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Stoma Care and Management Policy

1. Purpose and Commitment

The purpose of this policy is to outline how {{org_field_name}} ensures safe, effective, and compassionate stoma care for service users. Stoma care involves managing an artificial opening in the body, often created during surgery to divert waste from the digestive or urinary system. This policy ensures that all staff provide high-quality, person-centred stoma care while maintaining the dignity, comfort, and independence of service users.

Our commitment is to deliver stoma care that aligns with the Health and Social Care Act 2008, NICE guidelines, and the Care Quality Commission (CQC) standards. We prioritise service user safety, promote independence, and support emotional well-being by ensuring that staff are trained, competent, and equipped to manage stoma care effectively.

2. Scope

This policy applies to all employees, including care staff, administrative staff, volunteers, and contractors involved in stoma care. It covers:

• Daily stoma care and maintenance.
• Monitoring for complications and responding appropriately.
• Supporting service users’ physical and emotional well-being.
• Effective communication with healthcare professionals and families.

The policy applies to all domiciliary care settings where service users require stoma care as part of their care plan.

3. Policy Statement

Our domiciliary care company is committed to providing safe, respectful, and efficient stoma care. We ensure that all care is delivered by trained and competent staff who adhere to best practices. Our approach includes:

• Providing comprehensive staff training.
• Developing personalised care plans for each service user.
• Conducting regular risk assessments and monitoring for complications.
• Promoting service users’ dignity, independence, and quality of life.

4. Understanding Stoma Care

4.1 What is a Stoma? A stoma is a surgically created opening in the abdomen that allows waste to exit the body. Stomas are typically created for individuals with medical conditions affecting the digestive or urinary systems. There are three main types of stomas:

• Colostomy: Created from the large intestine to divert stool.
• Ileostomy: Created from the small intestine to divert stool.
• Urostomy: Created to divert urine from the urinary system.

4.2 Importance of Stoma Care Proper stoma care is essential to prevent complications such as infections, skin irritation, and leakage. Effective stoma management supports service users’ health, comfort, and confidence while promoting independence in daily activities.

5. Roles and Responsibilities

5.1 Care Staff Responsibilities All staff involved in stoma care must:

• Complete accredited stoma care training.
• Follow individualised care plans.
• Maintain strict infection prevention and control practices.
• Monitor for complications and report concerns immediately.
• Document all stoma care activities accurately.

5.2 Manager Responsibilities Managers are responsible for:

• Ensuring staff receive appropriate training and supervision.
• Conducting regular audits of stoma care practices.
• Reviewing care plans and risk assessments regularly.
• Addressing any issues identified during audits or staff feedback.

5.3 Service User and Family Responsibilities Service users and families are encouraged to:

• Participate in care planning and decision-making.
• Report any changes in the stoma site or health condition.
• Follow hygiene practices and care instructions.

6. Stoma Site Care and Hygiene

6.1 Daily Stoma Care To ensure stoma health and comfort, daily care includes:

• Washing hands thoroughly before and after care.
• Cleaning the stoma site with warm water and soft cloths.
• Inspecting the stoma for redness, swelling, or discharge.
• Drying the skin thoroughly before applying a new stoma appliance.

6.2 Infection Prevention Staff must adhere to infection control protocols, including:

• Using personal protective equipment (PPE) during stoma care.
• Maintaining a clean and sterile environment.
• Disposing of used appliances and waste appropriately.

7. Changing Stoma Appliances

7.1 Appliance Selection Stoma appliances should be selected based on individual needs, including skin type, stoma shape, and lifestyle. Options include:

• One-piece systems (combined bag and adhesive).
• Two-piece systems (separate bag and adhesive base).
• Drainable or closed-end pouches.

7.2 Changing Procedure Staff must follow these steps when changing stoma appliances:

1. Prepare all supplies and wash hands thoroughly.
2. Gently remove the old appliance, avoiding skin damage.
3. Clean the stoma site with warm water.
4. Inspect the skin for signs of irritation or infection.
5. Apply a barrier cream if necessary.
6. Fit the new appliance securely, ensuring a proper seal.

8. Monitoring and Managing Complications

8.1 Common Complications Staff must be vigilant for the following complications:

• Skin Irritation: Redness, soreness, or rash around the stoma site.
• Leakage: Appliance not fitting securely.
• Infection: Redness, swelling, or discharge.
• Prolapse: Stoma protruding more than usual.
• Blockage: Abdominal pain, nausea, or reduced output.

8.2 Responding to Complications If complications arise, staff must:

• Document observations and report concerns immediately.
• Follow the service user’s care plan for managing minor issues.
• Contact healthcare professionals for persistent or severe concerns.
• Support the service user emotionally while awaiting medical attention.

9. Supporting Service User Well-Being

9.1 Promoting Independence We encourage service users to participate in their own stoma care, promoting independence and confidence. Staff provide education and support, ensuring service users feel empowered to manage their stoma safely.

9.2 Emotional Support Living with a stoma can be challenging, both physically and emotionally. Our staff provide compassionate support by:

• Listening to concerns without judgment.
• Encouraging open communication about stoma-related challenges.
• Referring service users to support groups and counselling services if needed.

10. Training and Competency

10.1 Staff Training All staff involved in stoma care must complete:

• Accredited stoma care training courses.
• Regular refresher training.
• Competency assessments conducted by qualified trainers.

10.2 Competency Checks Managers will conduct regular competency checks, including:

• Observing stoma care procedures.
• Reviewing documentation practices.
• Providing feedback and additional training if needed.

11. Record-Keeping and Documentation

Accurate record-keeping is essential for safe stoma care. Staff must document:

• Daily stoma care activities.
• Appliance changes and supplies used.
• Any complications or concerns.
• Communication with healthcare professionals.

Records must be stored securely and accessible only to authorised personnel.

12. Communication and Collaboration

Effective communication ensures continuity of care. This includes:

• Regular updates to healthcare providers, including GPs and stoma nurses.
• Collaboration with dietitians and pharmacists if required.
• Clear communication with service users and families.
• Participating in multidisciplinary team meetings when needed.

13. Emergency Procedures

In case of an emergency, staff must:

• Stay calm and ensure the service user’s safety.
• Contact emergency services if there are signs of:
  • Severe pain or swelling.
  • Persistent bleeding from the stoma site.
  • Complete stoma blockage.
  • Appliance failure causing significant leakage.
• Follow the service user’s emergency care plan.

14. Supply Management and Storage

14.1 Ordering Supplies Stoma supplies should be ordered in advance to avoid shortages. Staff must:

• Monitor stock levels regularly.
• Ensure service users have sufficient supplies for daily care.
• Record all supply orders and deliveries.

14.2 Safe Storage Stoma supplies must be stored:

• In a clean, dry environment.
• Away from direct sunlight and moisture.
• In original packaging, clearly labelled.

15. Compliance and Review

This policy is reviewed annually or following any significant incident. Compliance is monitored through:

• Regular audits of stoma care practices.
• Staff feedback and incident reports.

Investigations following reported complications.

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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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