This optional unit for the Level 2 Diploma assesses the learner’s ability to undertake personal hygiene activities on behalf of individuals that may not be able to perform them independently. This can include washing, shaving and toileting.
Infection control is an important facet of this unit, as is ensuring that personal hygiene activities are carried out in line with the individual’s care plan.
On this page
- 1 Learning Outcomes & Assessment Criteria
- 2 Understand current legislation, national guidelines, policies, procedures, and protocols in relation to undertaking personal hygiene activities with individuals
- 3 Know the anatomy and physiology of the skin, nose, mouth, eyes and ears in relation to cleansing
- 4 3 Be able to prepare for undertaking personal hygiene activities with individuals
- 5 Be able to undertake personal hygiene activities with individuals
- 6 Be able to record and report the outcome of the personal hygiene activity
Learning Outcomes & Assessment Criteria
This unit consists of five learning outcomes:
- 1 Understand current legislation, national guidelines, policies, procedures and protocols in relation to undertaking personal hygiene activities with individuals
- 1.1 Identify current legislation, national guidelines, policies, procedures and protocols in relation to undertaking personal hygiene activities with individuals
- 1.2 Explain the importance of complying with health and safety guidance
- 1.3 Explain the importance of using aseptic techniques
- 2 Know the anatomy and physiology of the skin, nose, mouth, eyes and ears in relation to cleansing
- 2.1 Describe the anatomy and physiology of the skin, nose, mouth, eyes and ears in relation to cleansing
- 3 Be able to prepare for undertaking personal hygiene activities with individuals
- 3.1 Explain the importance of following the individual’s care plan
- 3.2 Explain why resources should be prepared prior to commencing the activity
- 3.3 Confirm all equipment and materials are fit for purpose as outlined in the individual’s care plan
- 3.4 Confirm the individual’s identity and gain valid consent
- 3.5 Communicate information in a way that is sensitive to the personal beliefs and preferences of the individual
- 4 Be able to undertake personal hygiene activities with individuals
- 4.1 Apply health and safety measures relevant to the procedure and environment
- 4.2 Apply standard precautions for infection control
- 4.3 Carry out personal hygiene activities in accordance with the individual’s care plan
- 4.4 Ensure that the individual’s privacy and dignity is maintained
- 4.5 Observe the individual while providing support and reassurance and address any concerns
- 4.6 Describe action to take in response to adverse reactions
- 5 Be able to record and report the outcome of the personal hygiene activity
- 5.1 Record the outcome of the personal hygiene activity
- 5.2 Report the outcomes of the activity to a member of the care team in line with local policy
Understand current legislation, national guidelines, policies, procedures, and protocols in relation to undertaking personal hygiene activities with individuals
1.1 Identify current legislation, national guidelines, policies, procedures, and protocols in relation to undertaking personal hygiene activities with individuals
https://www.england.nhs.uk/about/equality/equality-hub/resources/legislation/
NATIONAL LEGISLATION
In 2014 all these LAWS before the CARE ACT merged into ONE SINGLE MAINFRAME piece of legislation.
The Care Act – Introduction to Care Act 2014 https://youtu.be/l-yeoMMKIto
CARE ACT 2014 – Care & Statutory Guidance – Department of Health Paper
The Care Act 2014 encourages caregivers to take a person-centred approach when safeguarding vulnerable adults. When you follow the principles, you too place the vulnerable person’s wellbeing and needs at the forefront of safeguarding processes, it also requires local authorities to involve adults in their assessment, care and support planning and review
The principles of the CARE ACT include;
- To empower individuals to strive
- The individual is the best expert
- To incorporate an individuals, own choices, wishes, feelings, beliefs, and cultural needs when supporting someone
- To protect vulnerable people from abuse, harm, or neglect
- To prevent poor health and wellbeing through personalized care
- To promote wellbeing, prevent decline through independence and choice
- To encourage people to make day to day decisions and be central to their care and support
- To balance a person’s wellbeing with what other people want or feel is necessary, as this may not be the case
- To improve their social and economic situation
- To encourage and build partnerships and working relationships
- To prevent mental decline through emotional and mental health support
- To resolve accommodation or provide this
- To not restrict or minimize someone’s freedoms and right to make unwise choices
- Support work, education, and recreational opportunities
- Promote respect and dignity
- To consider the Proportionality of risk and the probability of occurrence – this is how likely is the risk going to become real and the person become injured, has neglected, maybe abused etc This is normally a risk assessment process with resolution and monitoring in place to find the best options in the least restrictive ways.
- Promote a strengths-based approach – this is acknowledged what people can do, and focus support of the things people find difficult and support these areas to balance these equally improving their life and providing quality care
- Partnership
- Accountability
The Health & Safety at Work Act
states that all employers have a duty to do whatever is ‘reasonably practicable’ to protect the health, safety, and wellbeing of their employees. A list of health & safety legislation can be found here.
The Health and Social Care Act 2012
Introduced the first legal duties about health inequalities. It included specific duties for health bodies including the Department of Health, Public Health England, Clinical Commissioning Groups, and NHS England which require the bodies to have due regard to reducing health inequalities between the people of England. The Act also brought in changes for local authorities on public health functions
The Equality Act 2010
established equality duties for all public sector bodies which aim to integrate consideration of the advancement of equality into the day-to-day business of all bodies subject to the duty.
The Human Rights Act 1998
The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
States that person centred care and the treatment of service users must be appropriate, meet their needs and reflect their choices, preferences and wishes
https://www.legislation.gov.uk/ukdsi/2014/9780111117613/regulation/9
The Social Value Act 2012
This effectively required local authorities and health sector bodies – to consider economic, social, and environmental wellbeing in procurement of services or contracts. It was suggested that creating social value has defined and clear connections with improved wellbeing which lead to a reduction in health inequalities through action to meet unmet needs and improving people’s lives, and provided control and quality of life.
