DC134-Self-Care, Wellbeing, and Personal Treatment Policy

Registration Number: {{org_field_registration_no}}

Self-Care, Wellbeing, and Personal Treatment Policy

1. Introduction

Our domiciliary care company is committed to promoting self-care, wellbeing, independence and safe personal treatment for people receiving domiciliary care and support. This policy supports compliance with the Health and Social Care Act 2008, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, CQC Fundamental Standards and CQC’s current assessment framework. It applies to the planning, delivery, review and monitoring of care and support in people’s own homes and must be implemented in a way that protects people’s rights, dignity, privacy, choice, safety and autonomy.

Self-care and wellbeing are essential aspects of delivering compassionate, person-centred care. It involves empowering service users to manage their own health, maintain independence, and enjoy the highest possible quality of life. Our approach is designed to promote choice, dignity, and respect while ensuring safety and effective care delivery.

Self-care must never be used as a reason to withdraw necessary support, ignore risk, or place responsibility on a service user where they are unable or unwilling to manage without support. Staff must balance independence with safety, consent, capacity, safeguarding duties, clinical advice, assessed needs and the person’s own wishes. Where a person chooses to take risks, staff must follow the organisation’s risk assessment, mental capacity, safeguarding and recording procedures.

2. Purpose of the Policy

The purpose of this policy is to:

Ensure service users receive personalised care that promotes self-care and wellbeing.
Foster a supportive environment for staff wellbeing.
Promote person-centred approaches that respect dignity, privacy, and choice.
Encourage preventative health practices and early interventions.
Comply with CQC regulations, including Regulation 9 on person-centred care, Regulation 10 on dignity and respect, and Regulation 12 on safe care and treatment.
Ensure care and support is provided only with valid consent, or where the person lacks capacity, in accordance with the Mental Capacity Act 2005 and best interests decision-making.
Ensure staff understand when wellbeing concerns may indicate abuse, neglect, self-neglect, deterioration, mental health crisis or unsafe care, and know how to escalate concerns promptly.
Ensure nutrition, hydration, medicines support, personal care, mobility, skin integrity, infection prevention and emotional wellbeing are considered as part of safe, holistic care planning.
Ensure records provide clear evidence of assessment, consent, care delivery, reviews, risk management, escalation, outcomes and learning.
Support compliance with CQC’s current quality statements under the Safe, Effective, Caring, Responsive and Well-led key questions.

3. Scope of the Policy

This policy applies to:

All service users receiving care and support from the company.
All staff, including carers, management, and support staff.
Any third-party professionals involved in the delivery of care.

In domiciliary care, this policy applies to all care and support delivered in a person’s own home, including support with personal care, continence, mobility, nutrition and hydration, medicines where included in the care plan, emotional wellbeing, communication, social inclusion, appointment support, and monitoring of changes in health or welfare. Where another professional, family member, advocate, attorney, deputy or unpaid carer is involved, staff must work collaboratively while maintaining confidentiality, consent, safeguarding and professional boundaries.

4. Principles of Self-Care and Wellbeing

We adopt the following principles to guide our care practices:

4.1 Person-Centred Approach

Self-care and wellbeing start with understanding each service user as an individual. Before care begins, and whenever needs change, the organisation will complete and record a person-centred assessment covering the person’s needs, preferences, strengths, abilities, communication needs, cultural and religious needs, protected characteristics, daily routines, risks, goals and desired outcomes. Care plans will be developed with the service user and, where appropriate and lawful, their representative, family, advocate, attorney, deputy or involved professionals. Staff must support the person to participate in decisions as much as they wish and are able to do, provide information in a format they can understand, make reasonable adjustments where required, and record how the person’s choices and preferences have shaped the care plan.

4.2 Holistic Wellbeing

Wellbeing extends beyond physical health to include emotional resilience, social connections, and mental health. Our approach ensures that care plans address all aspects of wellbeing, including:

Physical Wellbeing: Encouraging regular exercise, balanced nutrition, and access to healthcare services.
Emotional Wellbeing: Providing emotional support, companionship, and activities that promote happiness and reduce stress.
Social Wellbeing: Facilitating community engagement, social activities, and maintaining relationships with family and friends.

