DCW64-Catheter Care Policy
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Registration Number: {{org_field_registration_no}}
Catheter Care Policy
1. Purpose
The purpose of this policy is to ensure that {{org_field_name}} provides safe, dignified, and effective catheter care for service users requiring catheterisation as part of their care plan. This policy outlines how our organisation meets Care Inspectorate Wales (CIW) regulations, best practice guidelines, and infection prevention standards to promote comfort, maintain hygiene, and prevent catheter-related complications.
Our objectives are to:
- Ensure safe and appropriate catheter care to reduce the risk of infections and complications.
- Support service users’ dignity, privacy, and independence while managing catheters.
- Ensure staff are trained in catheter care best practices, including infection control.
- Monitor catheter use regularly and escalate any concerns to healthcare professionals.
- Work collaboratively with district nurses, GPs, and other healthcare providers.
2. Scope
This policy applies to:
- Service users with urinary catheters receiving domiciliary care from {{org_field_name}}.
- Care workers, supervisors, and administrative staff responsible for supporting catheter care.
- The Registered Manager and Responsible Individual, ensuring policy implementation and compliance.
- Healthcare professionals, including district nurses and urology specialists.
- Families and carers involved in catheter care planning and support.
3. Legal and Regulatory Framework
This policy has regard to the Welsh Government statutory guidance for care home and domiciliary support service providers and responsible individuals (Version 3 – March 2024) and is written to support compliance with the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017 (as amended).
In particular, this policy supports compliance with requirements relating to:
- Hygiene and infection control (including disposal of general and clinical waste).
- Health and safety risk management in the delivery of care and support.
- Accurate record keeping relevant to care and support delivered.
- Notifications to CIW where required (e.g., serious injury/accident, infectious disease outbreak, police involvement).
- Duty of candour (openness and transparency when things go wrong).
- Staff training, supervision, and competency for any catheter-related support provided.
This policy should be read alongside our confidentiality/data protection arrangements (UK GDPR / Data Protection Act 2018) and our safeguarding duties under the Social Services and Well-being (Wales) Act 2014.
4. Types of Catheters Supported
4.1 Indwelling (Foley) Catheters
A tube inserted into the bladder via the urethra or abdomen (suprapubic) to drain urine continuously.
4.2 Intermittent Catheters
A temporary catheter inserted at intervals to empty the bladder before removal.
4.3 Suprapubic Catheters
A catheter inserted through a small abdominal incision for long-term bladder drainage.
5. Initial Assessment and Individualised Care Planning
Upon admission, each service user requiring catheter care will have a detailed assessment and an individualised care plan developed in collaboration with healthcare professionals.
5.1 Catheter Care Plan Includes:
- Reason for catheterisation and type of catheter used.
- Frequency of catheter changes and required healthcare support.
- Specific hygiene, positioning, and fluid intake needs.
- Signs of infection or complications to monitor.
- Emergency procedures for catheter blockages, leaks, or dislodgements.
How we manage this efficiently:
- Digital records store catheter care plans, ensuring real-time updates for care staff.
- Regular care plan reviews with district nurses to adjust care as needed.
- A named key worker ensures consistent care and communication with healthcare teams.
5.2 Consent, Capacity and Best-Interest Decision-Making
Catheter care involves intimate personal care. Staff must explain what they are going to do, check the individual’s understanding, and obtain the individual’s consent before providing catheter-related support. Consent (or a refusal) must be respected and recorded in the daily notes.
Where there is reason to doubt an individual’s capacity to consent to catheter-related care at the time it is needed, staff must escalate to a supervisor/manager and follow the principles of the Mental Capacity Act 2005, ensuring any act is in the person’s best interests and is the least restrictive option. Where lawful authority is required (e.g., deprivation of liberty concerns), this must be pursued through the appropriate routes and recorded in the care plan.
Information and explanations must be provided in the individual’s preferred language/format and with communication support where needed.
5.3 Delegated Healthcare Tasks and Professional Boundaries
Care staff do not insert, remove, replace, flush/irrigate, or clinically adjust urinary catheters unless a suitably qualified healthcare professional has formally delegated the task, confirmed the individual’s plan of care, and the staff member has been assessed as trained and competent for that specific task for that individual.
Where catheter changes or clinical interventions are required, staff must refer promptly to the district nurse/GP/urology service as set out in the care plan and record the action taken.
6. Infection Prevention and Control in Catheter Care
6.1 Hand Hygiene and Personal Protective Equipment (PPE)
- Staff must perform hand hygiene in line with our Infection Prevention and Control Policy and current national guidance, using soap and water or alcohol hand rub as appropriate before and after any catheter-related contact and after glove removal.
- Gloves and aprons must be worn during catheter-related procedures.
- All PPE must be disposed of properly after use.
6.2 Catheter Hygiene and Cleaning Protocols
- Daily hygiene around the catheter site, using warm water and a clean cloth.
- Avoid using antiseptic solutions unless directed by a healthcare professional.
- Ensure the catheter bag is emptied regularly and changed as per the service user’s care plan.
How we manage this efficiently:
- Regular catheter care checklists ensure staff follow infection control measures.
- Training on catheter-associated urinary tract infection (CAUTI) prevention is mandatory for care staff.