Control of Substances Hazardous to Health 2002 (COSHH)
COSHH is the law that requires employers to control substances that are hazardous to health and includes nanomaterials. You can prevent or reduce workers’ exposure to hazardous substances by: finding out what the health hazards are; deciding how to prevent harm to health (risk assessment)
Source: https://www.hse.gov.uk/coshh/basics/index.htm
Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013, (RIDDOR)
is a law that requires employers, and other people in charge of work premises, to report and keep records of any;
- work-related accidents which cause deaths
- work-related accidents which cause certain serious injuries (reportable injuries)
- diagnosed cases of certain industrial diseases; and
- certain ‘dangerous occurrences’ (incidents with the potential to cause harm)
In the work place any incident or accident must be recorded on Accident or incident forms, with included body maps or photo evidence which shows the injury for an employer to investigate to determine if this falls into the categories above.
It is vital that all information and any witness statements are collected to provide, should this warrant investigation from outside or should this be required in law.
Other legislation may include;
- The Public Health (Control of Diseases) Act 1984
- The Public Health (Infectious Diseases) Regulations 1988
- The Health Protection (Notification) Regulations 2010
- The Food Safety and Hygiene (England) Regulations 2013
- Food Safety Act 1990
- The Management of Health and Safety at Work (Amendment) Regulations 2006
- The Management of Health and Safety at Work Regulations 1999
- Manual Handling Operations Regulations 1992 (MHOR) (Amended 2002)
- Provision and Use of Work Equipment Regulations 1998 (PUWER)
- Lifting Operations and Lifting Equipment Regulations 1998 (LOLER)
NATIONAL GUIDELINES
Regulations
- Health and Social Care Act 2008: code of practice on the prevention and control of infections
- DHSC/PHE Care homes: infection prevention and control
- NICE CG139: Healthcare-associated infections: prevention and control in primary and community care
- The Yellow Card scheme: guidance for healthcare professionals, patients and the public
COVID Specific Legislation
- Adult social care: coronavirus (COVID-19) winter plan 2020 to 2021
- Coronavirus (COVID-19): admission and care of people in care homes
- COVID-19: how to work safely in care homes
- COVID-19: Supporting autistic people and people with learning disabilities (SCIE)
- COVID-19: Supporting people with dementia (SCIE)
- Coronavirus (COVID-19): looking after people who lack mental capacity
- COVID-19: the ethical framework for adult social care
- COVID 19: Visiting arrangements for those receiving care at the end of life
- Guidance for care of the deceased with suspected or confirmed coronavirus (COVID-19)
- PHE Hub COVID-19: infection prevention and control (IPC)
- COVID-19: adult social care risk reduction framework
- PHE Guidance: A guide to the COVID-19 vaccination programme
- PHE Guidance: The flu vaccination: who should have it and why
Source:
NHS
When it was launched in 1948, it was based on three core principles: That it meets the needs of everyone. That it be free at the point of delivery. That it be based on clinical need, not ability to pay.
Constitutional Values include;
- Working together for the individuals
- Respect and Dignity
- Commitment to QUALITY care
- Compassion
- Improving people’s lives and therefore outcomes
- Everyone is EQUAL
The Health Foundation has identified a framework that comprises four principles of person-centred care:
- affording people dignity, compassion, and respect
- offering coordinated care, support, or treatment
- offering personalized care, support, or treatment
- supporting people to recognize and develop their own strengths and abilities to enable them to live an independent and fulfilling life.
Other Legislation That may be useful;
Safeguarding adults in care homes – NICE guideline [NG189]
https://www.nice.org.uk/guidance/ng189
Department of Health and social Care
www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england
Care & Support Statutory Guidance
Regulatory Governance – CQC & The Fundamental Standards
https://www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-9-person-centred-care
ORGANISATIONAL POLICIES & PROCEDURES
Most care homes will need to have specific policies in place to satisfy CQC’s Fundamental Standards and legislation, which you would have found within this guide.
- Organizational Handbook
- Code of Conduct
- Care Certificate & Mandatory Training
- Training and Development
Codes of Conduct
Source:
The Care Certificate
Source:
https://www.skillsforcare.org.uk/Developing-your-workforce/Care-Certificate/Care-Certificate.aspx
https://www.skillsforcare.org.uk/resources/documents/Developing-your-workforce/Care-Certificate/T
Most staff employed would have already provided all the necessary information and references to start employment and have completed Super-numeri or shadow shifts. Some or part of this process may include being shown where the Company or organization Policy and Procedure file is located, of which may include;
- Personal Care
- Medication
- Covid Safety and Management
- Infection Control
- Food Hygiene
- Fire Safety & Evacuation
- Health and Safety
- Moving and Handling
- Mental Capacity
- Safeguarding
- Whistleblowing and Reporting
DUTY OF CARE
Defined as ‘a moral or legal obligation to ensure the safety or well-being of others’, this refers to the obligations placed on people to act towards others in a certain way, in accordance with certain standards. The term can have a different meaning depending on the legal context in which it is being used.
Source:
https://www.rcn.org.uk/get-help/rcn-advice/duty-of-care
As care assistants and care support workers, think about how you implement these in your daily role, think about the process in which your delivery care and how you keep these five principles in mind as you perform all your daily duties and actions for the individuals you care for?
How can you reflect this in your answer, when does it work and what you need to develop as you progress through this course?
Responsibilities and Accountability of Care Given;
The importance of working within your own competency, do not be afraid to seek advice and ask questions, senior care staff are also a source to support your learning and development within a health and social care organization. There will be plenty of unusual experiences that may upset or confusing, however as a junior member of the team, ask questions. As time elapses, you will grow in confidence, will look to resources some are included to enhance your understanding and knowledge.
