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Stoma Care and Management Policy

1. Purpose

At {{org_field_name}}, we are committed to delivering safe, person-centred, and dignified stoma care for individuals requiring a colostomy, ileostomy, or urostomy. This policy ensures that all aspects of stoma care, hygiene, infection control, risk management, and staff training align with CQC regulations, NICE guidelines, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and the Mental Capacity Act 2005.

Our goal is to maintain skin integrity, prevent infections, and promote independence while ensuring individuals receiving support feel comfortable and confident in managing their stoma care.

2. Scope

This policy applies to all staff, including permanent, temporary, agency, and volunteer workers who provide support to individuals with a stoma in our Supported Living service. It covers daily stoma care, emptying and changing of stoma appliances, identifying complications, infection prevention, and emergency response procedures.

3. Related Policies

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

4. Understanding Stoma Care

A stoma is a surgically created opening in the abdomen that allows waste to exit the body. Types of stomas include:

• Colostomy – An opening from the large intestine to divert faeces.
• Ileostomy – An opening from the small intestine to divert liquid stool.
• Urostomy – A urinary diversion that allows urine to bypass the bladder.

Each type requires individualised care to ensure the stoma remains healthy and the person is supported appropriately.

5. Stoma Care and Management

5.1 Person-Centred Stoma Care Plans

• Every individual requiring stoma care must have a personalised stoma care plan, developed with healthcare professionals, the individual, and family members (if applicable).
• The care plan should include:
  • Type of stoma and reason for surgery.
  • Preferred stoma products (e.g., bags, adhesives, skin barriers).
  • Frequency of emptying and changing the stoma appliance.
  • Daily skin care routine to prevent irritation and infections.
  • Dietary and hydration needs.
  • Signs of complications and escalation procedures.

5.2 Daily Stoma Care Routine

• Wash hands and wear appropriate personal protective equipment (PPE) before handling a stoma.
• Inspect the stoma for signs of redness, swelling, irritation, or leakage.
• Clean the skin around the stoma with warm water and dry thoroughly.
• Ensure the stoma appliance is securely attached and fits correctly.
• Dispose of used stoma bags appropriately following infection control guidelines.

5.3 Emptying and Changing Stoma Bags

• Closed stoma bags are replaced when full.
• Drainable stoma bags should be emptied regularly into the toilet to prevent leakage.
• Staff must support individuals in maintaining independence where possible.
• Record stoma care activities in the daily care log.

6. Infection Prevention and Skin Integrity

6.1 Preventing Infections

• Follow strict hand hygiene and PPE protocols before and after stoma care.
• Ensure stoma appliances are stored hygienically and changed as per guidelines.
• Clean and dry the skin gently to avoid irritation.
• Report any unusual odours, discolouration, or signs of infection immediately.

6.2 Skin Care and Preventing Irritation

• Use protective stoma barriers to prevent skin breakdown.
• Avoid harsh soaps or wipes that can cause irritation.
• Rotate the positioning of the stoma bag to prevent pressure sores or rashes.

7. Identifying and Managing Stoma Complications

7.1 Recognising Common Stoma Issues

Staff must be trained to identify and respond to common complications, including:

• Leakage – Due to a poor-fitting appliance or excessive stoma output.
• Skin irritation – Caused by adhesive allergies, improper cleaning, or infection.
• Bleeding – A small amount is normal, but excessive bleeding must be reported.
• Hernias or prolapse – Requires medical attention if the stoma bulges or changes shape.
• Blockages – Symptoms include abdominal pain, bloating, and reduced output.

7.2 Responding to Stoma Emergencies

• If the stoma bag leaks:
  • Assist in replacing it immediately.
  • Ensure the skin is cleaned and dried before attaching a new bag.
• If an individual experiences pain or swelling around the stoma:
  • Stop food and fluids.
  • Seek urgent medical advice.
• If the stoma stops functioning (no output for 24 hours):
  • Contact healthcare professionals urgently.

8. Supporting Individuals with Stoma Care

• Encourage self-management and independence where possible.
• Provide psychosocial support for individuals struggling with stoma-related concerns.
• Offer privacy and dignity when assisting with stoma care.
• Ensure individuals have access to stoma nurses or support groups if needed.

9. Staff Training and Competency

• All staff providing stoma care must receive specialist training from healthcare professionals.
• Training includes:
  • Safe handling and application of stoma appliances.
  • Recognising signs of complications and knowing when to escalate concerns.
  • Maintaining dignity and providing emotional support.
  • Infection prevention and hygiene protocols.
• Competency assessments must be conducted annually to ensure adherence to best practices.

10. Record-Keeping and Documentation

• Staff must maintain detailed records of:
  • Stoma care activities.
  • Skin condition and hygiene measures taken.
  • Changes in stoma function or appliance leaks.
  • Any complications or concerns reported.
• Records must be stored securely in compliance with GDPR and confidentiality policies (SL34).

11. Monitoring and Continuous Improvement

• Quarterly audits will be conducted to ensure compliance with stoma care protocols.
• Feedback from individuals and healthcare professionals will be used to improve care quality.
• Lessons learned from incidents or near misses will be integrated into training and policy updates.

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 stoma management.
• 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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