4.3 Prevention and Early Intervention

Proactive health management reduces the risk of deterioration and promotes long-term wellbeing. We support service users in adopting healthy lifestyles, attending regular health checks, and identifying potential health issues early. Staff are trained to recognise early signs of physical or mental health decline and take appropriate action.

4.4 Respect for Dignity and Autonomy

Respecting the dignity and autonomy of service users is at the core of our care delivery. This includes:

Respecting personal choices, preferences, and cultural values.
Ensuring privacy during personal care and consultations.
Empowering service users to make informed decisions about their care.

4.5 Consent, Mental Capacity and Best Interests

Staff must not provide care or treatment unless the service user has given valid consent, or unless there is a lawful basis to act where the person lacks capacity. Consent must be specific, informed, voluntary and recorded where appropriate. Service users have the right to refuse care, support, food, fluids, medication assistance, equipment, appointments or other interventions, even where refusal may increase risk, provided they have capacity to make that decision.

Where there is reason to doubt a person’s capacity to make a specific decision at the time it needs to be made, staff must follow the Mental Capacity Act 2005 and the organisation’s Mental Capacity and Consent Policy. Capacity must be assessed decision-by-decision and time-by-time. Staff must not assume lack of capacity because of age, disability, diagnosis, communication needs, lifestyle choices, mental health condition, learning disability, dementia, substance use or an unwise decision.

Where a person lacks capacity for a specific decision, any act or decision made on their behalf must be in their best interests, be the least restrictive option, involve relevant people where appropriate, and be clearly recorded. Any attorney, deputy, advocate or representative must be consulted according to their lawful authority and the person’s known wishes, feelings, beliefs and values.

4.6 Equality, Human Rights and Reasonable Adjustments

Care and support must be delivered in a way that respects the person’s human rights and protected characteristics, including age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation. Staff must not discriminate, stereotype, make assumptions or impose personal values. Reasonable adjustments must be made where a person needs support to access care, understand information, communicate choices, participate in reviews, maintain independence or receive safe care.

Staff must consider communication needs, sensory needs, cultural identity, religious practice, diet, modesty, gender preferences for personal care, preferred name and pronouns, family relationships and community involvement. Any adjustment agreed must be recorded in the care plan and communicated to relevant staff.

5. Self-Care and Wellbeing for Service Users

Promoting self-care involves equipping service users with the knowledge, skills, and confidence to manage their health effectively. Our approach includes:

5.1 Promoting Independence

We encourage service users to remain as independent as possible. This includes supporting daily living activities, such as dressing, cooking, and personal hygiene, while providing assistance only where necessary.

Where equipment, adaptations or technology may support safe independence, staff will identify this through assessment and review, record the need, and either provide items within the organisation’s responsibility or refer/signpost to the appropriate professional, commissioner, occupational therapy service, local authority, equipment provider or health professional. Staff must not use equipment unless it is suitable, safe, clean, maintained where applicable, included in the care plan and staff have been trained or instructed in its correct use.

5.2 Health Promotion

We educate service users about healthy lifestyles, including balanced nutrition, regular exercise, and mental wellbeing. This includes:

Facilitating access to health screenings and vaccinations.
Providing guidance on managing long-term conditions, such as diabetes or arthritis.
Supporting adherence to prescribed treatments and medication management.

Any support with medicines must be provided only where it is included in the assessment and care plan and in accordance with the organisation’s Medication Policy, prescriber instructions, pharmacy labels and relevant professional guidance. Staff must not advise service users to start, stop, increase, reduce or change prescribed or over-the-counter medicines unless directed by an appropriate healthcare professional. Any medicines concerns, missed doses, refusal, side effects, errors or changes in the person’s ability to manage medicines must be reported and recorded promptly.

5.3 Mental Health and Emotional Wellbeing

Mental wellbeing is essential for overall health. We provide:

Regular wellbeing check-ins to discuss concerns and emotions.
Access to counselling or mental health support if needed.
Activities that promote mental stimulation, such as puzzles, reading, and hobbies.

Staff must be alert to signs of emotional distress, social isolation, anxiety, depression, confusion, delirium, cognitive decline, suicidal thoughts, self-neglect, domestic abuse, coercion, substance misuse or deterioration in mental health. Concerns must be recorded and escalated to the registered manager or nominated senior person without delay. Where there is immediate risk of serious harm, staff must seek urgent assistance in line with emergency, safeguarding and escalation procedures. Where appropriate and with consent, staff will support access to the GP, community mental health services, crisis services, social prescriber, advocate, local authority, safeguarding team or emergency services.