Think about when you are at work and how you may implement this into your work, some of which you may already do but not fully understand the impact, but understanding how this impacts a person through slight changes in practice can have huge benefits to the individual. How can you better incorporate this into your work environment?
Care Values
- Listening to and respecting the ideas and opinions of the person you are caring for – such as their choices and the best way to achieve this. Can they verbalize this to you or do you show them?
- How you build a relationship with the individual and form a partnership
- Promoting Respect, Integrity, and Independence
- Promoting Equality and diversity
- Being mindful of people’s emotions and feelings may reflect how well they engage in the support you are offering?
- Developing confidence and self-esteem and encouraging them with independent tasks they can still do with a little help
- Protect their rights and promote their freedoms
- Be a listening ear, show emotions, care, empathy – remember vulnerable people just want to be treated normally, they just need some support.
- Understand people’s conditions such as Dementia, Mental Health, Physical incapacity, Learning difficulties and the signs of distress
Aggitation and anxieties generally arise from NEEDS not being met, therefore changes in how people behave, react, settle, eat and drink, engage etc may change and this can impact other areas more significantly. Therefore, very important to understand how crucial PERSONAL HYGIENE aspects impact a person on a day-to-day basis.
BARRIERS
The Types of barriers people may experience and how they can be overcome by the service providers or users:
- Physical barriers
For example, issues getting into and around a environmental area whether this is home or out in the community, physical restriction in joints, additional pain, nerve difficulties, amputation, spinal instabilities, broken bones being treated in casts, paralysis, Ms, Me or other neurological deterioration disorders
- Sensory barriers
For example, hearing and visual difficulties, Cognitive processing and understanding of spoken language
- Social, Cultural, and psychological barriers
For example, lack of awareness, differing cultural or spiritual beliefs, social stigma, fear of loss of independence, Anxiety, BI-Polar
- language Barriers,
For example, differing first language, language impairments, Poor knowledge of British Spoken language, Mental translation processes and mixing words etc
- geographical or Environmental barriers
For example, distance of service provider, poor transport links, Physical limitations, Household design or layout
- intellectual barriers
For example, learning difficulties, Down syndrome, ADHD, Autism, Cerebral Palsy, Congenital Birth defects etc
- Resource barriers for service provider
For example staff shortages, lack of local funding, high local demand, Reduced service availability, Charity closures, Running costs of coffee mornings or lack of volunteers etc
- financial barriers
For example rising living costs, reduction in benefits, direct payments not covering needs, saving depletion or selling property, Running costs of car or mobility, cost of transport, loss of income or inability to maintain financial stability due to own difficulties, inequality, discrimination or attitudes of association etc
Care Standards
Source:
https://www.cqc.org.uk/what-we-do/how-we-do-our-job/fundamental-standards
https://www.skillsforcare.org.uk/Home.aspx
Health Education England www.hee.nhs.uk
Skills for Health www.skillsforhealth.org.uk
https://www.hse.ie/eng/services/public
https://www.england.nhs.uk/wp-content/uploads/2016/04/nhsiq-comms-eolc-tlkit-.pdf
1.2 Explain the importance of complying with health and safety guidance
http://www.hse.gov.uk/legislation/hswa.htm
http://www.legislation.gov.uk/uksi/1999/3242/contents/made
http://www.legislation.gov.uk/uksi/2005/1541/contents/made
http://www.hse.gov.uk/work-equipment-machinery/puwer.htm
http://www.hse.gov.uk/work-equipment-machinery/loler.htm
Health & Safety Act 1974 – sets out how employers, employees and the self-employed must work in a safe way, giving every person on the work premises legal duties and responsibilities. As this act is very general, subject-specific ‘regulations’ have also been put in place to help every workplace to be safe. The main reason for health and safety legislation is to protect people at work and those who are affected by work activities including those who receive care and support.
Most employers have a health and safety policy which sets out how they will protect everyone who is affected by their business, including employees, visitors, contractors, and individuals who access services. Even if your role involves working in the private homes of individuals you need to know what health and safety legislation applies there. Ask your manager about policies that are in place to support your health, safety, and wellbeing in all the places in which you work.
Agreed ways of Working include;
- A Policy – is a formal course of action that everyone must follow.
- A Procedure – is a set of foundations to explain or demonstrate a way in which specific tasks or duties must be carried out
- Use ELITE
- Environmental Risk Assessment and removal of any obstruction
- Prepare Area to maintain yours and persons safety
- Remove any risks – therefore reducing occurrence
- Infection Control – Safe Disposal Methods
- Biological Waste Disposal
- Hazardous Waste Disposal
All care staff are expected to be accountable and responsible for taking reasonable care of yourself and others within any work environment, the organizations policies and procedures are set to ensure that employers put in all the correct protocols or policies that enable the health and safety of all to be maintained. Staff must follow this expectation and not act in a way which can cause an accident or contribute to the ill-health of others including staff. Within any health and social care environment, different individuals can have a variety of needs therefore its important to be aware of their strengths – what they can do and their limitations- things they cannot do or that put them at significant risk of injuries of equal or intense level, often these can lead to a hospital admission as a result due to the nature of their physical levels whether this is fit and healthy up to elderly and frail.
1.3 Explain the importance of using aseptic techniques
Aseptic technique is a collection of medical practices and procedures that helps protect patients from dangerous germs. Bacteria, viruses, and microorganisms are everywhere, so using aseptic technique can help keep important equipment from being contaminated.
Things to Consider in your place of work whether this is in the community, residential Homes, Nursing Care, within a clinical environment or other hospital specialisms, you will need to think about;
- Legislation and Regulations
- Organizational Policy and Procedures
- Actual Risks to vulnerable people or children – Meningitis, Sepsis, Measles etc
- Hazards – Covid, MRSA, C-difficile etc
- Bacteria & Viral Transmission
- Infection Control Measures
- Accountability & Responsibilities
- Procedure or Method
- Application or Implemented
Think about what these are, how they impact people, how they impact the care worker, impact the environment etc, and what systems and procedures do you use and have in place.
