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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Assisting with Personal Care Policy

1. Purpose

The purpose of this policy is to ensure that all personal care provided by {{org_field_name}} is safe, person-centred, dignified, lawful and responsive to the individual needs, choices, protected characteristics, communication needs and outcomes of the people we support.

This policy supports compliance with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in particular Regulation 9 (Person-centred care), Regulation 10 (Dignity and respect), Regulation 11 (Need for consent), Regulation 12 (Safe care and treatment), Regulation 13 (Safeguarding service users from abuse and improper treatment), Regulation 16 (Receiving and acting on complaints), Regulation 17 (Good governance), Regulation 18 (Staffing), Regulation 19 (Fit and proper persons employed), and Regulation 20 (Duty of candour).

This policy also supports compliance with CQC’s current assessment approach under the single assessment framework, including the five key questions of whether services are safe, effective, caring, responsive and well-led. Personal care will be delivered in a way that promotes independence, privacy, choice, positive risk-taking, equality, inclusion and the least restrictive approach, while ensuring risks are assessed, managed and reviewed.

2. Scope

This policy applies to:

• all employees, bank staff, agency staff, volunteers, students and contractors involved in the delivery, supervision, review or auditing of personal care;
• the Registered Manager, Nominated Individual and senior staff responsible for oversight, quality assurance and regulatory compliance;
• all people supported by {{org_field_name}} who receive, or may require, assistance with personal care; and
• relatives, advocates, attorneys, deputies and other representatives involved lawfully in care planning, decision-making or review where appropriate.

3. Legal and Regulatory Framework

This policy is informed by, and must be read in line with, the following legislation, regulations and guidance:

• Health and Social Care Act 2008 and the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, including:
  • Regulation 9: Person-centred care
  • Regulation 10: Dignity and respect
  • Regulation 11: Need for consent
  • Regulation 12: Safe care and treatment
  • Regulation 13: Safeguarding service users from abuse and improper treatment
  • Regulation 16: Receiving and acting on complaints
  • Regulation 17: Good governance
  • Regulation 18: Staffing
  • Regulation 19: Fit and proper persons employed
  • Regulation 20: Duty of candour
• Mental Capacity Act 2005 and the Mental Capacity Act Code of Practice
• Equality Act 2010
• Health and Care Act 2022, including the requirement for learning disability and autism training appropriate to role
• Relevant CQC guidance on the fundamental standards, single assessment framework, and the five key questions of whether services are safe, effective, caring, responsive and well-led
• Any current national guidance on infection prevention and control, safeguarding, medicines management and information governance applicable to adult social care in England.

Where there is any conflict between this policy and current legislation, regulations or statutory guidance, the legislation, regulations and statutory guidance will take precedence.

4. Definition of Personal Care

Personal care includes:

• Washing and bathing – Assisting with showering, bathing, and maintaining hygiene.
• Toileting support – Assistance with continence care, use of toilet facilities, and changing incontinence products.
• Dressing and grooming – Supporting individuals with choosing and putting on clothes, hair care, and other personal grooming tasks.
• Oral hygiene – Assisting with brushing teeth, dentures, and mouth care.
• Skin care and pressure-area care – supporting with skin hygiene, application of prescribed or agreed topical preparations, observation of skin integrity, and escalation of any concerns such as redness, soreness, breakdown, bruising or signs of infection.
• Support with eating and drinking – Ensuring service users receive adequate nutrition and hydration.
• Medicines support – prompting, assisting with, or administering medicines only where this is authorised within the individual’s care plan and risk assessment, staff are trained and assessed as competent, and practice is in line with the organisation’s Medicines Policy.

5. Principles of Assisting with Personal Care

All staff must adhere to the following principles when providing personal care:

• Dignity and Respect: Always respect a service user’s privacy, choices, and personal preferences.
• Person-Centred Approach: Care should be tailored to the individual’s needs, preferences, and cultural background.
• Independence and Choice: Encourage and support service users to do as much as they can for themselves.
• Privacy: Always ensure privacy by closing doors, using screens, and covering the service user appropriately.
• Sensitivity: Be mindful of the individual’s feelings, emotions, and comfort when assisting with personal care.
• Informed Consent: Always obtain consent before providing assistance and document this appropriately.
• Safe Care and Treatment: Personal care must be delivered in a way that identifies, assesses, mitigates and reviews risks to the person, staff and others, including risks relating to moving and handling, skin integrity, infection, nutrition, hydration, continence, falls, choking, medicines, equipment and the home environment.
• Communication and Accessibility: Staff must provide information, explanations and choices in a way the person can understand, taking account of language, culture, sensory impairment, cognitive needs, autism, learning disability and any communication aids or support required.
• Equality, Diversity and Inclusion: Personal care must not be discriminatory and must respect the person’s religion, beliefs, gender, sexuality, age, disability, protected characteristics and lifestyle preferences.
• Least Restrictive Practice: Staff must always use the least restrictive option and must not impose unnecessary restrictions. Any restrictive practice, restraint or arrangements amounting to a deprivation of liberty must be lawful, proportionate, recorded and escalated in line with safeguarding and legal requirements.
• Professional Boundaries: Staff must maintain professional boundaries at all times and must never provide personal care in a way that is degrading, humiliating, intimidating, neglectful or abusive.
• Safeguarding and Protection: Report any concerns regarding abuse or neglect immediately.