5.4 Nutrition and Hydration

Meeting nutritional and hydration needs is a fundamental part of safe and effective care. Where the organisation provides or supports nutrition and hydration, the person’s needs, preferences, cultural requirements, religious requirements, allergies, intolerances, swallowing needs, diabetes needs, texture-modified diet requirements, fluid requirements, food safety needs and support level must be assessed and recorded in the care plan.

Staff must support service users to eat and drink in a way that promotes dignity, choice and independence. This may include prompting, preparing meals and drinks, assisting with eating and drinking, monitoring intake where required, supporting prescribed nutritional supplements, and encouraging access to preferred foods and fluids.

Staff must report and record concerns such as poor appetite, weight loss, dehydration, coughing or choking when eating or drinking, swallowing difficulties, repeated refusal of food or fluids, vomiting, diarrhoea, constipation, confusion, dizziness, signs of malnutrition, unsafe food storage or inability to access food. Where required, the registered manager or senior staff member will seek advice from the GP, dietitian, speech and language therapist, district nurse, pharmacist, commissioner or safeguarding team.

Where nutrition or hydration monitoring is part of the care plan, records must be accurate, completed at the time of care, reviewed regularly and escalated if intake falls below the agreed level or concerns arise.

5.5 Personal Care, Dignity and Privacy

Personal care must be delivered in a way that protects dignity, privacy, comfort, choice and safety. Staff must explain what they are doing, seek consent before each care task, respect the person’s preferred routine, maintain privacy during washing, dressing, toileting, continence care and intimate care, and use the person’s preferred name and communication method.

Staff must respect preferences about gender of care worker where reasonably practicable and recorded in the care plan. Staff must promote independence by encouraging the person to do what they can safely do for themselves and providing support only where needed. Any refusal of personal care, change in skin condition, continence concern, pain, discomfort, bruising, pressure damage, infection risk, distress or environmental concern must be recorded and escalated.

5.6 Safe Care, Risk and Deterioration

Promoting self-care must be balanced with safe care and treatment. Risk assessments must be completed, reviewed and updated for areas relevant to the person, which may include falls, mobility, moving and handling, medicines, nutrition and hydration, choking, skin integrity, infection prevention and control, fire safety, home environment, equipment, lone working, behaviours that may distress or challenge, self-neglect, mental health, domestic abuse and safeguarding.

Staff must monitor for changes in presentation, health, behaviour, mood, mobility, communication, appetite, fluid intake, skin condition, continence, pain, medication management, cognition, home environment and ability to manage daily living tasks. Any deterioration or new risk must be recorded and escalated promptly so that the care plan can be reviewed and appropriate professional advice obtained.

5.7 Safeguarding, Abuse, Neglect and Self-Neglect

Staff must understand that concerns about wellbeing may indicate abuse, neglect, self-neglect, domestic abuse, exploitation, coercive control, discrimination, organisational abuse, financial abuse, psychological abuse, physical abuse, sexual abuse or unsafe care. Staff must report safeguarding concerns immediately in line with the Safeguarding Adults Policy and local authority safeguarding procedures.

Staff must not investigate safeguarding concerns themselves unless asked to do so by the registered manager or safeguarding authority as part of an agreed process. The priority is to protect the person, preserve evidence where relevant, record factual information, escalate concerns and obtain urgent help where there is immediate risk. Where a person has capacity and declines safeguarding support, staff must still seek advice where others may be at risk, there is coercion or undue influence, a crime may have occurred, or the level of risk is serious.

6. Self-Care and Wellbeing for Staff

Staff wellbeing directly impacts the quality of care provided. Staff wellbeing is managed as part of safe staffing and good governance. The organisation will take reasonable steps to ensure staff are competent, supported, supervised and able to raise concerns. Staff must inform their line manager if their physical or mental wellbeing, fatigue, stress, health condition, medication, personal circumstances or workload may affect their ability to provide safe care. Managers will respond proportionately, confidentially and in line with employment, health and safety, equality and safeguarding responsibilities.