Things you may want to ask yourself when answering this element –
- How do you perform this technique in your daily role?
- What methods do you use?
- What disposal methods are in place?
- How do you reduce transmission?
- Do you have a high sickness rate or low sickness rate within your working environment – think about why this is?
Sources
RCN -Understanding Aseptic Technique An RCN investigation into clinician views to guide the practice of aseptic technique (February 2020 -RCN Online www.rcn.org.uk)
NHS – Community Infection Prevention and Control Policy for Care Home setting – Aseptic technique (IPC-Version 2.00 July 2020)
Nursing Times – https://www.nursingtimes.net/clinical-archive/infection-control/principles-of-asepsis-1-the-rationale-for-using-aseptic
Adults – Aseptic technique: key principles (NHS)
https://www.royalwolverhampton.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=13614
Know the anatomy and physiology of the skin, nose, mouth, eyes and ears in relation to cleansing
2.1 Describe the anatomy and physiology of the skin, nose, mouth, eyes and ears in relation to cleansing
- SKIN
- NOSE
- MOUTH
- EYES
- EARS
3 Be able to prepare for undertaking personal hygiene activities with individuals
3.1 Explain the importance of following the individual’s care plan
The 7 Principles of DUTY OF CARE include;
- Choice & Inclusion
- Communication.
- Confidentiality & Safeguarding from Harm & Abuse
- Privacy
- Independence
- Relationships and partnership working
- Safety
- Dignity
- Respect
- Rights & Freedoms
- Equality
TO Carry out the personal hygiene:
- at an appropriate time according to the individual’s plan of care
- Give the individual relevant information,
- To support and reassurance in a manner which is sensitive to their needs and concerns.
- The importance of gain valid consent to carry out the planned personal hygiene.
- Standards of Care – Core Values
- using appropriate techniques or Methods
- Provides guidance on how people need their support given
- The importance of reporting changes in physical, Health, social, mental health changes
- Identifying Triggers and awareness of risks
- Explains a person’s strengths
- Describes what support they have difficulty with or problems they experience daily
- Equipment is used in line with manufacturer’s instructions
- Equipment is used in a manner which optimizes the patient’s comfort and dignity and minimizes pain and trauma
Consider – This is what you will need prior to supporting a personal hygiene activity, however what other activities would you carry out daily and need to get ready for someone to be supported with their needs but also their safety?
- Towels – Flannels – (Think about hygiene and contamination and appropriate use)
- Hygiene – Wipes, Dry Wipes
- Washing – Soap, Shower Gel, Bath liquid or foam, Shampoo, Conditioner
- Shaving – Razor, Shaving Brush, Shaving Soap, Shaving Foam or Gel
- Skin Care – Emollients, Lotions, Creams
- Continance Care – Pads
- Disposal Methods – Things you use to dispose of the wipes and soiled pads etc
- Clothing – How have they chosen their outfits, will this keep them warm, do they have suitable footwear a person safe or being aware of the potential for harm or injury during tasks.
- Equipment Used – use TILE / ELITE
- Risks around the person – Consider eventual outcomes of not keeping
- How are Person centred Values promoted and supported?
- How this relates to codes of conduct and care standards etc
- What are the risks should these vital areas be missed?
- Think about the impact this may have on someone’s needs and consider if missing steps can lead to missed areas of wellbeing not being met.
The Definition of health and wellbeing: a combination of physical health and social and emotional wellbeing, and not just the absence of disease or illness.
How is wellbeing impacted – Consider how this may affect an individual you care for by considering;
- Physical Impact
- Biological Health impact
- Intellectual or Psychological Impact
- Mental Health Impact
- Social Impact
- Environmental or Economic Impact
- Cultural Impact
- Spiritual or Religious Impact
What contributory Factors can you think of, that would have a positive impact or a negative impact or outcome on an individual’s wellbeing?
Considerations include;
- genetic inheritance, including inherited conditions and predisposition to other
- conditions
- ill health (acute and chronic)
- diet (balance, quality, and amount)
- amount of exercise
- substance use, including alcohol, nicotine, illegal drugs, and misuse of prescribed drugs
- Personal hygiene.
- Mental Health or Mental Illness
- supportive/unsupportive relationships, social integration/isolation
- Stress or Anxieties
- A willingness to seek help and support or access services – what may these be influenced by?
- Conflicts around Culture, Religion, Gender, Ethnic Origin, Education etc
- Financial Difficulties or lack of
- Environmental elements – noise, pollution, community and people within this, Level of Housing and suitability, Location itself, access to public transport or shopping etc
- Life events relating to relationships
- Circumstances changing
Other areas of the plan will include
- Emmergency Contact Information, Preferences
- Emmergency documents such as a transfer doc or DNAR
- Medical or Health History
- Mental Health Plans
- Physical Care Plans
- Medical Plans
- PRN Medication Plans
- Medications
- Allergies
- Communication Planning
- Thinking Plan
- Behaviour support Planning
- Strengths and Weakness assessment or plan
- Wellbeing Plan
- Risk assessments
- Personal Figures
- Assessments
- Care Notes
- Body Maps
- Professional Log of outcome of visit
- Documents from Discharges, Gp summary, Emails, or other communications with outside people
You may also see DoLs documents or Mental Capacity Best Interest forms. This is a document that sets out capacity and weighed against need, to prevent potential risk or neglect from occurring and to enable the right support to be provided against the potential outcome and the adherence to duty of candour and duty of care. If you are not sure, do ask your supervisor or senior when you are next on duty. All care environments have differing forms, formats, systems, and some use electronic recording.