6. Staff Roles and Responsibilities

All staff involved in providing personal care must:

• follow the person’s current care plan, risk assessments, communication plan, behaviour support guidance and any specific clinical instructions relevant to the task;
• provide personal care in a way that promotes dignity, privacy, independence, choice and control;
• seek and record consent before each episode of care, unless it has been lawfully established that the person lacks capacity for the specific decision and the care is being provided in their best interests;
• recognise when the person’s needs, wishes, risks or presentation have changed and escalate promptly to senior staff or relevant professionals;
• use equipment safely, check equipment before use, and report defects immediately;
• follow infection prevention and control procedures, including hand hygiene, appropriate use of PPE and safe disposal of waste;
• work within the limits of their role, training and competence and seek guidance where they are unsure;
• maintain professional boundaries at all times;
• record care accurately, contemporaneously and factually, including the care provided, level of assistance, consent, refusals, concerns, changes in condition, incidents and action taken; and
• report safeguarding concerns, accidents, incidents, near misses and notifiable safety incidents without delay and in line with organisational procedures.

7. Consent and Mental Capacity

Staff must obtain valid consent before providing personal care. Consent must be voluntary, informed and given by a person with capacity to make the relevant decision. Staff must explain what support is being offered, why it is needed and what choices are available, in a way the person can understand.

Capacity is decision-specific and time-specific. Staff must not assume a person lacks capacity because they have a diagnosis, communication difficulty, unusual behaviour or make a decision others regard as unwise.

Before concluding that a person lacks capacity, staff must take all practicable steps to support decision-making, including adjusting the timing of care, simplifying information, using visual prompts, offering reassurance, involving someone the person trusts, and using any communication aids required.

Where a person lacks capacity for the specific decision, any decision about personal care must be made in their best interests, be the least restrictive option, and take account of the person’s past and present wishes, feelings, beliefs, values and the views of those lawfully involved in their care.

Staff must be aware of, and act within, any lawful authority held by an attorney, deputy or court order.

If care is refused, staff must assess whether there is an immediate risk, explore the reasons for refusal, offer alternatives, record the refusal clearly, and escalate concerns in line with the care plan, risk assessment and safeguarding procedures.

Any use of restriction, restraint or arrangements that may amount to a deprivation of liberty must be recognised, recorded and escalated immediately so that lawful authorisation can be considered or reviewed.

8. Safeguarding and Abuse Prevention

Personal care places staff in a position of trust. {{org_field_name}} operates a zero-tolerance approach to abuse, neglect, discrimination, bullying, harassment, humiliation, rough handling, unlawful restraint, coercion and any form of improper treatment.

Staff must remain alert to signs of physical, psychological, sexual, financial, organisational or discriminatory abuse, neglect, self-neglect, exploitation, coercive control and domestic abuse.

Staff must immediately report any safeguarding concern, allegation, disclosure, unexplained injury, repeated refusal of essential care, deterioration suggesting neglect, inappropriate staff conduct, or any concern that a person is being treated in a degrading, unsafe or overly restrictive way.

Where immediate safety is at risk, staff must take urgent protective action, seek emergency assistance where required, and inform the Registered Manager or on-call manager without delay.

All safeguarding concerns must be documented fully and referred in line with local authority safeguarding procedures, internal reporting procedures and any duty to notify external bodies.

Staff who raise safeguarding or whistleblowing concerns in good faith will be supported and protected from victimisation.

9. Infection Control Measures

Staff must provide personal care in a way that reduces the risk of cross-infection and protects people using the service, staff and others. This includes:

• effective hand hygiene before and after each episode of care;
• correct selection and use of PPE based on the task and level of risk;
• safe handling and disposal of waste, continence products, laundry and sharps where relevant;
• cleaning and disinfection of equipment used for personal care;
• prompt reporting and escalation of suspected infection, outbreaks or contamination risks;
• following current national and local infection prevention and control guidance applicable to adult social care; and
• ensuring personal care is adapted appropriately where someone has a known or suspected infectious condition.

10. Training and Competency Requirements

All staff providing personal care must complete induction, mandatory training, supervised practice and competency assessment before undertaking personal care independently.