We prioritise staff health through:

6.1 Health and Safety

Conducting regular risk assessments.
Providing personal protective equipment (PPE) and ergonomic tools.

6.2 Mental Health Support

Offering access to counselling and employee assistance programmes.
Encouraging open communication and peer support.

6.3 Work-Life Balance

Providing flexible working arrangements where possible.
Ensuring adequate rest breaks and manageable workloads.

6.4 Training and Development

Staff will receive induction, mandatory training, role-specific training, competency checks, supervision and refresher training appropriate to their role, responsibilities and the needs of service users. Training will include, as applicable, person-centred care, dignity and respect, consent and mental capacity, safeguarding adults, medication support, nutrition and hydration, infection prevention and control, moving and handling, health and safety, fire safety, equality and diversity, record keeping, information governance, complaints, duty of candour, recognising deterioration, dementia awareness, mental health awareness, and learning disability and autism.

In line with the Health and Care Act 2022 requirement, staff working for the purpose of regulated activities must receive learning disability and autism training appropriate to their role. The organisation will have regard to the Oliver McGowan Code of Practice and will record training completion, role relevance, refresher requirements and any reasonable adjustments needed for staff learning.

7. Monitoring and Evaluation

Effective implementation requires regular monitoring and evaluation:

7.1 Care Plan Reviews

Care plans, risk assessments and wellbeing outcomes will be reviewed at least quarterly, or sooner where the person’s needs, preferences, risks, capacity, health, medication, environment, support arrangements or circumstances change. Reviews will also take place following incidents, accidents, safeguarding concerns, complaints, hospital admission or discharge, professional advice, repeated refusals of care, evidence of deterioration, or concerns raised by the service user, family, advocate, staff member, commissioner or professional.

Reviews must involve the service user as much as they wish and are able to be involved. Where appropriate and lawful, representatives, family members, advocates, attorneys, deputies, commissioners and professionals may also be involved. The review must record what has changed, what the person wants to achieve, any decisions made, actions agreed, responsible persons and timescales.

7.2 Staff Wellbeing Surveys

Annual staff surveys assess wellbeing and job satisfaction.
Results inform initiatives to improve working conditions.

7.3 Incident, Accidents, Concerns and Learning

Any incident, accident, near miss, safeguarding concern, medication concern, missed or late visit, deterioration, refusal of care, complaint, infection risk, equipment concern, environmental risk, injury, pressure damage, choking risk, nutrition or hydration concern, or other matter affecting wellbeing or safety must be reported, recorded, reviewed and acted on promptly.

The registered manager or nominated senior person will ensure appropriate action is taken to protect the person, notify relevant people or authorities where required, update risk assessments and care plans, share learning with staff, and monitor whether actions have been completed and embedded. Lessons learned will be used to improve practice, training, supervision, staffing and care planning.

7.4 Complaints, Feedback and Concerns

Service users, families, advocates, staff and professionals must be encouraged to raise concerns, complaints, compliments and suggestions about self-care, wellbeing or personal treatment. Information about how to complain will be provided in an accessible format. Complaints will be acknowledged, investigated and responded to in line with the organisation’s Complaints Policy.

The organisation will use complaints and feedback to identify themes, improve care, reduce risk and strengthen service user experience. No person will be treated less favourably because they have raised a concern or complaint.

7.5 Duty of Candour

The organisation will act in an open, honest and transparent way when things go wrong. Where a notifiable safety incident occurs, the registered manager or authorised senior person will follow the Duty of Candour Policy, provide a truthful explanation, offer an apology, explain what further enquiries or actions will take place, keep appropriate records, and provide written follow-up where required. Staff must report incidents promptly so the organisation can meet its legal and regulatory responsibilities.

7.6 Records and Evidence of Good Care

Staff must keep accurate, complete, contemporaneous and factual records of care delivered, choices made, consent, refusals, wellbeing concerns, risks, actions taken, escalation, professional advice, family or representative contact, and outcomes. Records must show how care is person-centred, safe, dignified and responsive to the person’s needs and preferences.

Records must be stored securely and handled in accordance with confidentiality, the Data Protection Act 2018, UK GDPR and the organisation’s Record Keeping and Data Protection policies. Staff must not record personal opinions, blame, assumptions or discriminatory language.

