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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Continence Promotion and Toileting Policy

1. Purpose

The purpose of this policy is to provide a clear, lawful, and best-practice framework for promoting continence and supporting the toileting needs of clients who are cared for by temporary workers employed by {{org_field_name}}. The agency recognises that continence care is vital to preserving clients’ dignity, comfort, wellbeing, and health. This policy ensures that all temporary workers, including registered nurses and healthcare assistants, understand their responsibilities in supporting clients with sensitivity and competence, whether working in nursing homes, care homes, or other regulated settings. This policy aligns with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, the NICE guidelines on Continence (CG49 and NG123), the Care Act 2014, the Equality Act 2010, the Human Rights Act 1998, and the Mental Capacity Act 2005. Continence promotion is not solely about managing incontinence but supporting people to maintain their continence for as long as possible while ensuring safe, hygienic, and person-centred toileting assistance.

2. Scope

This policy applies to:

• All temporary workers employed by {{org_field_name}}, including registered nurses, healthcare assistants, and support workers under zero-hours or casual contracts
• All placements where staff are assigned, including nursing homes, residential care homes, and healthcare facilities
• All office staff involved in recruitment, placement coordination, or the oversight of client and worker relationships

Temporary workers must also adhere to any additional continence and toileting procedures implemented by client organisations.

3. Related Policies

• Safeguarding Adults and Children Policy
• Infection Prevention and Control Policy
• Record Keeping and Confidentiality Policy
• Equality, Diversity, and Inclusion Policy
• Health and Safety Policy
• Code of Conduct for Temporary Workers
• Incident Reporting and Management Policy

4. Key Principles of Continence Promotion

Temporary workers must:

• Promote dignity, independence, and choice at all times when supporting clients with continence needs
• Recognise continence promotion as part of fundamental care, not simply task-based activity
• Provide person-centred care by understanding each client’s needs, preferences, and continence care plan
• Act sensitively and discreetly to minimise embarrassment, anxiety, and distress
• Encourage clients to maintain their continence abilities where appropriate
• Follow safe, hygienic practices in line with infection prevention and control guidance

5. Legal Framework

This policy is underpinned by:

• The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, particularly Regulation 9 (Person-Centred Care) and Regulation 10 (Dignity and Respect)
• The Care Act 2014, ensuring the wellbeing and dignity of clients
• The Mental Capacity Act 2005, ensuring that clients’ choices regarding continence care are respected, and best-interest decisions are made where required
• The Equality Act 2010, preventing discrimination in relation to continence or toileting needs
• The Human Rights Act 1998, upholding clients’ rights to dignity, privacy, and autonomy

6. Temporary Workers’ Responsibilities

Temporary workers must:

• Familiarise themselves with each client’s care and continence plan as soon as possible after starting an assignment
• Assist clients with toileting and continence management in a way that maintains dignity, privacy, and comfort
• Encourage independence where possible (e.g., assisting to the toilet rather than automatically providing pads)
• Monitor and report any changes to continence patterns or concerns (e.g., increased frequency, incontinence, urinary tract infections, constipation)
• Ensure accurate documentation of toileting support, continence care interventions, and observations in line with the client’s record-keeping procedures
• Report concerns regarding potential safeguarding issues (e.g., signs of neglect relating to toileting or continence) following {{org_field_name}}’s Safeguarding Policy
• Comply with all infection prevention and control procedures, including the use of appropriate personal protective equipment (PPE)

7. Continence Promotion Strategies

Temporary workers should apply the following strategies where appropriate:

• Encouragement and reminders: Prompting clients regularly to use the toilet
• Bladder training: Supporting agreed care plans aimed at increasing bladder capacity and promoting continence
• Fluid intake management: Encouraging adequate hydration to prevent dehydration and reduce the risk of urinary tract infections
• Dietary considerations: Being mindful of diet-related bowel health and reporting concerns if clients experience constipation or diarrhoea
• Positioning and mobility support: Ensuring clients can access toilets safely or are positioned correctly when using commodes or bedpans
• Environmental adjustments: Ensuring clients have access to toilets that are safe, clean, and accessible

Temporary workers must always check with the client’s permanent care team before implementing new continence-promoting techniques, ensuring consistency and safety.