6.3 Clinical Waste, Spillages and Decontamination
Catheter care must be delivered in a way that prevents infection and the spread of infection. Staff must follow the service’s arrangements for:
- the safe handling and disposal of clinical waste (including used drainage bags/valves where these are classified as clinical waste in the individual’s arrangements),
- dealing with spillages of urine safely and promptly, and
- ensuring any reusable equipment used (e.g., measuring containers if used) is cleaned and decontaminated after each use in line with manufacturer instructions and our IPC procedures.
Where the individual has specific clinical waste arrangements in the home (e.g., local authority collection, designated bags/bins), these must be followed and recorded in the care plan.
7. Catheter Bag and Drainage System Management
7.1 Positioning and Securing the Catheter Bag
- Ensure the drainage bag is positioned below bladder level to prevent backflow.
- Use leg straps or stat-lock devices to secure the catheter tubing and avoid pulling.
7.2 Emptying the Catheter Bag
- Empty the drainage bag as set out in the individual’s care plan and before it becomes overly full/heavy to reduce pull on the catheter and reduce backflow risk.
- Use a clean, dedicated container for that individual (or single-use container where available) to avoid contamination. Any reusable container must be cleaned and dried after use in line with IPC procedures.
- Avoid touching the drainage outlet to the container. If accidental contamination occurs, escalate and follow IPC actions as per DCW22.
How we manage this efficiently:
- Staff complete catheter care logs, monitoring fluid balance and urinary health.
- Immediate escalation of concerns to the district nurse or GP.
8. Recognising and Responding to Catheter Complications
8.1 Signs of Catheter-Associated Urinary Tract Infection (CAUTI)
- Cloudy, foul-smelling urine.
- Pain or burning around the catheter site.
- Fever, chills, or lower back pain.
- Reduced urine output or blockage.
8.2 Responding to Catheter Emergencies
- Catheter Blockage: Encourage hydration, check for kinks, and escalate to a healthcare professional.
- Leakage or Bypassing: Ensure correct positioning and securement, and report persistent leakage.
- Dislodgement or Accidental Removal: Contact the district nurse immediately for reinsertion.
How we manage this efficiently:
- All catheter issues are documented and escalated appropriately.
- Emergency catheter protocols are included in all care plans.
8.3 Reporting, Duty of Candour and CIW Notifications
All catheter-related concerns, actions taken, and professional advice received must be recorded contemporaneously in the daily notes and (where used) the catheter care log. Records must be complete, accurate and stored in line with organisational record-keeping requirements.
Where something goes wrong and the individual experiences (or is exposed to a significant risk of) harm or distress, the service will act with openness and transparency, including providing an explanation, sharing outcomes of any review/investigation, and offering an apology where appropriate, in line with our duty of candour arrangements.
The Registered Manager/Responsible Individual must consider whether the event meets CIW notification requirements and ensure notifications are made without delay where required (for example serious accident or injury, outbreak of infectious disease, incident reported to the police, or events that could prevent the service being provided safely).
9. Promoting Service User Comfort and Dignity
9.1 Supporting Independence
- Encourage service users to participate in their catheter care, where possible.
- Provide privacy and respect personal dignity during catheter care procedures.
- Use discreet collection bags and clothing adaptations for comfort and confidence.
9.2 Maintaining Hydration and Bladder Health
- Encourage fluid intake (unless medically contraindicated) to prevent infections.
- Monitor bowel movements, as constipation can cause catheter discomfort.
How we manage this efficiently:
- Personalised hydration plans are integrated into care plans.
- Nutrition and hydration support is provided where needed.
10. Staff Training and Competency in Catheter Care
10.1 Mandatory Training Includes:
- Types of catheters and their functions.
- Correct techniques for catheter hygiene and bag management.
- Recognising and responding to catheter-related complications.
- Infection control measures to prevent CAUTI.
- Consent, privacy and dignity in intimate care.
- Mental Capacity Act principles and best-interest decision-making as relevant to catheter care.
- Record keeping standards for catheter care logs and daily notes.
- Duty of candour expectations and escalation routes when things go wrong.
- Infection control requirements specific to catheter care, including clinical waste/spillage management.
10.2 Competency Assessments
- All staff must demonstrate catheter care competency before providing direct support.
- Annual refresher training ensures staff stay updated on best practices.
How we manage this efficiently:
- A designated catheter care trainer oversees staff competency assessments.
- Regular audits and spot checks ensure compliance with best practices.
11. Multi-Agency Collaboration
- Care staff coordinate with district nurses and GPs for catheter changes and medical oversight.
- Any concerns regarding catheter use are escalated through agreed referral pathways.
- Regular multi-disciplinary meetings ensure service users receive holistic support.
12. Related Policies
This policy aligns with:
- Infection Prevention and Control Policy (DCW22).
- Medication Management Policy (DCW21).
- Dignity and Personal Care Policy (DCW07).
- Risk Management and Assessment Policy (DCW18).
13. Policy Review
This policy will be reviewed annually or sooner if required due to legislative changes, business needs, or CIW updates. Where changes are made that directly affect individuals and/or their representatives, we will communicate these changes in a timely way and make the updated policy available on request in an accessible format. The Registered Manager and Responsible Individual are responsible for ensuring compliance.
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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