Bathing and Showering




One of the policies and procedures a new home care business must have is the Bathing and Showering Policy and Procedure.

Below is the Bathing and Showering Policy and Procedure used by Quality Home Care which you are welcome to adapt to suit your own business needs. You can use it as a starting point to develop your own Bathing and Showering Policy and Procedure.

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QUALITY HOME CARE:

BATHING AND SHOWERING

Policy

All Quality Home Care employees must ensure that the temperature of water used for bathing, showering and washing is suitable for its purpose and that it will not cause the customer discomfort or harm by being too hot or too cold.

The safety and well being of all customers will be considered as part of the risk assessment and care planning process including potential risks of scalding from hot water. The risks associated with bathing and showering will vary for each individual and according to individual circumstances. For example, some customers need help with aspects of personal care but may not be vulnerable to a scalding injury.

The risk assessment will endeavour to identify those people who require assistance to maintain their safety as opposed to those who merely need physical assistance with normal activities of everyday living. High water temperatures may pose a scalding risk to certain customers who are most vulnerable to scalding/burning including children, older people, people with reduced mental capacity (for example because of dementia, challenging behaviour, learning difficulties etc) and who may lack the ability to indicate pain or recognise a dangerous situation. It may also include those with reduced mobility and anyone with sensory impairment, or who cannot react appropriately, or quickly enough, to prevent injury.

Quality Home Care will ensure that all care workers involved in bathing or showering customers receive training before they assist customers with bathing/showering, or perform checks.

Bathing and Showering Procedure

Risk Assessment




Where a vulnerable person uses a bath at an unsuitable temperature it may be difficult to remove them quickly, cool the water, or drain the water from the bath, resulting in increased risk of injury.

The Health and Safety Executive (HSE) has issued guidance on matters to consider when assessing the specific risk to vulnerable people in health and social care premises from hot water temperatures. Based on the HSE and UKHCA guidance, the risk assessment process for people receiving care at home could consider:

  • Can the customer get in/out, sit up and/or wash themselves unaided?
  • Does the customer have impaired sensitivity to temperature?
  • Does the customer have a mental state such that they can recognise a bath or shower that is too hot?
  • Is the person capable of summoning assistance if needed?
  • Will any lifting or other aids limit the customer’s mobility in the bath/shower?
  • Is the customer liable to run a bath/add water when unattended? (This could be a particular issue for those who are confused or with dementia).

The HSE provide information regarding the suitable water temperatures for bathing and showering which states that they should not exceed 44°C for bathing or 41°C for showering.

BATHING AND SHOWERING CARE PLANNING

The customer’s care plan should clearly indicate any vulnerability of the customer in relation to scalding risks and steps which should be employed to limit them. The care plan should describe a safe system of work according to the customers’ needs. Employees must ensure that the temperature is not likely to cause discomfort or harm by testing the water themselves before introducing it to the customer.

The arrangements for bathing or showering should be detailed in the care plan and risk assessment for staff to follow:

When assisting with bathing care workers should:

  1. Check the risk assessment and ascertain what level of support and supervision is needed for the customer, including whether they can be safely left and how to deal with interruptions while bathing.
  2. Prepare everything needed for the bath and run cold water into the bath before adding hot water, then mix the water thoroughly and check the temperature at both ends of the bath.
  3. Help the customer into the bath and never add hot water to an occupied bath.
  4. Ask the customer if the water temperature is agreeable and acceptable. If not, the customer must be removed from contact with the water immediately before the temperature is adjusted. This procedure should be safely repeated until the temperature is acceptable to the customer and in accordance with their wishes.

When assisting with showering care workers should:

  1. Check the risk assessment for showering and ascertain what level of support and supervision is needed for the customer including whether they can be safely left and how to deal with interruptions while showering. Also check the agreed safe water temperature for the customer.
  2. Prepare everything needed for the shower and run the shower to establish a constant temperature and check the suitability of the temperature (not just by adjusting the control switch but by checking how hot the water itself is in case of a faulty control switch.
  3. Help the customer into the shower and be aware of the potential for sudden water flow and temperature fluctuations even on modern showers. For vulnerable customers constant supervision will be required to ensure a rapid response in the event of any changes.
  4. Ask the customer if the water temperature is agreeable and acceptable. If not, the customer must be removed from contact with the water immediately before the temperature is adjusted. This procedure should be safely repeated until the temperature is acceptable to the customer and in accordance with their wishes.



Some degree of compromise may be required for customers on the precise detail of the care plan, to take account their individual wishes, if these can be accommodated safely. The care worker should not make changes to the care plan without input and agreement from their line manager under any circumstances.

BATHING AND SHOWEWRING EQUIPMENT

The assessment and care package agreement should also consider what adaptive aids may be necessary for safe bathing. The supply of adaptive aids do not form part of the company contract and any requirements in this respect should be in place prior to a service commencing and agreed with the customer or their representative. This might include the fitting of thermostatic mixing valves, or fitting a shower thermometer between the shower head and supply hose and/or other aids such as bath and shower seats/grab rails. The customer may require assessment by other professionals such as an occupational therapist. Advice may need to be sought on suitable thermometers for baths and showers for some people. The HSE has commented that the thermometer should be inherently safe for a bathing environment (not glass), easily cleaned, and able to measure accurately water temperature at different depth gradients.

Whether thermometers are used depends on the vulnerability of the customer and if a risk of scalding/burns exists. Any such risk needs to be managed by ensuring the vulnerable customer is not exposed to a temperature that will cause them harm and any risks identified and actions agreed included in the plan of care prior to commencement of service.

BATHING AND SHOWERING EMERGENCIES

In the case of any emergencies the care worker must make the customer as safe as possible and contact the emergency services and the care manager for advice.

Related policies:

Care Planning

Emergency Aid

Health and Safety

Induction

Risk Assessment

Supervision