8. Roles and Responsibilities

8.1 Provider and Registered Manager

The provider and registered manager are responsible for ensuring this policy is implemented, monitored and reviewed. They must ensure care is person-centred, safe, dignified, lawful and responsive; staff are trained and competent; risks are assessed and managed; records are accurate; concerns are escalated; and lessons are learned from incidents, complaints, safeguarding concerns, audits and feedback.

8.2 Management Team and Senior Staff

The management team and senior staff must support staff to apply this policy in practice, complete assessments and reviews, respond to changing needs, seek professional advice where required, monitor care records, complete audits, act on concerns and ensure agreed actions are followed up.

8.3 Care Staff

Care staff must promote independence, wellbeing, dignity, privacy, choice and safety during every care visit. They must follow the care plan, seek consent, respect refusals, encourage self-care where appropriate, identify and report changes or concerns, complete accurate records, maintain confidentiality and escalate any risk, safeguarding concern or deterioration promptly.

8.4 Service Users

Service users will be supported to participate in assessments, care planning, reviews and decisions about their care as much as they wish and are able to do so. They will be encouraged to express their preferences, goals, concerns and feedback.

8.5 Families, Representatives, Advocates and Professionals

Families, representatives, advocates and professionals may be involved where the service user consents, where they have lawful authority, where involvement is in the person’s best interests, or where safeguarding or legal duties require involvement. Staff must respect confidentiality and ensure that decisions are made by the person or by someone with lawful authority.

9. Legal and Regulatory Framework

This policy supports compliance with, and must be read in conjunction with, the following legislation, regulations and guidance:

Health and Social Care Act 2008.
Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, 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 14 Meeting nutritional and hydration needs, Regulation 16 Receiving and acting on complaints, Regulation 17 Good governance, Regulation 18 Staffing, Regulation 19 Fit and proper persons employed, Regulation 20 Duty of candour and Regulation 20A Display of performance assessments where applicable.
Care Quality Commission (Registration) Regulations 2009, including statutory notification requirements.
CQC Fundamental Standards and CQC guidance for providers and registered managers.
CQC assessment framework, including the Safe, Effective, Caring, Responsive and Well-led key questions and relevant quality statements.
Mental Capacity Act 2005 and associated Code of Practice.
Care Act 2014, including wellbeing and safeguarding duties.
Equality Act 2010.
Human Rights Act 1998.
Health and Safety at Work etc. Act 1974.
Management of Health and Safety at Work Regulations 1999.
Data Protection Act 2018 and UK GDPR.
Health and Care Act 2022, including the requirement for role-appropriate learning disability and autism training.
The Oliver McGowan Code of Practice on statutory learning disability and autism training.
Relevant NICE, UKHSA, Department of Health and Social Care, Skills for Care, local authority safeguarding and commissioner guidance, where applicable.

10. Training and Awareness

All staff will receive training and guidance appropriate to their role so they can promote self-care, wellbeing and safe personal treatment. Training will include person-centred care, dignity and respect, consent and mental capacity, safeguarding, equality and diversity, health and safety, infection prevention and control, nutrition and hydration, moving and handling, medication support where applicable, recognising deterioration, mental health awareness, dementia awareness where relevant, record keeping, complaints, duty of candour and information governance.

Staff must also receive learning disability and autism training appropriate to their role in accordance with the Health and Care Act 2022 requirement and the Oliver McGowan Code of Practice. Training completion, competency checks, supervision, spot checks and refresher training will be recorded and monitored. Where a staff member requires additional support, supervision or competency assessment, this will be arranged before they undertake tasks beyond their competence.

11. Review and Continuous Improvement

This policy will be reviewed annually or sooner where there are changes in legislation, CQC guidance, statutory guidance, best practice, commissioner requirements, organisational learning, safeguarding themes, complaints, incidents, audits or service user feedback.

The registered manager will monitor implementation through care plan audits, daily record audits, medication and nutrition audits where applicable, incident and complaint reviews, supervision, spot checks, staff feedback, service user feedback and quality assurance systems. Findings will be used to improve care planning, staff training, risk management, communication, policies and service delivery.

12. Conclusion

Our commitment to self-care, wellbeing, and personal treatment ensures that service users receive high-quality, person-centred care while staff remain supported and motivated. By embedding these principles into daily practice, we uphold our values and meet regulatory requirements effectively.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
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