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Leg Ulcer Management and Prevention Policy

1. Purpose

At {{org_field_name}}, we are committed to preventing, managing, and treating leg ulcers in individuals receiving support. This policy ensures that our staff provide evidence-based, person-centred care in compliance with CQC regulations, NICE guidelines, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and the Tissue Viability Society (TVS) best practices.

Leg ulcers can significantly impact mobility, independence, and overall quality of life, making their prevention and effective management a priority in our Supported Living service. This policy provides clear guidance on wound care, risk assessment, treatment protocols, staff training, and infection prevention.

2. Scope

This policy applies to all staff, including permanent, temporary, agency, and volunteer workers who provide care and support to individuals at risk of or suffering from leg ulcers. It covers:

• Risk assessment and prevention of leg ulcers
• Wound management and dressing selection
• Infection prevention and control
• Multidisciplinary care approach
• Staff training and competency requirements
• Emergency escalation and monitoring procedures

3. Related Policies

• SL12 – Safe Care and Treatment Policy
• SL07 – Person-Centred Care Policy
• SL16 – Infection Prevention and Control Policy
• SL21 – Medication Management and Administration Policy
• SL08 – Dignity and Respect Policy
• SL34 – Confidentiality and Data Protection (GDPR) Policy
• SL13 – Safeguarding Adults from Abuse and Improper Treatment Policy

4. Understanding Leg Ulcers

Leg ulcers are chronic wounds that fail to heal within six weeks, commonly caused by poor circulation, pressure, or underlying health conditions. The most common types include:

• Venous leg ulcers – Due to poor vein circulation, often associated with varicose veins.
• Arterial ulcers – Caused by reduced blood flow due to peripheral artery disease.
• Diabetic foot ulcers – Related to diabetes and nerve damage.
• Pressure ulcers – Caused by prolonged pressure on the skin, leading to tissue breakdown.

5. Prevention of Leg Ulcers

5.1 Risk Assessment

• All individuals at risk of leg ulcers will have a documented risk assessment, completed upon admission and reviewed monthly or as required.
• The assessment will consider:
  • Medical conditions (e.g., diabetes, vascular disease, immobility, obesity).
  • Previous history of ulcers or poor circulation.
  • Skin integrity and signs of early ulcer development.
  • Nutritional status and hydration levels.

5.2 Preventative Strategies

• Encourage mobility – Promote physical activity to improve circulation.
• Monitor skin condition – Regular skin checks to identify early warning signs (e.g., redness, swelling, dryness, pain).
• Promote leg elevation – Encourage individuals to elevate legs when sitting or lying down to reduce swelling.
• Provide compression therapy – Ensure individuals wear prescribed compression stockings to support venous return.
• Maintain skin hygiene – Keep the skin clean and moisturised to prevent dryness and cracking.
• Nutritional support – Encourage a balanced diet rich in protein, vitamins C and E, and zinc, which promote wound healing.

6. Leg Ulcer Management and Treatment

6.1 Wound Care and Dressing Selection

• All leg ulcer treatment must be individualised based on the type, size, depth, and severity of the wound.
• Staff must follow NICE-approved wound care guidelines, including:
  • Cleansing the wound with sterile saline or prescribed solutions.
  • Applying appropriate dressings (e.g., foam dressings, hydrocolloids, alginate dressings).
  • Changing dressings as per clinical instructions to prevent infection and support healing.
  • Using compression bandaging if prescribed to manage venous ulcers.

6.2 Infection Prevention and Control

• Hand hygiene and PPE (gloves, aprons) must be used when providing wound care.
• Signs of infection (e.g., increased redness, warmth, swelling, pus, odour) must be reported immediately to healthcare professionals.
• Aseptic techniques must be followed when changing dressings.
• Antibiotic therapy will be prescribed if necessary and should be documented appropriately.

6.3 Pain Management

• Assess pain levels regularly using validated pain scales.
• Administer prescribed pain relief medications and document their effectiveness.
• Encourage non-pharmacological pain relief methods, such as leg elevation, gentle massage, and warm compresses.

7. Multidisciplinary Approach to Leg Ulcer Care

7.1 Collaboration with Healthcare Professionals

• Our staff will work closely with GPs, tissue viability nurses (TVNs), district nurses, podiatrists, and dietitians to provide holistic care.
• All leg ulcer management plans will be reviewed by healthcare professionals regularly.
• Any worsening or non-healing ulcers will be referred for specialist assessment.

7.2 Education and Support for Individuals

• Individuals receiving support will be provided with education on self-care, including proper skincare, nutrition, and foot care.
• Support will be offered to those requiring psychological or emotional support due to the impact of chronic wounds on well-being.
• Family members and carers will be provided with guidance on leg ulcer prevention and home care.

8. Record-Keeping and Documentation

• Staff must document all risk assessments, wound care interventions, dressing changes, and treatment plans.
• All care notes must be accurate, clear, and updated after each wound care intervention.
• Records will be stored securely in compliance with GDPR and SL34 – Data Protection Policy.

9. Escalation and Emergency Response

9.1 When to Escalate Care

Urgent medical intervention is required if:

• The ulcer deteriorates rapidly (e.g., increased pain, necrosis, or spreading infection).
• Signs of systemic infection appear (e.g., fever, confusion, increased heart rate).
• Severe bleeding or sudden pain occurs.

9.2 Emergency Procedures

• Staff must contact {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}} ({{org_field_registered_manager_phone}}, {{org_field_registered_manager_email}}) to report urgent concerns.
• Immediate medical advice must be sought by contacting the individual’s GP, emergency services (999 or 112), or district nursing team.

10. Staff Training and Competency

• All staff involved in leg ulcer care must complete tissue viability and wound care training.
• Training must include:
  • Recognising early signs of ulcers.
  • Wound dressing techniques.
  • Infection control measures.
  • Pain management strategies.
• Competency assessments must be conducted annually.

11. Monitoring and Continuous Improvement

• Quarterly audits will be conducted to evaluate adherence to leg ulcer care protocols.
• Feedback from individuals and healthcare professionals will inform service improvements.
• Lessons learned from wound care incidents will be used to enhance training and procedures.

12. Policy Review

This policy will be reviewed annually or sooner if required due to:

• Updates in NICE or CQC guidelines.
• Changes in best practice for wound care and tissue viability.
• Feedback from staff, individuals receiving support, or healthcare professionals.

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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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