{{org_field_logo}}

{{org_field_name}}

Registration Number: {{org_field_registration_no}}

---

Pressure Ulcer Prevention and Management Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} provides a proactive and effective approach to the prevention, early identification, and management of pressure ulcers for individuals receiving domiciliary care. Pressure ulcers, also known as bedsores, can lead to serious complications if not managed properly. They are largely preventable through good skin care, mobility support, and appropriate intervention.

This policy ensures compliance with Care Inspectorate Wales (CIW) regulations, the Regulation and Inspection of Social Care (Wales) Act 2016​, and best practice guidelines from the National Institute for Health and Care Excellence (NICE) and the All Wales Tissue Viability Forum.

We are committed to:

• Preventing the development of pressure ulcers through early risk assessments and appropriate interventions.
• Providing prompt and effective care when pressure ulcers are identified.
• Training staff to recognise risk factors, implement preventative measures, and provide appropriate wound care.
• Collaborating with healthcare professionals to ensure service users receive the highest standard of care.

2. Scope

This policy applies to all employees at {{org_field_name}}, including care workers, team leaders, the registered manager, and any external healthcare professionals working with our service users.

It applies to all individuals receiving domiciliary care who are at risk of or have existing pressure ulcers, particularly those who are:

• Immobile or have limited movement.
• Bedbound or wheelchair-dependent.
• Elderly or frail with thin or delicate skin.
• Experiencing incontinence.
• Malnourished or have poor hydration.
• Living with chronic conditions such as diabetes or vascular disease.

3. Policy Statement

{{org_field_name}} is dedicated to delivering high-quality, person-centred care that prioritises the prevention of pressure ulcers through a structured risk assessment, prevention plan, and a responsive approach to managing existing wounds.

We ensure that our staff:

• Conduct thorough risk assessments to identify individuals at risk.
• Implement evidence-based preventative measures tailored to each individual’s needs.
• Recognise early warning signs of skin damage and escalate concerns promptly.
• Work closely with healthcare professionals to manage wounds effectively.
• Provide continuous training and support to ensure best practices are upheld.

4. Managing Pressure Ulcer Prevention and Treatment Efficiently

4.1. Risk Assessment and Identification

Risk assessment is the first step in preventing pressure ulcers. All service users will undergo an initial skin and pressure ulcer risk assessment upon commencement of care and regularly thereafter. The assessment will consider:

• Skin integrity – Checking for redness, skin breakdown, and other early signs of pressure damage.
• Mobility levels – Identifying individuals who are unable to reposition themselves.
• Nutritional status – Assessing for malnutrition or dehydration, which increases risk.
• Incontinence – Evaluating moisture-related skin damage.
• Use of medical equipment – Ensuring pressure points from catheters, oxygen masks, or splints are managed appropriately.

A validated risk assessment tool, such as the Waterlow Score or Braden Scale, will be used to document risk levels. Findings will be recorded in the Personal Care Plan and reviewed weekly or sooner if changes occur.

4.2. Preventative Measures

To reduce the risk of pressure ulcers, {{org_field_name}} implements the following preventative strategies:

Repositioning and Mobility Support

• Encouraging and assisting individuals to change position regularly (e.g., every two hours for bedbound individuals, every hour for those in wheelchairs).
• Using turning schedules for those who require assistance.
• Supporting service users with safe movement and transfers using appropriate aids.

Skin Care and Hygiene

• Keeping skin clean and dry, using pH-balanced cleansers rather than harsh soaps.
• Applying moisturising creams to maintain skin hydration and prevent dryness or cracking.
• Checking for signs of redness, swelling, or skin breakdown daily.

Pressure-Relieving Equipment

• Providing pressure-relieving cushions, mattresses, and overlays for high-risk individuals.
• Ensuring individuals are positioned correctly to avoid excess pressure on vulnerable areas (e.g., heels, sacrum, elbows).

Nutrition and Hydration

• Encouraging adequate fluid intake to maintain skin elasticity.
• Monitoring dietary intake to ensure individuals receive adequate protein, vitamins, and minerals for skin repair.
• Referring individuals to dietitians or speech and language therapists if there are swallowing or nutritional concerns.

4.3. Early Detection and Reporting

Care staff must closely monitor skin integrity and immediately report concerns to the Registered Manager and relevant healthcare professionals.

• Any sign of skin redness, blistering, or open wounds must be documented and escalated.
• Photos may be taken (with consent) to track progression and support clinical decisions.
• Affected areas must be kept clean, dry, and free from additional pressure while awaiting further medical advice.

4.4. Pressure Ulcer Management and Wound Care

If a pressure ulcer develops, prompt action is required:

• Severity grading using the European Pressure Ulcer Classification System (Stage 1–4).
• Referral to a GP, district nurse, or tissue viability specialist for further assessment and wound care planning.
• Application of appropriate dressings as per healthcare professional recommendations.
• Pain management to ensure comfort and quality of life.
• Close monitoring and review of the ulcer daily until healing is observed.

4.5. Collaboration with Healthcare Professionals

We work in close partnership with NHS professionals to ensure effective pressure ulcer management, including:

• District nurses for advanced wound care and dressing changes.
• Tissue viability nurses for specialist support and complex cases.
• Physiotherapists and occupational therapists for mobility and equipment recommendations.
• GPs and dietitians for medical management and nutritional advice.

All interventions and changes to the care plan will be documented and communicated to relevant parties.

4.6. Staff Training and Competency

All care staff will receive comprehensive training on pressure ulcer prevention and management, including:

• Understanding risk factors and early warning signs.
• Correct repositioning techniques and use of equipment.
• Skin care best practices to maintain integrity.
• Reporting procedures and escalation protocols.
• Application of non-invasive dressings and first aid where applicable.

Training will be mandatory for all staff upon induction and refreshed annually. Competency assessments will be carried out to ensure staff follow best practices.

4.7. Documentation and Record Keeping

Accurate record-keeping is vital for effective prevention and management. Staff must document:

• Risk assessments and reviews.
• Daily skin checks and observations.
• Repositioning schedules and interventions.
• Wound care provided and professional advice received.

All records must be kept up to date, confidential, and accessible for audits and CIW inspections.

5. Related Policies

This policy aligns with the following:

• Safe Care and Treatment Policy (DCW11) – Covers risk assessment and prevention.
• Infection Prevention and Control Policy (DCW17) – Ensures wound care hygiene.
• Medication Management and Administration Policy (DCW21) – Includes pain relief considerations.
• Nutritional and Hydration Needs Policy (DCW12) – Addresses dietary risk factors.

6. Policy Review

This policy will be reviewed annually or sooner if required due to legislation changes, regulatory updates, or incidents requiring improvement.

---

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}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.