3.2 Explain why resources should be prepared prior to commencing the activity
Active participation is a way of working that recognizes an individual’s right to participate in the activities and relationships of everyday life as independently as possible; the individual is regarded as an active partner in their own care or support, rather than a passive recipient
Well-being may include aspects that are:
- social
- emotional
- cultural
- spiritual
- intellectual
- economic
- physical
- mental.
Work setting – This may include one specific location or a range of locations, depending on the context of a particular work role.
Policies & Procedures may include other agreed ways of working as well as formal policies and procedures.
Others may include:
- team members
- other colleagues
- those who use or commission their own health or social care services
- families, Carer’s and advocates.
Your responsibility as a care worker
- Agreed ways of working include policies and procedures where these exist; they may be less formally documented with smaller employers however are still very important alongside care certificate training and codes of conduct.
- Know the difference between personal and professional relationship
- Can identity different roles and relationships of people you work with
- Keeping to agreed ways of working
- Following Training and Standards for best practices
- Aim to provide quality Care to vulnerable people and make a positive difference to their lives
- Be able to work with other professionals
- Able to express how you would refer for support for the individual
- Understand the skills and Approaches required to resolve conflicts and find solutions
Tasks that the Care Work should NOT carry out without special training may include those relating to:
- On supervision, Super-Numeri or Shadow shifts to be with an allocated member who is competent to mentor and explain systems used, where to find information, who to ask etc
- use of equipment not trained to use
- Advanced Fist Aid – Unless qualified in BFAW, AFAW, BLS Etc
- Medication
- Health care procedures
- Food handling and preparation.
Use of personal protective equipment (PPE)
- All care staff are required to know the different types of PPE
- How to use PPE correctly and appropriately in their work environment.
- What to Use and When
- How to remove in a non-contact way – Known as Donning & Doffing
- Hygiene and Skin Care
- Waste Disposal Methods & Procedures
- Appropriate use may, in some cases, mean after consideration PPE is not required
Identify Unsafe practices such as;
- poor working practices
- Poor Attention to Personal Care
- Inattention to continance needs
- Not using own clothing
- Not adhering by Infection Control methods
- Not disposing of waste appropriately
- Being care less with own hygiene
- Not laundering clothing
- Not changing clothing when this is soiled or has an odour
- Staff or resource difficulties
- Not taking someone to the toilet and them experiencing an accident
- Using a pad when they don’t need to use one
- Not providing enough fluid and food to satisfy Hunger and thirst
- Using broken or worn equipment
- Not risk assessing device or working environment
- Not attending to the needs of those you care for
- Ignoring pleas for help and support
- Being aggressive and agitated when individuals ask for help
- Restricting their freedom
- Not adhering to care principles
- Unsafe staffing Numbers not sufficient to meet needs of Individuals within home.
- Not changing bedlinen Frequently
3.3 Confirm all equipment and materials are fit for purpose as outlined in the individual’s care plan
Individual refers to someone requiring care or support; it will usually mean the person or people supported by the care worker.
Needs, wishes and preferences can include:
- importance of other people recognizing peoples unique individual needs
- Stage of Life
- language
- preferred method
- additional learning needs
- physical disabilities
- Phycological Impact of Reduced Mobility
- Physiological Impact of Reduce Mobility
- cognitive and communication difficulties
- alternative methods of communication, e.g. language: British Sign
Active participation is a way of working that recognizes an individual’s right to participate in the activities and relationships of everyday life as independently as possible; the individual is regarded as an active partner in their own care or support, rather than a passive recipient
Key Legislation
- Current legislation
- Guidance
- Best Practice
- Company Policy and Procedures
- Codes of Conduct
- Good practice Guidelines – NICE, NHS
as prescribed/detailed in the individual’s plan of care
- Do they need assistance with Moving?
- How many people are required with assisting individuals with transferring or mobility support?
- Do they need help to help to get in and out of Bed?
- Does the person need bedrails?
- Is the person Mobile?
- Are there immediate risks present?
- Action you may take to reduce or remove the risk presenting?
- Are there identified Risks?
- Identified potential Hazards?
- Do they use an Aid – Such as walking Stick, Rollator, Walking Zimmer Frame etc
- Does the Person need a stand aid or hoist to transfer?
- Does the person need to use a pressure or Gel device to reduce risk of skin breakdown?
- How is Consent Gained?
- How is mobility Assessed in your work place?
appropriate to the procedure
- Is this the right person?
- Is this the correct device or Aid?
- Promoted Active Participation and Care Values?
- Does the Plan specify the device name, and maximum load?
- Does the plan detail the sling, serial number, loop settings and other information required under regulatory requirements?
- Is the equipment Shared?
- Where are devices Stored when Not in use?
- Understanding the safety aspects when moving and possitioning people – what could happen?
- Do individuals use their own allocated equipment to reduce infection control?
- Is the equipment in reasonable condition or showing signs of deterioration?
- Does the device have a maximum weight load visible to ensure this is the correct device?
- Can you visible see a service sticker?
- Has the equipment recently been inspected to ensure it is appropriate and safe to use?
- Who would you ask to find out its last service or report issues with the device?
fit for purpose
- Are staff fit to operate the equipment?
- Do any of the staff have any other reasons why pushing and pulling a device could cause them harm or injury – such as arthritis, structural or nervous ailments flaring, pregnancy etc
- Do you perform a general check before you use the device?
- Is the battery Charged and where is this stored when not in use?
- Have you performed a visual analysis of your working environment?
- Do you need to remove objects to clear space?
- Is the procedure appropriate for the person’s needs?
- Is the sling in good working order – that is any faults?
- Do you regularly check the quality of the sling before use?
- How are you communicating with the person whilst they are using the device?
- Do they have sensory impairments which increase their anxiety or fears?
- Are they included and involved with what is happening and when?
- How do you provide reassurance?