Training must include, as relevant to role:

• dignity, privacy, equality and human rights;
• person-centred care and communication;
• consent and the Mental Capacity Act 2005;
• safeguarding adults and whistleblowing;
• infection prevention and control;
• moving and handling;
• continence care, skin care and oral care;
• safe medicines support where this forms part of the role;
• recognising deterioration, escalating concerns and incident reporting; and
• learning disability and autism training appropriate to the person’s role.

Competency must be assessed in practice and refreshed at appropriate intervals, including after incidents, concerns, prolonged absence, changes in role, or where practice indicates a need for reassessment.

The Registered Manager must maintain an up-to-date training matrix and ensure staff receive supervision, observation, support and development necessary to carry out their role safely and effectively.

11. Safe Delivery of Personal Care

Before providing personal care, staff must check the person’s current care plan, risk assessments, consent arrangements, equipment needs, preferred routines and any known clinical or behavioural risks.

Staff must consider, as relevant:

• moving and handling requirements;
• skin integrity and pressure risks;
• risk of falls;
• continence needs;
• nutritional and hydration concerns;
• oral health needs;
• infection risks;
• environmental hazards within the person’s home;
• distress, anxiety, trauma history or behaviours that may indicate the person is uncomfortable or does not wish to continue; and
• whether a second staff member is required under the care plan or risk assessment.

Staff must stop and seek advice immediately if it is not safe to proceed, if the person withdraws consent, if there is a change in presentation, or if the care required is outside their competence or plan of care.

12. Documentation and Record-Keeping

Accurate, complete and contemporaneous records must be kept for all personal care delivered. Records must include, where relevant:

• the date and time care was offered and provided;
• the specific support given and the level of assistance required;
• the person’s presentation, comfort, choices and response to care;
• consent obtained, or refusal of care and action taken in response;
• any risks identified, equipment used, moving and handling support required, or changes to risk level;
• observations relating to skin integrity, continence, hygiene, nutrition, hydration, pain, emotional wellbeing or possible deterioration;
• any incidents, accidents, near misses, safeguarding concerns or complaints raised; and
• the name, signature or electronic identifier of the staff member making the record.

Records must be factual, respectful, secure, auditable and stored in line with confidentiality, data protection and information governance requirements.

13. Duty of Candour and Learning from Incidents

{{org_field_name}} will act in an open and transparent way with people using the service and, where appropriate, those lawfully acting on their behalf.

Where a notifiable safety incident occurs in relation to personal care, the organisation will:

• inform the person affected, or their relevant representative, as soon as reasonably practicable;
• give a truthful account of what is known at the time;
• apologise appropriately;
• explain what further enquiries or investigations will take place;
• keep a written record of all communication and actions taken; and
• use the incident as a learning opportunity to improve care, reduce risk and prevent recurrence.

Staff must report incidents, near misses and errors immediately in line with organisational procedures so that appropriate action can be taken without delay.

14. Compliance Monitoring and Auditing

{{org_field_name}} will operate effective governance systems to assess, monitor and improve the quality and safety of personal care. This will include:

• regular audits of care records, consent records, risk assessments, incident reports, safeguarding records, complaints, staff training and competency;
• spot checks and direct observation of practice;
• review of accidents, incidents, safeguarding concerns, falls, skin issues, infections, medicines errors and missed or refused care;
• service user feedback, relative feedback and compliments analysis;
• supervision, appraisal and competency review of staff;
• action plans with clear timescales, responsibilities and follow-up; and
• periodic review against the relevant fundamental standards, CQC quality statements and organisational policies.

Audit findings must be reported to the Registered Manager and used to drive learning, improve practice and reduce the risk of recurrence.

15. Managing Non-Compliance

Where non-compliance places a person at actual or potential risk of harm, immediate action must be taken to protect the person, escalate concerns to senior management, consider safeguarding referral, review risk assessments and care plans, and take any other action required under the Duty of Candour and incident reporting procedures.

Non-compliance with this policy may result in:

• Retraining or additional supervision for staff.
• Formal warnings or disciplinary action if breaches occur.
• Reporting to external regulatory bodies if care standards are not met.
• CQC intervention in cases of serious breaches impacting service user well-being.

16. Related Policies

This policy should be read alongside:

• Safeguarding Adults Policy
• Mental Capacity Act and Consent Policy
• Medicines Policy
• Infection Prevention and Control Policy
• Moving and Handling Policy
• Duty of Candour Policy / Incident Reporting Procedure
• Complaints Policy
• Equality, Diversity and Human Rights Policy
• Data Protection and Confidentiality Policy
• Recruitment and Selection / Fit and Proper Persons Policy
• Staff Supervision, Training and Competency Policy
• Whistleblowing Policy
• Risk Assessment and Care Planning Policy

17. Policy Review

This policy will be reviewed at least annually, and sooner where required by:

identified themes from feedback, supervision or quality assurance processes.

changes in legislation, statutory guidance or CQC guidance;

changes to the service model or regulated activities;

learning from incidents, safeguarding concerns, complaints, audits or inspections; or

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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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