Providing personal care normally includes helping service users with aspects of daily living such as washing, going to the toilet, dressing, oral care, eating and drinking. Support in such aspects of care should be provided by trained staff with sensitivity, compassion and respect for people’s privacy and dignity. Personal care should be based on needs assessment and designed to ensure that people can retain their independence for as long as possible.
Care service managers are responsible for making sure that the care provided is well planned and organised and that their staff carry out their tasks in line with the above values and principles. They will need to be constantly monitoring their staff’s care practices, regularly reviewing them through supervision and developing and improving them through relevant training.
This topic outlines and discusses the principles and key tasks involved in the provision of personal care and the supervision and training issues that need to be addressed.
Employers are responsible for:
the planning, organisation and management of their personal care provision to the standards required
the registration of their service with the relevant regulatory body
making sure that all aspects of the service are legally compliant
providing appropriate guidance, supervision and training to their staff
regularly monitoring, reviewing and auditing their staff’s care practices
listening to their service users about the care provided
making sure that their service is socially inclusive, is non-discriminatory and reflects equality and diversity principles.
Care staff must make sure that they:
provide person-centred care by respecting the rights, wishes and needs of their service users, including their communication needs
keep service users safe from harm during the performance of their care tasks
keep themselves safe from harm by following all health and safety procedures
work to the care plans that have been agreed with the service users and their representatives
involve service users who might not have the mental capacity to make their own decisions about their care as they would service users who have decision-making capacity
follow all the good practice guidance provided
are aware of the standards of care to be achieved and achieve them in their day-to-day practice
seek appropriate help where needed and make good use of the supervision and training opportunities provided.
Personal care usually refers to assisting a service user with any care that is of a personal or private nature.
This definition encompasses activities such as:
help with washing, bathing and showering
providing skin care
providing hair care and shaving
care of fingernails
care of toenails and feet
oral hygiene and care of teeth, including toothbrushing and care of dentures
helping service users to dress
helping service users to eat and drink
aiding the management of continence — including going to the toilet, stoma care, catheter care, bed changing, etc
help with mobility or transferring, such as from bed to chair
help with surgical appliances and fitting prostheses.
Help with activities such as washing, bathing and going to the toilet are often referred to as intimate personal care. Personal care needs are also often referred to as activities of daily living.
The intimate and personal nature of most personal care needs means that dignity and privacy are key considerations in the delivery of support and care. It is particularly important that care staff adopt a sensitive and compassionate approach. Many service users may feel considerable embarrassment or frustration in having to receive personal care.
Personal care can be provided in both residential settings and at a service user’s home. It is important that in a residential care suitable privacy is available for intimate care to be carried out discreetly and with due regard to dignity.
A distinction is often made between personal care and nursing care.
Personal care needs should be identified during initial needs assessment and kept under review.
It is important when assessing personal care needs that the following factors are taken into consideration:
the assessment should be truly personalised to the needs and preferences of the individual concerned
always take the individual’s lifestyle choices into consideration and respect their wishes, eg choice of dress and hairstyle
consider cultural factors
consider communication needs
avoid making assumptions about appropriate standards of hygiene for individuals
plans should be developed that promote active participation and dignity while also supporting the individual
identify risks, such as bathing or showering risks relating to hot water
address any difficult or challenging behaviours relating to personal care.
Each person’s likes, dislikes and preferences should be recorded on their individual service user plan. All care planning should be person-centred, especially the planning of intimate personal care. The plan should include details of what the service user can do for themselves and what they seek to do for themselves.
Personal preferences are an area of key importance in consideration of personal care and hygiene needs. How someone wants their hair to look, how they want to dress and how a woman wants their make-up applied are intensely personal decisions and can vary from day to day. Care staff should use tact and sensitivity and support the individual to provide the degree of assistance they prefer.
The needs assessment should include any current or potential difficulties arising from the service user’s behaviour or situation and their relationships with carers and others involved. This is particularly relevant in domiciliary home care where support may be provided in partnership with others, such as close family members. In some cases, a service user may feel that carers are doing too much for them and they may wish for more independence. In other cases, a service user may feel that they are being encouraged to perform personal care activities that they cannot do.
Careful planning, organisation and effective management are required to meet each service user’s personal care needs.
Care staff must understand that each service user’s personal care tasks will be carried out differently as each individual has different needs. Staff must follow procedures that flow from a person’s plan of care. Some service users are dependent on help for even minor tasks of daily living. Care staff must always be aware of the importance of responding to their requests for help promptly and tactfully.
Managers must encourage care staff to take a professional approach to their work and to manage their time well. Personal care should never feel hurried or rushed for the service user. This should be the case in both care homes and for home care. In most situations, good teamwork is clearly required and this should be developed through supervision and training. All care practice provided must be adequately recorded. Care staff thus will need to have training in reporting and recording skills.
It is always important to stress that service users have the right to make choices both in respect of the care provision/package decided and how the care should be provided.
