presentation, wishes, continence status, skin condition, cognition, mobility, oral health, behaviour or capacity changes. If the service is no longer able to meet the individual’s assessed needs even after reasonable adjustment, this must be escalated immediately in line with regulatory requirements.

Assisting with washing, bathing and showering
Before providing support, staff must explain the proposed care, check consent, prepare the environment, assemble equipment, maintain privacy and ensure safe moving and handling arrangements are followed. Water temperature must be checked and suitable for the individual. The person’s preference for bath, shower, bed bath, strip wash or partial support must be respected wherever possible.

Staff must observe and record any concerns such as pain, distress, bruising, skin tears, rashes, pressure damage, fungal infection, deterioration in mobility, changes in mood or behaviour, or refusal of care. Concerns must be escalated promptly in accordance with clinical need and the personal plan must be updated where required.

Staff must encourage the individual to do what they can independently and must support preferred toiletries, routines and cultural or religious practices where these are safe and appropriate.

Assisting with Dressing and Grooming:

Staff must support the individual to choose clothing that is comfortable, appropriate for the weather, safe, and consistent with their identity, preferences, religious or cultural needs and planned activities. Support with hair care, shaving and grooming must be provided in line with the person’s wishes and personal plan. Staff must promote self-esteem, comfort and identity and must report any concerns such as skin damage, swelling, pain, refusal linked to distress, or a decline in dexterity or cognition that affects the person’s ability to dress or groom independently.

Toileting and Continence Support:

Staff must provide support with toileting and continence care in a way that protects dignity, privacy, comfort and skin integrity. The individual’s usual toileting pattern, level of independence, preferred continence products, positioning needs, moving and handling arrangements, skin care needs and any clinical instructions must be clearly recorded in the personal plan and followed by staff.

Staff must monitor and report changes such as constipation, diarrhoea, incontinence, urinary frequency, pain, bleeding, reduced output, odour, signs of urinary tract infection, damage to skin, repeated refusal of continence care or reduced awareness of toileting needs. The service must seek clinical advice where indicated and update the personal plan in response to any change. Hydration and nutrition relevant to continence management must be encouraged and recorded where this forms part of the plan of care.

Oral Hygiene and denture care:

Staff must encourage and support individuals to care for their teeth, mouth and dentures in accordance with their personal plan and level of independence. Appropriate oral healthcare products must be available, clean and in good condition. Staff must observe the person’s mouth, lips, gums, tongue, natural teeth and dentures during routine care where appropriate and within the scope of their role, and record and escalate concerns such as pain, bleeding, ulcers, thrush, broken teeth, poor denture fit, refusal of oral care, halitosis, dry mouth or signs of infection.

Oral care must be monitored as part of daily care and remedial action taken where issues are identified. Where appropriate, the individual must be supported to access regular dental checks or urgent dental review if pain, decay or oral deterioration is suspected.

Skin integrity, pressure area care and sensory aids

Staff must observe skin condition during personal care and report any redness, pressure damage, skin tears, bruising, fungal infection, swelling, pain, changes in wound appearance or deterioration in skin integrity. Personal care must be provided in accordance with any pressure area care plan, repositioning plan, wound care instructions and equipment guidance.

Staff must also ensure that sensory aids such as glasses and hearing aids are clean, available, functioning and used where the individual wishes and is able to use them. Where sensory impairment affects consent, communication, orientation or safety during personal care, staff must adapt their approach accordingly and record any changes or concerns for review.

Refusal of care, distress and escalation

If an individual declines personal care, staff must not respond in a punitive, coercive or dismissive manner. Staff must try to understand the reason for refusal, consider pain, fear, trauma, embarrassment, communication difficulty, cognitive impairment, cultural need, staff gender preference, environmental discomfort, timing, fatigue or mental ill health, and offer alternative approaches where appropriate.

Repeated refusal, sudden refusal, marked distress, deterioration in self-care ability, or any concern that the person’s needs are changing must be reported promptly to the senior person on duty and recorded clearly. A review of the personal plan, risk assessment, capacity considerations and any need for clinical input must follow without delay.

Recording of personal care

Staff must make accurate, contemporaneous records of personal care provided or declined, any assistance required, any changes observed, any concerns escalated, and the response taken. Records must be factual, respectful, legible, dated, timed and attributable to the member of staff making the entry. Electronic records must be completed using the staff member’s own secure login and must not be falsified, pre-completed or completed by another person on their behalf. Where care is not delivered as planned, the reason and follow-up action must be documented clearly.

End-of-life personal care

Where an individual is approaching the end of life, personal care must reflect their wishes, preferences, advance statements, advance decisions and any lawful health and welfare decision-making arrangements. Staff must provide comfort-focused, compassionate and dignified care, work collaboratively with relevant professionals, and support family or those important to the person in line with the individual’s wishes and the care plan. Any changes in condition, comfort, swallowing, oral intake, pain or skin integrity must be escalated promptly in accordance with the end-of-life care plan and clinical advice in place.

5. Staff Training and Responsibilities

All staff involved in personal care must receive induction, training, supervision and competency assessment appropriate to their role before working unsupervised. This must include, as relevant to the role, dignity and rights-based care, person-centred practice, communication, Welsh language awareness and active offer, equality and anti-discriminatory practice, safeguarding, infection prevention and control, moving and handling, continence care, oral care, skin integrity and pressure area awareness, dementia and cognitive impairment awareness, consent and the Mental Capacity Act 2005, restrictive practice, record keeping, and escalation of deteriorating needs.

Staff must only undertake personal care tasks for which they are trained, competent and authorised. Any delegated healthcare activity must only be undertaken in line with current guidance, professional accountability and service policy.

Staff must receive regular supervision no less than quarterly, annual appraisal, and additional support where concerns, incidents, complaints, safeguarding issues or competency gaps are identified. The service must maintain records of induction, training, competency assessment, supervision and appraisal and use these records to inform workforce development and quality improvement.

All staff must read, understand and work in accordance with this policy, the individual’s personal plan and associated risk assessments, and relevant Social Care Wales codes and practice guidance.

6. Related Policies

CHW07 – Person-Centred Care Policy
CHW08 – Dignity and Respect Policy
CHW09 – Consent to Care Policy
CHW13 – Safeguarding Adults from Abuse and Improper Treatment Policy
CHW17 – Infection Prevention and Control Policy
CHW34 – Confidentiality and Data Protection Policy
CHW36 – Initial Assessment and Care Planning Policy

7. Monitoring and Review

Compliance with this policy will be monitored through supervision, direct observation where appropriate, personal care record audits, personal plan audits, incident review, safeguarding review, complaints analysis, infection prevention and control monitoring, training compliance, competency assessments and feedback from individuals and their representatives.

The service will use monitoring findings to identify trends, lessons learned and required improvements in practice. Where deficits are identified, action plans will be implemented, monitored and reviewed through the service’s governance and quality assurance processes.

This policy will be reviewed at least annually and sooner if there are changes in legislation, statutory guidance, CIW expectations, Social Care Wales guidance, inspection findings, safeguarding learning, complaints trends or service need.

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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