8. Assisting with Toileting

When providing direct toileting support, temporary workers must:

• Respect clients’ preferences and privacy at all times
• Use screens, curtains, or closed doors to maintain dignity
• Ensure the client is comfortable and safe when using toilet facilities, commodes, bedpans, or urinals
• Apply safe moving and handling techniques when assisting with transfers
• Observe for and report signs of skin damage, pressure sores, or discomfort
• Clean and disinfect equipment after use to minimise infection risk
• Dispose of continence products safely and hygienically in line with client procedures and local regulations

9. Continence Products

Temporary workers must:

• Only use continence products specified in the client’s care plan (e.g., incontinence pads, catheters, commodes)
• Ensure that products are applied, fitted, and changed safely, with due consideration to client dignity
• Document product usage accurately where required by the client organisation
• Never improvise or make changes to a continence management plan without authorisation from a senior nurse or client manager

10. Capacity, Consent, and Choice

Temporary workers must:

• Support clients to make their own choices regarding continence care whenever possible
• Assess and respect the capacity of clients to make decisions about their toileting and continence needs
• Follow best interest decision-making processes in accordance with the Mental Capacity Act 2005 when clients lack capacity
• Work closely with client organisations and families, where appropriate, to ensure care plans are person-centred and lawful
• Avoid coercing or forcing clients into continence management routines against their will

11. Infection Prevention and Control

All toileting and continence care must be provided in line with infection prevention and control requirements. Temporary workers must:

• Use appropriate PPE, including gloves and aprons
• Practice good hand hygiene before and after providing personal care
• Dispose of waste products (e.g., used pads, gloves) safely in line with client and local waste management policies
• Ensure that continence care equipment is cleaned and maintained safely
• Report infection risks, including urinary tract infections or gastrointestinal symptoms, to the client organisation promptly

12. Record Keeping

Temporary workers must:

• Maintain clear, accurate, and timely records of toileting support and continence care in line with client organisation policies
• Record observations regarding changes in continence patterns, fluid intake, bowel movements, and client discomfort
• Report concerns regarding skin integrity, signs of neglect, or safeguarding risks immediately to the client and {{org_field_name}}
• Treat all records as confidential, in accordance with the Data Protection Act 2018 and GDPR

13. Training and Competence

{{org_field_name}} will:

• Provide induction and refresher training for all temporary workers regarding continence care and toileting support
• Ensure workers understand person-centred care, dignity in care, infection control, and safeguarding in relation to continence promotion
• Require registered nurses to comply with the Nursing and Midwifery Council (NMC) Code in all aspects of continence care
• Provide additional support or supervision to workers where concerns or learning needs are identified

Temporary workers must:

• Complete required training before being assigned to care roles involving personal care
• Request additional guidance or support if unsure about any aspect of continence care
• Participate in reflective practice and supervision as part of continuous professional development

14. Safeguarding and Continence

Poor continence care, neglect, or inappropriate toileting support can constitute abuse. Temporary workers must:

• Be vigilant for signs of neglect, including prolonged periods without toileting assistance, inappropriate use of continence products, or disregard for dignity
• Report safeguarding concerns immediately following {{org_field_name}}’s Safeguarding Policy
• Cooperate fully with safeguarding investigations and contribute to learning from incidents to improve practice

15. Director’s Responsibilities

In the absence of a registered manager, the director will:

• Take full responsibility for implementing, reviewing, and monitoring this policy
• Ensure that all temporary workers receive appropriate training and supervision in continence promotion and toileting
• Review incident reports, complaints, and safeguarding referrals related to continence care
• Liaise with client organisations to address concerns and promote best practices
• Identify areas for continuous improvement and incorporate learning into training and supervision

16. Working with Client Organisations

{{org_field_name}} will:

• Ensure temporary workers are informed of client-specific continence management protocols and expectations upon assignment
• Encourage temporary workers to collaborate with the client’s permanent staff to maintain continuity of care
• Respond promptly to concerns raised by clients regarding continence care provided by temporary workers
• Support client audits, inspections, and safeguarding processes relating to continence management and dignity in care

17. Continuous Quality Improvement

The director will:

• Review this policy annually or sooner if legislative, regulatory, or best practice changes occur
• Audit incident reports, feedback, and complaints to identify patterns or areas for improvement
• Implement changes to training, supervision, and placement procedures based on learning and feedback
• Promote a culture of respect, dignity, and person-centred care across all aspects of toileting and continence support

18. Policy Review

This policy will be reviewed annually by the director of {{org_field_name}} or sooner if required due to changes in legislation, CQC guidance, or operational needs. All updates will be communicated to temporary workers and client organisations to ensure full compliance and continuous improvement.

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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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