- When does the sling get laundered?
- How do you record Changes to someone’s mobility Needs in your own work place?
- Who do you report mobility concerns, difficulties, or problems to in your own workplace?
- What other sources of information could you use to learn and understand manual handling further?
- Is the equipment promoting their independence?
3.4 Confirm the individual’s identity and gain valid consent
What does consent mean?
CONSENT
- What is consent? Can this be defined?
- How is the persons consent communicated and is this recorded in their care plan?
- Do they provide this Verbally?
- Is this implied Consent?
- Are there different types of consent?
- How do we gain or understand how people communicate their consent?
- How can we document and provide evidence to demonstrate correct method and procedures of consent had been gained at all stages of care and support?
How do you gain consent from your residents and service users?
Think about how they may communicate this, what frustrations may be shown. Do they exhibit repetitive behaviours? Do they use a device or aid to respond to you? Can they understand what you are saying? Do they have sensory loss and therefore have additional areas to consider that could impact how they interact with you!
Reflect on your practice by asking yourself
- How do you achieve supporting someone to provide consent?
- What activities need different types of consent and when
- How do you know the person is the person and establish this?
- Where would you find this?
What do you attend to when you give yourself personal care? Does this include Washing and changing, shaving, brushing your hair, showering, using the bath, trimming your nails or getting nail extensions polished, having your eyebrows shaped, having your beard relined and tidied, applying makeup, deodorant and smellies, having clean clothes, wearing what you wish to demonstrate your own identity, hand hygiene etc The fact is that we attend to out own needs in the same ways but these are crucial to how people feel, how they perceive others, their thought, mental health, confidence, personality, interact with others, communicate etc…..
Using a Person Centred Approach can be beneficial as this will;
- Promote Care Values and quality care
- Encourages active participation – person feels included and central to their care
- Promotes their Choice, Dignity, Self-Respect, Identity, Integrity and Privacy
- Promotes better relationships
- Supports Trust, Friendship, Self-Worth and feeling Valued as n individual
- Encourages awareness when supporting individuals to maintain safety and support them to avoid potential injury or harm.
3.5 Communicate information in a way that is sensitive to the personal beliefs and preferences of the individual
Think about the ways people can communicate that you work with and how you support them to maintain personal safety or explain important things, how do you achieve this? Have you already identified difficulties that impact how they interact with others? How do you protect those who have no ability to recognize risk and keep themselves safe – how do you support this within the least restrictive way?
Communication Skills
This is how staff use their own skills and knowledge and communicate in a way that the individual can understand and produce a response or choice or decision. It is important people know what is happening around them, have that pre warning and know what’s happening and when, they need it feel and have control especially when people suffer with sensory difficulties and cognitive diseases such as brain disorders, Dementia, Parkinson’s or other neurological or degenerative diseases etc
This is fundamentally a main link especially when delivering intimate and private washing, people need to feel included, feel valued, feel protected, feel respected, understand, and can provide consent through the stages aswell as staff understanding that they may experience anxieties, fears or feel invaded especially if the opposite sex care giver is delivering care, not everyone can accept care from men or from women.
- Staff will need to identify how people prefer to communicate
- What aids they need – Glasses, Hearing Aids, Picture Cards etc
- Do they prefer one side over the other for people to communicate with them?
- How does their disorder or disease impact how they understand you?
- Do they prefer Male Care Staff or female staff to deliver care?
- Do they have fears or anxieties?
- Have they had a bad experience before and take time to trust people?
This takes time, trust and relationship building to reduce how someone may react or feel or behave as a result. This however is not a quick fix, it takes time aswell as the right approach to suit the persons needs whether this is mental health, mental illness care, Dementia Care, Community Care etc and lots of patience and relationship building.
Other things to consider include the individuals own Preferences, Choices, Wishes, Beliefs, Cultural or religious requirements or needs, however staff need to know how a person may communicate which could range from;
Non-Verbal Communication
- Eye contact
- Touch
- Physical Gestures
- Body Language
- Behaviour
- Sign Language
- Braille
- Picture Formal
Verbal Communication
- Verbally responds in Normal Language
- Uses vocabulary
- linguistic tone
- Pitch
Using Assistive Devices or Technological Aids
- Text to speech
- Touch Pads
- Tablets
- Eye to speech devices
Services an individual may use or need access to include:
- Accessing translation services
- Needing a referral to access interpreting service
- Access to speech and language services
- Access to advocacy services
Sharing Information to consider;
- Codes of Practice relating to handling Information within Care Settings
- Legislation or Regulations
- Main requirements of Information sharing
- Explore the manual Features to maintain security of Information
- Explore the electronic Features to maintain security of Information
- Keeping Care records up to date, complete, ensuring accuracy meets needs, and documentation can be easily read – that is clearly legible and read by others
- Own roles and responsibilities of when to share information and who that would be
- Supporting other staff to understand and explaining principles of GDPR or Data Protection
Be able to undertake personal hygiene activities with individuals
4.1 Apply health and safety measures relevant to the procedure and environment
- How do we assess Hazards and Risks and identify these?
- What information do we need and where would we get these resources or information from?
- What do we do to Remove or Resolve this?
More serious Hazards which would cause catastrophic injuries could include;
- Fire Route Obstruction
- Doors wedged open
- Carpets frayed
- Hoist slings aging and the structures becoming weak
- Un-serviced fire equipment
- Lack of first aid equipment
- Transporting devices such as wheelchairs unfit for use
- Stand aids sowing faulty wires or broken of sections that may injure a service user
- Old Hoist devices
Think about what you would need to do on a basic day in your role – How are you checking these things?
