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Registration Number: {{org_field_registration_no}}

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Pain Assessment and Management Policy

1. Purpose

The purpose of this Pain Assessment and Management Policy is to ensure that all people we support at {{org_field_name}} receive timely, effective, and person-centred pain management. This policy sets out clear guidelines for identifying, assessing, and managing pain in a way that aligns with best practice, regulatory requirements, and the individual needs of those in our care.

This policy ensures compliance with:

• The Health and Social Care Standards (Scotland)
• The National Care Standards: Care at Home
• The Regulation of Care (Scotland) Act 2001
• The Scottish Palliative Care Guidelines
• The Scottish Pain Management Programme (SPMP)
• The Scottish Social Services Council (SSSC) Codes of Practice
• The Medicines Act 1968 and associated regulations on pain relief administration

Our goal is to improve quality of life, promote dignity, and reduce discomfort for individuals experiencing pain, whether acute, chronic, or related to palliative care needs.

2. Scope

This policy applies to:

• All employees involved in care provision, including carers, nurses, supervisors, and management.
• People we support who experience pain due to medical conditions, injury, or chronic illnesses.
• Family members and healthcare professionals involved in an individual’s care plan.

It covers:

• Pain assessment procedures
• Management strategies, including non-pharmacological and pharmacological interventions
• Medication administration and monitoring
• Training and support for staff
• Documentation and record-keeping

3. Responsibilities

Management Responsibilities

• Ensure effective pain assessment tools are available and used correctly by care staff.
• Provide ongoing training in pain management and assessment techniques.
• Monitor and review pain management practices regularly to ensure best practice compliance.
• Collaborate with healthcare professionals (e.g., GPs, pharmacists, and pain specialists) to provide holistic pain management.
• Ensure pain management is person-centred, considering individual preferences, communication abilities, and cultural needs.

Care Staff Responsibilities

• Recognise and assess pain effectively, using appropriate tools and observation techniques.
• Follow individual care plans for pain management and escalate concerns if pain is not well controlled.
• Administer medication safely and accurately, following legal and regulatory guidelines.
• Monitor and document responses to pain relief strategies and adjust interventions accordingly.
• Use non-medication pain management techniques where appropriate.
• Communicate effectively with healthcare professionals, families, and the person experiencing pain.

People We Support and Their Families

• Participate in pain assessment discussions and communicate preferences for pain management.
• Report any changes in pain levels to care staff promptly.
• Support non-medical pain management strategies, such as lifestyle changes and relaxation techniques.

4. Pain Assessment Process

4.1 Recognising Pain

Pain can be physical, psychological, or emotional, and some individuals may struggle to express their discomfort due to cognitive impairments, communication difficulties, or neurological conditions.
Staff must recognise verbal and non-verbal signs of pain, including:

• Verbal expressions: Complaints of pain, moaning, crying, or requests for pain relief.
• Facial expressions: Grimacing, frowning, or clenched teeth.
• Behavioural changes: Restlessness, aggression, withdrawal, or difficulty sleeping.
• Physical symptoms: Increased heart rate, sweating, tension, or changes in mobility.

4.2 Pain Assessment Tools

At {{org_field_name}}, we use validated pain assessment tools to ensure consistency and accuracy, including:

• Numeric Rating Scale (NRS) – A 0-10 scale where individuals rate their pain from ‘no pain’ (0) to ‘worst pain imaginable’ (10).
• Verbal Descriptor Scale (VDS) – Uses words like ‘mild’, ‘moderate’, or ‘severe’ to describe pain.
• Faces Pain Scale (FPS-R) – A pictorial tool useful for individuals with cognitive impairments.
• Abbey Pain Scale – Designed for non-verbal individuals, including those with advanced dementia.
• PAINAD (Pain Assessment in Advanced Dementia) – Helps identify pain levels in people who cannot communicate verbally.

Pain assessments must be recorded in care plans and reviewed regularly.

5. Pain Management Strategies

5.1 Non-Pharmacological Pain Management

Pain relief is not solely reliant on medication. Staff at {{org_field_name}} are trained to provide alternative pain management techniques, including:

• Positioning and mobility support – Ensuring comfort and reducing pressure on painful areas.
• Heat and cold therapy – Applying warm compresses or ice packs as appropriate.
• Massage and relaxation techniques – Encouraging gentle touch therapy where suitable.
• Distraction techniques – Engaging in meaningful activities, music, or storytelling.
• Psychological support – Providing emotional reassurance, mindfulness, and breathing exercises.

These interventions are tailored to individual needs and preferences.

5.2 Pharmacological Pain Management

For individuals requiring medication-based pain relief, care staff follow strict medicines management protocols. This includes:

• Following prescribed pain relief regimens, ensuring correct dosages and administration times.
• Monitoring for side effects such as drowsiness, nausea, constipation, or confusion.
• Using PRN (as-needed) medications appropriately, based on assessed pain levels.
• Escalating concerns to a GP or prescribing professional if pain is uncontrolled.
• Following storage and disposal regulations for controlled drugs and opioid pain relief.

Pain relief may include:

• Mild pain relief (e.g., Paracetamol)
• Moderate pain relief (e.g., Codeine)
• Strong pain relief (e.g., Morphine, Fentanyl patches for palliative care)

6. Palliative and End-of-Life Pain Management

Pain control is a key priority for individuals receiving palliative care. {{org_field_name}} works closely with:

• Specialist palliative care teams to ensure comfort in end-of-life care.
• GPs and community nurses for continuous pain relief monitoring.
• Families and the individual to ensure care aligns with their wishes and dignity.

Palliative pain management may include:

• Long-acting opioids for constant pain relief.
• Breakthrough pain medication for sudden episodes.
• Syringe drivers for continuous pain relief administration.
• Alternative therapies (e.g., music therapy, aromatherapy, guided relaxation).

7. Documentation and Record Keeping

Staff must accurately record all pain assessments, interventions, and outcomes in the individual’s care plan. Documentation includes:

• Initial and ongoing pain assessment results.
• Medication administration records (MAR charts).
• Non-medical pain management interventions used.
• Effectiveness of pain relief measures and any adjustments made.
• Escalation of concerns to healthcare professionals.

Accurate record-keeping ensures accountability, compliance, and quality assurance in pain management.

8. Staff Training and Competency

All staff must receive mandatory training in pain assessment and management, including:

• Recognising and assessing pain in verbal and non-verbal individuals.
• Safe medication administration and monitoring.
• Alternative pain relief strategies.
• Palliative and end-of-life pain care.
• Reporting and documenting pain-related concerns.

Refresher training is conducted annually or as required when new pain management protocols are introduced.

9. Related Policies

This policy should be read alongside:

• Medication Administration Policy
• Palliative Care and End-of-Life Policy
• Risk Assessment and Management Policy
• Health and Safety Policy
• Staff Training and Development Policy

10. Policy Review

This policy will be reviewed annually or sooner if:

• New legislation or Care Inspectorate guidance is introduced.
• Service user feedback suggests improvements.
• Significant incidents or complaints indicate a need for policy updates.

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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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