Consider what hazards or potential for injury or harm is involved in
- Washing and dressing
- Mobility – use of equipment safely, supporting someone to stand or whilst being hoisted etc
- How you would support someone to and from the toilet
- How you support someone to get in and out of a chair
- When using a toilet – the flooring, the seat itself, grab rails etc
- Level of dependance depends on how able or not able a person is
- The space being used
- Objects in the area you are working within
- People within the environment
- Biological hazards from unwell individuals
- Sanitation and handwashing areas
- How mobile are the individuals you care for – what risks present in hallways or by doors etc.
- Laundry and old towels and flannels draped within the persons bedroom –
The employer has a legal duty to provide a safe place of work, organize and implement training and ensure that the environment is appropriate and safe to work in, including any equipment or tools required to carry out our duties when working with vulnerable people, young or frail.
Policies & Procedures must reinforce legislation duties and the regulatory duties a health and social care organization has to ensure people remain safe and are not harmed or injured at any stage. Regulatory duties are set out by CQC who are the body that inspect health and social care organizations and who have a set of standards which they feel meets best practice. This can be found on their website under fundamental standards. Examples include – How to Use, safety check equipment and store this correctly, how to dispose of PPE, Waste disposal, use of chemicals, recording and reporting of accidents or injuries, how to provide personal care, moving and handling of people, manual handling of objects, fire protocols and evacuation procedures, First aid, Food Hygiene, Laundry washes, separation, and storage etc
4.2 Apply standard precautions for infection control
To understand your own role and responsibility in relation to prevention and controlling infection
- Understand the employer’s role and responsibility in managing prevention and control of infection
- Identify Government Policy and Guidance & Outline current legislation & Regulation
- Outline any standards relevant to infection control
- Describe procedures and systems used nationally and within your own work environment to prevent and control infection
- Be able to explain the impact of an outbreak on the Individual aswell as the company or organization
Importance of PPE in the prevention and control of infections
- Define and understand risks within your work environment
- Understand the processes for Risk assessment – Why is this important?
- Legislation relating to PPE
- Discuss yours and the employers Role and responsibilities regarding use and disposal of PPE
- Understand and can demonstrate and describe how-to put-on PPE correctly and remove this correctly to avoid contamination
Waste Management & Disposal
- Understand how to maintain a clean environment
- Documentation and records to show when cleaning ahs been carried out and when
- How does this minimize infection and contamination spreading
- Color Codes
- 3 STEP Decontamination procedure
- Cleaning Agents
- Disinfecting Products and equipment
- Use of PPE during Cleaning
- How to deal with General waste, Clinical and Biological waste without risk to others
- Waste Storage and disposal procedures
- Understand and can identify the Hazard Warning Labels with the Risk
- Sharps Storage, Injuries and Procedures
- Own home systems – Policy and Procedure
- Legislation and Guidance
- When equipment should be cleaned
- How equipment is stored
Personal Hygiene
- Understand and know the key features of good personal hygiene
- Can demonstrate and show effective but appropriate method of handwashing
- Identify sequences of hand hygiene routine
- Be able to explain when hand hygiene is performed – How often do you change ppe and replace this? Do you wash your hands in-between?
- What products are used to remove bacteria from contaminating other surfaces?
- How do you care for your skin care – does your company have a skin care guide or procedure?
4.3 Carry out personal hygiene activities in accordance with the individual’s care plan
Key Value Words
- Individuality
- Rights
- Choice
- Privacy
- Independence
- Dignity
- Respect
- Care
- Compassion or Empathy
- Courage
- Communication
- Competence
- Partnership
- Integrity
Term: Individual
Relates to someone requiring care or support; it usually means the person or people supported by the learner whilst within a care environment, this may be in a clinical, Nursing, Residential, Domiciliary environment.
Care Plan
Can be known by other names such as a support plan, Medical Plan, or individual plan. It is the document where day-to-day requirements and preferences for care and support are detailed
How do you apply these in the workplace? Think about all the tasks involved during your day from the start until the finish and think about how many times you may actively involve these in your daily duties?
Are you……..
- Treating individuals with respect & valuing their individuality Promotes confidence and more likely to talk to you if they may be abused
- Promotes a person’s dignity through ensuring they do not feel dehumanized or humiliated through invasion of their private or personal space
- Showing compassion & Empathy through taking time to understand and communicate with the person, demonstrate respect, and show you value their individual personality
- Promoting and encouraging active participation. This is a way that puts the individual central to involvement and being included in how their care is provided or given. This means being included in care planning, interaction with staff, having a routine independent of others, getting up or going to bed at specific times, doing routine tasks, wanting to be active and have purpose etc
- Promotion of independence – what they want to do themselves, where they want to go or attend specific activities because this is an interest for example Chess, Walking Clubs, Pilates, Yoga etc This encourages them to maintain a sense of themselves for a little longer and allows them to decide and choose and have their preferences heard and acknowledged.
- Person Centred care is not led by the care giver or organization (Service Led), it is led by the needs and wellbeing requirements of an individual which promotes choice, inclusivity, control, ownership, value, empowerment, and human, (this is called needs led)
- Promoting Choice trough providing options whether this is verbally communicated or other methods used, or if this is presented so they can choose with their sight and therefore more likely to enable daily decision making to continue, but also the persons individual rights. Which is really treating someone how you would want to be treated, equally and maintaining own self integrity, identity, individuality, personality as people will feel respected and valued.
- If this is done successfully, this also will reduce likely abuse and neglect as individuals’ needs are put first and focus is on their best interest. In most cases, a vulnerable person can have any age.
- Promoting personal safety through effective prompting and reminders or demonstrating, this can be done through a variety of methods such as information leaflets, easy read documents, sign language, or other communication tools used to maintain participation and involvement to reduce the risks where possible.
Other Things to think about – Establishing what people’s own
- Beliefs
- own personal values
- Cultural and Spiritual
- religious routines, choices or preferences
4.4 Ensure that the individual’s privacy and dignity is maintained
Think about how dignity impacts the individual and the importance of
- Privacy
- Being able to Trust other people, other professionals, advocates, Nurses, Gps, Care staff etc
- Show and demonstrate Understanding of all of their needs – how do you support people to meet their daily needs?
- The importance of how staff conduct themselves, show moral regard – When do we show this or why would this be crucial?
- Staff provide understanding and empathy – How do we show this?
- Staff have awareness of delicate areas of support and how invasion of privacy may cause distress – How do we promote privacy in practice?
- Staff being aware of the signs and symptoms of abuse – A trusting relationship is almost going to identify as the person may confide more easily
- Providing re-assurance and respect when someone feels embarrass
- Providing gentle and sensitive approaches – how is this shown, body language, tone, phrasing
- Keeping flow simple and uncomplicated
- Maintain communication route – How would we achieve this, what things would you need to consider to open routes up to connect?
- Having awareness and regard for their Safety – How do we identify risks and where may risk assessments be found, who completes these and what risk assessments do you have in your work?
4.5 Observe the individual while providing support and reassurance and address any concerns
The 7 Principles of DUTY OF CARE include;
- Choice & Inclusion
- Communication.
- Confidentiality & Safeguarding from Harm & Abuse
- Privacy
- Independence
- Relationships and partnership working
- Safety
- Dignity
- Respect
- Rights & Freedoms
- Equality
Abuse & Neglect
The legal definition of abuse – Abuse is an action that intentionally causes harm or injures another person
- Abuse and neglect are forms of maltreatment of a VULNERABLE PERSON or CHILD. They can be caused by inflicting harm or by failing to act to prevent harm. VULNERABLE PEOPLE & Children may be abused by a family Member, Fiend, any adult in or out of an institutional or community setting, on most occasions is by who is known to them or, much more rarely, by a stranger.
Source: The Social Care Institute of Excellence
https://www.scie.org.uk/safeguarding/adults/introduction/types-and-indicators-of-abuse
Types of Abuse include;
- Physical
- Domestic Violence
- Emotional or psychological abuse
- Sexual abuse or mistreatment
- Financial or Material abuse
- Self-Neglect
- Discriminatory Abuse
- Organizational o Institutional Abuse
- Neglect or Acts of Omission
- Modern Slavery
- Female Genital Mutilation
- Forced & Arranged Marriages
- Radicalization & Prevent
REPORTING AND WHISTLEBLOWING PROCEDURES & CONFIDENTIALITY
- Think about when you may need to breech confidentiality
- Think about how you may feel if staff were talking between themselves about another resident Infront of you, but is not about you.
- Think about how attention to personalized Care is delivered – Are others promoting the Care Values? Who would you discuss your concerns with if this wasn’t the case?
- Is the person vulnerable to being Abused or Neglected or allowed to self-Neglect?
- How do you identify signs and symptoms – what sorts of things would you be looking for or have observed?
- What are your responsibilities in terms of safeguarding people you care for?
- Think about when it is appropriate and not appropriate to discuss people you care for
- When do you need to breech confidentiality – What does your organizational policy and procedure tell you?
- Can you locate you organizational Policy and Procedure File?
- Do you have access to Care Certificate information and a copy of the skills for care Code of conduct?
- What have you learnt from care codes of conduct and the care certificate around confidentiality and reporting?
- Are you able to list the procedures to show how you may report this in reality?
- Who would you inform?
- How should the information be shared?
- How might you document this – would this be formally or on an informal basis?
- Are you protected under confidentiality and whistle blowing procedures? What do these procedures tell you?
- Protection of disclosure?
- How do you document this?
- What do you write in the Care Notes?
- Think about the forms you may need to complete – what would these be?
- Think about how this would be respectfully worded in the care notes and plan (Remember All care documents can be used in a court of law, therefore notes must be clear, concise, a true reflection of events and activity, must include choices, wishes, preferences and decision opportunity, their mood, how they presented, what had been said, whom they said it to or disclosure referenced? Carers MUST understand that this highlights importance of accuracy and truthfully, as you may need to reference this should any incident ever go to court)
- Documentation needs to be in black white – so it can be read and copied well even if photocopied
- Documentation must avoid paraphrasing – using shortened words or abbreviations
It is important to practice Reflection, this is considering or thinking about included prompts below, which provides you with real life, practical developmental learning opportunity which may Include;
- identifying your own strengths and areas for improvement against the care values
- Allow for you to discuss with others and receive practical real work-based feedback from other senior staff or even the service users around what you can do and what you need to improve – Effectively evaluating you own performance
- Being able to then respond positively to constructive feedback and identifying ways to improve own performance to make changes, progress and develop your skills and knowledge areas.
4.6 Describe action to take in response to adverse reactions
Considerations;
- Why you should follow the procedure exactly as it is specified, and the potential effects of not doing so.
Using correct equipment
Safety
Infection control
Impact on mental health
Impact on physical wellbeing
Socially removed from friends or acquaintances
Impact on Health
Skin Problems – dry skin, scabies, eczema, psoriasis, lesions
- Understanding the importance of undertaking personal hygiene with service users
- Neglect
- Abuse
- What to identify in terms of
- Allergy
- Adverse reactions
These are not quite the same, similar but not the same.
- Why questions which are beyond your role or knowledge need to be passed onto the appropriate member of the care team.
Be able to record and report the outcome of the personal hygiene activity
5.1 Record the outcome of the personal hygiene activity
Things to consider when documenting this in care notes
the importance of keeping accurate and up-to-date records
the specific records required for each personal hygiene activity you are required to undertake
5.2 Report the outcomes of the activity to a member of the care team in line with local policy
CONSIDERATIONS TO THINK ABOUT;
- The importance of any discussions the person made
- Importance of changes in their mood
- The importance of immediately reporting any issues which are outside your own sphere of competence without delay to the relevant member of staff